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Objectives: Currently, there is no scoring system for assessing the complexity of migraine aura. Our goal was to develop a Migraine Aura Complexity Score that synthesizes the quantity and quality of aura symptoms and to test its applicability in neuroimaging studies.Methods: Patients with migraine aura were interviewed in order to obtain characteristics of migraine aura. Explorative and confirmatory analyses were used to develop the Migraine Aura Complexity Score. Median values were derived from 10 consecutive migraine auras in each patient. The Migraine Aura Complexity Score was correlated with an average cortical thickness of different brain areas in studied patients. The Surface-based Morphometric Analysis approach was used to estimate cortical thickness.Results: This study included 23 (16 females and seven males) migraineurs with aura. Confirmatory factor analysis suggested the second-order model with three-factor measurement for grading migraine aura. The first factor is linked to higher cortical dysfunction during migraine aura, while the second is associated with the degree of involvement of primary visual and somatosensory cortices; the third linked symptoms of somatosensory aura and hand and head involvement. Positive correlation of Migraine Aura Complexity Score and averaged cortical thickness were found in the left and right hemispheres overall (r = 0.568, p = 0.007; r = 0.617, p = 0.003) and in some of their regions.Conclusions: This study demonstrates that the Migraine Aura Complexity Score could be a valuable tool for assessing migraine aura. The score could be used in neuroradiological studies in order to achieve a stratification of patients with migraine aura. [ABSTRACT FROM AUTHOR]

Although migraine represents one of the most common form of primary headache in the teenage population, most neurophysiologic studies are only on the adulthood. We investigated 38 teenage patients with migraine with aura, 17 male and 21 female, with a mean age of 16.2 years, comparing them with gender- and age-matched patients with migraine without aura and healthy subjects. Also, characteristics of aura were correlated with pattern-reversal visual evoked potential parameters. There was a significant difference in left and right eye N2 wave latencies between migraine with aura and migraine without aura patients or healthy controls. In migraine with aura and migraine without aura, 26.3% of patients had abnormal wave latency. Reported tunnel vision during the aura was correlated with lower N1P1 and/or P1N2 wave amplitudes. Also, higher amplitude in patients with migraine with aura correlated with younger age and earlier disease onset, whereas longer aura duration correlated with prolonged wave latency. Findings suggest that migraine subtypes may be differentiated on the basis of N2 wave latency prolongation. [ABSTRACT FROM AUTHOR]

A response from the authors of the article "Pattern-reversal visual evoked potential parameters and migraine in the teenage population" in the 2016 issue is presented.

Patients with migraine with aura often experience a variety of visual and somatosensory phenomena and disturbances of higher cortical functions. Analysis of these alterations may provide important information about the involvement of different cortical regions in cortical spreading depression (CSD). We report five cases of migraineurs who experience unusually abundant clinical phenomena during auras. These patients were selected from a cohort of migraine with aura patients who were interviewed, using a specially designed questionnaire, to evaluate the presence of higher cortical dysfunctions. On the basis of the aura symptoms they reported, we attempted to infer the origin and the possible paths of CSD in each patient. According to their reported symptoms, CSD could begin in the primary visual cortex, in the primary somatosensory cortex or simultaneously in both, and propagate to the posterior parietal cortex, the temporal lobe and Broca's area. We believe that clinical descriptions of aura could play an important role in further investigations of the pathophysiology of migraine.