Tag Archives: migraine

Advances In Fighting Migraines

Migraine affects more than 10 percent of people throughout the world, and about 12 percent of people in the United States. It strikes three times as many women as men. Migraine is wildly under-diagnosed, however, because exactly what it is and how it works is not clear. That means that public health experts estimate that more than half of all people with migraine have never received a diagnosis. It also means there is no reliable treatment for migraine headaches. It is also difficult to research treatments because people who experience migraines show no symptoms between times.

That’s why prevention is best. As best as can be understood, migraines appear to be linked to a neurotransmitter—a chemical used by the brain for various functions—called dopamine. The exact nature of the link is not clear, but dopamine in migraines may be activated by triggers which vary from person to person. Among the most common migraine triggers are onions, alcohol, secondhand smoke, and MSG. Some chemical compounds are also common triggers, such as the nitrates used in curing meat or tyramine, which naturally forms in aged foods such as wine or certain cheeses. Stress is another frequent cause of migraines, not necessarily directly, but in the period after the stress has passed hen the body is recovering from its heightened state. That means a migraine sufferer’s best option may be to learn and avoid their specific triggers, though this can require painful trial and error

However, it may not always be possible to avoid triggers. In these cases, there are some treatments that may help alleviate symptoms. While caffeine is a trigger for some patients, in others it can improve matters. Some prescription medications also have benefits. Beta blockers, the antidepressant amitriptylene, and anti-seizure medications seem to prevent migraines from occurring. More unusual approaches have also been tried. One of these is transcranial magnetic stimulation, in which powerful magnets are moved over the skull. Although it’s not clear what effect this has, it has been shown to work for many patients. Another treatment option that helps with migraines is medical marijuana, though again, that can be a trigger for some patients.

Migraine Predicts Parkinson’s

Researchers believe they have found a connection between a tendency to get migraines and risk of Parkinson’s disease. In particular, people who get migraine with aura—an alteration in vision that often presages a migraine—are twice as likely to develop Parkinson’s later in life as people without migraines. Migraine affects an estimated 30 million people and is the most common brain disorder in adults, so potentially millions of people are at risk for Parkinson’s disease, as well as for the cardiovascular illnesses with which migraine is also associated.

In addition, people in the study with a family history of Parkinson’s were more likely to get migraines, providing more evidence of a connection. The reason for the link, if it exists, is not entirely clear, but one possibility is that dopamine, a messenger chemical in the brain that has been implicated as a major cause of Parkinson’s, is also involved in migraines. Past research has indicated that dopamine receptors may be involved in migraines.

The dopamine issues that cause migraines, however, are imperfectly understood themselves. Their causes—called triggers—vary from person to person. Among the most common migraine triggers are onions, alcohol, secondhand smoke, and MSG. Some chemical compounds are also common triggers, such as the nitrates used in curing meat or tyramine, which naturally forms in aged foods such as wine or certain cheeses. Stress is another frequent cause of migraines. A recent study found that referring to a stressful situation as a "headache" isn’t just a metaphor; people with more stress in their lives are more prone to headaches of the literal sort. With migraines, it seems the let-down after is a bigger problem, and keeping stress levels even is important for prevention.

In fact, avoiding triggers in general is the most effective way of preventing migraines. There is a learning curve to this, since avoiding triggers requires first determining what they are. However, once a patient’s triggers have mostly been determined, avoiding them can significantly reduce migraine instances. In addition, medications and medical devices are available to prevent migraines or lessen their severity or duration. Two new electromagnetic stimulation devices, for example, seem to be useful for stopping migraines as soon as they start, if not sooner.

Fellowship And Treatment For Migraine

For reasons scientists are not at all clear on, approximately 45 million Americans suffer migraines—though for many of them, the actual headaches are so infrequent, so mild, or so far from the usual migraine pattern that neither they nor their doctors even recognize that as what is occurring, rather than an ordinary, if perhaps unusually strong, headache. A tendency to suffer migraines, particularly with aura—light sensitivity coupled with a slight visual disturbance lasting a few minutes to an hour signaling the onset of a migraine headache—seems to have a strong genetic component, but heredity is not the whole story.

The headaches are largely random, but there are often broad patterns. Sufferers are particularly prone to migraines after triggers. These triggers vary from person to person, but the common ones include onions, nitrates in cured meat, the compound tyramine in some aged or preserved foods, alcohol, secondhand smoke, and MSG. Menstruation or pregnancy can also trigger migraine headaches in some people. Caffeine withdrawal can also bring them on. Stress is also frequently a trigger, with one study finding that people with migraine going through a period of stress had over four percent more headaches. Headaches often strike when the stress goes away.

Researchers are also working to learn more about other aspects of migraine. One tool is social media. Twitter and other social media services are invaluable tools for researchers of all stripes because they provide more or less anonymous self-reports of a wide variety of human experiences, including medical conditions, and migraines are no exception. It turns out migraine headache sufferers—seeking sympathy, looking for advice, or just self-documenting—frequently share their pain on Twitter. Researchers are using this vast amount of data to glean important information about where, when, and to whom migraines happen.

This information can help in developing treatments. Some existing treatments are truly off-the-wall. One company created a headband with an electrode placed so as to stimulate the nerves found behind the eyes. Powerful magnets run over the skull—called transcranial magnetic simulation—can also be effective. Medication is also helpful, though not always with the usual delivery method. A patch that administers medicine through the skin was recently introduced, and migraine is one indication for medical marijuana.

It Still Knows How To Pound

Migraines are painful, unpleasant, inconvenient—and they might be rewiring your brain. Researchers say migraine symptoms—particularly migraine aura, visual symptoms such as spots, flashes, shapes, or temporary blindness, or a pins-and-needles sensation, that can last up to an hour shortly before the onset of the pain, nausea, light and sound sensitivity, and lightheadedness—may be associated with the development lesions, changes in brain volume, and alterations to the glial "white matter" of the brain.

It’s not clear whether these changes are caused by migraines, or cause them, or are caused by another factor that makes people susceptible to migraine. If the headaches themselves are causing the brain changes, that suggests that reducing the frequency of attacks, or stopping them altogether, can stop if not reverse the changes. That means avoiding migraine triggers.

Triggers vary, but there are some things that tend to set off migraines. Certain foods can do it; onions are associated with migraine in many people. Aged cheeses, alcoholic beverages, pickled, aged, smoked, and fermented foods, soy-based foods, chocolate, bananas, figs, snow peas, and a variety of other foods contain a compound called tyramine, which is often a migraine trigger. Cured meats also often have nitrates. Sometimes, giving things up can be a trigger; a migraine is a common symptom of caffeine withdrawal. Other triggers are environmental, such as secondhand smoke, or circumstantial, such as menstruation or changes in sleep.

When avoiding triggers isn’t enough or is not possible, there are a few medical treatments for migraines, though the nature of the condition makes researching remedies difficult. Beta blockers, the antidepressant amitriptylene, and anti-seizure medications seem to prevent attacks. In recent studies, a blood pressure drug called candesartan has proven effective as well.

New Insights Into Migraine

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.

Botox as Medicine

It’s often associated with costly cosmetic procedures, but onabotulinum toxin A, or Botox, is actually an important medical treatment. It is very useful for relieving or treating several conditions, including neck pain called cervical dystonia, eye spasms, crossed eyes, chronic migraines and even underarm sweating.

The botulinum toxin is, as the name suggests, the chemical that causes botulism, a form of food poisoning. When it’s in food, it causes paralysis, but the same paralyzing effect can be harnessed to unstiffen limbs and unclench muscles. It also blocks certain bodily secretions, meaning people with excessive underarm perspiration can use it to keep that under control. Overactive bladder is another problem that botulism toxin can treat.

The use of Botox as a treatment for migraines does follow directly from its cosmetic use—patients getting Botox treatments for wrinkles noticed that their chronic migraines briefly stopped after the injection was given. Scientists aren’t sure how botulism toxin treats migraines, but one possibility is a combination of blocking the nerves activated by the pain, the way many over-the-counter painkillers work, and relaxing the muscles in the face. The injections are helpful in both treating patients who suffer migraines more than half of each month, and in preventing those frequent headaches from happening for as long as three months after each dose.

People who suffer a condition called cervical dystonia are given botulism toxin to keep that under control. There is no permanent cure for cervical dystonia, a painful and uncontrollable neck muscle twitch, which causes the patient’s head to continually jerk to one side. Injected directly into the neck, the medication relaxes the muscle, stopping the twitching for three to four months

The muscle relaxing properties of the substance are also useful in helping restore a full range of motion to stroke patients. Too often, these patients are unaware of the usefulness of the injection for their conditions—it’s a new application, and an “off-label,” or unofficial, one, so many doctors are unaware of it—and so are not able to get the benefits it provides. Botulism toxin is targeted, unlike standard treatments for post-stroke paralysis, which affect the whole body and can cause drowsiness.