Migraine pathophysiology possibly involves deficient mitochondrial energy res erve and diminished cortical habituation. Using functional magnetic resonance sp ectroscopic imaging (fMRSi), we studied cortical lactate c...
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Migraine pathophysiology possibly involves deficient mitochondrial energy res erve and diminished cortical habituation. Using functional magnetic resonance sp ectroscopic imaging (fMRSi), we studied cortical lactate changes during prolonge d visual stimulation to search for different pathophysiological mechanisms in cl inically distinct subgroups of migraine with aura. Eleven healthy volunteers (HV ) and 10 migraine patients were investigated interictally: five with visual aura (MA) and five with visual symptoms and at least one of the following: paraesthe sia, paresis or dysphasia (MAplus). Using MRSi (philips, 1.5 T) 1H- spectra wer e repeatedly obtained from a 25 mm- thick slice covering visual and non- visua l cortex, with the first and fifth measurements in darkness and the second to fo urth with 8- Hz checkerboard stimulation. in MAplus lactate increased only duri ng stimulation, only in visual cortex; in MA resting lactate was high in visual cortex, without further increase during stimulation. This is compatible with an abnormal metabolic strain during stimulation in MAplus, possibly due to dishabit uation, and a predominant mitochondrial dysfunction in MA.
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