Source-level α periodic power in visual and default mode networks predicts topiramate treatment response in migraine
The Journal of Headache and Pain July 17, 2026 Siyuan Xie, Chenghui Pi, Kang Jin et al.
Periodic alpha-band brain activity, measured with electroencephalography (EEG) before treatment, predicts how well patients with episodic migraine without aura will respond to the preventive drug topiramate. Higher alpha power in specific brain regions—the cuneus, pericalcarine cortex, medial orbitofrontal cortex, frontal pole, and precuneus—indicates a poorer clinical response. A predictive model using these features achieved an area under the receiver operating characteristic curve of 0.859 in identifying treatment responders. The visual network and default mode network together explained 26.1% of the variance in headache improvement. These findings suggest that baseline alpha activity is a strong neurobiological marker for personalizing migraine preventive therapy.