Migraine sufferers can tell you a thing or two about it: agonizing pain that, if left untreated, can last anywhere from one to three days at a time. These attacks, which can strike several times a month, can have disastrous effects on a patient’s quality of life. Most people familiar with migraines report similar symptoms: fatigue, a stiff neck or trouble concentrating. Yet if it were possible to objectively predict migraine attacks, preventative treatments – either through medication or alternative means – would be an option. And this would be a vast improvement for patients. Psychophys, the Steinbeis Research Center at the University of Rostock, is currently developing predictive medical tests for patients to carry out themselves at home. A pilot study is looking into this new testing technique.
During a migraine attack, short-term electrophysiological and blood vessel changes have been observed in patients. Researchers attribute these to functional disorders in the brainstem. Comparing migraine patients to non-sufferers, EEGs show marked differences in the amplitudes and latencies of individual testing components. And in contingent negative variation (CNV) measurements – a simple attention paradigm that stimulates a standard expectancy situation and the neuroelectric changes this brings about – there were significant differences between test candidates from the control group in comparison to the migraine patients. These tests not only reveal differences in amplitudes, but also changes in habituation during the measurements. Steinbeis researchers are including these findings in their work on the new medical testing technique.
But migraine patients also exhibit particularly strong electrophysiological changes in the days leading up to and throughout the attack itself: Before the attack, the CNV measurement shows a sharp increase in electrocortical negativation; these then start to normalize during the migraine spell itself. Researchers have recognized: In cases of extreme negativation, a subsequent migraine episode is likely.
These electrophysiological changes that accompany a migraine occur systematically. That’s why researchers are using this measurement technique and the results it delivers as an indicator for an impending migraine. If CNV measurements can help predict migraines, all kinds of novel medication-based and alternative treatment options would open up, allowing sufferers to prevent the actual migraine itself. For example, the cortical excitability that occurs in the initial phase of the migraine could be reduced for a few days with medications such as fast-acting, shortterm beta blockers; daily medication doses could be avoided altogether. Even alternative practices such as progressive muscle relaxation treatment could be applied as relaxation techniques to reduce cortical hyperactivity.
Until now, CNV amplitudes could only be measured in the lab – medical facilities with an extensive infrastructure. As a result, CNV measurements could previously only be used as an early detection mechanism in very few cases at very high cost. The Steinbeis researchers are actively working to change this: For migraine sufferers, their work could result in a significant step towards a pain free life.
Prof. Dr. Peter Kropp, PD Dr. Wolfgang Meyer
Steinbeis Research Center Psychophys (Rostock)
su1546@stw.de | www.steinbeis.de/su/1546