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Cortical Mechanisms of Single-Pulse Transcranial Magnetic Stimulation in Migraine.
Neurotherapeutics ( IF 5.7 ) Pub Date : 2020-07-06 , DOI: 10.1007/s13311-020-00879-6
Joseph O Lloyd 1 , Kim I Chisholm 2 , Beatrice Oehle 2 , Martyn G Jones 2, 3 , Bright N Okine 1 , Adnan Al-Kaisy 4 , Giorgio Lambru 1, 5 , Stephen B McMahon 2 , Anna P Andreou 1, 5
Affiliation  

Single-pulse transcranial magnetic stimulation (sTMS) of the occipital cortex is an effective migraine treatment. However, its mechanism of action and cortical effects of sTMS in migraine are yet to be elucidated. Using calcium imaging and GCaMP-expressing mice, sTMS did not depolarise neurons and had no effect on vascular tone. Pre-treatment with sTMS, however, significantly affected some characteristics of the cortical spreading depression (CSD) wave, the correlate of migraine aura. sTMS inhibited spontaneous neuronal firing in the visual cortex in a dose-dependent manner and attenuated l-glutamate-evoked firing, but not in the presence of GABAA/B antagonists. In the CSD model, sTMS increased the CSD electrical threshold, but not in the presence of GABAA/B antagonists. We first report here that sTMS at intensities similar to those used in the treatment of migraine, unlike traditional sTMS applied in other neurological fields, does not excite cortical neurons but it reduces spontaneous cortical neuronal activity and suppresses the migraine aura biological substrate, potentially by interacting with GABAergic circuits.



中文翻译:

偏头痛中单脉冲经颅磁刺激的皮质机制。

枕叶皮层的单脉冲经颅磁刺激 (sTMS) 是一种有效的偏头痛治疗方法。然而,sTMS 在偏头痛中的作用机制和皮层效应尚待阐明。使用钙成像和表达 GCaMP 的小鼠,sTMS 不会使神经元去极化,并且对血管张力没有影响。然而,sTMS 预处理显着影响了皮质扩散抑制 (CSD) 波的一些特征,这是偏头痛先兆的相关性。sTMS 以剂量依赖性方式抑制视觉皮层中的自发神经元放电并减弱l-谷氨酸诱发的放电,但在 GABA A/B拮抗剂存在的情况下则不然。在 CSD 模型中,sTMS 增加了 CSD 电阈值,但不存在 GABA A/B拮抗剂。我们首先在此报告,与用于治疗偏头痛的强度相似的 sTMS,与应用于其他神经领域的传统 sTMS 不同,它不会激发皮层神经元,但它会减少自发的皮层神经元活动并抑制偏头痛先兆生物基质,可能是通过相互作用与 GABA 能电路。

更新日期:2020-07-06
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