Migraines Could Lead To White Matter Damage In Brain: New Study

Migraine photo

Abnormalities are common in the signal-sending white matter of migraineurs with aura (1)

A recent analysis of some 19 medical studies put together on migraineurs point that permanent changes likely occur in the brain of those who suffer from migraines and particularly those among them who experience aura – visual or otherwise, before the onset of an attack.

The analysis which was published online in the latest Journal of Neurology concluded that migraineurs with aura were almost two times as likely to have anamolies/abnormalities in the brain structure as those who do not suffer from migraines.

MRIs clearly show white-matter blips and other tissue changes in the migraineurs brain images but how exactly do these neurological variances translate to significant imagery correlate or give a prognosis of progressive deterioration is yet to be seen.

According to Dr. Richard B. Lipton, a neurologist who heads the Montefiore Headache Center in the Bronx, N.Y. “Part of the message I hope to communicate here is: If you have migraine with aura and you have white-matter lesions, they’re probably not a cause of concern.”  (2) However he noted that migraineurs with aura have twice the risk of getting a stroke than non-aura migraineurs

The 19 medical study analysis said the occurrence of tiny lesions that imitate scars left from strokes in aura migraineurs have left them inconclusive because there was no significant evidence of cognitive decline or other neurological symptoms from such lesions or other white-matter anomalies.

In addition, Dr Lipton said that it was good to follow the ‘you never know’ strategy,  further saying, “If you have migraine with aura, certainly you shouldn’t smoke,. Certainly, if you are going to use oral contraceptives, you should use the lowest possible hormonal dose. If you have other stroke risk factors such as hypertension or diabetes or high cholesterol, it becomes particularly important to manage those risk factors.” (2)

What was found to be more disturbing was the uncertainty that surrounds the direction of the correlations. This especially so because it puts forth the reverse question on the table : Is it that the peculiar white-matter phenomena of aura migraineurs on MRI images is what makes for a migraine-prone brain? That is, are the brains of migraine patients different to begin with?

SOURCE:

  1. Image Credits: Sad Middle Aged Woman Suffering From Headache; StockImages; FreeDigitialPhotos.net; Web August 2103; http://www.freedigitalphotos.net/images/Emotions_g96-Sad_Middle_Aged_Woman_Suffering_From_Headache_p150766.html
  2. Migraine could be associated with brain damage, study warns; Los Angeles Times; Web August 2013; http://www.latimes.com/science/sciencenow/la-sci-sn-migraine-brain-damage-20130828,0,7497521.story

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Biological Roots of Migraine Identified In Large Scale Genome Study

Gene Skull

12 genetic regions have been identified with migraine susceptibility (1)

How does a migraineur look to you when not experiencing a migraine attack?  I suspect you would say, ‘I had no idea ABC suffered migraines at all’ or ‘s/he looks fit and fine to me’. Correct. Both times…and that is what makes migraine as a neurological disorder very hard to study by researchers. The underlying pathologies and biomarkers are just not present during a non-episode.

To work around this problem, a team of international researchers at Wellcome Trust Sanger Institute worked on 29 different genomic studies, including over 100,000 samples from both migraine patients and control samples – the best way we think to study neurological disorders like migraines and epilepsy and understand it’s biology.

12 regions of migraine susceptibility were identified out of which:

  • 8 regions were found in/ near genes known to play a role in controlling brain circuitries;
  • 2 regions were associated with genes that are responsible for maintaining healthy brain tissue;
  • Some regions of susceptibility lay close to a network of genes sensitive to oxidative stress, a biochemical process that results in the dysfunction of cells.

According to Dr Gisela Terwindt, co-author from Leiden University Medical Centre, “This large scale method of studying over 100,000 samples of healthy and affected people means we can tease out the genes that are important suspects and follow them up in the lab.” (2)

Besides this, the team also identified an additional 134 genetic regions potentially related to migraine susceptibility though statistical evidence backing it were not very strong. However, there have been other studies that exhibit that these statistically weaker culprits can play an equal part in the underlying biology of a disease or

As per Dr Mark Daly, from the Massachusetts General Hospital and the Broad Institute of MIT and Harvard, “Effective studies that give us biological or biochemical results and insights are essential if we are to fully get to grips with this debilitating condition. Pursuing these studies in even larger samples and with denser maps of biological markers will increase our power to determine the roots and triggers of this disabling disorder.” (3)

SOURCES:

  1. Image credits: Human Head With DNA Structure; FreeDigitalPhotos.net;Victor Habbick; Web June 2013; http://www.freedigitalphotos.net/images/agree-terms.php?id=10073380
  2. Getting to Grips With Migraine: Researchers Identify Some of the Biological Roots of Migraine from Large-Scale Genome Study; Science Daily News; Web June 2013; http://www.sciencedaily.com/releases/2013/06/130623144952.htm
  3. Getting to grips with migraine; Cambridge Network; Web June 2013; http://www.cambridgenetwork.co.uk/news/getting-to-grips-with-migraine/

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No Sign Of Early Mental Deterioration In Migraineurs: Study

Forgetful

No Mental Deterioration In Elder Migraineurs Due To Repeated Episodes (1)

Neurological research for some time has shown that migraineurs are at an increased risk of developing vascular lesions in the brain and exhibit frequent changes in their cerebral white matter.

A recent study conducted by the University Hospital Graz, Austria took a look at the possibility that such striking change that occur in the migraineurs’ cerebral white matter was indeed going to lead to an earlier age-expected mental deterioration, at least for a significant percentage of the migraining population thus causing them compromising lifestyles and depending on care.

White matter makes up for a majority of brain mass in humans. It is a network of axons sheathed in white fat that renders conductivity of neural and electrical pulses. White matter is believed to be crucial for how the brain functions, for successful learning and for social behaviour.

The study took into its fold some 639 elderly with the average age of 74 years who had had some history of neurological conditions like migraines, cognitive or motor conditions and whose diagnosis was supported by an initial MRI scan and report. The assessment was carried out case by case on the basis of a comprehensive clinical, neuropsychological and functional protocol throughout the three year period. MRI scans were conducted at the start and at the end of the study. Both volume and extent of changes in the cerebral white matter was recorded.

The results showed that 16% of all subjects suffered from migraines out of which over 66% of migraineurs also experienced with aura; women were three times more likely than men in the same age group to suffer migraines though the severity and volume changes in brain were the same in both men and women.

According to leading author of the study, Prof Fazekas, “The welcome result of the study was this: We can say for elderly patients at least that their migraines do not increase the risk of vascular injuries in cerebral white matter. They are also not at risk of these pain attacks exacerbating vascular lesions in the brain.” (2)

However, in the follow-up examination after three years there was found to be no significant correlation between migraines and the progression of changes in white matter. No gender-specific differences were detected, either. In short, the assumed correlation between headaches and neurological changes was not confirmed. The correlation between migraines and changes in white matter is a specific phenomenon amongst affected younger people and presumably attributable to some other pathogenic mechanism.

SOURCES:

  1. Image Credit: Photopin.com; Sticky note via Creative Commons; Web June 2013; http://farm5.staticflickr.com/4076/4883925774_fb796f0e6c.jpg
  2. Migraines Do Not Exacerbate Mental Deterioration; Medical News Today, MNT; Web June 2013; http://www.medicalnewstoday.com/releases/261713.php

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Serotonin and Neurological Afflictions

Hi,

Last week we saw how eating a tryptophan-rich diet didn’ t necessarily translate into increased serotonin levels in the brain unless backed by adequate Vitamin B3, B6 and complex carbohydrates. It however, did place one a better chance at getting a serotonin boost.

Studies have established some links to a defecient state of brain serotonin with other neurological afflictions besides migraines, such as alcoholism, depression, suicidal tendencies, PTSD, obsessive compulsive disorders, generalised anxiety disorders and social phobia to name a few.

We may experience low brain serotonin levels due to a variety of reasons:

1. Low levels of production of brain serotonin.

2. Less number of serotonin receptors in our brain region

3. High reuptake rate of serotonin back from the synapse into the presynaptic neurons, and

4. Defeciency in tryptophan levels in our body.

There is a new and fifth interesting dimension that has cropped up – that of the serotonin transporter gene (SERT). To relay a message, a neuron releases serotonin into the synapse or the gap between two neurons from where their dendrites begin. Once the message is relayed to the next neuron, the released serotonin in the synapse is collected and transported back to the pre-synaptic neuron by the SERT. SERTS are monoamine proteins. It has been found that when there are changes in the SERT metabolism, neurological afflictions begin.

It is also now being thought that the gene (called SLC6A4 – Solute Carrier family 6, member 4) that encodes the SERT can be mutated and result in changing the functions of SERT.

The area (aka promotor) in the gene SLC6A4 which synthesises RNA under the instrucions from DNA, contains polymorphism – some long repeats (16 repeats of a sequence) and some short repeats (14 repeats of a sequence). Shorter repeats obviously enable lesser coding in them and thus when we have a pair of short repeats we get an increase in the risks of developing disorder states.

So though SSRIs and beta blockers may help migraineurs as well as those suffering from insomnia, depression, PTSD and other anxiety disorders, their efficacy will not be the same between 2 persons with the same condition. Those predisposed to neurological and psychological conditions due to the presence of 2 short versions of the gene will be less benefitted than those with other variations (2 long or 1 long and 1 short).

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De-mystifying Migraines In Women

I was struck by the statistics on migraineurs worldwide published by the WHO. Apparently, 303 million people the world over suffer migraines, out of which women account for 70% of the patients. India alone has 100 million sufferers and the US has 30 million patients. The report went on to add that it is estimated that 20 million migraine attacks happen everyday!!!! Staggering by any scale.

Though a lot of cutting edge research has been done, especially in the last decade to control this beast, scientific reports still grapple with unknowns, and are still clueless on issues such as why or how magnesium release regulates calcium ions in the neurons or why a certain chain of events takes place in the cranium that bring on migraines or even why they wind up.

With so much still in the grey, one wonders when and if help will come from drugs that will be safe to consume in the long run or if there are any strategies out there to shake this neurological disease.

In my book, ‘Migraines for the Informed Woman’, I have attempted to simplify the esoteric jargon of research papers and scientific material on migraines. After more than one decade of trying most therapies, I have come to the conclusion, that some work and others that are not as effective. More importantly, I have come to realise that certain mixes of therapies done simultaneously work wonders.

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Best Regards