PMID- 23566101
OWN - NLM
STAT- MEDLINE
DCOM- 20130924
LR  - 20211021
IS  - 1129-2377 (Electronic)
IS  - 1129-2369 (Print)
IS  - 1129-2369 (Linking)
VI  - 14
IP  - 1
DP  - 2013 Mar 11
TI  - Transcranial Direct Current Stimulation (tDCS) of the visual cortex: a 
      proof-of-concept study based on interictal electrophysiological abnormalities in 
      migraine.
PG  - 23
LID - 10.1186/1129-2377-14-23 [doi]
AB  - BACKGROUND: Preventive pharmacotherapy for migraine is not satisfactory because 
      of the low efficacy/tolerability ratio of many available drugs. Novel and more 
      efficient preventive strategies are therefore warranted. Abnormal excitability of 
      cortical areas appears to play a pivotal role in migraine pathophysiology. 
      Transcranial direct current stimulation (tDCS) is a non-invasive and safe 
      technique that is able to durably modulate the activity of the underlying 
      cerebral cortex, and is being tested in various medical indications. The results 
      of small open studies using tDCS in migraine prophylaxis are conflicting, 
      possibly because the optimal stimulation settings and the brain targets were not 
      well chosen. We have previously shown that the cerebral cortex, especially the 
      visual cortex, is hyperresponsive in migraine patients between attacks and 
      provided evidence from evoked potential studies that this is due to a decreased 
      cortical preactivation level. If one accepts this concept, anodal tDCS over the 
      visual cortex may have therapeutic potentials in migraine prevention, as it is 
      able to increase neuronal firing. OBJECTIVE: To study the effects of anodal tDCS 
      on visual cortex activity in healthy volunteers (HV) and episodic migraine 
      without aura patients (MoA), and its potentials for migraine prevention. METHODS: 
      We recorded pattern-reversal visual evoked potentials (VEP) before and after a 
      15-min session of anodal tDCS over the visual cortex in 11 HV and 13 MoA 
      interictally. Then 10 MoA patients reporting at least 4 attacks/month 
      subsequently participated in a therapeutic study, and received 2 similar sessions 
      of tDCS per week for 8 weeks as migraine preventive therapy. RESULTS: In HV as 
      well as in MoA, anodal tDCS transiently increased habituation of the VEP N1P1 
      component. VEP amplitudes were not modified by tDCS. Preventive treatment with 
      anodal tDCS turned out to be beneficial in MoA: migraine attack frequency, 
      migraine days, attack duration and acute medication intake significantly 
      decreased during the treatment period compared to pre-treatment baseline (all p < 
      0.05), and this benefit persisted on average 4.8 weeks after the end of tDCS. 
      CONCLUSIONS: Anodal tDCS over the visual cortex is thus able to increase 
      habituation to repetitive visual stimuli in healthy volunteers and in episodic 
      migraineurs, who on average lack habituation interictally. Moreover, 2 weekly 
      sessions of anodal tDCS had a significant preventive anti- migraine effect, 
      proofing the concept that the low preactivation level of the visual cortex in 
      migraine patients can be corrected by an activating neurostimulation. The 
      therapeutic results indicate that a larger sham-controlled trial using the same 
      tDCS protocol is worthwhile.
FAU - Vigano, Alessandro
AU  - Vigano A
AD  - Headache Research Unit, Dept of Neurology, University of Liege, Liege, Belgium.
FAU - D'Elia, Tullia Sasso
AU  - D'Elia TS
FAU - Sava, Simona Liliana
AU  - Sava SL
FAU - Auve, Maurie
AU  - Auve M
FAU - De Pasqua, Victor
AU  - De Pasqua V
FAU - Colosimo, Alfredo
AU  - Colosimo A
FAU - Di Piero, Vittorio
AU  - Di Piero V
FAU - Schoenen, Jean
AU  - Schoenen J
FAU - Magis, Delphine
AU  - Magis D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20130311
PL  - England
TA  - J Headache Pain
JT  - The journal of headache and pain
JID - 100940562
SB  - IM
MH  - Adult
MH  - Electric Stimulation Therapy/*methods
MH  - Evoked Potentials, Visual/physiology
MH  - Female
MH  - Habituation, Psychophysiologic/physiology
MH  - Humans
MH  - Male
MH  - Migraine Disorders/*physiopathology/*therapy
MH  - Visual Cortex/*physiopathology
PMC - PMC3620516
EDAT- 2013/04/10 06:00
MHDA- 2013/09/26 06:00
PMCR- 2013/01/01
CRDT- 2013/04/10 06:00
PHST- 2013/01/15 00:00 [received]
PHST- 2013/03/02 00:00 [accepted]
PHST- 2013/04/10 06:00 [entrez]
PHST- 2013/04/10 06:00 [pubmed]
PHST- 2013/09/26 06:00 [medline]
PHST- 2013/01/01 00:00 [pmc-release]
AID - 1129-2377-14-23 [pii]
AID - 10.1186/1129-2377-14-23 [doi]
PST - epublish
SO  - J Headache Pain. 2013 Mar 11;14(1):23. doi: 10.1186/1129-2377-14-23.