Migraine and the blood-brain barrier

Area of Science:

• Neurology
• Neuroscience
• Vascular Biology

Background:

• Migraine prodromal symptoms correlate with decreased cerebral blood flow (CBF).
• The cerebral vasculature is typically unresponsive to circulating vasoactive agents.
• Systemic monoamines and prostaglandins significantly alter cerebral perfusion if the blood-brain barrier is disrupted.

Purpose of the Study:

• To investigate the role of the blood-brain barrier in migraine-associated cerebral blood flow changes.
• To explore potential mechanisms linking diet, vasoactive substances, and migraine attacks.

Main Methods:

• The study reviews existing findings on cerebral blood flow regulation during migraine prodrome.
• It analyzes the impact of blood-brain barrier integrity on cerebral vascular response to vasoactive substances.
• The research considers both external (dietary) and internal (endogenous) sources of vasoactive agents.

Main Results:

• A defective blood-brain barrier in migraine patients could render cerebral circulation susceptible to circulating vasoactive substances.
• This vulnerability is particularly relevant in diet-triggered migraine attacks.
• In non-dietary migraine, endogenous release of monoamines or prostaglandins might explain altered cerebral circulation.

Conclusions:

• Blood-brain barrier integrity is a critical factor in migraine pathophysiology.
• Dysregulation of cerebral blood flow in migraine may be mediated by vasoactive substances acting on a compromised or altered blood-brain barrier.
• Understanding these mechanisms could inform novel therapeutic strategies for migraine prevention and treatment.