There's a new Migraine World Summit due in March, and they send out emails from the prior summit in the lead up.
One of the interviews last year was about the biology of migraine, and apart from being really interesting, it also highlights that migraine isn't a headache.
They think that one of the things to happen for a migraine attack to occur is for the trigeminal nerve to be activated/turned on.
There's a correlation between cortical spreading depression (when we have normal activity in the brain, and then there’s a depressed period where no activity can occur) and migraine with aura (eg, activity is the visual aura, and the cortical spreading depression is the period of darkness after), and that it may play a part in 'general' migraine.
A wave of electrical activity opens up the blood vessels and the covering around the brain, which allows for abnormal proteins like CGRP to be released.
CGRP and other proteins go and turn on the trigeminal nerve and other parts of the brain.
The trigeminal nerve - a large nerve that controls all facial sensation, in the head and the mouth - then turns on different parts of the migraine pathway, which includes activating various parts of the brain that correspond to migraine symptoms.
For example, this process disrupts the back part of the brain that controls vision, which is why you might become light sensitive during a migraine attack.
It can also affect parts of your brain that control appetite and your body temperature, which explains the stomach upset, nausea and difficulty regulating temperature when you have an attack.
All of this is happening because this nerve, the trigeminal nerve, is turned on and then goes and activates all these other parts of the brain.
Fascinating, I wonder if anything's changed since last year in terms of research and how much more we know. We used to think migraine was caused by problems with the vascular system, and now we're really drilling down into the chemical and neurological activity that causes migraines
Having migraines is terrible, but if you're going to have them, now is a much better time than even 3 years ago.