Clinical and neurophysiological effects of topiramate in chronic migraine

DOI: https://doi.org/10.29296/25877305-2018-11-14
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Issue: 
11
Year: 
2018

V. Shevchenko(1); A. Artemenko(1), MD; A. Kurenkov(2), MD; M. Bzhilyansky(3), Candidate of Medical Sciences; F. Bushkov(3), Candidate of Medical Sciences 1-I.M. Sechenov First Moscow State Medical University (Sechenov University) 2-Research Medical Center for Children’s Health, Ministry of Health of Russia, Moscow 3-Preodolenie (Overcoming) Rehabilitation Center, Moscow

In order to clarify the mechanism of analgesic action of topiramate in the prophylactic treatment of chronic migraine (CM), the time course of changes in the clinical indicators of the severity of cephalgia and in cortical excitability by transcranial magnetic stimulation (TMS) was studied in 42 patients with CM. After 3 months of treatment with topiramate (100 mg/day), along with a significant decrease in the frequency of headache, there was a significant increase in the thresholds of evoked motor responses and in the threshold for phosphenesis in the absence of changes in the silent period duration. The results of the investigation made it possible to clarify the central effects of topiramate in CM in reducing visual and motor cortical neuronal excitability in the presence of stability of the cortical inhibition mechanisms estimated by TMS.
Keywords: 
neurology
chronic migraine
topiramate
prophylactic treatment
transcranial magnetic stimulation
cortical hyperexcitability
cortical inhibition
threshold for phosphenesis
threshold of evoked motor response
silent period

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