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NEUROLOGY 2003;61:1446-1448
© 2003 American Academy of Neurology
Brief Communications

1 Hz rTMS enhances extrastriate cortex activity in migraine

Evidence of a reduced inhibition?

B. Fierro, MD, R. Ricci, PhD, A. Piazza, MD, S. Scalia, MD, G. Giglia, MD, G. Vitello, MD and F. Brighina, MD

From the Neurophysiological Unit (Drs. Fierro, Piazza, Scalia, Giglia, Vitello, and Brighina), University of Palermo; and Department of Psychology (Dr. Ricci), University of Torino, Italy.

Address correspondence and reprint requests to Dr. Filippo Brighina, Istituto di Neuropsichiatria, Università di Palermo, via G. La Loggia, 1, 90129 Palermo, Italy; e-mail: fierro{at}unipa.it

We recently reported a paradoxical facilitatory effect of 1 Hz repetitive TMS (rTMS) on the primary visual cortex in migraine possibly due to the failure of inhibitory circuits, unable to be upregulated by low frequency rTMS. To investigate if inhibitory circuit dysfunction extends beyond striate cortex in migraine with aura, we studied the effects of 1 Hz rTMS over the right extrastriate cortex on perception of illusory contours in these patients. Low-frequency rTMS enhanced activity of extrastriate cortex in migraineurs, speeding up reaction times on illusory contour perception. This finding supports the view of a failure of inhibitory circuits also involving the extrastriate cortex in migraine with aura.

Received April 16, 2003. Accepted in final form July 31, 2003.




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