Migraine: Danish study reveals a new communication pathway between the brain and sensory nerves, opening up new possibilities for treatment.
For years, migraines have held millions of people in check. Like the most skilful and elusive of villains, they ‘hit and run‘. Now, a team of Danish researchers may have shed light on its mechanisms. The discovery could be a breakthrough for therapies.
The mystery of unilateral migraine
Millions of people worldwide are affected by migraine. The condition is characterised by ‘unilateral pain‘, often preceded by an aura (temporary visual or sensory disturbance). Until now, the mechanism behind this phenomenon has remained a mystery to the scientific community.
Researchers at the University of Copenhagen, Rigshospitalet and Bispebjerg Hospital have finally solved the mystery in a new study on mice. Research has shown for the first time that proteins released by the brain during aura are transported from the cerebrospinal fluid to the nerves that signal pain.
The trigeminal ganglion’s key role
Martin Kaag Rasmussen, lead study author, explains:
We found that these proteins activate a group of sensory nerve cell bodies at the base of the skull called the trigeminal ganglion, which can be described as the gateway to the peripheral sensory nervous system of the skull.
The barrier that normally prevents substances from entering the peripheral nerves is missing at the root of the trigeminal ganglion. This allows substances in the cerebrospinal fluid to enter and activate the sensory nerves that signal pain, triggering the attack.
The voice of pain
This finding also plausibly explains the unilateral nature of migraine. Rasmussen says: “Our study of how proteins are transported in the brain shows that substances are not transported to the entire intracranial space, but mainly to the sensory system on the same side, causing the one-sided headache typical of this manifestation.
Using advanced techniques such as mass spectrometry, the researchers analysed the cocktail of substances released during the aura phase of a migraine attack. They identified 1,425 proteins in the cerebrospinal fluid, 11% of which showed changes in concentration during a seizure.
Among the proteins identified is CGRP. CGRP is already known for its role in migraine and is used in existing treatments. But she is not the only one, of course. Other proteins that could pave the way for new treatments were also discovered.
Migraine, next steps in research
The team of researchers is now working to identify the protein that has the greatest potential for therapeutic use. Rasmussen’s hope is to identify the proteins that trigger migraine phenotypes. His team will then carry out provocation tests in humans to see if exposure to any of the identified proteins can trigger an attack.
It could be a short step from there to the development of targeted therapies. These proteins could be important targets for new preventive and therapeutic treatments if they can trigger migraine attacks in humans.
Conclusions
The discovery of this new communication pathway between the brain and the peripheral nervous system is a major step forward in our understanding of migraine.. It offers both an explanation for the symptoms and a direction for the search for more effective treatments.
This discovery marks an important turning point in the journey to fully understand and treat migraine. Soon, unilateral pain could be a thing of the past for millions of people.
