• Laura Di Clemente, Francesca Puledda, Antonella Biasiotta, Alessandro Viganò, Edoardo Vicenzini, Andrea Truini, Giorgio Cruccu, and Vittorio Di Piero.
• Department of Neuroscience, Sapienza University of Rome, viale dell'Università 30, Rome 00185, Italy. laura.diclemente@libero.it.
• J Headache Pain. 2013 Mar 12; 14 (1): 2525.

BackgroundLack of habituation during repetitive stimulation is the most consistent interictal abnormality of cortical information processing observed in migraine. Preventive migraine treatments might act by stabilizing cortical excitability level and thus the habituation to external stimuli.MethodsWe examined the effects of preventive treatment with topiramate on migraineur's habituation to nociceptive stimulation. Scalp potentials were evoked by Nd-YAP Laser stimulation of the hand dorsum and supraorbital region in 13 patients with migraine without aura (MO) and 15 healthy volunteers (HV). The exam was repeated in MO before and after treatment.ResultsWe observed a lack of habituation and lower initial amplitudes in MO compared to HV. These abnormalities reached statistical significance for N1 LEPs component, generated in the secondary somatosensory cortex (SII), but not for N2/P2 complex, generated in the insula and anterior cingulated cortex (ACC). Topiramate normalized the N1 habituation pattern in MO, with a significant correlation between clinical effects and normalization of neurophysiological responses.ConclusionsOur results indicate a modulating action of topiramate on cortical processing of sensorial stimuli, mainly regarding the sensory-discriminative component of pain, elaborated by SII, without a significant effect on the affective dimension of pain, in which the ACC has an important role.

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