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Wolf-Dieter Gerber

Publications and source records attributed to Wolf-Dieter Gerber.

7 recordsLinked to original sources

Neurophysiological reactivity before a migraine attack.

Migraine patients are characterized by increased amplitudes and reduced habituation of the contingent negative variation (CNV) response, especially before a migraine attack. As shown previously, migraine provoking and precipitating agents can cause CNV abnormalities. However, it is unclear whether the temporal relation to the migraine attack determines how the brain reacts to a migraine precipitant. In this study, experimentally-induced achievement stress, one of the typical precipitants for migraine, was examined for its effects upon the CNV response. CNV was recorded during conditions of rest and stress, both before and after a migraine attack, as well as during a headache-free interval. The neurophysiological reactivity to stress in migraineurs was compared with those of healthy subjects. Before a migraine attack, migraine patients demonstrated significantly more pronounced neurophysiological reactivity to stress: the amplitude of the early CNV component was more increased and its habituation was more reduced in the stress condition, especially 1-3 days before an attack compared with changes of CNV amplitudes and habituation under stress obtained after an attack, during the headache-free interval, or in healthy controls. The study demonstrates that the brain of migraine patients is characterized by increased susceptibility to migraine provoking agents before an actual attack.

Adult↗

Slow cortical potentials in migraine families are associated with psychosocial factors.

OBJECTIVE: The aim of the study was the determination of the relationships between neurophysiological and psychosocial factors within the pathogenesis of migraine. METHODS: The contingent negative variation (CNV), parent-child interactions and theirs relationship were investigated in 30 families with a migraine child and 20 healthy families. RESULTS: (1) None of the groups of children, independent of diagnosis, differed according to amplitude or habituation of the CNV. (2) Parents from migraine families exerted significantly more control over migraine children compared with interactions with healthy brothers/sisters. (3) The strong relation between CNV habituation/amplitude and abnormal pattern of parent-child interactions (especially overwhelming dominance and control) was found only for young migraineurs. This relation was not seen in healthy families or for healthy siblings of migraine children. CONCLUSION: This study provides significant evidence for a strong influence of family interactions on the development and maintenance of neurophysiological abnormalities in the migraineous headache. The role of psychosocial factors in the etiopathogenesis of migraine has to be investigated in further studies in more detail.

Adult↗

On the pathophysiology of migraine--links for "empirically based treatment" with neurofeedback.

Psychophysiological data support the concept that migraine is the result of cortical hypersensitivity, hyperactivity, and a lack of habituation. There is evidence that this is a brain-stem related information processing dysfunction. This cortical activity reflects a periodicity between 2 migraine attacks and it may be due to endogenous or exogenous factors. In the few days preceding the next attack slow cortical potentials are highest and habituation delay experimentally recorded during contingent negative variation is at a maximum. These striking features of slow cortical potentials are predictors of the next attack. The pronounced negativity can be fed back to the patient. The data support the hypothesis that a change in amplitudes of slow cortical potentials is caused by altered habituation during the recording session. This kind of neurofeedback can be characterized as "empirically based" because it improves habituation and it proves to be clinically efficient.

Adolescent↗

[Role of family in development of neurophysiological manifestations in children with migraine].

Migraine is a familial disorder. The aim of this study was to compare the relationship between specific neurophysiologic pathogenetic mechanisms of migraine such as abnormal information processing and enhanced cortical excitability on the one hand, and parent-child-interactions and personality traits such as neuroticism and extraversion on the other hand in migraine and healthy families. The correlation and factor analyses demonstrated that the stronger the control over a child and the more intensive the suppression of a child's independence by a parent during a stressful situation in migraine families, the more pronounced the loss of habituation of the contingent negative variation (CNV), and the greater the neuroticism in a migraine child. The CNV amplitude was independent of psychosocial conditions in the family but represented similarities in information processing between parents and their children suffering from migraine. This could be possibly explained by genetic influences on information processing in migraine. In healthy families only the relationship between parameters of parent-child-interaction could be observed. This investigation demonstrates that the neurophysiological disposition to a migraine attack as well as personality traits in migraine could be influenced by psychosocial factors such as parent-child interactions and that different parameters of information processing in headache patients are related to either non-genetic familial conditions (habituation) or functional genetic factors (amplitude).

Arousal↗

Contingent negative variation in subjects at risk for migraine without aura.

Migraine is a complex disease with a significant genetic background. One possible strategy to investigate the genetics of migraine is the evaluation of functional vulnerability markers or biological elementary endophenotypes in individuals with the greatest probability of developing the disorder (high-risk design). In this study the contingent negative variation (CNV) was recorded in 35 high-risk subjects with a positive family history of migraine without aura (FHP), 35 low-risk individuals without a positive family history (FHN), and 35 migraineurs (migraine without aura). FHP subjects and migraine patients differed significantly from FHN individuals with regard to amplitude and habituation slope of the early CNV component (initial CNV or iCNV). FHP participants demonstrated the same iCNV abnormalities and distribution among iCNV characteristics as migraineurs. The amplitude of the iCNV correlated significantly with the relative number of subjects suffering from migraine among first- and second-degree relatives. The higher the density of affected individuals in the family, the more pronounced were the CNV abnormalities in relatives. This study provides evidence that the familial factor contributes to the abnormal amplitude, and to a lesser degree, habituation of the iCNV, and that the iCNV may be used as a functional-genetic vulnerability marker in further research of migraine genetics.

Adolescent↗

Changes in cortical dynamics in the preictal stage of a migraine attack.

Neurophysiologic studies suggest that migraineurs without aura have a dysfunction of cortical information processing in the pain-free interval. In this study, the advanced method of nonlinear multielectrode sleep-EEG analysis is used to investigate changes of cortical activity in the preictal time span. Five patients (four women, one man; age range, 29 to 58 years) experiencing migraine without aura participated in the study. The patients spent two blocks in the sleep laboratory. The first block was taken in a headache-free interictal time interval, and the second block when the onset of a migraine attack was most likely. After a nocturnal migraine attack, the patient was asked to mark the maximum of migraine pain in a surface-head scheme. The comparison of preictal and interictal EEGs enabled the authors to obtain a topographical view of changes in cortical dynamics. In each patient map, an area was found that displayed a pronounced focus indicating the region of maximum change in dimensional complexity. It shows a clearly recognizable correspondence with the scalp topography of the later pain perception. These findings indicate an association between cortical status and pain lateralization in the preictal time span.

Adult↗

Slow cortical potentials in migraine. Predictive value and possible novel therapeutic strategies to prevent an attack.

During the pain-free interval migraine patients display increased negative amplitudes in recordings of slow cortical potentials compared to healthy controls. This fact can be linked to diminished or absent habituation during the recording session. This difference in amplitude and habituation is at its maximum the day before the migraine attack. After the attack, amplitudes and habituation course are comparable with those of healthy controls. This observation enables the migraine patient to predict the next migraine attack and to become acquainted with other symptoms which indicate an imminent attack and which can be present one or two days before it. During this period, when the attack has begun but the pain has not yet developed, novel therapeutic strategies for preventing the full-blown attack can be introduced. These "pre-emptive" strategies--which may include intake of tranquillizers to reduce the high cortical arousal, but also non-medical relaxation methods--constitute neither acute treatment (because there is no acute pain) nor prophylaxis.

Adult↗