Most of the approximately 45 million Americans with migraine don’t know it. The headaches, for these sufferers, are too irregular, infrequent, and atypical for the person to even consider the possibility that it’s a migraine, or for a doctor to diagnose it as such. For these people migraine seems to be an occasional ordinary—perhaps unusually severe—headache, and is endured. Some patients don’t have, or don’t notice, the sensitivity to light, sound, and smells that makes migraine recognizable as migraine.
For many, however, the condition is clear. They have the sensitivity, they have the visual or auditory aura that predicts the incident, and in some cases they have a rare sleep disorder that scientists believe is connected to migraines. A mutation in the gene responsible for a protein called CK1δ has recently been found to be associated with both some times of migraine headaches and a form of disrupted sleep called familial advanced sleep phase syndrome, an inherited condition which causes people to both retire and rise unusually early, without any benefits in the way of health, wealth, or wisdom. CK1δ has a significant share of responsibility for circadian rhythm, the body clock that regulates the sleep cycle. Now evidence has appeared that the same mutation that causes the sleep disorder is also found in people who suffer chronic migraines.
Although it is believed to be the most costly neurological disorder worldwide, migraine is one of the more intractable health conditions for researchers because it is cyclical, unpredictable, and leaves no real trace. Patients are either in the middle of a migraine, or they are to all appearances healthy, and there’s no more than a few minutes’ warning when the latter state will give way to the former. This is one reason causes remain unclear, with CK1δ’s contribution only a very recent discovery. Painkillers and drugs called triptans that constrict blood vessels are used to treat migraines as they happen, but preventative treatments are generally off-label or new uses of medications for other conditions, such as depression of heart disease. CPK1δ offers the possibility of a migraine-specific treatment.