Cause of migraines finally found, points to possible treatment

Scientists claim to have finally discovered the cause of migraines, opening the way to ending them.

Migraine remains one of the mysteries of medicine. In Spain, 1.5 million people suffer from migraine, causing nausea, paralyzing pain and the inability to get out of bed for several hours. One in four also suffers from extreme sensitivity to light, blurred vision and black spots that make it difficult to function.

Despite how common these migraines are, scientists understand little about what causes them, and many people have no effective medication. Scientists have discovered a new way to trigger migraines, a breakthrough that could help them create new drugs to combat this debilitating disease.

Researchers have found that during migraine with aura, various proteins are created that leak out of the brain through microscopic holes and cause severe pain.

The brain does not feel pain

For a person to feel pain, a migraine must activate pain receptors outside the brain, something researchers have known for some time. The pathway migraines take from the brain to the rest of the body “still remains a largely elusive mystery,” according to Dr. Jeffrey Iliff of the University of Washington School of Medicine and Dr. Andrew Russo of the University of Iowa, who were not involved in the study.

In a published response to the new study, Dr. Iliff and Dr. Russo called the authors “pioneers” and said it could help us find new drugs for migraines.

Over-the-counter pain relievers like Advil and Tylenol often help people with mild headaches, but they’re usually not enough for migraines.

There are FDA-approved drugs to treat migraines, but they don’t help many people, according to the study authors at the University of Copenhagen and the University of Rochester Medical Center.

Migraines are more than just a bad headache, they are more serious. That is why doctors prescribe medications such as triptans, which can treat migraines after they start, or antidepressants, anticonvulsants, or beta blockers, which are supposed to prevent migraines.

But these medications have a lot of variability. Even if they work, they have some unpleasant side effects, such as nausea, insomnia, memory problems, weight gain, and hair loss. These side effects make these drugs not the best solution for many migraine sufferers.

Migraine proteins

To create drugs that more effectively treat migraines, doctors need to understand what causes them. Despite years of research, the cause remains controversial, the study authors say. Researchers have long known that migraines do not directly affect the brain because the brain is unable to feel pain.

The brain is surrounded by many membranes that isolate it from the rest of the body and allow only what is absolutely necessary to pass through. Molecules have a hard time passing through these layers, whether they are coming or going. Researchers had no idea how these complex migraines got past these barriers. But they did know that in some types of migraines, people experience strange visual signs, such as blurred vision, blinding lights, and black spots, an hour to five minutes before the pain begins.

It turns out that when an aura occurs, there’s a rush of cerebrospinal fluid and signals through the brain that push out the small molecules that trigger migraines. The study found that in mice, the migraine-triggering molecules leave the brain by riding on this fluid: They’re pushed into a small gap where the nerve that controls the face protrudes from the brain.

According to Illiff and Russo, this is the first time this space has been identified. They believe that these tiny particles, which are small proteins, could be a target for new drugs to stop migraines. Although this work provides some of the most compelling evidence to date about the role of the glymphatic system in migraines, much remains to be discovered, write Drs. Illiff and Russo.

Some of the molecules identified in this new study have already been studied by pharmaceutical companies. In 2018, the US FDA released the first of these drugs, called calcitonin gene-related peptide inhibitors, after the specific protein they target.

At the time, the American Migraine Foundation called these types of drugs “the biggest advances in migraine treatment and prevention in decades.” However, they don’t solve the migraine problem for everyone.

According to Dr Martin Kaag Rasmussen, author of the study, other molecules discovered could be key to “discovering new drug targets that will benefit the vast majority of patients who do not respond to available treatments.”

LINK

A New Path to Migraine