Pinpointing the Origins of Migraine in the Brain

Migraines are a very unpleasant variety of headaches, often associated with other symptoms such as nausea, vomiting, photophobia (aversion to light) and visual disturbances. Hundreds of millions of people around the world suffer regular migraines, but their brain basis remains largely unclear. Now a new paper reports that the origin of migraines may have been pinpointed - in the brain of one sufferer, at least. German neuroscientists Laura H. Schulte and Arne May used fMRI to record brain activity in one migraine sufferer, a woman, who was scanned once per day for 30 days straight.During the month of the study, the patient suffered three migraines, lasting one or two days each. She chose not to take any medications during the study period. To evoke brain activity, Schulte and May exposed the patient to a small amount of ammonia vapor, a painful and unpleasant stimulus. Schulte and May found that on the day before a migraine struck (i.e. the 'preictal' or prodromal phase) evoked neural activity in the hypothalmus was higher, and functional connectivity between the hypothalamus and the brainstem was increased. During the migraine itself (the 'ictal' phase), hyperactivity was seen in an area of the brainstem called the dorsal pons. These results are interesting because the dorsal pons has previously been found to be hyperactive during migraine. It's been dubbed the brain's "migraine generator". Schulte and May's data suggest that this is not entirely true - rather, it looks like the hypothalamus may be the true generator of migraine, while the brainstem could be a downstream mediator of the disorder.