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Mechanisms of migraine aura revealed by functional MRI in human visual cortex
Open accessAbstract
Cortical spreading depression (CSD) has been suggested to underlie migraine visual aura. However, it has been challenging to test this hypothesis in human cerebral cortex. Using high-field functional MRI with near-continuous recording during visual aura in three subjects, we observed blood oxygenation level-dependent (BOLD) signal changes that demonstrated at least eight characteristics of CSD, time-locked to percept/onset of the aura. Initially, a focal increase in BOLD signal (possibly reflecting vasodilation), developed within extrastriate cortex (area V3A). This BOLD change progressed contiguously and slowly (3.5 ± 1.1 mm/min) over occipital cortex, congruent with the retinotopy of the visual percept. Following the same retinotopic progression, the BOLD signal then diminished (possibly reflecting vasoconstriction after the initial vasodilation), as did the BOLD response to visual activation. During periods with no visual stimulation, but while the subject was experiencing scintillations, BOLD signal followed the retinotopic progression of the visual percept. These data strongly suggest that an electrophysiological event such as CSD generates the aura in human visual cortex.
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Cited by
Pathophysiology of migraine: a disorder of sensory processing
Goadsby, P. J., Holland, P. R., Martins-Oliveira, M., Hoffmann, J., Schankin, C., & Akerman, S. (2017) · Physiological Reviews · doi:10.1152/physrev.00034.2015 · Cited by 1,998
Migraine — Current Understanding and Treatment
Goadsby, P. J., Lipton, R. B., & Ferrari, M. D. (2002) · New England Journal of Medicine · doi:10.1056/nejmra010917 · Cited by 1,918
Dreier, J. P. (2011) · Nature Medicine · doi:10.1038/nm.2333 · Cited by 1,132
Mutation in the neuronal voltage-gated sodium channel SCN1A in familial hemiplegic migraine
Dichgans, M., Freilinger, T., Eckstein, G., Babini, E., Lorenz-Depiereux, B., Biskup, S., Ferrari, M. D., Herzog, J., van den Maagdenberg, A. M., Pusch, M., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66786-4 · Cited by 854
Lauritzen, M., Dreier, J. P., Fabricius, M., Hartings, J. A., Graf, R., & Strong, A. J. (2011) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.2010.191 · Cited by 782
Metadata
- Authors
- Hadjikhani, N., Sanchez del Rio, M., Wu, O., Schwartz, D., Bakker, D., Fischl, B., Kwong, K. K., Cutrer, F. M., Rosen, B. R., Tootell, R. B. H., Sorensen, A. G., & Moskowitz, M. A.
- Venue
- Proceedings of the National Academy of Sciences
- Published
- 2001-04-03
- Volume
- 98
- Issue
- 8
- Pages
- 4687-4692
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- OpenAlex
- W2066875663
- Cited by
- 1,518
- References
- 0
- FWCI
- 23.51
- Type
- journal article
- Language
- en
- Open access
- green
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- Hadjikhani, N., Sanchez del Rio, M., Wu, O., Schwartz, D., Bakker, D., Fischl, B., Kwong, K. K., Cutrer, F. M., Rosen, B. R., Tootell, R. B. H., Sorensen, A. G., & Moskowitz, M. A. (2001). Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proceedings of the National Academy of Sciences. https://doi.org/10.1073/pnas.071582498
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