Neurophysiology of the Migraine Brain

Roughly one in every five patients referred to a neurologist suffers from headaches; the majority have migraines. Although headache specialists understand migraine on a clinical basis, the pathophysiological changes that provoke and accompany the development of a migraine attack continue to elude us.

Several decades have passed since the pioneering electroencephalographic study by Golla and Winter (1959), which underscored the role of abnormal rhythmic activities in migraine. Since then, there have been substantial advances in the field; a wealth of neurophysiological studies has enriched our understanding of the pathophysiological facets of the migraine pathology. Virtually every known technique of clinical electrophysiology has since been used to study the migraine brain and, more recently, new neurophysiological tools have been added to the arsenal. Nevertheless, applying the principles of peripheral and central neuromodulation offers a promising way to transfer the principles of synaptic plasticity to the patient’s bedside.

This book belongs to the Headache Series endorsed by the European Headache Federation. Written by internationally recognized experts in their respective fields, it covers all aspects of clinical neurophysiological methods that represent significant advances in our understanding of the pathophysiology of migraine. It will offer a valuable toolkit for beginners, and a reference guide for experts.

Gianluca Coppola is a board-certified neurologist and holds a doctoral degree from Sapienza University of Rome. Having subsequently completed the certification as a Full Professor of Neurology, he is currently a University Researcher at Sapienza University of Rome Polo Pontino, Latina, Italy. He is trustee for the International Headache Society (IHS), and secretary of the Italian Society for the Study of Headache (SISC). His research interests include the use of neurophysiology and neuroimaging techniques to understand primary headaches pathophysiology, and the study of synaptic plasticity in visual, somatosensory, and motor systems.

Wei-Ta Chen, MD PhD,  is a headache specialist at Taipei Veterans General Hospital and a Professor of Neurology at the School of Medicine, National Yang-Ming University, Taipei, Taiwan. He also serves on the Board of Directors for the Taiwan Headache Society. Dr. Chen has long been interested in exploring the mechanisms of neurological diseases by means of functional neuroimaging. He has published a series of magnetoencephalographic (MEG) studies regarding brain excitability change of migraine in prestigious medical journals including Brain, Pain, and Cephalalgia. His current focus is on combining MEG with structural and functional MRI to unravel the pathomechanism and neuroplasticity of chronic pain disorders including migraine, tension-type headache and fibromyalgia.