Migraine affects 28 million Americans and is the most frequent neurological disorder in the adult population worldwide. Migraine predominantly affects young adults, particularly women and has a high impact on our society due to its disabling nature and reduced quality of life.
A typical migraine attack produces some or all of these signs and symptoms:
Moderate to severe pain, which may be confined to one side of the head or may affect both sides
Head pain with a pulsating or throbbing quality
Pain that worsens with physical activity
Pain that interferes with regular activities
Nausea with or without vomiting
Sensitivity to light and sound
Inflammatory Toxins Mediate the Pain in Migraine
Inflammatory toxins mediate the pain in the neurovascular system. The following evidence suggests that inflammation contributes to migraine transformation:
The source of pain in migraine headache involves release of inflammatory cytokines (soluble intracellular adhesion molecule (sICAM-1), interleukin (IL)-6, and tumor necrosis factor (TNF)-alpha) and proinflammatory mediators such as calcitonin gene-related peptide (CGRP), substance P (SP), vasodilator peptide, and vasoactive intestinal polypeptide (VIP).
C-reactive protein, an inflammatory biomarker, is increased in young adult patients with migraine.
Levels of several inflammatory cytokines are significantly higher in migraine patients than in healthy controls.
Cross talk between nitric oxide (NO) and prostaglandins (PGs) contributes to the severity of pain response. Under inflammatory states, nitric oxide and prostaglandins are released simultaneously in large amounts.
During migraine attacks, elevated levels of PGE2 have been detected in blood and saliva.
Inflammatory mediators may increase the frequency, severity, and duration of migraine attacks, which in turn would cause central sensitization.
Other known risk factors to migraine transformation include depression, stressful life events, head trauma, sleep apnea, frequency of headache attacks, and medication overuse.
Inflammation is a Common Link Among Migraine, Obesity and Depression
A longitudinal population study showed that persons with obesity develop chronic daily headache at more than five times the rate of normal weighted individuals. A large population study confirmed that obesity was a risk factor for chronic daily headache and high body mass index was associated with more frequent headache attacks among migraine sufferers. Several of the inflammatory mediators that are increased in obese individuals are also elevated in migraine. It has been suggested that these mediators are responsible for increased frequency, severity, and duration of migraine attacks.
A recent population study showed that, in the United States, obesity was associated with significant increases in major depression, bipolar disorder, and panic disorder, and sleep apnea, all of which are risk factors for migraine progression. Obesity has also been associated with a number of chronic pain syndromes including fibromyalgia, arthritis, back, and neck pain.
There Is No Safe Treatment for Migraine Headaches
There’s still no cure for migraine. Medications can help reduce the frequency of migraine and stop the pain once it has started. However, side-effects of these medicines are not compatible with long-term use. Complementary therapies (acupuncture and massage) and natural remedies (herbs, vitamins and minerals) may be helpful to relieve chronic headaches.
Whole Body Approach – Focusing on Systemic Inflammation
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