Electrophysiological studies on headache: The contingent negative variation

The contingent negative variation (CNV) is a slow cortical potential recorded from the scalp. This method allows the pathophysiology of chronic headaches to be elucidated. When assessed during the pain-free interval patients suffering from migraine without aura show significantly more negative amplitudes than healthy controls. This negativity reflects the activity of cerebral noradrenergic systems. Some studies using repeated recordings of the CNV show a periodicity in amplitude change. When migraine patients are assessed a few days before a migraine attack occurs, they show pronounced negativity, which normalized during the attack. Despite these interesting findings that are based on group comparisons, evaluating the CNV on an individual basis does not allow specific conclusions. Thus, assessment of the CNV is an important tool to examine pathophysiological aspects of chronic headaches, but is not suitable as a diagnostic procedure.