Skip to main content
The Journal of Headache and Pain logoLink to The Journal of Headache and Pain
. 2009 Aug 25;10(5):331–339. doi: 10.1007/s10194-009-0140-4

Interictal quantitative EEG in migraine: a blinded controlled study

Marte Helene Bjørk 1,, Lars J Stovner 1,3, Morten Engstrøm 2, Marit Stjern 1,3, Knut Hagen 1,3, Trond Sand 1,2
PMCID: PMC3452093  PMID: 19705061

Abstract

Abnormal electroencephalography (EEG) in migraineurs has been reported in several studies. However, few have evaluated EEG findings in migraineurs during a time period when neither the last attack nor the next attack may interact with the results. We, therefore, compared interictal EEG in migraineurs and headache-free subjects with a design controlled for interference by pre-ictal changes. Pre-ictal EEG findings in the painful cranial side during the next attack after registration were also investigated. Correlations between clinical variables and EEG are reported as well. Interictal EEGs from 33 migraineurs (6 with and 27 without aura) and 31 controls were compared. Absolute power, asymmetry and relative power were studied for delta, theta and alpha frequency bands in parieto-occipital, temporal and fronto-central areas. EEG variables were correlated to attack frequency, headache duration, attack duration, pain intensity, photo- and phonophobia. Compared with controls, migraineurs had increased relative theta power in all cortical regions and increased delta activity in the painful fronto-central region. Absolute power and asymmetry were similar among groups. In age-adjusted analyses, headache intensity correlated with increased delta activity. In this blinded controlled study, we found globally increased relative theta activity in migraineurs. A slight interictal brain dysfunction is probably present between attacks.

Keywords: Migraine, Headache, Hemicrania, QEEG, Delta, Theta

Full Text

The Full Text of this article is available as a PDF (215.0 KB).

Acknowledgments

We are most grateful for the assistance of Grethe Helde, Gøril Bruvik Gravdahl, Nikita Zhitniy. The Norwegian University of Science and Technology (NTNU), The Research Council of Norway and The Norwegian National Headache Centre provided funding.

Conflict of interest

None.

Footnotes

An invited commentary on this article can be found at doi:10.1007/s10194-009-0149-8.

References

  • 1.Bigal ME, Ferrari M, Silberstein SD, Lipton RB, Goadsby PJ. Migraine in the triptan era: lessons from epidemiology, pathophysiology, and clinical science. Headache. 2009;49(Suppl 1):S21–S33. doi: 10.1111/j.1526-4610.2008.01336.x. [DOI] [PubMed] [Google Scholar]
  • 2.Vingen JV, Pareja JA, Storen O, White LR, Stovner LJ. Phonophobia in migraine. Cephalalgia. 1998;18(5):243–249. doi: 10.1046/j.1468-2982.1998.1805243.x. [DOI] [PubMed] [Google Scholar]
  • 3.Silberstein SD. Migraine symptoms: results of a survey of self-reported migraineurs. Headache. 1995;35(7):387–396. doi: 10.1111/j.1526-4610.1995.hed3507387.x. [DOI] [PubMed] [Google Scholar]
  • 4.Vingen JV, Sand T, Stovner LJ. Sensitivity to various stimuli in primary headaches: a questionnaire study. Headache. 1999;39(8):552–558. doi: 10.1046/j.1526-4610.1999.3908552.x. [DOI] [PubMed] [Google Scholar]
  • 5.Blau JN, Solomon F. Smell and other sensory disturbances in migraine. J Neurol. 1985;232(5):275–276. doi: 10.1007/BF00313864. [DOI] [PubMed] [Google Scholar]
  • 6.Vanagaite J, Pareja JA, Storen O, White LR, Sand T, Stovner LJ. Light-induced discomfort and pain in migraine. Cephalalgia. 1997;17(7):733–741. doi: 10.1046/j.1468-2982.1997.1707733.x. [DOI] [PubMed] [Google Scholar]
  • 7.Weiller C, May A, Limmroth V, Jüptner M, Kaube H, Schayck RV, et al. Brain stem activation in spontaneous human migraine attacks. Nat Med. 1995;1(7):658–660. doi: 10.1038/nm0795-658. [DOI] [PubMed] [Google Scholar]
  • 8.Bahra A, Matharu MS, Buchel C, Frackowiak RS, Goadsby PJ. Brainstem activation specific to migraine headache. Lancet. 2001;357(9261):1016–1017. doi: 10.1016/S0140-6736(00)04250-1. [DOI] [PubMed] [Google Scholar]
  • 9.Kaube H, Katsarava Z, Przywara S, Drepper J, Ellrich J, Diener HC. Acute migraine headache: possible sensitization of neurons in the spinal trigeminal nucleus? Neurology. 2002;58(8):1234–1238. doi: 10.1212/wnl.58.8.1234. [DOI] [PubMed] [Google Scholar]
  • 10.Schoenen J, Wang W, Albert A, Delwaide PJ. Potentiation instead of habituation characterizes visual evoked potentials in migraine patients between attacks. Eur J Neurol. 1995;2:115–122. doi: 10.1111/j.1468-1331.1995.tb00103.x. [DOI] [PubMed] [Google Scholar]
  • 11.Coppola G, Vandenheede M, Di Clemente L, Ambrosini A, Fumal A, Pasqua V, et al. Somatosensory evoked high-frequency oscillations reflecting thalamo-cortical activity are decreased in migraine patients between attacks. Brain. 2005;128(Pt 1):98–103. doi: 10.1093/brain/awh334. [DOI] [PubMed] [Google Scholar]
  • 12.Bille BS. Migraine in school children. A study of the incidence and short-term prognosis, and a clinical, psychological and electroencephalographic comparison between children with migraine and matched controls. Acta Paediatr Suppl. 1962;51(Suppl 136):1–151. [PubMed] [Google Scholar]
  • 13.Giel R, Vlieger M, Vliet AG. Headache and the EEG. Electroencephalogr Clin Neurophysiol. 1966;21(5):492–495. doi: 10.1016/0013-4694(66)90198-2. [DOI] [PubMed] [Google Scholar]
  • 14.Whitehouse D, Pappas JA, Escala PH, Livingston S. Electroencephalographic changes in children with migraine. N Engl J Med. 1967;276(1):23–27. doi: 10.1056/NEJM196701052760104. [DOI] [PubMed] [Google Scholar]
  • 15.Rowan AJ. The electroencephalographic characteristics of migraine. Arch Neurobiol (Madr) 1974;37(Suppl):95–113. [PubMed] [Google Scholar]
  • 16.Gronseth GS, Greenberg MK. The utility of the electroencephalogram in the evaluation of patients presenting with headache: a review of the literature. Neurology. 1995;45(7):1263–1267. doi: 10.1212/wnl.45.7.1263. [DOI] [PubMed] [Google Scholar]
  • 17.Sand T. EEG in migraine: a review of the literature. Funct Neurol. 1991;6(1):7–22. [PubMed] [Google Scholar]
  • 18.Schoenen J. Clinical neurophysiology studies in headache: a review of data and pathophysiological hints. Funct Neurol. 1992;40(4):191–204. [PubMed] [Google Scholar]
  • 19.Sand T. Electroencephalography in migraine: a review with focus on quantitative electroencephalography and the migraine vs. epilepsy relationship. Cephalalgia. 2003;23(Suppl 1):5–11. doi: 10.1046/j.1468-2982.2003.00570.x. [DOI] [PubMed] [Google Scholar]
  • 20.Farkas V, Benninger C, Matthis P, Scheffner D, Lindeisz F. The EEG background activity in children with migraine. Cephalalgia. 1987;6:59–64. doi: 10.1177/03331024870070s619. [DOI] [PubMed] [Google Scholar]
  • 21.Neufeld MY, Treves TA, Korczyn AD. EEG and topographic frequency analysis in common and classic migraine. Headache. 1991;31(4):232–236. doi: 10.1111/j.1526-4610.1991.hed3104232.x. [DOI] [PubMed] [Google Scholar]
  • 22.Lia C, Carenini L, Degioz C, Bottachi E. Computerized EEG analysis in migraine patients. Ital J Neurol Sci. 1995;16(4):249–254. doi: 10.1007/BF02282996. [DOI] [PubMed] [Google Scholar]
  • 23.Bramanti P, Grugno R, Vitetta A, Di Bella P, Muscara N, Nappi G. Migraine with and without aura: electrophysiological and functional neuroimaging evidence. Funct Neurol. 2005;20(1):29–32. [PubMed] [Google Scholar]
  • 24.Genco S, Tommaso M, Prudenzano AM, Savarese M, Puca FM. EEG features in juvenile migraine: topographic analysis of spontaneous and visual evoked brain electrical activity: a comparison with adult migraine. Cephalalgia. 1994;14(1):41–46. doi: 10.1046/j.1468-2982.1994.1401041.x. [DOI] [PubMed] [Google Scholar]
  • 25.Jonkman EJ, Lelieveld MH. EEG computer analysis in patients with migraine. Electroencephalogr Clin Neurophysiol. 1981;52(6):652–655. doi: 10.1016/0013-4694(81)91440-1. [DOI] [PubMed] [Google Scholar]
  • 26.Rainero I, Amanzio M, Vighetti S, Bergamasco B, Pinessi L, Benedetti F. Quantitative EEG responses to ischaemic arm stress in migraine. Cephalalgia. 2001;21(3):224–229. doi: 10.1046/j.1468-2982.2001.00209.x. [DOI] [PubMed] [Google Scholar]
  • 27.Vonderheid-Guth B, Todorova A, Wedekind W, Dimpfel W. Evidence for neuronal dysfunction in migraine: concurrence between specific qEEG findings and clinical drug response—a retrospective analysis. Eur J Med Res. 2000;5(11):473–483. [PubMed] [Google Scholar]
  • 28.Facchetti D, Marsile C, Faggi L, Donati E, Kokodoko A, Poloni M. Cerebral mapping in subjects suffering from migraine with aura. Cephalalgia. 1990;10(6):279–284. doi: 10.1046/j.1468-2982.1990.1006279.x. [DOI] [PubMed] [Google Scholar]
  • 29.Bjork M, Sand T. Quantitative EEG power and asymmetry increase 36 h before a migraine attack. Cephalalgia. 2008;28(9):960–968. doi: 10.1111/j.1468-2982.2008.01638.x. [DOI] [PubMed] [Google Scholar]
  • 30.Sand T, Zhitniy N, Nilsen KB, Helde G, Hagen K, Stovner LJ. Thermal pain thresholds are decreased in the migraine preattack phase. Eur J Neurol. 2008;15(11):1199–1205. doi: 10.1111/j.1468-1331.2008.02276.x. [DOI] [PubMed] [Google Scholar]
  • 31.Sand T, Vingen JV. Visual, long-latency auditory and brainstem auditory evoked potentials in migraine: relation to pattern size, stimulus intensity, sound and light discomfort thresholds and pre-attack state. Cephalalgia. 2000;20(9):804–820. doi: 10.1046/j.1468-2982.2000.00098.x. [DOI] [PubMed] [Google Scholar]
  • 32.Judit A, Sandor PS, Schoenen J. Habituation of visual and intensity dependence of auditory evoked cortical potentials tends to normalize just before and during the migraine attack. Cephalalgia. 2000;20(8):714–719. doi: 10.1111/j.1468-2982.2000.00122.x. [DOI] [PubMed] [Google Scholar]
  • 33.Fritzer G, Strenge H, Goder R, Gerber WD, Aldenhoff J. Changes in cortical dynamics in the preictal stage of a migraine attack. J Clin Neurophysiol. 2004;21(2):99–104. doi: 10.1097/00004691-200403000-00004. [DOI] [PubMed] [Google Scholar]
  • 34.Kropp P, Gerber WD. Prediction of migraine attacks using a slow cortical potential, the contingent negative variation. Neurosci Lett. 1998;257(2):73–76. doi: 10.1016/S0304-3940(98)00811-8. [DOI] [PubMed] [Google Scholar]
  • 35.Siniatchkin M, Gerber WD, Kropp P, Vein A. How the brain anticipates an attack: a study of neurophysiological periodicity in migraine. Funct Neurol. 1999;14(2):69–77. [PubMed] [Google Scholar]
  • 36.Bowyer SM, Aurora KS, Moran JE, Tepley N, Welch KM. Magnetoencephalographic fields from patients with spontaneous and induced migraine aura. Ann Neurol. 2001;50(5):582–587. doi: 10.1002/ana.1293. [DOI] [PubMed] [Google Scholar]
  • 37.Sand T, Zhitniy N, White LR, Stovner LJ. Brainstem auditory-evoked potential habituation and intensity-dependence related to serotonin metabolism in migraine: a longitudinal study. Clin Neurophysiol. 2008;119(5):1190–1200. doi: 10.1016/j.clinph.2008.01.007. [DOI] [PubMed] [Google Scholar]
  • 38.Sand T, Zhitniy N, White LR, Stovner LJ. Visual evoked potential latency, amplitude and habituation in migraine: a longitudinal study. Clin Neurophysiol. 2008;119(5):1020–1027. doi: 10.1016/j.clinph.2008.01.009. [DOI] [PubMed] [Google Scholar]
  • 39.Kruit MC, Launer LJ, Buchem MA, Terwindt GM, Ferrari MD. MRI findings in migraine. Rev Neurol. 2005;128(Pt 9):661–665. doi: 10.1016/s0035-3787(05)85110-0. [DOI] [PubMed] [Google Scholar]
  • 40.Kruit MC, Buchem MA, Hofman PA, Bakkers JT, Terwindt GM, Ferrari MD, et al. Migraine as a risk factor for subclinical brain lesions. JAMA. 2004;291(4):427–434. doi: 10.1001/jama.291.4.427. [DOI] [PubMed] [Google Scholar]
  • 41.Kruit MC, Launer LJ, Ferrari MD, Buchem MA. Brain stem and cerebellar hyperintense lesions in migraine. Stroke. 2006;37(4):1109–1112. doi: 10.1161/01.STR.0000206446.26702.e9. [DOI] [PubMed] [Google Scholar]
  • 42.Kruit MC, Launer LJ, Ferrari MD, Buchem MA. Infarcts in the posterior circulation territory in migraine. The population-based MRI CAMERA study. Brain. 2005;128(Pt 9):2068–2077. doi: 10.1093/brain/awh542. [DOI] [PubMed] [Google Scholar]
  • 43.Rozen TD. Vanishing cerebellar infarcts in a migraine patient. Cephalalgia. 2007;27(6):557–560. doi: 10.1111/j.1468-2982.2007.01317.x. [DOI] [PubMed] [Google Scholar]
  • 44.Valfre W, Rainero I, Bergui M, Pinessi L. Voxel-based morphometry reveals gray matter abnormalities in migraine. Headache. 2008;48(1):109–117. doi: 10.1111/j.1526-4610.2007.00723.x. [DOI] [PubMed] [Google Scholar]
  • 45.Rocca MA, Ceccarelli A, Falini A, Colombo B, Tortorella P, Bernasconi L, et al. Brain gray matter changes in migraine patients with T2-visible lesions: a 3-T MRI study. Stroke. 2006;37(7):1765–1770. doi: 10.1161/01.STR.0000226589.00599.4d. [DOI] [PubMed] [Google Scholar]
  • 46.Finnigan SP, Walsh M, Rose SE, Chalk JB. Quantitative EEG indices of sub-acute ischaemic stroke correlate with clinical outcomes. Clin Neurophysiol. 2007;118(11):2525–2532. doi: 10.1016/j.clinph.2007.07.021. [DOI] [PubMed] [Google Scholar]
  • 47.Cohen BA, Bravo-Fernandez EJ, Sances A., Jr Quantification of computer analyzed serial EEGs from stroke patients. Electroencephalogr Clin Neurophysiol. 1976;41(4):379–386. doi: 10.1016/0013-4694(76)90100-0. [DOI] [PubMed] [Google Scholar]
  • 48.Nuwer MR, Jordan SE, Ahn SS. Evaluation of stroke using EEG frequency analysis and topographic mapping. Neurology. 1987;37(7):1153–1159. doi: 10.1212/wnl.37.7.1153. [DOI] [PubMed] [Google Scholar]
  • 49.Headache Classification Committee of the International Headache Society Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 2004;24(Suppl 1):1–160. [PubMed] [Google Scholar]
  • 50.Bjork MH, Stovner LJ, Nilsen BM, Stjern M, Hagen K, Sand T. The occipital alpha rhythm related to the “migraine cycle” and headache burden: a blinded, controlled longitudinal study. Clin Neurophysiol. 2009;120(3):464–471. doi: 10.1016/j.clinph.2008.11.018. [DOI] [PubMed] [Google Scholar]
  • 51.Clemens B, Bank J, Piros P, Bessenyei M, Veto S, Toth M, et al. Three-dimensional localization of abnormal EEG activity in migraine: a low resolution electromagnetic tomography (LORETA) study of migraine patients in the pain-free interval. Brain Topogr. 2008;21(1):36–42. doi: 10.1007/s10548-008-0061-6. [DOI] [PubMed] [Google Scholar]
  • 52.Hughes JR, Robbins LD. Brain mapping in migraine. Clin Electroencephalogr. 1990;21(1):14–24. doi: 10.1177/155005949002100110. [DOI] [PubMed] [Google Scholar]
  • 53.Klimesch W, Freunberger R, Sauseng P, Gruber W. A short review of slow phase synchronization and memory: evidence for control processes in different memory systems? Brain Res. 2008;1235:31–44. doi: 10.1016/j.brainres.2008.06.049. [DOI] [PubMed] [Google Scholar]
  • 54.Steriade M, Gloor P, Linas R, Lopes da Silva F, Mesulam MM. Report of IFCN Committee on Basic Mechanisms. Basic mechanisms of cerebral rhythmic activities. Electroencephalogr Clin Neurophysiol. 1990;76(76):481–508. doi: 10.1016/0013-4694(90)90001-z. [DOI] [PubMed] [Google Scholar]
  • 55.Buzsaki G. Theta oscillations in the hippocampus. Neuron. 2002;33(3):325–340. doi: 10.1016/S0896-6273(02)00586-X. [DOI] [PubMed] [Google Scholar]
  • 56.Vertes RP, Kocsis B. Brainstem-diencephalo-septohippocampal systems controlling the theta rhythm of the hippocampus. Neuroscience. 1997;81(4):893–926. doi: 10.1016/S0306-4522(97)00239-X. [DOI] [PubMed] [Google Scholar]
  • 57.McCormick DA. Neurotransmitter actions in the thalamus and cerebral cortex and their role in neuromodulation of thalamocortical activity. Prog Neurobiol. 1992;39(4):337–388. doi: 10.1016/0301-0082(92)90012-4. [DOI] [PubMed] [Google Scholar]
  • 58.Ingvar DH, Sjolund B, Ardo A. Correlation between dominant EEG frequency, cerebral oxygen uptake and blood flow. Electroencephalogr Clin Neurophysiol. 1976;41(3):268–276. doi: 10.1016/0013-4694(76)90119-X. [DOI] [PubMed] [Google Scholar]
  • 59.Llinas RR, Ribary U, Jeanmonod D, Kronberg E, Mitra PP. Thalamocortical dysrhythmia: a neurological and neuropsychiatric syndrome characterized by magnetoencephalography. Proc Natl Acad Sci USA. 1999;96(26):15222–15227. doi: 10.1073/pnas.96.26.15222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 60.Tai C, Kuzmiski JB, MacVicar BA. Muscarinic enhancement of R-type calcium currents in hippocampal CA1 pyramidal neurons. J Neurosci. 2006;26(23):6249–6258. doi: 10.1523/JNEUROSCI.1009-06.2006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 61.Crunelli V, Cope DW, Hughes SW. Thalamic T-type Ca2+ channels and NREM sleep. Cell Calcium. 2006;40(2):175–190. doi: 10.1016/j.ceca.2006.04.022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 62.Schmitz N, Arkink EB, Mulder M, Rubia K, Admiraal-Behloul F, Schoonman GG, et al. Frontal lobe structure and executive function in migraine patients. Neurosci Lett. 2008;440(2):92–96. doi: 10.1016/j.neulet.2008.05.033. [DOI] [PubMed] [Google Scholar]
  • 63.Thomsen LL, Oestergaard E, Bjornsson A, Stefansson H, Fasquel AC, Gulcher J, et al. Screen for CACNA1A and ATP1A2 mutations in sporadic hemiplegic migraine patients. Cephalalgia. 2008;28(9):914–921. doi: 10.1111/j.1468-2982.2008.01599.x. [DOI] [PubMed] [Google Scholar]
  • 64.Jen JC, Kim GW, Dudding KA, Baloh RW. No mutations in CACNA1A and ATP1A2 in probands with common types of migraine. Arch Neurol. 2004;61(6):926–928. doi: 10.1001/archneur.61.6.926. [DOI] [PubMed] [Google Scholar]
  • 65.Schoenen J, Jamart B, Delwaide PJ. Cartographie electroencephalographique dans les migraines en periodes critique et intercritique. Rev Electroencephalogr Neurophysiol Clin. 1987;17(3):289–299. doi: 10.1016/S0370-4475(87)80066-7. [DOI] [PubMed] [Google Scholar]
  • 66.Tommaso M, Sciruicchio V, Guido M, Sasanelli G, Specchio LM, Puca FM. EEG spectral analysis in migraine without aura attacks. Cephalalgia. 1998;18(6):324–328. doi: 10.1046/j.1468-2982.1998.1806324.x. [DOI] [PubMed] [Google Scholar]
  • 67.Fritzer G, Strenge H, Göder R, Gerber WD, Aldenhoff J. Changes in cortical dynamics in the preictal stage of a migraine attack. J Clin Neurophysiol. 2004;21(2):99–104. doi: 10.1097/00004691-200403000-00004. [DOI] [PubMed] [Google Scholar]
  • 68.Gloor P, Ball G, Schaul N. Brain lesions that produce delta waves in the EEG. Neurology. 1977;27(4):326–333. doi: 10.1212/wnl.27.4.326. [DOI] [PubMed] [Google Scholar]
  • 69.Rocca MA, Ceccarelli A, Falini A, Tortorella P, Colombo B, Pagani E, et al. Diffusion tensor magnetic resonance imaging at 3.0 T shows subtle cerebral grey matter abnormalities in patients with migraine. J Neurol Neurosurg Psychiatry. 2006;77(5):686–689. doi: 10.1136/jnnp.2005.080002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 70.Schmitz N, Admiraal-Behloul F, Arkink EB, Kruit MC, Schoonman GG, Ferrari MD, et al. Attack frequency and disease duration as indicators for brain damage in migraine. Headache. 2008;48(7):1044–1055. doi: 10.1111/j.1526-4610.2008.01133.x. [DOI] [PubMed] [Google Scholar]
  • 71.Waldie KE, Hausmann M, Milne BJ, Poulton R. Migraine and cognitive function: a life-course study. Neurology. 2002;59(6):904–908. doi: 10.1212/wnl.59.6.904. [DOI] [PubMed] [Google Scholar]
  • 72.Cabeza R. Hemispheric asymmetry reduction in older adults: the HAROLD model. Psychol Aging. 2002;17(1):85–100. doi: 10.1037/0882-7974.17.1.85. [DOI] [PubMed] [Google Scholar]
  • 73.Salinsky MC, Oken BS, Storzbach D, Dodrill CB. Assessment of CNS effects of antiepileptic drugs by using quantitative EEG measures. Epilepsia. 2003;44(8):1042–1050. doi: 10.1046/j.1528-1157.2003.60602.x. [DOI] [PubMed] [Google Scholar]
  • 74.Clemens B, Menes A, Piros P, Bessenyei M, Altmann A, Jerney J, et al. Quantitative EEG effects of carbamazepine, oxcarbazepine, valproate, lamotrigine, and possible clinical relevance of the findings. Epilepsy Res. 2006;70(2–3):190–199. doi: 10.1016/j.eplepsyres.2006.05.003. [DOI] [PubMed] [Google Scholar]
  • 75.Perneger TV. What’s wrong with Bonferroni adjustments. BMJ. 1998;316(7139):1236–1238. doi: 10.1136/bmj.316.7139.1236. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 76.Feise RJ. Do multiple outcome measures require p value adjustment? BMC Med Res Methodol. 2002;2:8. doi: 10.1186/1471-2288-2-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 77.Schulz KF, Grimes DA. Multiplicity in randomised trials I: endpoints and treatments. Lancet. 2005;365(9470):1591–1595. doi: 10.1016/S0140-6736(05)66461-6. [DOI] [PubMed] [Google Scholar]

Articles from The Journal of Headache and Pain are provided here courtesy of BMC

RESOURCES