TY - JOUR
T1 - Sleep restriction alters cortical inhibition in migraine
T2 - A transcranial magnetic stimulation study
AU - Mykland, Martin Syvertsen
AU - Uglem, Martin
AU - Neverdahl, Jan Petter
AU - Øie, Lise Rystad
AU - Meisingset, Tore Wergeland
AU - Dodick, David W.
AU - Tronvik, Erling
AU - Engstrøm, Morten
AU - Sand, Trond
AU - Omland, Petter Moe
N1 - Publisher Copyright:
© 2022 International Federation of Clinical Neurophysiology
PY - 2022/7
Y1 - 2022/7
N2 - Objective: Migraine is a primary headache disorder with a well-known association with insufficient sleep. However, both the underlying pathophysiology of the disease and the relationship with sleep is still unexplained. In this study, we apply transcranial magnetic stimulation to investigate possible mechanisms of insufficient sleep in migraine. Methods: We used a randomised, blinded crossover design to examine 46 subjects with migraine during the interictal period and 29 healthy controls. Each subject underwent recordings of cortical silent period, short- and long-interval intracortical inhibition, intracortical facilitation and short-latency afferent inhibition after both two nights of habitual eight-hour sleep and two nights of restricted four-hour sleep. Results: We found reduced cortical silent period duration after sleep restriction in interictal migraineurs compared to controls (p = 0.046). This effect was more pronounced for non-sleep related migraine (p = 0.002) and migraine with aura (p = 0.017). The sleep restriction effect was associated with ictal symptoms of hypersensitivity such as photophobia (p = 0.017) and overall silent period was associated with premonitory dopaminergic symptoms such as yawning (p = 0.034). Conclusions: Sleep restriction reduces GABAergic cortical inhibition during the interictal period in individuals with migraine. Significance: Sleep related mechanisms appear to affect the pathophysiology of migraine and may differentiate between migraine subgroups.
AB - Objective: Migraine is a primary headache disorder with a well-known association with insufficient sleep. However, both the underlying pathophysiology of the disease and the relationship with sleep is still unexplained. In this study, we apply transcranial magnetic stimulation to investigate possible mechanisms of insufficient sleep in migraine. Methods: We used a randomised, blinded crossover design to examine 46 subjects with migraine during the interictal period and 29 healthy controls. Each subject underwent recordings of cortical silent period, short- and long-interval intracortical inhibition, intracortical facilitation and short-latency afferent inhibition after both two nights of habitual eight-hour sleep and two nights of restricted four-hour sleep. Results: We found reduced cortical silent period duration after sleep restriction in interictal migraineurs compared to controls (p = 0.046). This effect was more pronounced for non-sleep related migraine (p = 0.002) and migraine with aura (p = 0.017). The sleep restriction effect was associated with ictal symptoms of hypersensitivity such as photophobia (p = 0.017) and overall silent period was associated with premonitory dopaminergic symptoms such as yawning (p = 0.034). Conclusions: Sleep restriction reduces GABAergic cortical inhibition during the interictal period in individuals with migraine. Significance: Sleep related mechanisms appear to affect the pathophysiology of migraine and may differentiate between migraine subgroups.
KW - Insufficient sleep
KW - Interictal migraine
KW - Intracortical facilitation
KW - Intracortical inhibition
KW - Pathophysiology
KW - Silent period
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U2 - 10.1016/j.clinph.2022.04.004
DO - 10.1016/j.clinph.2022.04.004
M3 - Article
C2 - 35490438
AN - SCOPUS:85129493760
SN - 1388-2457
VL - 139
SP - 28
EP - 42
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
ER -