MRI investigations of the brainstem in migraine patients (2020)

Abstract

Migraine is a complex neurological disorder, which involves dysfunction of the peripheral and central divisions of the nervous system. Despite years of research, the origin of migraine attacks

remains a conundrum. One indication is abnormal neuronal activation in the pons during migraine attacks, as demonstrated by previous neuroimaging studies. However, the exact implication of this finding to the migraine attack pathophysiology is unknown. Increased glutamate levels in the pons, as suggested by a line of evidence, might be associated with pontine hyperactivity, thereby providing a possible mechanism of migraine attack initiation.

Due to the spontaneous nature of migraine, challenging the research of the attack mechanisms, human experimental migraine models are applied for this purpose. As there are no available

methods for pontine investigation of glutamate, we firstly developed and validated such a method using the two headache-inducing substances, calcitonin gene-related peptide (CGRP)

and sildenafil, as they modulate attacks via different modes of action (study I). We found that the newly developed method showed no persistent drug-induced effects on the pontine

measurements and provided good spectral quality. This method was applied in study III. In study II, we aimed to further expand our understanding of the intracellular signaling pathways

of migraine....