title: Reduced cerebellar inhibition in migraine with aura: a TMS study.
abstract: Subtle clinical cerebellar alterations have been found in migraine. Moreover, abnormalities in visual and motor cortex excitability consistent with a lack of inhibitory efficiency have been described in migraine, and it is known that cerebellum exerts an inhibitory control on cerebral cortex. Here, we investigated if impairment of cerebellar activity on motor cortex, i.e. reduced inhibitory control, can be found in migraine. Ten migraineurs with aura and seven healthy controls underwent a transcranial magnetic stimulation (TMS) protocol to investigate the cerebellar inhibitory drive on motor cortex: a conditioning pulse on right cerebellar cortex was delivered 5, 7, 10, 15 ms before a test stimulus (TS) on contralateral motor cortex. The cerebellar conditioning stimulus inhibits the size of the motor-evoked potential (MEP) produced by the TS alone by approximately 30-50%. Amplitude of MEP to TS alone showed no significant difference between patients and controls. Cerebellar conditioning TMS showed a significant deficit of cerebellar inhibition in migraine patients as compared to controls at all interstimulus intervals (5-15 ms) tested. Cerebellar inhibition is reduced in migraineurs. This could account, at least in part, for the reduced inhibitory efficiency previously showed in cerebral cortex of these patients.
authors.affiliation: Dipartimento Universitario di Neuroscienze Cliniche, University of Palermo, 90129 Palermo, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Brighina
authors.forename: Antonio
authors.initials: A
authors.lastname: Palermo
authors.forename: Maristella L
authors.initials: ML
authors.lastname: Panetta
authors.forename: Ornella
authors.initials: O
authors.lastname: Daniele
authors.forename: Antonina
authors.initials: A
authors.lastname: Aloisio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cosentino
authors.forename: Brigida
authors.initials: B
authors.lastname: Fierro
mesh_terms: D000328:Adult; D000344:Afferent Pathways / Q000503:physiopathology; D000704:Analysis of Variance; D001703:Biophysics; D002531:Cerebellum / Q000503:physiopathology*; D004576:Electromyography / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D020325:Migraine with Aura / Q000473:pathology*; D009044:Motor Cortex / Q000503:physiopathology*; D011930:Reaction Time / Q000502:physiology; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*