Migraines are a complex neurological condition, and their exact causes are not fully understood by science yet. What we do know for sure is that while migraines are highly individualized with triggers and symptoms varying from person to person, they happen in the brain.

Relief can be found in the brain.

Factors Contributing to Migraines

Migraines are a neurological disorder characterized by recurrent, severe headaches often accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound. While the exact causes are not fully understood, they involve complex neurological and vascular processes in the brain and researchers have identified several factors linked to migraines. It’s important to note that the exact mechanisms underlying migraines are still the subject of ongoing research, and there are variations in the specific processes for each person. A combination of factors is most likely, including:

Genetics and Epigenetics

Migraines often run in families. Some types of migraines are caused by mutations in specific genes. For example, three identified causal genes found in Hemiplegic Migraine are: CACNA1A, ATP1A2, SCN1A. Science found epigenetic changes have also been found in people with migraines.

Brain Abnormalities

Research has shown that people who experience migraines may have certain structural or functional abnormalities in the gray and white matter of their brains. These abnormalities can affect the way the brain processes pain signals.

Neurotransmitter Imbalances

Imbalances in certain neurotransmitters have been linked to migraines. The neurotransmitters found to be involved in migraines include: serotonin, dopamine, and GABA and glutamate. For example, GABA and glutamic acid are the main inhibitory and excitatory neurotransmitters of the central nervous system (CNS). Among other functions they modulate the pain threshold in the CNS, and their turn–over may play a role in migraines.

Triggers

Different triggers can bring about migraine headaches in individuals. Common triggers include foods, hormonal changes, stress, lack of sleep, bright lights, strong odors, and weather changes.

Hormonal Changes

Migraines are more common in women and hormonal changes are likely the contributing cause. Specifically, estrogen and progesterone levels can cause or worsen a headache. These hormones control menstrual cycles and pregnancy, and they also affect chemicals in the brain that influence pain sensations.

Inflammation

Inflammation in the blood vessels and surrounding tissues of the brain can contribute to the occurrence and severity of headaches. Migraine headaches can also trigger an inflammatory response in the brain, leading to the release of substances that further irritate and sensitize pain receptors. Medications that reduce inflammation may help alleviate migraines.

What Happens in the Brain During a Migraine?

Here’s what science shows is happening in your brain during a migraine:

Cortical Spreading Depression (CSD)

CSD is an electrophysiological phenomenon involving a wave of excitation of cortical neurons followed by inhibition. The aura phase that precedes about 20–30 percent of migraines may be a direct consequence of CSD. During a migraine, it is thought that there’s a wave of electrical activity that moves slowly across the brain’s cortex. This wave disrupts the normal functioning of neurons and can lead to changes in blood flow and the release of inflammatory substances that contribute to symptoms.

Vascular Changes

Migraines were originally thought to be primarily a vascular disorder, caused by changes in blood vessels. This theory has evolved to an understanding that blood vessel changes do play a role in migraines. Initially, there is vasoconstriction (narrowing) of blood vessels, which can reduce blood flow and oxygen supply to parts of the brain. This is often associated with the aura phase. Subsequently, there is vasodilation (widening) of blood vessels, which can lead to increased blood flow and inflammation in the brain.

Release of Neurotransmitters

Biochemical studies show metabolic abnormalities in neurotransmitters and neuromodulators during a migraine. In a resulting theory, it is proposed that migraine attacks derive from a top-down dysfunctional process that initiates hyperexcitability in the frontal lobe and progresses to abnormally activate the pain matrix.

Trigeminal Nerve Activation

The trigeminal nerve is a network of wiring that sends pain impulses from the eyes, scalp, forehead, upper eyelids, mouth, and jaw to the brain. The trigeminal nerve is involved for almost all people in migraines. It becomes activated during a headache, leading to the release of neuropeptides and the sensation of pain. The FDA cleared a device called Cefaly for sale without a prescription to both prevent and treat migraines.

Pain Processing

The brain’s pain-processing centers, including the thalamus and the brainstem, become sensitized during a migraine. The thalamus is a relay center for pain information during a migraine, and the brainstem modulates pain. This heightened sensitivity can make the headache more severe and trigger additional physical symptoms like nausea and sensitivity to light and sound.

Neurological Symptoms

Some people experience an “aura” before or during migraines, which can include temporary visual or other disturbances. Auras usually occur within an hour before pain begins and generally lasts less than 60 minutes. Auras are typically visual disturbances but can also include sensory or motor disturbances. These are thought to be related to the temporary changes in brain activity associated with CSD.

Neurofeedback for Migraines

Treatment approaches for migraines most often aim at managing the condition by preventing and lessening the severity of headaches. This would include identifying and avoiding personal triggers, lifestyle changes, medications, and relaxation techniques. There’s another option proving highly successful at improving the condition for many people: neurofeedback.

Neurofeedback is a non-invasive, painless, and medication-free technique that trains and guides a person’s brain activity to healthier functioning through real-time monitoring and feedback of brainwave patterns. A person’s brain actually learns, through operant conditioning, to perform at optimal levels which alleviate symptoms. The brain continues to self-regulate at these levels after the training.

Because neurofeedback can guide the brain to create new pathways, turn down brain activity, and retrain how the brain responds to stimuli, research is showing it can greatly decrease migraine pain and frequency. In one study using neurofeedback training on people with recurrent migraines, 54 percent of participants experienced a complete cessation of their migraines, and 39 percent experienced a reduction in migraine frequency of greater than 50 percent. Another study concluded:

“All combined neuro and biofeedback interventions were effective in reducing the frequency of migraines with clients using medication resulting in a more favorable outcome (70% experiencing at least a 50% reduction in headaches) than just medications alone (50% experience a 50% reduction) and that the effect size of our study involving three different types of biofeedback for migraine (1.09) was more robust than effect size of combined studies on thermal biofeedback alone for migraine (.5). These non-invasive interventions may show promise for treating treatment-refractory migraine and for preventing the progression from episodic to chronic migraine.”

Migraines Start in Your Brain and Can End There

Even though we don’t exactly know what all is going on to cause a migraine, we know that they happen in your brain. The answer to easing them is also in your brain — in altering its activity. Neurofeedback does exactly that. At Grey Matters of Carmel we rely on science and the information that your brain gives us about how its functioning to pinpoint and retrain brain operation.

At Grey Matters of Carmel, we are passionate about helping people live their best lives, including optimizing their brain’s health and function. Give us a call at (317) 215-7208 or send us a message today to talk about how we can help you.

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