- Extreme sensitivity to light and sound
- Poor focus and concentration
Migraine has long been thought to be caused by a combination of genetics and environment, with the following being the main triggers:
- Hormonal changes in women: Some research points to a drop in estrogen that occurs right before menstruation and right after menopause as a common migraine trigger.
- Food: Food additives and preservatives can trigger migraine when sensitivity to those are present. Alcohol, preserved meats and cheeses, and the artificial sweetener aspartame has also been linked to migraine.
- Sensory input: Bright lights, loud noise, or unusual, strong smells (e.g., gasoline fumes or solvents) have all been linked to an onset of migraine.
Other common triggers can include changes in barometric pressure, dramatic changes to sleep patterns, and an overload of stress.
Migraine research has been focusing on more effective ways to treat migraine headaches. Common treatments have focused on prevention first and then pain-reducing medications, but the latter can cause gastrointestinal issues or have other unwanted side effects. Here are four new treatments currently being studied.
A first-line treatment for migraines has been non-steroidal anti-inflammatory drugs (NSAIDs), but taking these for extended periods of time can result in bleeding ulcers, especially when a migraine patient takes a high enough dose to be effective. Achelios Therapeutics is developing a carrier gel that will allow NSAIDs to be applied topically close to the trigeminal nerve, which is largely believed to be responsible for conveying migraine pain. The therapy is in Phase 2a trials, studying results in 40 patients and finding that 77% of them are reporting significant pain relief, 45% of whom felt this relief for anywhere between two and 24 hours.
This is especially promising for migraine sufferers who are unable to take triptans due to cardiovascular issues, but it can also be offered as a complementary therapy for those who are able to take these vasodilating medications.
Treatment that targets the neck
Migraine research has long focused on the head, but new research is beginning lower down. Dr. Houman Danesh of Mount Sinai Hospital in New York City had this to say about the way the bones interact in the neck to cause pain:
“Essentially the joints start rubbing against each other, and that irritates the nerve that goes from the back of your neck to the back of your head, and can offset and trigger a nightmare.”
Once doctors have identified the nerve being affected by these joints rubbing together, they can then apply a nerve block to help offer immediate relief.
Targeted nerve blocks
Another targeted treatment from the Society of Interventional Radiology has been shown to offer more prolonged pain relief. This migraine research was presented at the Society of Interventional Radiology’s Annual Scientific Meeting. Image-guided, intranasal sphenopalatine ganglion (SPG) blocks are a minimally-invasive treatment that uses a catheter inserted nasally to administer 4% lidocaine to the sphenopalatine ganglion, the nerve bundle often associated with migraine.
Participants in the study reported pain that was cut in half, with 88% reporting needing fewer medications to supplement their block. Kenneth Mandato, M.D., the study’s lead researcher and an interventional radiologist at Albany Medical Center, believes that the procedure is so safe that it can be repeated when the effects wear off.
Mandato had this to say about how even a re-administration may be unnecessary:
“Administration of lidocaine to the sphenopalatine ganglion acts as a ‘reset button’ for the brain’s migraine circuitry. When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did. Some patients have reported immediate relief and are making fewer trips to the hospital for emergency headache medicine.”
New enzyme discovery yields potential treatments for brain inflammation
Brain inflammation has been linked not only to Alzheimer’s, multiple sclerosis, Parkinson’s, and ALS but also to a rare neurodegenerative disorder called PHARC. PHARC was discovered in 2009 by Norwegian researchers and is the acronym created by its set of typical symptoms (polyneuropathy, hearing loss, ataxia, retinitis pigmentosa, and cataract). In 2010, researchers found that a gene caused the enzyme ABHD12 to become inactive. This enzyme normally breaks down lipid molecules called lysophosphatidylserines (lyso-PSs) in the brain, and without it ABHD12 builds up, causing inflammation.
This discovery could potentially lead to powerful, specific medications to fight brain inflammation, benefitting not only migraine sufferers but also countless more who suffer from other brain disorders caused by inflammation. Researchers are currently working on a treatment to lower lyso-Ps in the brain.
Benjamin F. Cravatt, chair of TSRI’s department of chemical physiology and member of TSRI’s Skaggs Institute for Chemical Biology, believes in the potential for this discovery to be a huge leap in the treatment of many different diseases:
“This finding is a good example of what can be gained from studying enzymes linked to rare human genetic disorders…We also think there is a potential for applying the lyso-PS-lowering strategy more broadly against neurological and immunological disorders.”
Migraine is a serious, sometimes debilitating condition. Do you or someone you love suffer from migraines? What treatments or preventative measures have helped you the most?
Image by Allan Ajifo via Flickr