What happens in the brain during a migraine attack?

As a lecturer at the Bauer International Academy of Holistic Medicine, it is particularly important to me to bring you closer to the latest scientific findings on migraine. Migraine is a fascinating and at the same time extremely complex clinical picture that poses great challenges for many of us, whether as therapists or possibly as sufferers.

Migraine: More than just headaches

Migraines are much more than just a “severe headache”. It is a neurological disease that affects the central nervous system and affects millions of people worldwide. Many patients experience a variety of symptoms that go far beyond the classic headache – these include nausea, sensitivity to light, blurred vision, and many more. But what actually happens in our brain during a migraine attack?

Cortical Scattered Depolarization: A Wave of Excitation

One of the most important discoveries in migraine research in recent decades is the so-called “cortical scatter depolarization”. This phenomenon is best compared to a wave that is created when a stone is thrown into a still lake. In the context of migraine, such a wave spreads in waves over the cerebral cortex, which leads to a massive excitation of the nerve cells. This wave is particularly pronounced in people with migraines and is often associated with the so-called migraine aura symptoms.

The role of nerve cells and oxygen deficiency

During a migraine attack, the nerve cells in the cerebral cortex “fire” excessively, which consumes an enormous amount of energy. This overactivity leads to temporary exhaustion of nerve cells, which slows down signal transmission in the brain and puts the brain in a state of exhaustion. In addition, the oxygen supply in the affected brain areas is restricted, which can lead to visual disturbances, especially during the aura phase.

Pain and inflammation: The double burden

Another critical aspect of migraines is the pain caused by the release of messenger substances in the brain. These so-called mediators move from the brain tissue towards the meninges and trigger a pain reaction there. The nerve endings respond by releasing pro-inflammatory substances, which in turn increase sensitivity to pain and prolong the duration of pain. This vicious circle contributes significantly to the intensity and duration of a migraine attack.

The link between aura and migraine attack

It has been known for many years that there is a close connection between the migraine aura and the onset of the actual migraine attack. Today we assume that the aura is caused by the slow propagation of the excitation wave in the brain, which is particularly noticeable when the visual center is affected. This excitation leads to the typical optical phenomena such as flashes of light or visual distortions that many patients experience before a migraine.

The challenge for science

Despite advances in migraine research, much remains to be done. The real challenge is to put together the multitude of research results into a coherent overall picture that gives us a complete understanding of migraine. Such an understanding could not only help to better explain the different forms of migraine, but also to develop new, targeted therapies.

Our journey together

In this course, we will take an in-depth look at these topics and try to better understand the complex mechanisms underlying a migraine attack. I invite you to actively apply this knowledge to your professional practice in order to support your patients in the best possible way. Let’s walk this exciting path of knowledge together.

Yours, Nick Bauer, PhD student at the Bauer International Academy of Holistic Medicine