Migraine as an allostatic reset triggered by unresolved interoceptive prediction errors.

Area of Science:

• Neuroscience
• Computational Psychiatry
• Physiology

Background:

• Migraine's cause and purpose remain unclear.
• Allostasis and active inference offer potential explanatory frameworks.

Purpose of the Study:

• To explain migraine within the theoretical frameworks of allostasis and active inference.
• To elucidate the role of prediction error in migraine pathophysiology.

Main Methods:

• Conceptual analysis integrating allostasis and active inference theories.
• Explanation of migraine phases (premonitory, attack) through prediction error amplification.

Main Results:

• Migraine is proposed as a 'failsafe' mechanism for allostasis, triggered by persistent, amplified prediction errors.
• Elevated prediction error, particularly concerning interoception, signals potential allostatic dysfunction.
• The premonitory phase involves broad amplification of errors to prioritize resolution.

Conclusions:

• Migraine serves as a critical, albeit potentially maladaptive, regulatory process for maintaining physiological stability.
• Understanding migraine through allostasis and active inference may reveal new therapeutic targets.