Visual evoked potentials in migraine: Is the “neurophysiological hallmark” concept still valid?

- Habituation measured by visual evoked potentials (VEPs) were not significantly different between persons with and without migraine.
- Lack of VEP habituation is not a reliable “neurophysiological hallmark” in interictal migraine.
- Strict focus on methodology, including blinding during the recording and assessment of VEP, is important to avoid overestimation of effect sizes in future studies.

ObjectiveLack of habituation is considered a neurophysiological hallmark of migraine. However, the results of visual evoked potential (VEP) studies have been discrepant, possibly because of different stimulation parameters and lack of blinding. Hence, there is a need for independent confirmation of lack of VEP habituation in migraine. In this blinded study we applied 16′ checks to supplement our previous findings with 8′, 31′, 62′ and 65′ checks.MethodsVEPs in 41 interictal migraineurs and 30 controls were compared. VEPs were recorded in six blocks of 100 single responses. Linear N70-P100 amplitude change over blocks (habituation slope) was compared with an independent samples Student's t-test.ResultsAmplitude decline over blocks was observed in both groups. Habituation slope was not significantly different between controls (−0.43 ± 0.54 μV/block) and migraineurs (−0.29 ± 0.35 μV/block) (p = 0.33).ConclusionVEP habituation with 16′ checks did not differ in migraineurs and controls. This is in agreement with previous findings with other stimulation parameters. It is therefore unlikely that use of different stimulation parameters could explain the discrepant results of previous studies. No studies that applied blinding during recording of VEP have found lack of habituation in migraineurs.SignificanceLack of VEP habituation cannot be considered a reliable neurophysiological hallmark in migraine.