TRANSCRANIAL DIRECT STIMULATION (TDCS) CAN MODULATE ESOPHAGEAL MOTILITY IN GASTROESOPHAGEAL REFLUX DISEASE (GERD) PATIENTS

Cortical excitability in episodic cluster headache

Background: Cluster headache (CH) is a severe primary headache disorder, whose pathophysiological processes remain largely unknown. Along with central disinhibition of the trigeminal nociceptive system and hypothalamic impairment, a cortical involvement has been supposed. Aim: To evaluate cortical excitability in episodic CH patients by using different paradigms of transcranial magnetic stimulation (TMS). Methods: Twenty-five patients with episodic CH and thirteen healthy subjects underwent an experimental session where we evaluated, in both hemispheres, motor-cortical response to: 1) single-pulse TMS: i.e. motor threshold (MT); input-output (IO) curves and cortical silent period (CSP) and …

Efficacy and safety of topiramate in migraine prophylaxis: an open controlled randomized study comparing Sincronil and topamax formulations.

AIM: Topiramate is a small molecule widely used for the treatment of epilepsy, migraine, bipolar disorders and alcoholism, and its availability as a generic formulation could significantly reduce the National Health Service expenditure. A generic formulation, available in Italy under the trademark Sincronil, recently showed superimposable blood levels, after oral administration to healthy volunteers, with the reference formulation. In the present study we report the results of an open label, parallel group, randomized, controlled study performed to evaluate the efficacy, tolerability and impact on disability of two different formulations of topiramate (Sincronil and Topamax) in patients wit…

SHORT-TERM SYNAPTIC PLASTICITY IN MIGRAINE MOTOR CORTEX: EVIDENCE BY PRECONDITIONING OF HIGH-FREQUENCY REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (rTMS) WITH TRANSCRANIAL DIRECT CURRENT STIMULATION (tDCS).

Background: Brief 5Hz repetitive transcranial magnetic stimulation (rTMS) trains at 120% of the resting- motorthreshold (RMT) intensity determine in healthy subjects a potentiation of motor evoked potentials (MEPs), likely due to short-term presynaptic plasticity facilitation. We recently showed paradoxical intensity-dependent MEP changes to 5Hz rTMS in migraine with MEP facilitation at 110% and inhibition at 130% RMT. This provides evidence of both hyper-responsivity and self-limiting hyperexcitability capacity in migraine, likely due to earlier activation of inhibitory homeostatic plasticity mechanisms. To explore this, we applied in migraineurs cathodal transcranial Direct Current Stimul…