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Interhemispheric differences of fMRI responses to visual stimuli in patients with side-fixed migraine aura

Authors

  • Anders Hougaard,

    1. Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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  • Faisal Mohammad Amin,

    1. Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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  • Michael B. Hoffmann,

    1. Visual Processing Laboratory, Ophthalmic Department, Otto-von-Guericke-University Magdeburg, Germany
    2. Center for Behavioral Brain Sciences, Otto-von-Guericke-University Magdeburg, Germany
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  • Egill Rostrup,

    1. Functional Imaging Unit and Department of Diagnostics, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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  • Henrik B.W. Larsson,

    1. Functional Imaging Unit and Department of Diagnostics, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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  • Mohammad Sohail Asghar,

    1. Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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  • Vibeke Andrée Larsen,

    1. Department of Radiology, Rigshospitalet, Denmark
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  • Jes Olesen,

    1. Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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  • Messoud Ashina

    Corresponding author
    1. Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
    • Correspondence to: Messoud Ashina, MD, PhD, DMSc, Danish Headache Center and Department of Neurology, Glostrup Hospital, Ndr. Ringvej 67, Building 14, DK-2600 Glostrup, Denmark. E-mail: ashina@dadlnet.dk

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  • Conflicts of Interest: Dr. Hougaard reports no conflicts of interest. Dr. Amin has received honoraria for lecturing from Allergan. Dr. Hoffmann reports no conflicts of interest. Dr. Rostrup reports no conflicts of interest. Dr. Larsson reports no conflicts of interest. Dr. Asghar reports no conflicts of interest. Dr. Larsen reports no conflicts of interest. Dr. Olesen has received grants and/or research support from, has been a consultant and/or scientific adviser for, and has been in the speakers' bureau of Allergan Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim, Eli Lilly, GlaxoSmithKline, Janssen Pharmaceutical Products, Lundbeck, Merck and Pfizer. Dr. Ashina has received grant support and honoraria for lecturing from Merck, and honoraria for lecturing from Pfizer, GlaxoSmithKline, Norpharma and AstraZeneca, and he is a consultant and/or scientific adviser for Allergan, Amgen and Alder.

Abstract

Migraine sufferers with aura often report photosensitivity and visual discomfort outside of attacks and many consider bright or flickering light an attack-precipitating factor. The nature of this visual hypersensitivity and its relation to the underlying pathophysiology of the migraine aura is unknown. Using fMRI measurements during visual stimulation we examined the visual cortical responsiveness of patients with migraine with aura. We applied a within-patient design by assessing functional interhemispheric differences in patients consistently experiencing visual aura in the same visual hemifield. We recruited 20 patients with frequent side-fixed visual aura attacks (≥90% of auras occurring in the same visual hemifield) and 20 age and sex matched healthy controls and compared the fMRI blood oxygenation level dependent (BOLD) responses to visual stimulation between symptomatic and asymptomatic hemispheres during the interictal phase and between migraine patients and controls. BOLD responses were selectively increased in the symptomatic hemispheres. This was found in the inferior parietal lobule (P = 0.002), the inferior frontal gyrus (P = 0.003), and the superior parietal lobule (P = 0.017). The affected cortical areas comprise a visually driven functional network involved in oculomotor control, guidance of movement, motion perception, visual attention, and visual spatial memory. The patients also had significantly increased response in the same cortical areas when compared to controls (P < 0.05). We discovered a lateralized alteration of a visually driven functional network in patients with side-fixed aura. These findings suggest a hyperexcitability of the visual system in the interictal phase of migraine with visual aura. Hum Brain Mapp 35:2714–2723, 2014. © 2013 Wiley Periodicals, Inc.

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