References of "D'Ostilio, Kevin"
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See detailInvasive and Non-invasive Electrical Pericranial Nerve Stimulation for the Treatment of Chronic Primary Headaches
D'Ostilio, Kevin ULg; MAGIS, Delphine ULg

in Current Pain and Headache Reports (2016), 20

Chronic primary headaches are widespread disorders which cause significant quality of life and socioprofessional impairment. Available pharmacological treatments have often a limited efficacy and/or can ... [more ▼]

Chronic primary headaches are widespread disorders which cause significant quality of life and socioprofessional impairment. Available pharmacological treatments have often a limited efficacy and/or can generate unbearable side effects. Electrical nerve stimulation is a well known non-destructive method of pain modulation which has been recently applied to headache management. In this review, we summarise recent advances in invasive and non-invasive neurostimulation techniques targeting pericranial structures for the treatment of chronic primary headaches, chiefly migraine and cluster headache: occipital nerve, supraorbital nerve, vagus nerve, and sphenopalatineganglion stimulations. Invasive neurostimulation therapies have offered a new hope to drug-refractory headache sufferers but are not riskless and should be proposed only to chronic patients who failed to respond to most existing preventives. Non-invasive neurostimulation devices are user-friendly, safe and well tolerated and are thus taking an increasing place in the multidisciplinary therapeutical armamentarium of primary headaches. [less ▲]

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See detailDistinct cerebral metabolic patterns related to high pain sensitivity in episodic or chronic migraine patients and healthy volunteers
D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg; Schoenen, Jean ULg et al

in Frontiers in Aging Neuroscience (2016, July)

Introduction Allodynia, i.e. pain evoked by a non-painful stimulus, is prevalent in chronic pain and in migraine where it augments with disease severity and chronicity [1]. Central sensitization is ... [more ▼]

Introduction Allodynia, i.e. pain evoked by a non-painful stimulus, is prevalent in chronic pain and in migraine where it augments with disease severity and chronicity [1]. Central sensitization is thought to be the culprit [2]. It is not known, however, which central areas are involved. The aim of the present study was to evaluate whether brain metabolism in subjects that are more sensitive to pain is different between migraine patients and healthy controls. Subjects and methods Quantitative heat sensory testing on the forehead and 18FDG-PET were performed in 55 subjects: 20 healthy volunteers (HV, 21-59 years, 5M), 21 patients with episodic migraine in the interictal phase (MO, age range: 20-63 years, 5M) and 14 patients with chronic migraine (CM, age range: 22-62 years, 1M). The 3 cohorts were subdivided according to the median heat pain threshold into subgroups with low and high pain thresholds. PET results were compared between these subgroups in each cohort. Data analyses were restricted to areas of the pain/salience matrix. Results There was no significant difference in heat pain thresholds between HV (median: 43.7 °C), MO median: 44.2°C) and CM (median: 43.3°C) (p=0.64). In an SPM-ANOVA, a contrast modelling the potential gradual effect of increased differences in pain sensitivity in relation to disease severity showed significant metabolic changes in bilateral thalamus and midbrain (p < 0.001). Additional analyses revealed that hypometabolic areas in subgroups with a low heat pain threshold differed between HV (anterior cingulate and somatosensory cortices), MO (lower pons and somatosensory cortex) and CM (midbrain and thalamus) (Figure 1). Conclusion Overall migraine patients do not have reduced heat pain thresholds. However, hypometabolic areas related to high thermal pain sensitivity are strictly cortical in HV, but comprise the pons in episodic migraine and are restricted to midbrain and thalamus in chronic migraine. The distinct central correlates of heat pain sensitivity in migraine patients might therefore represent a biomarker of migraine and its chronification. Legend to figure Figure 1. Hypometabolic areas in low pain threshold subgroups in HV (green), MO (orange) and CM (red). p < 0.01 for display purpose. Résumé en Français: Titre: Métabolisme cérébral distinct en relation avec la sensibilité à la douleur entre sujets sains, migraine épisodique et migraine chronique. Les migraineux ont une sensibilité anormale à la douleur. Les mécanismes cérébraux en sont inconnus. Nous avons comparé le métabolisme cérébral chez des sujets sains et chez des migraineux épisodiques ou chroniques et correlé les résultats avec le seuil douloureux. Les aires cérébrales hypométaboliques liées à un seuil douloureux bas diffèrent entre groupes: régions corticales chez les sujets sains, aires corticales et sous-corticales dans la migraine épisodique, régions sous-corticales dans la migraine chronique .Le contrôle central de la douleur semble modifié distinctement dans les formes de migraine, ce qui pourrait en constituer un biomarqueur et avoir des implications thérapeutiques. [less ▲]

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See detailFunction–structure connectivity in patients with severe brain injury as measured by MRI-DWI and FDG-PET
Annen, Jitka ULg; Heine, Lizette ULg; Ziegler, Erik et al

in Human Brain Mapping (2016), 37(11), 3707-3720

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See detailCerebral metabolism before and after external trigeminal nerve stimulation in episodic migraine
MAGIS, Delphine ULg; D'Ostilio, Kevin ULg; Thibaut, Aurore ULg et al

in Cephalalgia : An International Journal of Headache (2016)

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See detailAnodal transcranial direct stimulation (tDCS) targeting the anterior cingulate gyrus for the preventive treatment of chronic cluster headache: a proof of concept trial.
MAGIS, Delphine ULg; D'Ostilio, Kevin ULg; Cosseddu, Anna et al

Poster (2016, April)

Background There is a need for better treatments in chronic cluster headache (CCH). In responders to percutaneous occipital nerve stimulation, the subgenual anterior cingulate gyrus (sACG) was found ... [more ▼]

Background There is a need for better treatments in chronic cluster headache (CCH). In responders to percutaneous occipital nerve stimulation, the subgenual anterior cingulate gyrus (sACG) was found hypermetabolic (Magis et al. 2011). We reasoned that activation of this area by transcranial neurostimulation could be effective in CCH. Aim To explore the preventive effect of anodal (i.e. activating) transcranial direct current stimulation (tDCS) targeting the anterior cingulate gyrus in CCH patients. Method & subjects Difficult-to-treat CCH patients with a stable preventive drug regimen applied tDCS (2mA) interictally in 20-minute daily sessions for 4 weeks with the anode positioned over the forehead (FpZ), the cathode over the C7 spinous process. Therapeutic effects were monitored with paper diaries. Results Nineteen patients were enrolled up to now. In 13 patients who completed the trial, mean weekly attack frequency decreased by 38% after 4 weeks of daily stimulation (W-test: p = 0.002). The 50% responder rate was 54%. Patients (n=12) reported an improvement in headache impact, as shown by 5-point decrease in the mean HIT-6 score (from 67 to 62, p = 0.02). In 10 patients who were followed up after the treatment period, the benefit remained stable up to 4 weeks after the last stimulation. The first 3 enrolled patients had superficial skin burns under the adhesive cathode electrode. Sponge electrodes were therefore used in all subsequent patients without any adverse effect. Conclusion Anodal tDCS targeting the anterior cingulate gyrus seems promising for the preventive treatment of chronic cluster headache as suggested by this ongoing proof-of-concept trial. Use of adhesive electrodes is not recommended. [less ▲]

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See detailNon-invasive vagus nerve stimulation with the gammaCore® in healthy subjects: is there electrophysiological evidence for activation of vagal afferents ?
Schoenen, Jean ULg; NONIS, Romain ULg; D'Ostilio, Kevin ULg et al

Poster (2016, April)

Abstract: Background Non-invasive vagus nerve stimulation (nVNS) with the gammaCore® improves migraine and cluster headache. Animal experiments suggest that nVNS acts via stimulation of vagal afferents ... [more ▼]

Abstract: Background Non-invasive vagus nerve stimulation (nVNS) with the gammaCore® improves migraine and cluster headache. Animal experiments suggest that nVNS acts via stimulation of vagal afferents, but proof in humans is lacking. Vagal somatosensory evoked potentials (vSEP) are identified after invasive VNS or transcutaneous stimulation of auricular vagal branches, but late components could be muscle artifacts. Objective To search in healthy volunteers for reliable vSEP during nVNS with the gammaCore® Methods In 12 healthy subjects (7males) evoked potentials were recorded at A1/A2 (ref Cz) and C3/C4 (ref F3/F4) during 2-minute stimulation over left/right cervical vagus nerve with the gammaCore® (25Hz, 6-24V) and during stimulation over the inner tragus with a monopolar stimulator (2Hz, 50 stimuli, mean intensity 8mA). Results We identified 3 reproducible peaks P1, N1, P2 in 10 patients on the side of the gammaCore® stimulation at mean latencies of 2.05ms, 5.20ms and 9.13ms. P1-N1 amplitude increased significantly (p<0.01) with increasing voltage from 0.04μV to 0.52μV (C3/C4) and from 0.13µV to 2.04μV (A1/A2) respectively at 10V and 30V. Inner tragus stimulation elicited P1, N1, P2 peaks with shorter mean latencies (2.21ms, 3.72ms, 5.71ms) and a mean P1-N1 amplitude (A1/A2) of 5.0µV. When the gammaCore® was placed over the sternocleidomastoid muscle, there were no reproducible evoked potentials. Conclusion Non-invasive transcutaneous stimulation of the cervical vagus nerve with the gammaCore® elicits evoked potentials similar to those found with implanted electrodes or stimulation of Arnold’s nerve in the outer ear. The gammaCore®-evoked potentials increase in amplitude with stimulation intensity and disappear when the stimulator is positioned over neck muscles, suggesting that they are not muscle artifacts. Their short latency is compatible with their generation at the level of the foramen jugulare. The therapeutic effects reported with the gammaCore® in primary headaches can thus be mediated by genuine activation of vagus nerve afferents. [less ▲]

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See detailEffect of coil orientation on strength-duration time constant and I-wave activation with controllable pulse parameter transcranial magnetic stimulation
D'Ostilio, Kevin ULg; Goetz, Stefan; Hannah, Ricci et al

in Clinical Neurophysiology (2016), 1

Objective: To compare the strength-duration (S-D) time constants of motor cortex structures activated by current pulses oriented posterior-anterior (PA) or anterior-posterior (AP) across the central ... [more ▼]

Objective: To compare the strength-duration (S-D) time constants of motor cortex structures activated by current pulses oriented posterior-anterior (PA) or anterior-posterior (AP) across the central sulcus. Methods: Motor threshold and input–output curve, along with motor evoked potential (MEP) latencies, of first dorsal interosseus were determined at pulse widths of 30, 60, and 120 μs using a controllable pulse parameter (cTMS) device, with the coil oriented PA or AP. These were used to estimate the S-D time constant and we compared with data for responses evoked by cTMS of the ulnar nerve at the elbow. Results: The S-D time constant with PA was shorter than for AP stimulation (230.9 ± 97.2 vs. 294.2 ± 90.9 us; p<0.001). These values were similar to those calculated after stimulation of ulnar nerve (197 ± 47us). MEP latencies to AP, but not PA stimulation were affected by pulse width, showing longer latencies following short duration stimuli. Conclusion: PA and AP stimuli appear to activate the axons of neurons with different time constants. Short duration AP pulses are more selective than longer pulses in recruiting longer latency corticospinal output. [less ▲]

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See detailMETABOLIC CORRELATES OF VISUAL EVOKED POTENTIALS HABITUATION IN MIGRAINEURS AND CONTROLS
D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg; SCHOENEN, Jean ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 60

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See detailMETABOLIC CHANGES IN THE MIGRAINE BRAIN IN RELATION TO AGEING AND DISEASE LOAD
D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg; NONIS, Romain ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 59

Introduction: Migraine prevalence tends to decrease with advancing age. Morphological and functional brain changes occuring in migraine could be secondary to repeated attacks and/or to abnormal sensory ... [more ▼]

Introduction: Migraine prevalence tends to decrease with advancing age. Morphological and functional brain changes occuring in migraine could be secondary to repeated attacks and/or to abnormal sensory processing. In normal ageing, brain modifications could traduce a progressive refinement to cope with the environment, associated with a reduction in the complexity of brain connections. We hypothesized that metabolism in various brain regions might be differentially modified by age in migraine patients. Materials and methods: Forty-one subjects underwent a FDG-PET scan: 21 patients with interictal episodic migraine without aura (MO, age range: 20–63 years, 5M) and 20 healthy controls (HV, 21–59 years, 5 M). Results: In MO vs. HV, the overall FDG uptake was reduced in the left visual cortex, left medial frontal gyrus and bilaterally in the insula, somatosensory and motor cortices. Metabolisms of the posterior thalamus, brainstem including the periaqueductal gray (PAG), visual cortex, and (para)hippocampus, strongly increased with age in MO patients but not in HV. Disease duration positively correlated with PAG, (para)hippocampus and rostral anterior cingulate cortex (rACC) metabolisms in MO. Conclusion: Migraine patients, compared to HV, have a decreased resting metabolism in several areas belonging to the ‘‘pain/salience matrix’’, which is in line with previous neuroimaging studies. Metabolism of the rACC is specifically related to disease load whereas metabolism of other sensory processing regions is more affected by age. Whether these functional changes are due to repeated stereotyped attack-related stimulations and to a learning process with complexity reduction of neuronal connections and/or compensatory age-related hyperactivity, remains to be demonstrated [less ▲]

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See detailDOES NON-INVASIVE VAGUS NERVE STIMULATION NORMALIZE HABITUATION OF EVOKED POTENTIALS IN PATIENTS WITH EPISODIC MIGRAINE
NONIS, Romain ULg; D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 58

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See detailNON-INVASIVE CERVICAL VAGUS NERVE STIMULATION: IS THERE ELECTROPHYSIOLOGICAL EVIDENCE FOR GENUINE VAGAL AFFERENTS ACTIVATION?
NONIS, Romain ULg; D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 56

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See detailA MACHINE-LEARNING CLASSIFIER FOR EPISODIC MIGRAINE BASED ON VISUAL EVOKED GAMMA BAND ACTIVITY
D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg; SCHOENEN, Jean ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 56

Introduction: Objective and reliable biomarkers of migraine may be of interest for diagnosis and research purposes. Neuroimaging-based machine-learning classifiers are promising but hampered by ... [more ▼]

Introduction: Objective and reliable biomarkers of migraine may be of interest for diagnosis and research purposes. Neuroimaging-based machine-learning classifiers are promising but hampered by availability and cost issues. Conversely, evoked potential are of easy access and affordable. They have provided increasing evidence that sensory information processing is impaired in migraine. We have used gamma band oscillations (GBOs) of visual evoked potentials (VEPs) to compute a machine-learning neural network classifier in episodic migraine. Materials and methods: We analyzed GBOs from VEPs (6x100 responses). Recordings were performed in two matched samples: a training sample composed of 43 migraine patients (EM) and 20 healthy volunteers (HV) and a validating sample of 18 EM and 10 HV. A logistic regression model of the training sample was performed to evaluate the relevance of the predictor variables. Ten neural networks were automatically generated based on late component frequency, n3-p4 and p4-n4 slopes, 1st block n1-p2 amplitude and age. Results: The logistic regression model of the training sample reached a significant classification rate of 79% (EM: 88%; HV: 60%, p¼0.002). The best neural network was able to classify the groups with an accuracy of 73% in the training phase and 89% in the subsequent validation (success rate HV: 90%; EM: 88%). The mean global accuracy within the training and validating samples were 69% (63–78%) and 84% (82–89%). Conclusions: This machine-learning neural network classifier based on visual GBOs provides an accurate and costefficient tool for objective migraine diagnosis. Further training and validation studies with new cohorts are warranted [less ▲]

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See detailTRANSCUTANEOUS OCCIPITAL NERVE STIMULATION AND TRANSCRANIAL DIRECT CURRENT STIMULATION IN CHRONIC MIGRAINE: A PILOT COMPARISON OF THERAPEUTIC AND ELECTROPHYSIOLOGICAL EFFECTS
MAGIS, Delphine ULg; D'Ostilio, Kevin ULg; Baschi et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 31

Background: Management of chronic migraine (CM) is often challenging. There is a need for more effective and better-tolerated preventive therapies. Among non-invasive neurostimulation procedures ... [more ▼]

Background: Management of chronic migraine (CM) is often challenging. There is a need for more effective and better-tolerated preventive therapies. Among non-invasive neurostimulation procedures, transcutaneous occipital nerve stimulation (tONS) would act via central pain modulation, while transcranial direct current stimulation (tDCS) would modify cortical excitability that is abnormal in CM. Objectives: In this pilot trial we compared the clinical effects of tDCS and tONS in refractory CM and their ability to modify nociception and cortical responsiveness. Methods: Forty-three CM patients (17 with history of drug overuse) applied either 2mA tDCS during 2 months (N¼20, cathode over visual cortex, anode over left DLPFC), or tONS during 3 months (N¼23, Cefaly Kit ArnoldTM), both in daily 20 min-sessions. Visual evoked potentials (VEP), nociceptive blink reflexes (nBR) and quantitative sensory testing were recorded before and after treatment. Results: During the last stimulation month, total headache days decreased in both groups ( 16.4% for tDCS, 17% for tONS, p<0.05). Migraine days were reduced by 21.4% (p¼0.06) and 22% (p<0.05) respectively, while 30% responder rates were 47% and 42%. Medication intake was significantly reduced after tONS ( 43%). There was no significant change of nBR in either group. VEP habituation reversed to an episodic migraine pattern, i.e. a deficit, after tONS but not after tDCS. Conclusion: tONS and inhibitory tDCS of the visual cortex are interesting non-invasive options for the treatment of CM, but these results have to be confirmed in a randomized controlled trial. tONS was able to induce recordable changes in visual cortex responsiveness [less ▲]

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See detailEffects of 10Hz and 20Hz transcranial alternating current stimulation on automatic motor control
Cappon, Davide; D'Ostilio, Kevin ULg; Garraux, Gaëtan ULg et al

in Brain Stimulation (2016)

Background: Automatic motor inhibition is an important and adaptive process through which an activated motor plan is suppressed if the movement is not intended to be executed. Neuronal networks are ... [more ▼]

Background: Automatic motor inhibition is an important and adaptive process through which an activated motor plan is suppressed if the movement is not intended to be executed. Neuronal networks are characterized by oscillatory activity. In the brain, a large variety of rhythms have been described that differ in their frequency, origin and reactivity to changes in task demands. Recent studies have demonstrated that active cortical networks are susceptible to weak sinusoidal perturbations of exogenous electric fields. Objective/Hypothesis: The aim of this study was to investigate the frequency-specific effect of transcranial alternate current stimulation (tACS) over the automatic control of movement in healthy volunteers. We hypothesized that applying two different tACS frequencies during a visuo-motor task would result in different behavioural effects and in diverse modulation of cortical excitability. Methods: In this study we used tACS to interact non-invasively with the ongoing task-related oscillatory activity. Stimulation was delivered at alpha (10 Hz) and beta (20 Hz) frequency over the supplementary motor area and the primary motor cortex (SMA-M1) connections, which are part of the BG-cortical motor loop, during the execution of the subliminal masked prime task. We measured the effects on task performance and on motor cortex corticospinal excitability by means of motor evoked potentials (MEPs) evoked by transcranial magnetic stimulation (TMS). Results: Results indicate a specific effect of 10 and 20-Hz tACS on functional inhibition in the SMA-M1 circuit. Behaviorally there is an interference in task-related automatic inhibition: 10 Hz tACS reduced the automatic inhibition. In contrast 20 Hz tACS increased the automatic inhibition. At a neurophysiological level there is a modulation in excitability of M1: 20 Hz tACS reduced MEP amplitudes, whereas there was no change after 10 Hz tACS. Conclusion(s): The current study provides novel evidence that automatic mechanisms of motor behaviour can be modulated by imposing synchronized electrical oscillatory activity upon motor cortical regions. Our study has important implications for cognitive neuroscience studies suggesting that the use tACS might offer the possibility to demonstrate a causal link between endogenous brain oscillations, specific exogenous alternate current frequencies and specific cognitive processes. [less ▲]

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See detailThe network model of depression as a basis for new therapeutic strategies for treating major depressive disorder in Parkinson’s disease
D'Ostilio, Kevin ULg; Garraux, Gaëtan ULg

in Frontiers in Human Neuroscience (2016), 10(161),

The high prevalence of major depressive disorder in people with Parkinson's disease, its negative impact on health-related quality of life and the low response rate to conventional pharmacological ... [more ▼]

The high prevalence of major depressive disorder in people with Parkinson's disease, its negative impact on health-related quality of life and the low response rate to conventional pharmacological therapies call to seek innovative treatments. Here, we review the new approaches for treating major depressive disorder in patients with Parkinson's disease within the framework of the network model of depression. According to this model, major depressive disorder reflects maladaptive neuronal plasticity. Non-invasive brain stimulation using high frequency repetitive transcranial magnetic stimulation over the prefrontal cortex has been proposed as a feasible and effective strategy with minimal risk. The neurobiological basis of its therapeutic effect may involve neuroplastic modifications in limbic and cognitive networks. However, the way this networks reorganize might be strongly influenced by the environment. To address this issue, we propose a combined strategy that includes non-invasive brain stimulation together with cognitive and behavioral interventions. [less ▲]

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See detailCerebral FDG uptake changes with supraorbital transcutaneous electrical stimulation for episodic migraine prevention
D'Ostilio, Kevin ULg; Thibaut, Aurore ULg; Laureys, Steven ULg et al

Conference (2015, May)

Background: A recent multicentre RCT has shown that supraorbital transcutaneous stimulation (STS) targeting branches of the ophtalmic nerve with the Cefaly® device is effective as a preventive therapy for ... [more ▼]

Background: A recent multicentre RCT has shown that supraorbital transcutaneous stimulation (STS) targeting branches of the ophtalmic nerve with the Cefaly® device is effective as a preventive therapy for migraine (Schoenen et al., Neurology 2013). However, the mechanisms of action in the central nervous system remain unknown. Here, we conducted voxel-based analyses of [18]FDG-PET to evaluate metabolic changes immediately after the first STS session and after 3 months of treatment in patients with migraine. Methods: Twenty-eight subjects participated in the experiment: 14 patients with episodic migraine (ICHD3 beta criteria) and 14 age-matched controls. Healthy volunteers underwent only one [18]FDG-PET scan whereas patients were scanned at baseline, directly after a first session of STS and after 3 months of daily treatment. Results: Compliant patients showed a significant decrease in the number of attacks (p = 0.03). When compared to controls, patients (n = 14) at baseline were hypometabolic in the fronto-temporal regions (p < 0.001), especially in the orbitofrontal (OFC) and perigenual anterior cingulate cortex. OFC hypometabolism was not correlated with medication intake. In compliant patients, daily STS for 3 months was followed by a normalization of the fronto-temporal hypometabolism (p< 0.001; OFC: pFWE<0.01). Conclusion: Our study suggests that the OFC is hypoactive in episodic migraine. STS with the Cefaly° device is able to normalize this hypoactivity. This indicates that STS exerts its beneficial effect via slow neuromodulatory mechanisms, as also previously shown for percutaneous occipital nerve stimulation in refractory cluster headache (Magis et al., BMC Neurology 2011). [less ▲]

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See detailEffects of transcranial magnetic stimulation coil orientation and pulse width on short-latency afferent inhibition
Hannah, Ricci; D'Ostilio, Kevin ULg; Goetz, Stefan et al

Poster (2015, March)

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