73. Transcutaneous supraorbital nerve stimulation increases thalamocortical activity in migraine between attacks

• Published in: Clinical neurophysiology 2016-12, Vol.127 (12), p.e341-e341
• Main Authors: Coppola, G, Di Lenola, D, Serrao, M, Di Lorenzo, C, Pierelli, F
• Format: Article
• Language: English
• Subjects: Neurology
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2016.10.085

In a recent randomized double-blind sham-controlled study the Cefaly®, a novel transcutaneous supraorbital electrostimulation device, has been successfully used as a prophylactic treatment for episodic migraine. The possible mechanisms of action through which the device is able to induce clinical improvement in migraine are not known. Here, we investigated whether Cefaly® may act centrally at the thalamocortical/cortical level. We have recorded the somatosensory evoked potentials (SSEPs) before and two times after one session of supraorbital stimulation with Cefaly® lasting 20 min in 10 migraine without aura patients between attacks. We measured the N20-P25 amplitudes on the low-frequency SSEP, and, after applying a band-pass filter (450–750 Hz), maximal peak-to-peak amplitudes of the pre-synaptic, reflecting thalamocortical activity, and post-synaptic, reflecting primary cortical activation, high-frequency oscillations (HFOs). Pre-synaptic HFO amplitudes, reflecting somatosensory thalamocortical activity, significantly increased after the stimulation (from 0.035 microV to 0.058 microV, p < 0.01), whereas both the low-frequency N20 SSEP component and post-synaptic HFOs were unaffected. Present data might support the hypothesis that Cefaly® acts centrally through increased thalamocortical activity induced by the neurostimulation. It is of obvious interest to verify whether these device-induced changes might persist at long-term after 3-month daily preventive stimulation, and if they follow clinical improvement.