Table 2.
Comparison of unique aspects of cortical spreading depression with the findings in migraine
| CSD in rodents | CSD in primates | CSD in humans (TBI, SAH) | During Migraine Aura | During Migraine Headache Without Aura | |
|---|---|---|---|---|---|
| DC shift accompanying electrical silence | + | + | + | Not detected a | Not detected a |
| ADC decrease DWI change | + | + | + | Negative even in FHM patients with neurological deficit lasting days | – |
| Propagation speed of DC shift | 2–6 mm/min | 4 mm/min | 1.6–5.9 mm/min | – | – |
| Area occupied by DC shift | Whole cerebral hemisphere | Limited to a few gyruses | Limited to few centimeters | – | – |
| Spreading hyperemia |
+ 20 s following a DC shift |
+ Following a DC shift |
+ Following a DC shift lasting 680 s |
Focal hyperemic areas, focal oligemic areas and global oligemia (3 cases, 9) Multifocal hyperemia (3 cases, 11 attacks, after 19 h during prolonged aura, 95) Propagating increased BOLD response followed by reduced BOLD signal, (1 case, 35) |
– |
| Spreading oligemia |
+ Few minutes Following a DC shift |
No oligemia detected | + |
Spreading oligemia towards the end of the visual aura (5 cases, 46), Anteriorly progressing oligemia irrelevant to aura symptoms in time and location (45) Multifocal oligemia (3 cases, 95) Spreading BOLD suppression (2 cases,49; 3 cases, 35) |
Spreading BOLD suppression (6 cases) (in case 3 right sided HA + suppression on the left side) (49) Bilateral spreading oligemia (1 case, 48) Focal oligemia (2 cases, 92) |
| Area occupied by hyperemia/oligemia | Whole cerebral hemisphere | Limited to a few gyruses | Limited to few centimeters | Global reduction in the hemisphere (9, 45, 95), occipital cortex (35, 49) |
Whole brain from occipital pole to temporal pole (48) Occipital lobe (49) |
| Propagation speed of hyperemia/oligemia | 2–6 mm/min | NA | NA |
2 mm/min, 3.1 mm/min 2.9–5.3 mm/min Detected during aura and end of aura (35, 45, 49) |
3 mm/min |
a See text for comments on MEG DC shifts