Beta-blocker migraine prophylaxis affects the excitability of the visual cortex as revealed by transcranial magnetic stimulation |
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Authors: | Marcus Gerwig L Niehaus P Stude Z Katsarava H C Diener |
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Institution: | (1) Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany;(2) Department of Neurology, Otto-von-Guericke-University, Magdeburg, Germany;(3) Department of Neurology, University Hospital Bergmannsheil, Bochum, Germany |
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Abstract: | The objective of this study is to assess effects of beta-blocker migraine prophylaxis on cortical excitability determined
by transcranial magnetic stimulation (TMS). Phosphene and motor thresholds (PT, MT) were investigated in 29 patients with
migraine, in 15 of them prior to and following preventive medication with metoprolol and in 14 patients without prophylaxis.
Following prophylaxis headache frequency significantly decreased (p = 0.005) and mean PT were significantly increased (51.5 ± 7.5 vs. 63.6 ± 8.4%) compared to patients without preventive treatment
(53.7 ± 5.3 vs. 52.3 ± 6.3%; p = 0.040). Mean MT did not significantly differ either between groups or due to treatment. In the group of all patients, a
significant inverse correlation between headache frequency and the level of PT was found (R = −0.629; p < 0.01). There was, however, no significant correlation in the subgroups of patients. We conclude that (a) clinical efficacy
of beta-blocker treatment in migraine could be (at least partly) linked to its ability to modulate the excitability of the
visual cortex and (b) the PT determined by TMS appears suitable to assess the effects of prophylaxis on cortical excitability
in the individual patient. This may be useful in clinical trials investigating migraine preventive drugs. |
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Keywords: | Cortical excitability Migraine prophylaxis Phosphene threshold Transcranial magnetic stimulation |
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