Migraine: a chronic sympathetic nervous system disorder

Area of Science:

• Neurology
• Autonomic Neuroscience

Background:

• Migraine is linked to sympathetic nervous system dysfunction.
• Reduced sympathetic function is observed in migraineurs during headache-free periods.
• Sympathetic dysfunction characterizes disorders like pure autonomic failure and multiple system atrophy.

Purpose of the Study:

• To compare diagnostic and clinical similarities between chronic sympathetic nervous system disorders and migraine.
• To investigate migraine as a subtype of sympathetic dysfunction.

Main Methods:

• A comprehensive literature review was conducted.
• Diagnostic tests and clinical signs of migraine, pure autonomic failure, and multiple system atrophy were compared.

Main Results:

• Migraine shares significant features with pure autonomic failure and multiple system atrophy.
• Migraine is characterized by reduced supine plasma norepinephrine and adrenergic receptor supersensitivity, similar to pure autonomic failure.
• Unlike other disorders, migraineurs can still increase norepinephrine levels under stress.

Conclusions:

• Migraine is a chronic sympathetic dysfunction disorder with shared characteristics with pure autonomic failure and multiple system atrophy.
• Migraine's sympathetic dysfunction occurs within an anatomically intact system.
• Proposed mechanisms involve an imbalance of sympathetic co-transmitters, potentially aiding in migraine diagnosis and treatment.