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Heterogenous migraine aura symptoms correlate with visual cortex functional magnetic resonance imaging responses
Author(s) -
Arngrim Nanna,
Hougaard Anders,
Ahmadi Khazar,
Vestergaard Mark Bitsch,
Schytz Henrik Winther,
Amin Faisal Mohammad,
Larsson Henrik Bo Wiberg,
Olesen Jes,
Hoffmann Michael B.,
Ashina Messoud
Publication year - 2017
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.25096
Subject(s) - aura , photostimulation , functional magnetic resonance imaging , migraine , cortical spreading depression , migraine with aura , neuroscience , psychology , visual cortex , photic stimulation , magnetic resonance imaging , blind spot , brain activity and meditation , medicine , audiology , electroencephalography , visual perception , psychiatry , radiology , perception
Objective Migraine aura is sparsely studied due to the highly challenging task of capturing patients during aura. Cortical spreading depression (CSD) is likely the underlying phenomenon of aura. The possible correlation between the multifaceted phenomenology of aura symptoms and the effects of CSD on the brain has not been ascertained. Methods Five migraine patients were studied during various forms of aura symptoms induced by hypoxia, sham hypoxia, or physical exercise with concurrent photostimulation. The blood oxygenation level–dependent (BOLD) functional magnetic resonance imaging (fMRI) signal response to visual stimulation was measured in retinotopic mapping–defined visual cortex areas V1 to V4. Results We found reduced BOLD response in patients reporting scotoma and increased response in patients who only experienced positive symptoms. Furthermore, patients with bilateral visual symptoms had corresponding bihemispherical changes in BOLD response. Interpretation These findings suggest that different aura symptoms reflect different types of cerebral dysfunction, which correspond to specific changes in BOLD signal reactivity. Furthermore, we provide evidence of bilateral CSD recorded by fMRI during bilateral aura symptoms. Ann Neurol 2017;82:925–939