Abstract text (incl. figure legends and references)

Brain excitability appears a critical biosignature of migraine leading up to attacks that can help to monitor a participant's susceptibility to develop an attack. We have shown – in our clinical EEG laboratory – that differences in cortical responsivity (as measure of brain excitability) in relation to the initiation of a migraine attack can be identified using longitudinal measurements of electroencephalographic (EEG)¹ responses to flashing light, using the 'Chirp' paradigm² (fig. 1c). For the current study we have moved out of the lab to the patient's home environment.

We will record EEG changes toward the (pre-)ictal phase of individual attacks using visual evoked potential EEG (VEP-EEG) (fig. 1a). Participants fill out our validated headache E-Diary, providing daily information about headache, medication use and menstrual bleeding.^3,4 Recordings will start six days prior to an expected (menstrual) migraine attack. In the majority of cases 3-7 days of daily sessions (~30 min each) will be performed, but if needed recordings will be extended until an attack occurs. VEP-EEGs will be measured using a mobile EEG-system and flashing lights presented by LED goggles (fig. 1b).¹ The flash light sequences consist of a short pulse-train over a broad frequency range of 10-40 Hz ('chirp' stimulation).²

We have successfully set up a home-based neuromonitoring system that will help us understand brain excitability changes in a patient's home environment by capturing daily fluctuations as possible early warning signs of upcoming migraine attacks.

We have set up a neuromonitoring system to perform home-based VEP-EEG measurements in a large group of migraine patients. For the future, picking up early changes in EEG signals in relation to attacks may form the basis for guiding early interventions and monitoring treatment effects.

Perenboom et al. 2020 Cephalalgia Gantenbein et al. 2014 Cephalalgia van Casteren et al. 2021 Cephalalgia van Casteren et al. 2021 Neurology