title: Non-invasive cortical modulation of experimental pain in migraine.
abstract: OBJECTIVE
  To test the hypothesis that secondary somatosensory cortex (S2) is involved in the migraine pathogenesis, by exploring the effect of navigated repetitive transcranial magnetic stimulation (rTMS) to S2 on thermal perception and pain.
  
  
  METHODS
  In this blinded sham-controlled case-control study of 26 interictal migraineurs and 31 controls, we measured thermal detection and pain thresholds on the hand and forehead, and pain ratings to heat stimulation on the forearm and temple, after real and sham 10Hz rTMS.
  
  
  RESULTS
  rTMS increased cold and heat pain thresholds in controls as compared to interictal migraineurs (p<0.026). rTMS decreased forehead and arm pain ratings (p<0.005) and increased hand cool detection thresholds (p<0.005) in both interictal migraineurs and controls.
  
  
  CONCLUSIONS
  The effects of rTMS to S2 on thermal pain measures differed significantly between migraine and control subjects, although the effects were generally low in magnitude and not present in pain ratings. However, the lack of cold and heat pain threshold increase in migraineurs may reflect a hypofunction of inhibitory pain modulation mechanisms.
  
  
  CONCLUSIONS
  The expected rTMS-induced cold and heat hypoalgesia was not found among migraineurs, possibly a reflection of reduced intracortical inhibition.
authors.affiliation: Norwegian University of Science and Technology, Department of Neuroscience, Trondheim, Norway. Electronic address: martin.uglem@ntnu.no.
authors.forename: M
authors.initials: M
authors.lastname: Uglem
authors.affiliation: Norwegian University of Science and Technology, Department of Neuroscience, Trondheim, Norway.
authors.forename: P M
authors.initials: PM
authors.lastname: Omland
authors.affiliation: Norwegian University of Science and Technology, Department of Neuroscience, Trondheim, Norway; St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Engstrøm
authors.affiliation: St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway.
authors.forename: G B
authors.initials: GB
authors.lastname: Gravdahl
authors.affiliation: Norwegian University of Science and Technology, Department of Neuroscience, Trondheim, Norway; St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Linde
authors.affiliation: Norwegian University of Science and Technology, Department of Neuroscience, Trondheim, Norway; St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Hagen
authors.affiliation: Norwegian University of Science and Technology, Department of Neuroscience, Trondheim, Norway; St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Sand
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000628:therapy*; D009044:Motor Cortex / Q000503:physiopathology; D059408:Pain Management; D058748:Pain Perception; D013003:Somatosensory Cortex / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation
keywords: Migraine; Navigated repetitive transcranial magnetic stimulation; Non-invasive brain stimulation; Pain ratings; Secondary somatosensory cortex; Thermal thresholds