Visual and auditory cortical evoked potentials in interictal episodic migraine: An audit on 624 patients from three centres

Anna Ambrosini, Aliaksei Kisialiou, Gianluca Coppola, Livio Finos, Delphine Magis, Francesco Pierelli, Jean Schoenen

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Many studies report a habituation deficit of visual evoked potentials (VEP) and/or increased intensity dependence of auditory evoked cortical potentials (IDAP) in episodic migraine patients between attacks. These findings have a pathophysiological interest, but their diagnostic utility is not known.

AIMS: To perform an audit on a large database of interictal VEP and IDAP recordings in episodic migraine patients and evaluate their diagnostic accuracy.

METHODS: We pooled data for VEP habituation and IDAP measured in 624 episodic migraineurs (EM) and 360 healthy volunteers (HV) from three centers. Thresholds were calculated by Receiver Operating Curve analysis and used to calculate sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) and the accuracy of each test, using ICHD diagnostic criteria as the gold standard.

RESULTS: In EM, VEP habituation was significantly lower than in HV, and IDAP slopes were significantly steeper. VEP (five blocks of 50 responses), VEP (six blocks of 100 responses) and IDAP had respectively 61.0%, 61.4% and 45.7% sensitivity, and 77.9%, 77.9% and 87.2% specificity. Their positive (LR+) and negative (LR-) likelihood ratios were respectively 2.760, 2.778, 3.570 and 0.500, 0.495, 0.623, with diagnostic accuracies of 65.3%, 69.0% and 54.3%. In combined VEP + IDAP recordings, an abnormality of at least one test had 83.4% sensitivity, 66.7% specificity, 2.504 LR+, 0.249 LR- and 81.1% accuracy.

CONCLUSIONS: In this large database, VEP habituation is significantly reduced and IDAP increased in episodic migraine patients between attacks. Taken alone, neither VEP nor IDAP has sufficient diagnostic accuracy. However, when both tests are performed in the same patient, an abnormality of at least one of them is highly predictive of interictal episodic migraine.

Original languageEnglish
JournalCephalalgia
DOIs
Publication statusE-pub ahead of print - Aug 31 2016

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Auditory Evoked Potentials
Visual Evoked Potentials
Migraine Disorders
Healthy Volunteers
Databases
Sensitivity and Specificity

Keywords

  • Journal Article

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Visual and auditory cortical evoked potentials in interictal episodic migraine : An audit on 624 patients from three centres. / Ambrosini, Anna; Kisialiou, Aliaksei; Coppola, Gianluca; Finos, Livio; Magis, Delphine; Pierelli, Francesco; Schoenen, Jean.

In: Cephalalgia, 31.08.2016.

Research output: Contribution to journalArticle

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title = "Visual and auditory cortical evoked potentials in interictal episodic migraine: An audit on 624 patients from three centres",
abstract = "BACKGROUND: Many studies report a habituation deficit of visual evoked potentials (VEP) and/or increased intensity dependence of auditory evoked cortical potentials (IDAP) in episodic migraine patients between attacks. These findings have a pathophysiological interest, but their diagnostic utility is not known.AIMS: To perform an audit on a large database of interictal VEP and IDAP recordings in episodic migraine patients and evaluate their diagnostic accuracy.METHODS: We pooled data for VEP habituation and IDAP measured in 624 episodic migraineurs (EM) and 360 healthy volunteers (HV) from three centers. Thresholds were calculated by Receiver Operating Curve analysis and used to calculate sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) and the accuracy of each test, using ICHD diagnostic criteria as the gold standard.RESULTS: In EM, VEP habituation was significantly lower than in HV, and IDAP slopes were significantly steeper. VEP (five blocks of 50 responses), VEP (six blocks of 100 responses) and IDAP had respectively 61.0{\%}, 61.4{\%} and 45.7{\%} sensitivity, and 77.9{\%}, 77.9{\%} and 87.2{\%} specificity. Their positive (LR+) and negative (LR-) likelihood ratios were respectively 2.760, 2.778, 3.570 and 0.500, 0.495, 0.623, with diagnostic accuracies of 65.3{\%}, 69.0{\%} and 54.3{\%}. In combined VEP + IDAP recordings, an abnormality of at least one test had 83.4{\%} sensitivity, 66.7{\%} specificity, 2.504 LR+, 0.249 LR- and 81.1{\%} accuracy.CONCLUSIONS: In this large database, VEP habituation is significantly reduced and IDAP increased in episodic migraine patients between attacks. Taken alone, neither VEP nor IDAP has sufficient diagnostic accuracy. However, when both tests are performed in the same patient, an abnormality of at least one of them is highly predictive of interictal episodic migraine.",
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author = "Anna Ambrosini and Aliaksei Kisialiou and Gianluca Coppola and Livio Finos and Delphine Magis and Francesco Pierelli and Jean Schoenen",
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T1 - Visual and auditory cortical evoked potentials in interictal episodic migraine

T2 - An audit on 624 patients from three centres

AU - Ambrosini, Anna

AU - Kisialiou, Aliaksei

AU - Coppola, Gianluca

AU - Finos, Livio

AU - Magis, Delphine

AU - Pierelli, Francesco

AU - Schoenen, Jean

N1 - © International Headache Society 2016.

PY - 2016/8/31

Y1 - 2016/8/31

N2 - BACKGROUND: Many studies report a habituation deficit of visual evoked potentials (VEP) and/or increased intensity dependence of auditory evoked cortical potentials (IDAP) in episodic migraine patients between attacks. These findings have a pathophysiological interest, but their diagnostic utility is not known.AIMS: To perform an audit on a large database of interictal VEP and IDAP recordings in episodic migraine patients and evaluate their diagnostic accuracy.METHODS: We pooled data for VEP habituation and IDAP measured in 624 episodic migraineurs (EM) and 360 healthy volunteers (HV) from three centers. Thresholds were calculated by Receiver Operating Curve analysis and used to calculate sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) and the accuracy of each test, using ICHD diagnostic criteria as the gold standard.RESULTS: In EM, VEP habituation was significantly lower than in HV, and IDAP slopes were significantly steeper. VEP (five blocks of 50 responses), VEP (six blocks of 100 responses) and IDAP had respectively 61.0%, 61.4% and 45.7% sensitivity, and 77.9%, 77.9% and 87.2% specificity. Their positive (LR+) and negative (LR-) likelihood ratios were respectively 2.760, 2.778, 3.570 and 0.500, 0.495, 0.623, with diagnostic accuracies of 65.3%, 69.0% and 54.3%. In combined VEP + IDAP recordings, an abnormality of at least one test had 83.4% sensitivity, 66.7% specificity, 2.504 LR+, 0.249 LR- and 81.1% accuracy.CONCLUSIONS: In this large database, VEP habituation is significantly reduced and IDAP increased in episodic migraine patients between attacks. Taken alone, neither VEP nor IDAP has sufficient diagnostic accuracy. However, when both tests are performed in the same patient, an abnormality of at least one of them is highly predictive of interictal episodic migraine.

AB - BACKGROUND: Many studies report a habituation deficit of visual evoked potentials (VEP) and/or increased intensity dependence of auditory evoked cortical potentials (IDAP) in episodic migraine patients between attacks. These findings have a pathophysiological interest, but their diagnostic utility is not known.AIMS: To perform an audit on a large database of interictal VEP and IDAP recordings in episodic migraine patients and evaluate their diagnostic accuracy.METHODS: We pooled data for VEP habituation and IDAP measured in 624 episodic migraineurs (EM) and 360 healthy volunteers (HV) from three centers. Thresholds were calculated by Receiver Operating Curve analysis and used to calculate sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) and the accuracy of each test, using ICHD diagnostic criteria as the gold standard.RESULTS: In EM, VEP habituation was significantly lower than in HV, and IDAP slopes were significantly steeper. VEP (five blocks of 50 responses), VEP (six blocks of 100 responses) and IDAP had respectively 61.0%, 61.4% and 45.7% sensitivity, and 77.9%, 77.9% and 87.2% specificity. Their positive (LR+) and negative (LR-) likelihood ratios were respectively 2.760, 2.778, 3.570 and 0.500, 0.495, 0.623, with diagnostic accuracies of 65.3%, 69.0% and 54.3%. In combined VEP + IDAP recordings, an abnormality of at least one test had 83.4% sensitivity, 66.7% specificity, 2.504 LR+, 0.249 LR- and 81.1% accuracy.CONCLUSIONS: In this large database, VEP habituation is significantly reduced and IDAP increased in episodic migraine patients between attacks. Taken alone, neither VEP nor IDAP has sufficient diagnostic accuracy. However, when both tests are performed in the same patient, an abnormality of at least one of them is highly predictive of interictal episodic migraine.

KW - Journal Article

U2 - 10.1177/0333102416665224

DO - 10.1177/0333102416665224

M3 - Article

C2 - 27582121

JO - Cephalalgia

JF - Cephalalgia

SN - 0333-1024

ER -