Ever had a strong throbbing pain in your head? Felt that your brain was being pounded with Thor’s hammer? The pain might’ve been on the left of your head, or maybe the right. Honestly, you didn’t care, all you needed was for it to stop. When you were lying in a dark room with your eyes closed hoping that the painkillers you took might cure this agony, you probably wondered what on earth could cause such a dreadful time. Well, if this experience sounds familiar to you, then you, my friend, may suffer from migraines!
So now you know what it’s like to suffer a migraine attack, but what is a migraine? Defined by the NHS as a moderate or severe throbbing pain on one side of the head, migraines are a largely genetic disorder that can leave you unable to function for hours with seemingly never-ending pain. Symptoms also include nausea, sickness, and increased sensitivity to light and sound. Some sufferers may experience these many times a week, whilst others may go years between migraine attacks.
Even if you’ve never suffered from a migraine personally, it is more than likely you know someone who has. There are an estimated 1 billion migraine sufferers worldwide, making it the third most common illness in the world. It claims more sufferers than asthma, diabetes, and epilepsy combined.
There are an estimated 1 billion migraine sufferers worldwide, making it the third most common illness in the world. It claims more sufferers than asthma, diabetes, and epilepsy combined.
The science of migraines is indeed quite the head-scratcher and has been for quite a while. What is really happening in the brain during these attacks? Well, migraines are a disorder of how the brain deals with incoming information, such as sounds, smells, or light. During a migraine, parts of the brain that help people concentrate do not work in the synchronous way they should be. This broad brain dysfunction is often associated with visual disturbance, as it is often the most noticeable symptom. Migraines with visual disturbance, or with aura, contribute to 20-30% of attacks.
Why does the brain struggle to deal with incoming information during these attacks, and why does this then cause pain? The answer is to be found in looking at the trigeminal nerve. This is the nerve in your brain that causes a sensation in your head. This nerve communicates with the head by using chemicals called neurotransmitters. One specific neurotransmitter it uses is calcitonin gene-related peptide (CGRP). During migraine attacks, CGRP levels in the brain increase. This is what causes the throbbing pain that migraine sufferers know all too well.
The discovery of CGRP’s role in migraine attacks has caused novel medicines to be developed. Drugs like Triptans and Gepants are currently in testing and development and they could hold the key to solving the migraine medical mystery. Triptans stop further CGRP release and turn off the attack whereas Gepants block CGRP receptors that catch the incoming migraine-induced overflow of CGRP. As well as these, there are certain monoclonal antibodies that even bind to CGRP directly and may also be effective in treating the hellish headache horror. Extraordinarily, Gepants and monoclonal antibodies can also prevent the attacks from happening in the first place, potentially improving the lives of hundreds of millions of regular migraine sufferers.
Although these revolutionary novel medicines are incredible, more research needs to be done. We still don’t know what causes the trigeminal nerve to turn on CGRP. Discovering this would be ground-breaking, and would go a long way to eradicating the disorder, potentially saving everyone from having to go through that horrible experience of seemingly never-ending throbbing pain. But while scientists may still remain in clueless confusion about the complete nature of the trigeminal nerve, the most important thing is that they don’t get a total headache from thinking about it too much!