Migraine Headache Causes
Migraine headaches are often associated with severe pain. Several causes of migraine headaches can be identified. The clinical history and reported symptoms of the headaches are used to confirm the diagnosis. Migraine headaches can be classified as either chronic or episodic, with or without aura. Migraine pain typically starts as a dull ache but can quickly become severe. The pain is usually felt on the forehead but may also affect one or both sides of the head.
Serotonin
Low Serotonin levels are known to be a trigger of migraine headaches. Because of this connection, most medications used to treat migraines act on Serotonin levels to some degree. These include ergotamine tartrate (the first type of anti-migraine drug) and Triptans, a newer category of anti-migraine drugs. Additionally, over-the-counter painkillers can also lower Serotonin levels. When taken too often, these drugs will reduce the levels of Serotonin in the body and trigger migraines.
Studies have also linked serotonin levels to the frequency of migraine attacks. One possibility is that Serotonin is involved in modulating the production of CGRP, a neurotransmitter associated with migraine attacks. Other explanations for migraine symptoms include the influence of estrogen and ovarian hormones.
Triptans are anti-migraine drugs that mimic the actions of Serotonin in the brain. Serotonin calms overactive pain nerves. Triptans are available as single drugs and as combinations with non-steroidal anti-inflammatory drugs. Doctors select a combination based on a patient's symptoms and the duration of the migraine attacks.
Anti-depressants are another standard treatment for migraines. They act on specific serotonin receptors in the brain. As a result, anti-depressants may help to improve mood and manage pain. In addition, some migraine sufferers may opt for over-the-counter pain relievers and prescription medications, such as sumatriptan.
Serotonin receptors
Studies have found a link between the neurotransmitter Serotonin and migraine headache. Serotonin is a neurotransmitter that passes signals from one part of the brain to another. In migraine, Serotonin levels increase during the attack. Because of this, some medications aim to increase Serotonin levels in migraine patients. In addition to medications, people can learn to recognize fluctuations in their Serotonin levels and refined foods that increase tryptophan.
Serotonin receptors are highly heterogeneous and have been divided into seven families. One of the families is the 5-HT3 receptor, a G-protein coupled receptor linked to several psychiatric and neurological disorders. Moreover, 5-HT3 receptors have been implicated in the pathophysiology of migraine.
Serotonin receptors are involved in several aspects of the pathophysiology of migraine. These include the release of vasoactive neuropeptides by the trigeminovascular system, increased nociceptive neurotransmission within the central trigeminocerebral complex, and vasodilation of intracranial extracerebral vessels. In addition, these receptors are also involved in the vasoconstriction of painful cerebral blood vessels and inhibition of neurotransmission.
The study found that 5-HT4 receptor density was lower in migraine patients than in healthy controls. This may be explained by the repeated 5-HT surges that occur during a migraine attack, resulting in a higher level of 5-HT in the brain and decreased binding to the 5-HT4 receptor in the cerebrum. In addition, functional neuroimaging studies have found that 5-HT4 receptors are enriched in specific brain regions associated with migraine, including the insula, the temporal lobe, and the orbitofrontal cortex. However, these studies have not confirmed a causal link between the two groups.
