Cortical hot spots and labyrinths: why cortical neuromodulation for episodic migraine with aura should be personalized

Frontiers in Computational Neuroscience
M A DahlemJürgen Kurths

Abstract

Stimulation protocols for medical devices should be rationally designed. For episodic migraine with aura we outline model-based design strategies toward preventive and acute therapies using stereotactic cortical neuromodulation. To this end, we regard a localized spreading depression (SD) wave segment as a central element in migraine pathophysiology. To describe nucleation and propagation features of the SD wave segment, we define the new concepts of cortical hot spots and labyrinths, respectively. In particular, we firstly focus exclusively on curvature-induced dynamical properties by studying a generic reaction-diffusion model of SD on the folded cortical surface. This surface is described with increasing level of details, including finally personalized simulations using patient's magnetic resonance imaging (MRI) scanner readings. At this stage, the only relevant factor that can modulate nucleation and propagation paths is the Gaussian curvature, which has the advantage of being rather readily accessible by MRI. We conclude with discussing further anatomical factors, such as areal, laminar, and cellular heterogeneity, that in addition to and in relation to Gaussian curvature determine the generalized concept of cortical hot s...Continue Reading

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Citations

Feb 23, 2017·International Journal for Numerical Methods in Biomedical Engineering·Julia M KroosLuca Gerardo-Giorda
Feb 13, 2018·IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society·Gehan AbouelseoudJaidaa Mekky
Mar 30, 2019·Cephalalgia : an International Journal of Headache·Else A TolnerKatharina Eikermann-Haerter

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