Cortical spreading depression, aura and migraine

Critics of CSD have long pointed out that, although observed in animal studies, CSD has not been consistently observed using electroencephalograms (EEG) in humans with migraine.^{[Charles & Brennan, 2010]} Furthermore, CSD would be expected to have quite profound effects on cognitive functioning – effects that are not universally observed in migraine.^{[Charles & Brennan, 2010]} Taken together, it is argued that migraine may involve cortical waves that are related to the CSD observed in animal models, but also that different types of cortical waves may propagate a signal through the cortex: so-called ‘astrocyte waves’.^{[Charles & Brennan, 2010]}

Reference:
Charles A, Brennan KC. The neurobiology of migraine. Handb Clin Neurol 2010; 97: 99–108.

Other references used on slide:
Charles A, Brennan KC. Cortical spreading depression – new insights and persistent questions. Cephalalgia 2009; 29 (10): 1115–1124.

Close LN, Eftekhari S, Wang M, et al. Cortical spreading depression as a site of origin for migraine: role of CGRP. Cephalalgia 2019; 39 (3): 428–434.

Lashley KS. Patterns of cerebral integration indicated by the scotomas of migraine. Arch NeurPsych 1941; 46 (2): 331–339.

Leão AAP. Spreading depression of activity in the cerebral cortex. J Neurophysiol 1944; 7 (6): 359–390.

McComas AJ, Upton ARM. Cortical spreading depression in migraine – time to reconsider? Arq Neuropsiquiatr 2015; 73 (8): 714–721.

Tolner EA, Chen SP, Eikermann-Haerter K. Current understanding of cortical structure and function in migraine. Cephalalgia 2019; 39 (13): 1683–1699.