PMC:4630240 / 3469-5814 JSONTXT

{"project":"TEST0","denotations":[{"id":"26527348-146-152-1500448","span":{"begin":146,"end":148},"obj":"[\"16492238\"]"},{"id":"26527348-232-238-1500449","span":{"begin":383,"end":385},"obj":"[\"10612640\"]"},{"id":"26527348-231-237-1500450","span":{"begin":412,"end":414},"obj":"[\"11817265\"]"},{"id":"26527348-141-147-1500451","span":{"begin":853,"end":855},"obj":"[\"15955037\"]"},{"id":"26527348-114-120-1500452","span":{"begin":972,"end":974},"obj":"[\"19393012\"]"},{"id":"26527348-146-152-1500453","span":{"begin":1004,"end":1006},"obj":"[\"26037553\"]"},{"id":"26527348-128-134-1500454","span":{"begin":1220,"end":1222},"obj":"[\"16996036\"]"},{"id":"26527348-132-138-1500455","span":{"begin":1224,"end":1226},"obj":"[\"17408578\"]"},{"id":"26527348-195-201-1500456","span":{"begin":1287,"end":1289},"obj":"[\"1618937\"]"},{"id":"26527348-127-133-1500457","span":{"begin":1419,"end":1421},"obj":"[\"1603349\"]"},{"id":"26527348-131-137-1500458","span":{"begin":1423,"end":1425},"obj":"[\"8857754\"]"},{"id":"26527348-116-122-1500459","span":{"begin":2021,"end":2023},"obj":"[\"17986271\"]"},{"id":"26527348-120-126-1500460","span":{"begin":2025,"end":2027},"obj":"[\"23565983\"]"}],"text":"It was suggested that migraine with aura is a condition with a spectrum of clinical subtypes that likely differ in pathophysiological mechanisms [17]. Distinct electrophysiological abnormalities were especially found at the neuromuscular junction in patients suffering from complex neurological auras characterized by visual symptoms followed by sensorimotor and dysphasic symptoms [18] or from prolonged auras [19]. Using 1H-MR-spectroscopy, migraine patients with visual symptoms and at least one of paraesthesia, paresis, or dysphasia had a significant lactate increase in the visual cortex during sustained visual stimulation, while this was not the case in controls and patients with exclusive visual aura. In the latter group, however, lactate levels were already elevated at baseline and remained consistently high during the visual stimulation [20]. Besides its role as energy substrate of the brain, lactate acts as a neuromodulator and interacts with glutamate [21], GABA [22], and monoamines [23], which suggest that it is important in regulating the activity of cortical neurons. Lactate may increase to attenuate the electrical activity of excessively active neurons as observed in experimental models [22, 24, 25] and in healthy humans during sustained visual stimulation [26]. Considering these data and those obtained by NMR spectroscopy showing altered metabolic homeostasis of the migraineur’s brain [27, 28], it is of interest to verify whether activity of visual cortical neurons is increased in migraine patients suffering from complex auras respective to those experiencing pure visual symptoms. We decided therefore to compare amplitude and habituation of pattern reversal VEP in healthy volunteers, migraine patients with pure visual auras, and in patients with complex neurological auras including at least one of sensory and language symptoms in addition to visual disturbances. Considering the abovementioned NMR spectroscopy studies and our prior interictal VEP studies in migraine with aura [14, 15], we reasoned that subgroups of migraine with aura patients would show both common and specific neurophysiological abnormalities. We hypothesized that VEP amplitude would be higher in migraine with complex aura than in migraine with pure visual aura, while habituation would be equally deficient in both MA subgroups."}

{"project":"2_test","denotations":[{"id":"26527348-16492238-60555187","span":{"begin":146,"end":148},"obj":"16492238"},{"id":"26527348-10612640-60555188","span":{"begin":383,"end":385},"obj":"10612640"},{"id":"26527348-11817265-60555189","span":{"begin":412,"end":414},"obj":"11817265"},{"id":"26527348-15955037-60555190","span":{"begin":853,"end":855},"obj":"15955037"},{"id":"26527348-19393012-60555191","span":{"begin":972,"end":974},"obj":"19393012"},{"id":"26527348-26037553-60555192","span":{"begin":1004,"end":1006},"obj":"26037553"},{"id":"26527348-16996036-60555193","span":{"begin":1220,"end":1222},"obj":"16996036"},{"id":"26527348-17408578-60555194","span":{"begin":1224,"end":1226},"obj":"17408578"},{"id":"26527348-1618937-60555195","span":{"begin":1287,"end":1289},"obj":"1618937"},{"id":"26527348-1603349-60555196","span":{"begin":1419,"end":1421},"obj":"1603349"},{"id":"26527348-8857754-60555197","span":{"begin":1423,"end":1425},"obj":"8857754"},{"id":"26527348-17986271-60555198","span":{"begin":2021,"end":2023},"obj":"17986271"},{"id":"26527348-23565983-60555199","span":{"begin":2025,"end":2027},"obj":"23565983"}],"text":"It was suggested that migraine with aura is a condition with a spectrum of clinical subtypes that likely differ in pathophysiological mechanisms [17]. Distinct electrophysiological abnormalities were especially found at the neuromuscular junction in patients suffering from complex neurological auras characterized by visual symptoms followed by sensorimotor and dysphasic symptoms [18] or from prolonged auras [19]. Using 1H-MR-spectroscopy, migraine patients with visual symptoms and at least one of paraesthesia, paresis, or dysphasia had a significant lactate increase in the visual cortex during sustained visual stimulation, while this was not the case in controls and patients with exclusive visual aura. In the latter group, however, lactate levels were already elevated at baseline and remained consistently high during the visual stimulation [20]. Besides its role as energy substrate of the brain, lactate acts as a neuromodulator and interacts with glutamate [21], GABA [22], and monoamines [23], which suggest that it is important in regulating the activity of cortical neurons. Lactate may increase to attenuate the electrical activity of excessively active neurons as observed in experimental models [22, 24, 25] and in healthy humans during sustained visual stimulation [26]. Considering these data and those obtained by NMR spectroscopy showing altered metabolic homeostasis of the migraineur’s brain [27, 28], it is of interest to verify whether activity of visual cortical neurons is increased in migraine patients suffering from complex auras respective to those experiencing pure visual symptoms. We decided therefore to compare amplitude and habituation of pattern reversal VEP in healthy volunteers, migraine patients with pure visual auras, and in patients with complex neurological auras including at least one of sensory and language symptoms in addition to visual disturbances. Considering the abovementioned NMR spectroscopy studies and our prior interictal VEP studies in migraine with aura [14, 15], we reasoned that subgroups of migraine with aura patients would show both common and specific neurophysiological abnormalities. We hypothesized that VEP amplitude would be higher in migraine with complex aura than in migraine with pure visual aura, while habituation would be equally deficient in both MA subgroups."}