Visual evoked potentials in subgroups of migraine with aura patients

Gianluca Coppola, Martina Bracaglia, Davide Di Lenola, Cherubino Di Lorenzo, Mariano Serrao, Vincenzo Parisi, Antonio Di Renzo, Francesco Martelli, Antonello Fadda, Jean Schoenen, Francesco Pierelli

Research output: Contribution to journalArticlepeer-review


Background: Patients suffering from migraine with aura can have either pure visual auras or complex auras with sensory disturbances and dysphasia, or both. Few studies have searched for possible pathophysiological differences between these two subgroups of patients. Methods: Methods - Forty-seven migraine with aura patients were subdivided in a subgroup with exclusively visual auras (MA, N = 27) and another with complex neurological auras (MA+, N = 20). We recorded pattern-reversal visual evoked potentials (VEP: 15 min of arc cheques, 3.1 reversal per second, 600 sweeps) and measured amplitude and habituation (slope of the linear regression line of amplitude changes from the 1st to 6th block of 100 sweeps) for the N1-P1 and P1-N2 components in patients and, for comparison, in 30 healthy volunteers (HV) of similar age and gender distribution. Results: VEP N1-P1 habituation, i.e. amplitude decrement between 1st and 6th block, which was obvious in most HV (mean slope −0.50), was deficient in both MA (slope +0.01, p = 0.0001) and MA+ (−0.0049, p = 0.001) patients. However, VEP N1-P1 amplitudes across blocks were normal in MA patients, while they were significantly greater in MA+ patients than in HVs. Conclusions: Our findings suggest that in migraine with aura patients different aura phenotypes may be underpinned by different pathophysiological mechanisms. Pre-activation cortical excitability could be higher in patients with complex neurological auras than in those having pure visual auras or in healthy volunteers.

Original languageEnglish
Article number92
JournalJournal of Headache and Pain
Issue number1
Publication statusPublished - Dec 1 2015


  • Complex aura
  • Cortical excitability
  • Habituation
  • Migraine with aura
  • Visual aura
  • Visual evoked potentials

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology


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