The migraine—a common but debilitating brain disorder characterized by severe headaches, often with accompanying nausea and visual auras—has perplexed neurologists for decades. There are so many types of migraine, and each person’s physiology responds differently to the few drugs and treatments available.
In the hunt for an umbrella drug to treat all migraines, researchers at the University of British Colombia have investigated a potential new treatment for migraine with aura, which affects about one-third of migraine sufferers: pregabalin (brand name Lyrica). In a class of drugs called gabapentinoids, pregabalin is an anticonvulsant used to treat epilepsy, neuropathic pain, and fibromyalgia. The researchers published their results today in Proceedings of the National Academy of Sciences (PNAS).
Migraines begin in the brain before they’re ever visualized as an aura or felt as an intense headache. Researchers believe migraines are triggered by a brain pattern known as cortical spreading depression, or SD. Though triggers can be numerous, the SD starts in the brain as a “depolarization of neurons in a particular area of the brain,” Stuart Cain, lead author and a neurophysiologist at University of British Columbia, Vancouver tells mental_floss. “This causes a wave of excitation that travels across the brain.”
After the excitation period, there’s a long period of inactivity in which the neurons become stuck in this inactive state. “It’s this wave of inactivity that is actually causing spreading depression, and that causes the migraine aura,” he explains. Though the mechanisms are still not fully understood, they also believe this SD triggers the trigeminal nerve, one of the most widely distributed nerves in the head. That is what causes the headache pain.
As the SD travels slowly through the brain, it may go into the visual cortex and stimulate visual hallucinations, or even the auditory cortex, causing auditory hallucinations….