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Migraine-triggering mechanism broken down

According to estimates, one in ten people suffers from migraines. But who is the culprit? What causes this neurological dysfunction in the brain? Scientists used to assume that there was a malfunction in the blood vessels in the brain. According to this, shortly before a Migraine attack the blood vessels, which means that the affected brain region receives less blood. In an excessive counter-reaction, the same blood vessels then expand, which hurts. This expansion of the vessels then causes the pain typical of migraines.

For a long time, it was thought that this was the only cause. But it is not true. Recently, researchers discovered a signaling pathway, a mechanism that explains migraine attacks.

About Migraine

If migraines were a true crime format, it would look like this: As if from nowhere, the culprit attacks the central computer and causes serious incidents, including a malfunction. Sometimes he announces his appearance with flickering flashes of light or double images (aura), sometimes not.

The victim has to endure extreme pain, it feels as if someone with a red-hot hammer in his head smashing everything to piecesThe stomach heaves with severe nausea, and vomiting occurs. Since daylight would be unbearable, the room in which the patient is lying must be darkened. Working is impossible. A migraine attack simply knocks the patient out, usually for one or two days.

Role of proteins in cerebrospinal fluid in migraine still unclear

Around a quarter of migraine sufferers experience what is known as an aura, which occurs up to an hour before the actual attack. They see flashes of light or double vision or feel a tingling sensation in the body. Previous studies suggest that these auras are triggered by spontaneous surges of glutamate or potassium that spread through the cerebral cortex or cerebellum. This reduces oxygen levels and blood flow and causes perceptual disturbances.

In addition, during the attacks over the Cerebrospinal fluid Proteins are released in the brain, which in turn activate pain receptors on sensory nerve cells in areas of the head outside the brain. But how exactly this mechanism works has been completely unclear until now.

More on the topic of nerve cells:

Nerve node: Trigeminal and migraine

Once again, laboratory mice had to be used to make the protein pathway visible. And yes, there are specially bred mice with migraines. Using imaging techniques and protein analyses using a mass spectrometer, American researchers recently discovered the following: There is a previously unknown signaling pathway through which the central nervous system in the brain and the nerve cells in the rest of the body communicate with each other.

This path does not run via synapses, but rather via a specific nerve node outside the brain, the trigeminal ganglion. This is located at the base of the skull below the brain and connects it to the nerve cells in the face and head.

Signal path works either left or right side

And now the special thing: In contrast to the other brain regions, the blood-brain barrier permeable at this junction. It is a hole in the fence, so to speak. This makes it possible for the peripheral nerve cells to come into contact with the proteins from the cerebrospinal fluid, because the small proteins can flow unhindered through the gap. There are twelve different proteins that can bind to the trigeminal ganglion. Among them is the CGRP protein, which was already known to be linked to migraines.

It is also interesting that this mechanism appears to occur separately for each half of the brain. The proteins released on one side bind predominantly to the node in the same half of the head. This could explain why the pain during migraine attacks occurs on one side.

New migraine therapy in sight?

Because the researchers have discovered this signaling pathway, this could be the approach to a new migraine therapy – for example, by finding an active ingredient that inhibits the CGRP protein. This would benefit all those who do not respond to the therapies available to date, and that would be a real sensation.

In addition to migraines, the newly discovered signaling pathway could also be involved in other diseases. This will now be investigated further in follow-up studies. This could also clarify why the headaches often continue for a long time after the triggering protein wave in the brain has flattened out again.

Sources:
https://www.scinexx.de/news/medizin/ausloeser-fuer-migraene-anfaelle-identifiziert/
https://www.science.org/doi/10.1126/science.adl0544

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