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Migraine pathogenesis: the neural hypothesis reexamined
Summary
Migraine may originate in the brain's sensory cortex or hypothalamus, challenging vascular theories. This neurological basis, proposed a century ago, warrants further investigation for migraine treatment.
Area of Science:
- Neurology
- Neuroscience
- Vascular Biology
Background:
- Migraine is often viewed as having vascular origins.
- Previous theories suggested a neurological basis for migraine.
Purpose of the Study:
- To test the hypothesis that migraine is a primary neurological disorder with secondary vascular symptoms.
- To evaluate the viability of a century-old neurological mechanism for migraine initiation.
Main Methods:
- Analysis of the five phases of migraine attacks.
- Examination of eight recognized groups of migraine precipitating factors.
- Inclusion of accessory evidence from cerebral blood flow and electroencephalogram (EEG) recordings during attacks.
Main Results:
- Evidence supports the sensory cortex and hypothalamus as potential initiating sites for migraine attacks.
- Findings indicate that a neurological mechanism is a viable explanation for migraine.
Conclusions:
- The study supports a primary neurological disturbance in migraine, with vascular changes being secondary.
- A neurological mechanism for migraine, first proposed by Liveing and Gowers, remains relevant for future research.