Are you one of the many suffering from new or chronic migraines? You are searching or have given up hope that you will find something that will work for you. There are traditional medications given for migraines such as imitrex, maxalt, relpax, and propranolol to name a few. There are alternative therapies such as acupuncture, essential oils, chiropractic care, and massages. Alternative and traditional care work for many, but there are many more that still have persistent headaches. Other individuals aren’t wanting to be on medications the rest of their life. This brings us to the focus of this article, which is what causes migraines?
There has long been a debate whether vascular or neurological issues lead to migraines. Research has shown that migraines are neurologically based. It is important to remember that part of your nervous system is your autonomics which will control vascular diameter to allow blood flow to different areas. The term used to describe the neurological changes is “cortical spreading depression”, which we will call CSD. CSD results in failure in a part of the brain that will then spread to other parts. The first part that fails can be the aura that individuals experience. For example, if you have CSD of your occipital lobe you will have a visual aura where you may see spots or streaks. From here it is a chain of events that leads to failure in the other parts of the brain. Let’s focus on the basics of cellular function of the brain.
The functional cell of the brain is known as a neuron. Each neuron has a resting activity level and in order for it to fire it will need to hit its firing threshold. For example, let’s assume the resting level is 40 and the firing level is 70. When CSD occurs, let’s assume the resting level is increased to 55 which puts it closer to the firing level of 70. This leads to less stimulation needed before the neuron will fire. The increased resting level happens before a migraine occurs and can actually precede it by weeks. The increased firing rate leads to the use of more energy. This increased energy usage will lead to energy depletion. The need for energy creates stress on the mitochondria which results in increased production of inflammatory chemicals.
What Can Lead to Abnormal Cortical Activity?
While the principle mechanism for migraines are neurologically based, it is important to remember that there are many things that can affect the brain. An alternation in female hormones, anemia, thyroid, or other metabolic issues have the ability to contribute to and trigger neurological dysfunction. Head injuries such as concussion, repetitive hits, or mild traumatic brain injury. Leaky gut can lead to systemic inflammation that will trigger excessive neuronal firing. This is why it is important to have a comprehensive examination that includes more than a basic physical and neurological exam. By understanding the cause and contributing factors of migraines you can now evaluate other aspects of your health that could be acting as a trigger and predisposing you to recurrent attacks.
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Pietrobon, D., & Striessning, J. (2003). Neurobiology of migraine. Nature Reviews Neuroscience, 4(5), 386-398. Doi:10.1038/nrn1102