Hard-Wired for Chronic Migraines?

August 27, 2013

Call it what you want: hard-wired; destined to be; built for it.  But, could it be possible that some people are physiologically pre-designed to suffer with chronic migraines?

These individuals might be ideal candidates for a migraine procedure.  A study from the University of Pennsylvania Perelman School of Medicine (Penn) found that certain individuals indeed might have a certain brain arterial structure that increases the likelihood they will develop a migraine condition.

The Penn researchers divided 170 subjects into three groups.  One group had migraines with aura, the second had migraines without aura and the third was a migraine free control group.  The Penn website’s news release did not indicate whether subjects with chronic migraines were independently evaluated.

Using arterial spin labeling (a type of MRI) and magnetic resonance angiography, the researchers observed cerebral blood flow patterns as well as blood vessel architecture within the brain.

They frequently discovered a specific abnormality within an arterial structural, called the ‘Circle of Willis’, among migraineurs. The lead author of the study said, “abnormalities in both the circle of Willis and blood flow were most prominent in the back of the brain, where the visual cortex is located.  This may help explain why the most common migraine auras consist of visual symptoms such as seeing distortions, spots, or wavy lines.”  According to the Penn news release, affected blood flow in the brain may influence neuron activity that is involved with onset of migraines.

The doctors believe that with a deeper understanding about how migraines occur, it will become more feasible to administer customized medical care.  In the future, doctors may be able to implement diagnostic capabilities that detect whether the Circle of Willis is a contributing factor in someone’s migraine condition.

After which, they will be able to apply personalized treatment.  For example, individuals with chronic migraines who also have this incomplete ‘Circle of Willis’, may undergo a migraine procedure such as implanting a neurostimulation device.  Episodic migraine sufferers may receive optimized medication protocols.  Genetic based therapies might also become highly personalized migraine solutions.

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