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Papers of the Week

Papers: 4 Jan 2020 - 10 Jan 2020

Human Studies, Pharmacology/Drug Development


2020 Jul - Aug

J Pain



Multisensorial perception in chronic migraine and the role of medication overuse.


Maccora S, Bolognini N, Cosentino G, Baschi R, Vallar G, Fierro B, Brighina F
J Pain. 2020 Jul - Aug; 21(7-8):919-929.
PMID: 31904501.


Multisensory processing can be assessed by measuring susceptibility to crossmodal illusions such as the Sound-Induced Flash Illusion (SIFI). When a single flash is accompanied by two or more beeps, it is perceived as multiple flashes (fission illusion); conversely, a fusion illusion is experienced when more flashes are matched with a single beep, leading to the perception of a single flash. Such illusory perceptions are associated to crossmodal changes in visual cortical excitability. Indeed, increasing occipital cortical excitability, by means of transcranial electrical currents, disrupts the SIFI (i.e. fission illusion). Similarly, a reduced fission illusion was shown in patients with episodic migraine, especially during the attack, in agreement with the pathophysiological model of cortical hyperexcitability of this disease. If episodic migraine patients present with reduced SIFI especially during the attack, we hypothesize that chronic migraine patients should consistently report less illusory effects than healthy controls; drugs intake could also affect SIFI. On such a basis, we studied the proneness to SIFI in chronic migraine (CM) patients (n=63), including 52 patients with Medication Overuse Headache (MOH), compared to 24 healthy controls. All migraine patients showed reduced fission phenomena than controls (p<0.0001). Triptan MOH patients (n=23) presented significantly less fission effects than other chronic migraine groups (p=0.008). This exploratory study suggests that CM – both with and without medication overuse – is associated to a higher visual cortical responsiveness which causes deficit of multisensorial processing, as assessed by the SIFI. Perspective: This observational study shows reduced susceptibility to the sound-induced flash illusion in chronic migraine, confirming and extending previous results in episodic migraine. Medication overuse headache contributes to this phenomenon, especially in case of triptans.