Article

The Cerebellum

, Volume 8, Issue 3, pp 260-266

First online:

Reduced Cerebellar Inhibition in Migraine with Aura: A TMS Study

  • Filippo BrighinaAffiliated withDipartimento Universitario di Neuroscienze Cliniche, University of Palermo
  • , Antonio PalermoAffiliated withDipartimento Universitario di Neuroscienze Cliniche, University of Palermo
  • , Maristella L. PanettaAffiliated withDipartimento Universitario di Neuroscienze Cliniche, University of Palermo
  • , Ornella DanieleAffiliated withDipartimento Universitario di Neuroscienze Cliniche, University of Palermo
  • , Antonina AloisioAffiliated withDipartimento Universitario di Neuroscienze Cliniche, University of Palermo
  • , Giuseppe CosentinoAffiliated withDipartimento Universitario di Neuroscienze Cliniche, University of Palermo
  • , Brigida FierroAffiliated withDipartimento Universitario di Neuroscienze Cliniche, University of Palermo Email author 

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Abstract

Subtle clinical cerebellar alterations have been found in migraine. Moreover, abnormalities in visual and motor cortex excitability consistent with a lack of inhibitory efficiency have been described in migraine, and it is known that cerebellum exerts an inhibitory control on cerebral cortex. Here, we investigated if impairment of cerebellar activity on motor cortex, i.e. reduced inhibitory control, can be found in migraine. Ten migraineurs with aura and seven healthy controls underwent a transcranial magnetic stimulation (TMS) protocol to investigate the cerebellar inhibitory drive on motor cortex: a conditioning pulse on right cerebellar cortex was delivered 5, 7, 10, 15 ms before a test stimulus (TS) on contralateral motor cortex. The cerebellar conditioning stimulus inhibits the size of the motor-evoked potential (MEP) produced by the TS alone by approximately 30–50%. Amplitude of MEP to TS alone showed no significant difference between patients and controls. Cerebellar conditioning TMS showed a significant deficit of cerebellar inhibition in migraine patients as compared to controls at all interstimulus intervals (5–15 ms) tested. Cerebellar inhibition is reduced in migraineurs. This could account, at least in part, for the reduced inhibitory efficiency previously showed in cerebral cortex of these patients.

Keywords

Migraine Cerebellum TMS Test stimulus Cerebellar brain inhibition