Introduction 1 2 3 5 6 7 9 10 Materials and methods Patients 11 The study was conducted after approval of our Institution’s ethics committee and performed in accordance with the ethical standards of the 1964 Declaration of Helsinki, with the understanding and consent of each involved subject. SFEMG recordings ® 12 1 Fig. 1 top bottom  3D-movement analysis Movements were recorded at 100 Hz in three dimensions (3D) using an infrared optoelectronic-tracking-system (ELITE™, Milan, Italy) with a reflective marker attached to the tip of the index finger and another marker to the movement target. 2 10 Fig. 2 Experimental setup for the movement task  U Results On SFEMG, the median value for mean MCD was not significantly different between MO (16.05 μs; range 9.50–22.93) and MTA (18.91 μs; range 11.50–24.55). The median value of mean horizontal deviation was 4.01 mm (range −3.25 to 18.12) in MO and 10.74 mm (range 1.60–17.03) in MTA, a nonsignificant difference. R P 3 Fig. 3 X squares dashed line triangles continuous line  Discussion Our within-patient analysis shows that, in migraine with aura, the mean MCD on SFEMG increases significantly with the degree of horizontal deviation in a visually guided reaching movement. This suggests that, in subgroups of migraine patients, neuromuscular transmission (NMT) performance and control of ballistic movements by the lateral cerebellum are similarly influenced by a common biochemical and/or neural mechanism. 13 14 2+ 15 18 ++ 19 20 21 22 23 ++  24 25 26 19 27 28 29 30 In conclusion, the correlation between NMJ and cerebellar performances that we have found in migraine with aura patients might be due to a common genetically determined molecular mechanism, possibly influencing ion channels functions, but this has still to be proven by appropriate genetic studies.