Migraine Sufferers Have Different Brains

Researchers have identified specific differences in the
brains of migraine sufferers linked to the processing of sensory information,
including pain .

In earlier research, Harvard Medical School investigators used magnetic
resonance imaging (MRI) to show structural differences between the brains
of people with and without migraines.

Specifically, the imaging showed thickening in a specific area of the brain
related to the communication of sensory processing called the somatosensory
cortex (SSC).

It is not clear if migraines cause the brain changes or if the brain
differences cause migraines, researcher Nouchine Hadjikhani, MD, of the
Martinos Center for Biomedical Imaging at Massachusetts General Hospital tells
WebMD.

"That is the big question," she says. "A person could be born
with these cortical differences, making them susceptible to migraines later in
life. But we just don't know."

Migraines and the Brain

In the newly reported imaging study, researchers compared the brains of 24
people with migraines and 12 people without them. They found that the SSC was
an average of 21% thicker in migraine sufferers. The thickness changes were
especially pronounced in the part of the SSC related to sensation of the head
and face.

Most study participants with migraines had experienced the severe headaches since childhood, suggesting that long-term
stimulation of this sensory area of the brain could lead to structural changes,
Hadjikhani says.

The study is published in the Nov. 20 online issue of the journal
Neurology.

Other studies have also shown differences in cortex thickness in patients
with multiple
sclerosis and Alzheimer's disease.

But it is also possible that the structural changes precede migraines and
actually cause them to occur.

Hadjikhani and colleagues hope to shed light on this 'chicken and egg'
conundrum in a much larger study.

Imaging studies on young children who are at high risk for having migraines
later in life because their mother or father had them may also help answer the
question of which comes first.

"If we already see these changes in children who have never had a
headache in their life, that will tell us something," she says.

Whatever the outcome, it is increasingly clear that the brain's sensory
processing center plays an important role in migraines.

Treat Migraines Aggressively

It is also now clear that the brains of migraine sufferers are different
from those of people without the severe headaches.

In an unrelated study, researcher Mark C. Kruit, MD, and colleagues from
Leiden University in the Netherlands identified tiny brain lesions in the
brains of a significant percentage of migraine sufferers who underwent MRI.

In an interview with WebMD in 2004 , Kruit predicted that the imaging
studies would "change the common perception that migraine is a trivial
problem with only transient symptoms."

The studies also point to the importance of aggressively treating migraines , Hadjikhani
says, to both prevent the headaches from occurring and to manage the pain when
they do occur.

She reasons that if frequent migraines cause structural damage to the brain,
having fewer migraines and migraines with less intense pain may prevent this
damage from happening.

"It is important not to let the pain get out of hand," she says.

By Salynn Boyles
Reviewed by Louise Chang
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