title: Cortical inhibition at rest and under a focused attention challenge in adults with migraine with and without aura.
abstract: OBJECTIVE
  We aimed to further elucidate the functional and attentional regulation of cortical excitability in migraine patients.
  
  
  METHODS
  We investigated the cortical silent period (CSP) after transcranial magnetic stimulation as a measure of cortical inhibition under three conditions: resting condition, cortical preactivation during reaction preparation, and during the post-processing of a motor response using a visual contingent negative variation paradigm in adults with migraine with aura, migraine without aura and healthy controls.
  
  
  RESULTS
  CSP was reduced in individuals with migraine with aura and unaffected in those with migraine without aura under resting conditions. Along with the intensity of transcranial magnetic stimulation, CSP increased equally in all groups (equal slopes). Furthermore, the functional challenge by a contingent negative variation task requiring focused sustained attention led to a comparable reduction of CSP duration in all groups.
  
  
  CONCLUSIONS
  Our data provide further hints towards the conclusion that a specific cortical inhibition deficit in migraine with aura but not migraine without aura is due to a tonic imbalance and not related to increased reactions to phasic stressors. Given that CSP at rest is related to GABA-ergic inhibition whereas the CSP reduction during late contingent negative variation is thought to be related to dopaminergic disinhibition in the basal ganglia, our results point towards reduced GABA-ergic cortical inhibition related to dysfunctional thalamo-cortical loops, especially in migraine with aura.
authors.affiliation: Department of Child and Adolescent Psychiatry,Psychosomatics and Psychotherapy, Goethe-University, Deutschordenstrasse 50, Frankfurt, Germany. joachim.maier@kgu.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Maier
authors.forename: Imke
authors.initials: I
authors.lastname: Sebastian
authors.forename: Matthias
authors.initials: M
authors.lastname: Weisbrod
authors.forename: Christine M
authors.initials: CM
authors.lastname: Freitag
authors.forename: Franz
authors.initials: F
authors.lastname: Resch
authors.forename: Stephan
authors.initials: S
authors.lastname: Bender
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D001921:Brain / Q000503:physiopathology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology*; D020325:Migraine with Aura / Q000503:physiopathology*; D012146:Rest / Q000502:physiology; D050781:Transcranial Magnetic Stimulation