Migraines

There are more than 300 million people who suffer from migraines and as a result also experience nausea, sensitivity to light, and terrible headaches. Migraines have existed for thousands of years, and there is still no cure; many people who suffer from the severe pain of migraines do not even seek medical attention. The truth is that migraines are a very disabling disorder, and they cost the government over 17 billion dollars a year for loss of work, disability, and health expenses. Many people are now realizing how serious of a problem that a migraine is, and there has been a great deal of interest in research that may work to prevent and treat migraine pain.

No one knows for sure what causes migraines. It was once thought that the pain is caused from the dilation and stretching of blood vessels in the brain. A more recent theory is that migraine pains develop from a problem in the nervous system, specifically the brain stem. While it’s uncertain why migraines occur, an attack can be brought on by alcohol, menstruation, stress, weather, lack of sleep, allergies, hunger, and a plethora of other things. Victims usually experience an attack once a month, and the pain lasts two to three days. There are two parts of a migraine: the aura (what precedes the headache), and the actually headache. Aura is often a bright visual illusion followed by dark spots and is not experienced in all migraine sufferers. It is thought to come from cortical spreading depression which is a time of strong nerve cell activity, or when the neurons become very excited, followed by neuronal inhibition. When the neurons are in a state of inhibition they cannot be excited. This has to do with migraines because the changes in how the neurons behave explain the changes of blood flow-when neurons are excited and active, the require lots of blood, and when they aren’t active, the need less blood. When someone experiencing an aura has a bright visual hallucination, excited neurons are crossing the cortex, the same area of the brain that controls visual, sensory, and motor skills. The dark spots one experiences after the bright illusions are consistent with the neurons not being active.

There have been many studies regarding genetics and how they are related to migraines. While scientists aren’t sure which exact genes influence migraines, there are three genes that carry mutations powerful enough to cause migraine pain. These mutations increase the excitability of the nerve cells, which is related to cortical spreading depression. Researchers have developed strong theories about the connection of aura to cortical spreading depression, and they also have an idea where the headache itself comes from. The researchers think that cortical spreading depression stimulates the trigeminal nerves, a network of nerves that carry pain signals. As the excited neurons travel across the cortex of the brain, glutamate, oxide, and ions are released causing the trigeminal nerves to send out the pain signals. Another theory of the cause of migraine pain is that the base of migraine pain is in the brain stem. Many researchers think that the migraine headache comes from a problem in brain stem activity which brings on the pain.While it is not sure whether migraines are caused from cortical spreading depression or a problem in the brain stem, there is much work being done in efforts to stop the problem and pain of migraines. There are only a few drugs that stop migraines from occurring, but they only work half the time. Researchers have come up with a drug that prevents cortical spreading depression, and it is being tested in those with migraines. The drugs hinder gap junctions from opening, and therefore stop the flow of calcium between brain cells. Treatments used during a migraine block the trigeminal nerves from transmitting pain signals, but also constrict blood vessels. While there is no one definite treatment to prevent and treat migraines, there have been many new breakthroughs that have given many migraine sufferers hope.
My Review

This article really made me think about things I’d never thought about before. Since I’ve never experienced a migraine, like many Americans I did not think they were a big deal. The article made me realize that migraines are a very debilitating problem. While researchers are not positive, they think that aura comes from cortical spreading depression. It was interesting to learn about the change of neurons from a state of extreme excitability to inhibition, and how that makes sense that during aura one experiences a time of bright illusion and then dark spots. If researchers can come up with a way to treat and prevent migraines, many people would benefit. The drug that prevents cortical spreading depression is interesting because keep gap junctions shut, stopping the flow of calcium. The drugs that are used during a migraine to block the nerves from transmitting pain signals seem effective, and if there was a way to stop them from constricting blood vessels they would be even more effective. I think researchers are definately on the right track in their studies. Migraines are a serious problem, and not many people are aware of how serious they are. Hopefully with all the research that is being done, investigators will be certain of the cause and treatment of migraine pain.
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