Brain Abnormalities In The Migraineur
A recent study by Danish Researchers highlighted on the BBC news website, has revealed through the use of MRI scanning, the formation of tiny lesions or abnormalities in brains of Migraine sufferers. At this current time there is no evidence to prove that the lesions lead to migraine, are as a result of the migraine or are even linked. What this article on the BBC website fails to state is how common lesions of this kind are amongst non-migraine sufferers. In our experience many “normal” brains exhibit subtle differences within the white matter that do not seem to have an impact on the person’s health. At Headache and Migraine Specialists we tend to agree that there are possible changes within the brain of a migraine sufferer, however these are not necessarily visible or accessible via MRI due to these being essentially changes within the “circuitry” or “electrical wiring”. The brain is like a computer with various wires, connections and switches. Using MRI we can see when certain areas of the brain are working but it is very difficult to detect which wires feed into this part are active (imagine an electrical circuit board with thousands of wires coming in and out of a switch, unless you cut into each wire it is impossible to detect which ones are sending message to the switch).
We believe that in the migraine sufferer the subtle changes occur in the “wiring” of the brain stem (in particular a region called the Trigemino-Cervico Nucleus) and that these changes occur at such a microscopic level it is hard to identify them with the current technology. In the migraineur the brain stem becomes over sensitised as a result of receiving continuous “warning” signals from the upper neck. The signals are normally as a result of dysfunction, pain, stiffness and muscle spasm that is occurring in the neck and are referred to as noxious information. Once the brain stem reaches a certain sensitivity level the person experiences a migraine and its associated symptoms. One could liken this to a computer being over loaded by its users and freezing or shutting down. Maybe migraine is our bodies’ way of forcing us to take notice of an upper neck problem because as most migraine sufferer will tell you they do not want to move their head or neck during an attack!
What about the headache? The sensory signals (or noxious information) from the upper neck and trigeminal field (face) mix together in the brain stem and are passed on to the brains cortex for processing. Unfortunately the cortex cannot decipher where the mixed message comes from (neck or head) and in turn gives the person pain in the head.
Relating this back to the Danish research, there probably are changes within the migraineur brain but maybe these changes are more subtle than they propose and relate to processing and over sensitization rather than any visible structural changes seen on MRI.
Migraine can be an extremely disabling condition