King's College London

Research portal

Treating chronic migraine with neuromodulation: The role of neurophysiological abnormalities and maladaptive plasticity

Research output: Contribution to journalArticle

Standard

Treating chronic migraine with neuromodulation : The role of neurophysiological abnormalities and maladaptive plasticity. / Viganò, Alessandro; Toscano, Massimiliano; Puledda, Francesca; Di Piero, Vittorio.

In: Frontiers in Pharmacology, Vol. 10, No. FEB, 32, 05.02.2019.

Research output: Contribution to journalArticle

Harvard

Viganò, A, Toscano, M, Puledda, F & Di Piero, V 2019, 'Treating chronic migraine with neuromodulation: The role of neurophysiological abnormalities and maladaptive plasticity', Frontiers in Pharmacology, vol. 10, no. FEB, 32. https://doi.org/10.3389/fphar.2019.00032

APA

Viganò, A., Toscano, M., Puledda, F., & Di Piero, V. (2019). Treating chronic migraine with neuromodulation: The role of neurophysiological abnormalities and maladaptive plasticity. Frontiers in Pharmacology, 10(FEB), [32]. https://doi.org/10.3389/fphar.2019.00032

Vancouver

Viganò A, Toscano M, Puledda F, Di Piero V. Treating chronic migraine with neuromodulation: The role of neurophysiological abnormalities and maladaptive plasticity. Frontiers in Pharmacology. 2019 Feb 5;10(FEB). 32. https://doi.org/10.3389/fphar.2019.00032

Author

Viganò, Alessandro ; Toscano, Massimiliano ; Puledda, Francesca ; Di Piero, Vittorio. / Treating chronic migraine with neuromodulation : The role of neurophysiological abnormalities and maladaptive plasticity. In: Frontiers in Pharmacology. 2019 ; Vol. 10, No. FEB.

Bibtex Download

@article{c8ebd6666b0d43b39ac6f543e10628ad,
title = "Treating chronic migraine with neuromodulation: The role of neurophysiological abnormalities and maladaptive plasticity",
abstract = "Chronic migraine (CM) is the most disabling form of migraine, because pharmacological treatments have low efficacy and cumbersome side effects. New evidence has shown that migraine is primarily a disorder of brain plasticity and migraine chronification depends on a maladaptive process favoring the development of a brain state of hyperexcitability. Due to the ability to induce plastic changes in the brain, researchers started to look at Non-Invasive Brain Stimulation (NIBS) as a possible therapeutic option in migraine field. On one side, NIBS techniques induce changes of neural plasticity that outlast the period of the stimulation (a fundamental prerequisite of a prophylactic migraine treatment, concurrently they allow targeting neurophysiological abnormalities that contribute to the transition from episodic to CM. The action may thus influence not only the cortex but also brainstem and diencephalic structures. Plus, NIBS is not burdened by serious medication side effects and drug-drug interactions. Although the majority of the studies reported somewhat beneficial effects in migraine patients, no standard intervention has been defined. This may be due to methodological differences regarding the used techniques (e.g., transcranial magnetic stimulation, transcranial direct current stimulation), the brain regions chosen as targets, and the stimulation types (e.g., the use of inhibitory and excitatory stimulations on the basis of opposite rationales), and an intrinsic variability of stimulation effect. Hence, it is difficult to draw a conclusion on the real effect of neuromodulation in migraine. In this article, we first will review the definition and mechanisms of brain plasticity, some neurophysiological hallmarks of migraine, and migraine chronification-related (dys)plasticity. Secondly, we will review available results from therapeutic and physiological studies using neuromodulation in CM. Lastly we will discuss the results obtained in these preventive trials in the light of a possible effect on brain plasticity.",
keywords = "Chronic migraine, LTD, LTP, Neuromodulation, NIBS, Plasticity, Prophylaxis",
author = "Alessandro Vigan{\`o} and Massimiliano Toscano and Francesca Puledda and {Di Piero}, Vittorio",
year = "2019",
month = feb,
day = "5",
doi = "10.3389/fphar.2019.00032",
language = "English",
volume = "10",
journal = "Frontiers in Pharmacology",
issn = "1663-9812",
publisher = "Frontiers Media S.A.",
number = "FEB",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Treating chronic migraine with neuromodulation

T2 - The role of neurophysiological abnormalities and maladaptive plasticity

AU - Viganò, Alessandro

AU - Toscano, Massimiliano

AU - Puledda, Francesca

AU - Di Piero, Vittorio

PY - 2019/2/5

Y1 - 2019/2/5

N2 - Chronic migraine (CM) is the most disabling form of migraine, because pharmacological treatments have low efficacy and cumbersome side effects. New evidence has shown that migraine is primarily a disorder of brain plasticity and migraine chronification depends on a maladaptive process favoring the development of a brain state of hyperexcitability. Due to the ability to induce plastic changes in the brain, researchers started to look at Non-Invasive Brain Stimulation (NIBS) as a possible therapeutic option in migraine field. On one side, NIBS techniques induce changes of neural plasticity that outlast the period of the stimulation (a fundamental prerequisite of a prophylactic migraine treatment, concurrently they allow targeting neurophysiological abnormalities that contribute to the transition from episodic to CM. The action may thus influence not only the cortex but also brainstem and diencephalic structures. Plus, NIBS is not burdened by serious medication side effects and drug-drug interactions. Although the majority of the studies reported somewhat beneficial effects in migraine patients, no standard intervention has been defined. This may be due to methodological differences regarding the used techniques (e.g., transcranial magnetic stimulation, transcranial direct current stimulation), the brain regions chosen as targets, and the stimulation types (e.g., the use of inhibitory and excitatory stimulations on the basis of opposite rationales), and an intrinsic variability of stimulation effect. Hence, it is difficult to draw a conclusion on the real effect of neuromodulation in migraine. In this article, we first will review the definition and mechanisms of brain plasticity, some neurophysiological hallmarks of migraine, and migraine chronification-related (dys)plasticity. Secondly, we will review available results from therapeutic and physiological studies using neuromodulation in CM. Lastly we will discuss the results obtained in these preventive trials in the light of a possible effect on brain plasticity.

AB - Chronic migraine (CM) is the most disabling form of migraine, because pharmacological treatments have low efficacy and cumbersome side effects. New evidence has shown that migraine is primarily a disorder of brain plasticity and migraine chronification depends on a maladaptive process favoring the development of a brain state of hyperexcitability. Due to the ability to induce plastic changes in the brain, researchers started to look at Non-Invasive Brain Stimulation (NIBS) as a possible therapeutic option in migraine field. On one side, NIBS techniques induce changes of neural plasticity that outlast the period of the stimulation (a fundamental prerequisite of a prophylactic migraine treatment, concurrently they allow targeting neurophysiological abnormalities that contribute to the transition from episodic to CM. The action may thus influence not only the cortex but also brainstem and diencephalic structures. Plus, NIBS is not burdened by serious medication side effects and drug-drug interactions. Although the majority of the studies reported somewhat beneficial effects in migraine patients, no standard intervention has been defined. This may be due to methodological differences regarding the used techniques (e.g., transcranial magnetic stimulation, transcranial direct current stimulation), the brain regions chosen as targets, and the stimulation types (e.g., the use of inhibitory and excitatory stimulations on the basis of opposite rationales), and an intrinsic variability of stimulation effect. Hence, it is difficult to draw a conclusion on the real effect of neuromodulation in migraine. In this article, we first will review the definition and mechanisms of brain plasticity, some neurophysiological hallmarks of migraine, and migraine chronification-related (dys)plasticity. Secondly, we will review available results from therapeutic and physiological studies using neuromodulation in CM. Lastly we will discuss the results obtained in these preventive trials in the light of a possible effect on brain plasticity.

KW - Chronic migraine

KW - LTD

KW - LTP

KW - Neuromodulation

KW - NIBS

KW - Plasticity

KW - Prophylaxis

UR - http://www.scopus.com/inward/record.url?scp=85065921824&partnerID=8YFLogxK

U2 - 10.3389/fphar.2019.00032

DO - 10.3389/fphar.2019.00032

M3 - Article

AN - SCOPUS:85065921824

VL - 10

JO - Frontiers in Pharmacology

JF - Frontiers in Pharmacology

SN - 1663-9812

IS - FEB

M1 - 32

ER -

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454