Lack of habituation of visual-evoked potential in the interictal period is not a consistent neurophysiological marker of migraine: A cross-sectional analytical study

Abstract

Objectives: Migraine is a frequent incapacitating neurovascular illness characterized by severe headache bouts. Individuals suffering from migraine appear to process auditory and visual information differently from those without migraine. The visual-evoked potential (VEP) is a commonly used standardized test to measure excitability in the occipital cortex. Patients with migraine exhibit amplification rather than habituation of stimulus-induced brain responses, between attacks. Our objective is to compare the amplitude of P100 and the latencies of N75, P100, and N145 (N and P represent negative and positive peaks, respectively, with average latency being subscripted with the alphabet) in the fourth block between migraine patients and controls and to determine the various clinical factors associated with the P100 mean amplitude and latency differences between the first and the fourth block in migraine patients. Materials and Methods: The study compared 20 migraine patients (with or without aura) and 20 apparently healthy subjects with no history of migraines or secondary headaches, focusing on the habituation of the VEP. Four blocks of 200 responses were recorded during the headache-free period, and the latencies and amplitudes of N75, P100, and N145 components were analyzed. Results: There was a statistically significant (P < 0.05) decrement in the P100 amplitude in the fourth block when compared to the first block in both eyes in the controls as well as migraine patients. In addition, there was no statistically significant difference between controls and migraine sufferers in the P100 amplitude of the fourth block in either eye. The N145 latency in the fourth block was shorter in both eyes in migraine patients compared to controls (P < 0.05). The mean P100 amplitude difference between the first and fourth block correlated negatively with age and positively with headache frequency, while there was a moderate negative correlation with headache duration. The mean P100 latency difference between the first and fourth block correlated positively with age and negatively with headache frequency, while there was a moderate positive correlation with headache duration. Conclusion: In our study, VEP habituation was not lacking in migraine patients which means that habituation of the P100 wave was noted in migraineurs. The VEP reveals neurological changes due to ischemia injury or neurotransmitter imbalances. Migraine alters cortical excitability, but it is unclear if these changes are due to altered excitatory connections, damaged inhibitory networks or subcortical pre-activation. Our findings suggest that at least during the interictal period, lack of habituation cannot be employed as a consistent neurophysiological marker of migraine across laboratories.