title: Topiramate modulates habituation in migraine: evidences from nociceptive responses elicited by laser evoked potentials.
abstract: BACKGROUND
  Lack of habituation during repetitive stimulation is the most consistent interictal abnormality of cortical information processing observed in migraine. Preventive migraine treatments might act by stabilizing cortical excitability level and thus the habituation to external stimuli.
  
  
  METHODS
  We examined the effects of preventive treatment with topiramate on migraineur's habituation to nociceptive stimulation. Scalp potentials were evoked by Nd-YAP Laser stimulation of the hand dorsum and supraorbital region in 13 patients with migraine without aura (MO) and 15 healthy volunteers (HV). The exam was repeated in MO before and after treatment.
  
  
  RESULTS
  We observed a lack of habituation and lower initial amplitudes in MO compared to HV. These abnormalities reached statistical significance for N1 LEPs component, generated in the secondary somatosensory cortex (SII), but not for N2/P2 complex, generated in the insula and anterior cingulated cortex (ACC). Topiramate normalized the N1 habituation pattern in MO, with a significant correlation between clinical effects and normalization of neurophysiological responses.
  
  
  CONCLUSIONS
  Our results indicate a modulating action of topiramate on cortical processing of sensorial stimuli, mainly regarding the sensory-discriminative component of pain, elaborated by SII, without a significant effect on the affective dimension of pain, in which the ACC has an important role.
authors.affiliation: Department of Neuroscience, Sapienza University of Rome, viale dell'Università 30, Rome 00185, Italy. laura.diclemente@libero.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Di Clemente
authors.forename: Francesca
authors.initials: F
authors.lastname: Puledda
authors.forename: Antonella
authors.initials: A
authors.lastname: Biasiotta
authors.forename: Alessandro
authors.initials: A
authors.lastname: Viganò
authors.forename: Edoardo
authors.initials: E
authors.lastname: Vicenzini
authors.forename: Andrea
authors.initials: A
authors.lastname: Truini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cruccu
authors.forename: Vittorio
authors.initials: V
authors.lastname: Di Piero
mesh_terms: D000328:Adult; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006185:Habituation, Psychophysiologic / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007834:Lasers; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D017288:Pain Threshold / Q000187:drug effects / Q000502:physiology; D000077236:Topiramate
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose