Transcranial magnetic stimulation and potential cortical and trigeminothalamic mechanisms in migraine

Andreou A., Holland P., Akerman S., Summ O., Fredrick J., Goadsby P.

Research article (journal) | Peer reviewed

Abstract

A single pulse of transcranial magnetic stimulation has been shown to be effective for the acute treatment of migraine with and without aura. Here we aimed to investigate the potential mechanisms of action of transcranial magnetic stimulation, using a transcortical approach, in preclinical migraine models. We tested the susceptibility of cortical spreading depression, the experimental correlate of migraine aura, and further evaluated the response of spontaneous and evoked trigeminovascular activity of second order trigemontothalamic and third order thalamocortical neurons in rats. Single pulse transcranial magnetic stimulation significantly inhibited both mechanical and chemically-induced cortical spreading depression when administered immediately post-induction in rats, but not when administered preinduction, and when controlled by a sham stimulation. Additionally transcranial magnetic stimulation significantly inhibited the spontaneous and evoked firing rate of third order thalamocortical projection neurons, but not second order neurons in the trigeminocervical complex, suggesting a potential modulatory effect that may underlie its utility in migraine. In gyrencephalic cat cortices, when administered post-cortical spreading depression, transcranial magnetic stimulation blocked the propagation of cortical spreading depression in two of eight animals. These results are the first to demonstrate that cortical spreading depression can be blocked in vivo using single pulse transcranial magnetic stimulation and further highlight a novel thalamocortical modulatory capacity that may explain the efficacy of magnetic stimulation in the treatment of migraine with and without aura.

Details about the publication

JournalBrain
Volume139
Issue7
Page range2002-2014
StatusPublished
Release year2016
Language in which the publication is writtenEnglish
DOI10.1093/brain/aww118
Link to the full texthttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84977566530&origin=inward
Keywordsaura; cortical spreading depression; migraine; thalamus; transcranial magnetic stimulation

Authors from the University of Münster

Summ, Oliver
Department for Neurology