Transcranial magnetic stimulation of visual cortex in migraine patients: a systematic review with meta-analysis
The Journal of Headache and Pain,

Brigo F et al. – Skull thickness and ovarian cycle should be assessed as possible confounding variables, and sham stimulation should be performed to reduce the rate of false positives. Phosphene prevalence alone cannot be considered a measure of cortical excitability, but should be integrated with phosphene threshold (PT) evaluation.

Methods
  • Authors systematically reviewed the literature to evaluate the prevalence of phosphenes and the phosphene threshold (PT) values obtained during single–pulse transcranial magnetic stimulation (TMS) in adults with migraine.
  • Controlled studies measuring PT by single–pulse TMS in adults with migraine with or without aura (MA, MwA) were systematically searched.
  • Prevalence of phosphenes and PT values were assessed calculating mean difference (MD) and odds ratio (OR) with 95 % confidence intervals (CI).
  • Ten trials (277 migraine patients and 193 controls) were included.
  • Patients with MA had statistically significant lower PT compared with controls when a circular coil was used (MD –28.33; 95 % CI –36.09 to –20.58); a similar result was found in MwA patients (MD –17.12; 95 % CI –23.81 to –10.43); using a figure–of–eight coil the difference was not statistically significant.
  • There was a significantly higher phosphene prevalence in MA patients compared with control subjects (OR 4.21; 95 % CI 1.18–15.01).
  • No significant differences were found either in phosphene reporting between patients with MwA and controls, or in PT values obtained with a figure–of–eight coil in MA and MwA patients versus controls.
  • Overall considered, these results support the hypothesis of a primary visual cortex hyper–excitability in MA, providing not enough evidence for MwA.
  • A significant statistical heterogeneity reflects clinical and methodological differences across studies, and higher temporal variabilities among PT measurements over time, related to unstable excitability levels.
  • Patients should therefore be evaluated in the true interictal period with an adequate headache–free interval.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Internal Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Internal Medicine Articles

1 Statins and physical activity in older men the osteoporotic fractures in men study JAMA Internal Medicine, June 12, 2014    Evidence Based Medicine    Clinical Article

2 Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials BMJ, June 11, 2014    Evidence Based Medicine    Clinical Article

3 CPAP, weight loss, or both for obstructive sleep apnea New England Journal of Medicine, June 13, 2014    Evidence Based Medicine    Clinical Article

4 Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: A meta-analysis JAMA, June 26, 2014    Evidence Based Medicine    Clinical Article

5 Avoidance of sun exposure is a risk factor for all-cause mortality: results from the MISS cohort Journal of Internal Medicine, April 22, 2014    Evidence Based Medicine    Clinical Article

6 Outpatient antibiotic prescribing in the United States: 2000 to 2010 Full Text BMC Medicine, June 19, 2014    Free full text    Evidence Based Medicine    Clinical Article

7 Efficacy and safety of nebivolol and valsartan as fixed-dose combination in hypertension: a randomised, multicentre study The Lancet, May 30, 2014    Evidence Based Medicine    Clinical Article

8 Enzalutamide in metastatic prostate cancer before chemotherapy New England Journal of Medicine, June 3, 2014    Evidence Based Medicine    Clinical Article

9 Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry BMJ, June 10, 2014    Evidence Based Medicine    Clinical Article

10 HIV infection: epidemiology, pathogenesis, treatment, and prevention The Lancet, June 5, 2014    Evidence Based Medicine    Clinical Article

11 Cryptogenic stroke and underlying atrial fibrillation New England Journal of Medicine, June 27, 2014    Evidence Based Medicine    Clinical Article

12 Resveratrol levels and all-cause mortality in older community-dwelling adults JAMA Internal Medicine, May 13, 2014    Evidence Based Medicine    Clinical Article

13 Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial The Lancet, June 18, 2014    Evidence Based Medicine    Clinical Article

14 Outpatient glycemic control with a bionic pancreas in type 1 diabetes New England Journal of Medicine, June 20, 2014    Evidence Based Medicine    Clinical Article

15 Rosuvastatin for sepsis-associated acute respiratory distress syndrome New England Journal of Medicine, May 20, 2014    Evidence Based Medicine    Clinical Article

16 Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications JAMA, June 17, 2014    Evidence Based Medicine    Clinical Article

17 5{alpha}-reductase inhibitors and risk of high-grade or lethal prostate cancer JAMA Internal Medicine, June 3, 2014    Evidence Based Medicine    Clinical Article

18 Time to treatment with recombinant tissue plasminogen activator and outcome of stroke in clinical practice: retrospective analysis of hospital quality assurance data with comparison with results from randomised clinical trials BMJ, June 9, 2014    Evidence Based Medicine    Clinical Article

19 Fracture prediction after discontinuation of 4 to 5 years of alendronate therapy: The FLEX study JAMA Internal Medicine, May 7, 2014    Evidence Based Medicine    Clinical Article

20 Association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia JAMA, June 4, 2014    Evidence Based Medicine    Clinical Article

Indexed Journals in Internal Medicine: New England Journal of Medicine, The Lancet, Archives of Internal Medicinemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close