Motor Evoked Potential and Cortical Silent Period in Migraine

NCT07250464 | Not Yet Recruiting

• 1 other identifier: IGU-ENF-MK-1
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The primary objective of this study is to assess the level of inhibitory control in the motor cortex of migraine patients using objective and non-invasive methods. To this end, Motor Evoked Potential (MEP) and Cortical Silence Period (CSP) parameters obtained using Transcranial Magnetic Stimulation (TMS) will be measured and comparisons will be made between migraine patients and healthy controls. Since CSP duration is used specifically in the evaluation of GABA-B-mediated inhibitory mechanisms, it has the potential to directly measure the effect of migraine on cortical inhibition.

Conditions

Migraine; Healty Controls

Keywords

cortical silent period; migraine; single motor unit; transcranial magnetic stimulation

Outcome Measures

Primary Outcomes (1)

• Cortical Silent Period (CSP) Duration

  CSP duration will be recorded from the first dorsal interosseous (FDI) muscle using surface EMG during TMS. CSP reflects GABA-B-mediated cortical inhibitory mechanisms, allowing direct assessment of cortical inhibition in migraine patients compared to healthy controls.

  Single session measurement during TMS

Secondary Outcomes (1)

• Motor Evoked Potential (MEP) Amplitude

  Single session measurement during TMS

Other Outcomes (2)

• Correlation Between Neurophysiological Parameters and Disease Duration

  Single session measurement during TMS

• Single Motor Unit (SMU) Firing Rate

  Single session measurement during TMS

Study Arms (2)

Migraine Patients

EXPERIMENTAL

Adult participants aged 18-45 with a prior diagnosis of migraine according to IHS criteria. Transcranial Magnetic Stimulation (TMS) Surface Electromyography (sEMG) Needle EMG / Single Motor Unit (SMU) Recording

Other: Transcranial Magnetic Stimulation (TMS); Device: Surface Electromyography (sEMG); Other: Needle EMG / Single Motor Unit (SMU) Recording

Healthy Controls

SHAM COMPARATOR

Age- and sex-matched adults without a history of migraine or neurological disorders. They undergo the same sEMG and needle EMG/SMU procedures as the migraine group, but the TMS is sham. Surface Electromyography (sEMG) Needle EMG / Single Motor Unit (SMU) Recording Transcranial Magnetic Stimulation (TMS) SHAM

Device: Surface Electromyography (sEMG); Other: Needle EMG / Single Motor Unit (SMU) Recording

Interventions

Transcranial Magnetic Stimulation (TMS) OTHER

Non-invasive brain stimulation applied to the primary motor cortex to elicit motor evoked potentials (MEP) and cortical silent periods (CSP). 70 mm figure-of-eight coil used with Magstim 200² Monophasic Stimulator.

Migraine Patients

Surface Electromyography (sEMG) DEVICE

Bipolar Ag/AgCl electrodes placed over the first dorsal interosseous (FDI) muscle to record muscle responses to TMS.

Healthy Controls; Migraine Patients

Needle EMG / Single Motor Unit (SMU) Recording OTHER

Sterile Teflon-coated needle electrodes inserted into the FDI muscle to record activity of individual motor units during TMS and voluntary contractions.

Healthy Controls; Migraine Patients

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age 18-45 years.
• Right-handed individuals.
• Migraine patients: diagnosed according to International Headache Society (IHS) criteria.
• Healthy controls: no history of migraine or other neurological disorders.
• Able and willing to provide informed consent.

You may not qualify if:

• History of epilepsy or other seizure disorders.
• Presence of metal implants, pacemakers, or other contraindications to TMS.
• Pregnancy or breastfeeding.
• History of significant neurological or psychiatric disorders.
• Use of medications that significantly alter cortical excitability (e.g., antiepileptics, benzodiazepines) in the last 2 weeks.
• Any musculoskeletal condition preventing safe participation in EMG/TMS procedures.

Sponsors & Collaborators

• Istanbul Gelisim University: lead

Study Sites (1)

Istanbul Gelisim University, Faculty of Dentistry, Translational Dentistry Research Laboratory

Istanbul, Istanbul, 34310, Turkey (Türkiye)

Location

Related Publications (5)

• Haavik H, Niazi IK, Jochumsen M, Ugincius P, Sebik O, Yilmaz G, Navid MS, Ozyurt MG, Turker KS. Chiropractic spinal manipulation alters TMS induced I-wave excitability and shortens the cortical silent period. J Electromyogr Kinesiol. 2018 Oct;42:24-35. doi: 10.1016/j.jelekin.2018.06.010. Epub 2018 Jun 19.

  PMID: 29936314 BACKGROUND

• Ozyurt MG, Haavik H, Nedergaard RW, Topkara B, Senocak BS, Goztepe MB, Niazi IK, Turker KS. Transcranial magnetic stimulation induced early silent period and rebound activity re-examined. PLoS One. 2019 Dec 4;14(12):e0225535. doi: 10.1371/journal.pone.0225535. eCollection 2019.

  PMID: 31800618 BACKGROUND

• Todd G, Rogasch NC, Turker KS. Transcranial magnetic stimulation and peristimulus frequencygram. Clin Neurophysiol. 2012 May;123(5):1002-9. doi: 10.1016/j.clinph.2011.09.019. Epub 2011 Oct 22.

  PMID: 22019353 BACKGROUND

• Haavik, H., Özyurt, M. G., Niazi, I. K., Nedergaard, R. W., Topkara, B., Yilmaz, G., & Türker, K. S. (2018). Re-investigation on the nature and sign of transcranial magnetic stimulation-induced cortical silent period. In 11th Biennial Meeting of the International Motoneuron Society, IBS, 11-14 June 2018, Boulder, CO, USA (pp. 28-29). Article 46 https://motoneuron2018.org/wp-content/uploads/2018/05/IMS-Poster-Abstracts-2018.pdf

  BACKGROUND

• Kahya MC, Yavuz SU, Turker KS. Cutaneous silent period in human FDI motor units. Exp Brain Res. 2010 Sep;205(4):455-63. doi: 10.1007/s00221-010-2380-6. Epub 2010 Aug 8.

  PMID: 20694723 BACKGROUND

Related Links

• No public protocol page available; contact murkara@gelisim.edu.tr for study information.

MeSH Terms

Conditions

Migraine Disorders

Interventions

Transcranial Magnetic Stimulation; Electromyography

Condition Hierarchy (Ancestors)

Headache Disorders, Primary; Headache Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Magnetic Field Therapy; Therapeutics; Electrodiagnosis; Diagnostic Techniques and Procedures; Diagnosis; Myography

Study Officials

• Kemal Sıtkı Türker, Prof. Dr.

  Istanbul Gelisim University, Faculty of Dentistry, Translational Dentistry Research Laboratory

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Murat Kara, MSc

CONTACT

+905314708141; murkara@gelisim.edu.tr

Kemal Sıtkı Türker, Prof. Dr.

CONTACT

+905325987791; ksturker@gelisim.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Participants and responsible investigators do not know group assignments. Only the technical staff performing TMS and EMG recordings are aware of group allocation.
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Two groups (migraine patients and healthy controls) are evaluated in parallel. Participants and the responsible investigators are blinded to group assignments to reduce bias. Only the staff performing TMS and EMG measurements are aware of group allocation.

Study Record Dates

• First Submitted: November 14, 2025
• First Posted: November 26, 2025
• Study Start: December 1, 2025
• Primary Completion: January 1, 2026
• Study Completion: February 1, 2026
• Last Updated: November 28, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)