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‘Infraslow EEG activity’ tijdens migraine aanval bij kinderen :Een nieuwe indirecte marker voor cortical spreading depression?

(2016) Lansink, J.G.H.

Background: In migraine and the juvenile head trauma syndrome (JHTS) the occurrence of cortical spreading depression is an important underlying mechanism. In both syndromes transient neurological deficits develop in minutes.1,2 Recent papers show that cortical spreading depressions can be detected invasively with electrocorticography (ECoG)3 and non- invasively with magneto-encephalography (MEG), by detection of infraslow activity (ISA).4 ISA describes brain activity that occurs in frequencies below 0,1 Hz and may be viewed as part of the natural spectrum of rhythmic changes in neural network excitability.5-7 Conventional electro encephalography (EEG) (2- 30 Hz) cannot detect ISA because these low frequencies will be filtered out. Aim: To increase the insight into the pathophysiology of migraine we will try to detect changes of ISA which indicates cortical spreading depression. Material and methods: During a migraine attack and a control condition at children 4 to 16 years old, one hour during full- band EEG will be made. Results: During the migraine attack, amplitude of the ISA and the coherence between the phase of the ISA and amplitude of het conventional EEG increase, compared to the control. Besides, a reasonable correlation with a Spearman correlation coefficient of 0,600 is found between an increased amplitude of ISA and the amplitude difference of the conventional EEG at the same location during migraine attack. The frequency of the ISA and the amplitude of the conventional EEG don’t change during an hour registration of the migraine attack compared to the control and there was no spreading of increased amplitude of ISA during the migraine attack. Conclusion: During a migraine attack the amplitude of the ISA increases significantly at the majority of the patients with a suppression of the amplitude of the EEG in the conventional frequency range.

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