Exploring the Pathophysiology of Migraine with Aura

Abstract

A migraine is a common neurological disease that causes a headache with the symptoms of severe throbbing or pulsing pain, typically on one side of the head. Up to 30% of people with migraine experience auras or visual disturbances as a symptom that occurs before or during the headache. Through experiments using animal models, researchers have found many possible reasons for the cause of migraine. While the underlying mechanisms of this disease are not yet fully understood, current research theorizes that migraine with aura is likely due to Cortical Spreading Depression (CSD). CSD is a temporary wave of electrical activity that spreads in the outer layer of the brain, the cortex. CSD can also directly affect the visual cortex, which contributes to the development of auras associated with migraine. This wave is thought to be caused by the excessive buildup of glutamate, an excitatory neurotransmitter.  CSD is also thought to trigger the release of Calcitonin Gene-Related Peptide (CGRP), a neuropeptide that causes blood vessels to dilate and widen. This leads to the inflammation and pain that occurs during a migraine attack. People with this disease usually take prescription drugs such as sumatriptan and rizatriptan to help reduce the pain. Another common method is using antibodies that target the CGRP receptors and CGRP itself. Further research is necessary to improve our understanding of aural migraines and develop more effective treatments.