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Papers of the Week


Papers: 4 Jul 2020 - 10 Jul 2020


Human Studies

PAIN TYPE:
Migraine/Headache


2020 Jul 06


Neurotherapeutics

Cortical Mechanisms of Single-Pulse Transcranial Magnetic Stimulation in Migraine.

Authors

Lloyd JO, Chisholm KI, Oehle B, Jones MG, Okine BN, Al-Kaisy A, Lambru G, McMahon SB, Andreou AP
Neurotherapeutics. 2020 Jul 06.
PMID: 32632772.

Abstract

Single-pulse transcranial magnetic stimulation (sTMS) of the occipital cortex is an effective migraine treatment. However, its mechanism of action and cortical effects of sTMS in migraine are yet to be elucidated. Using calcium imaging and GCaMP-expressing mice, sTMS did not depolarise neurons and had no effect on vascular tone. Pre-treatment with sTMS, however, significantly affected some characteristics of the cortical spreading depression (CSD) wave, the correlate of migraine aura. sTMS inhibited spontaneous neuronal firing in the visual cortex in a dose-dependent manner and attenuated L-glutamate-evoked firing, but not in the presence of GABA antagonists. In the CSD model, sTMS increased the CSD electrical threshold, but not in the presence of GABA antagonists. We first report here that sTMS at intensities similar to those used in the treatment of migraine, unlike traditional sTMS applied in other neurological fields, does not excite cortical neurons but it reduces spontaneous cortical neuronal activity and suppresses the migraine aura biological substrate, potentially by interacting with GABAergic circuits.