By: Tia Ghose

Published: 04/22/2013 08:18 AM EDT on MyHealthNewsDaily


The pain of migraine headaches might not be caused by expanded blood vessels in the brain, as previously thought. Instead, the real culprit may be overactive pain-signal firing in brain cells, new research suggests.


Moreover, there are several treatments being developed that could address this signaling and, in turn, help treat migraine pain. However, further studies are needed to confirm that the overactive signaling is a cause of migraine pain.


"Many people are nonresponders to existing drugs," said study co-author Dr. Messoud Ashina, a physician at the University of Copenhagen in Denmark. "So there is room for improvement -- that's why we need the new drugs."


Ashina and his co-authors have received money from pharmaceutical companies.The findings, which were published online April 9 in the journal Lancet Neurology, come from studying the brain scans of patients as they were suffering from a migraine.


Mysterious phenomenon


About one in 10 Americans suffer from migraines, with women more likely to be affected. The headaches typically last from four to 72 hours, and are often accompanied by nausea, pain, and sensitivity to light and sound. Past studies showed an increased risk of stroke and depression in women who suffer from migraines.


The most common treatments for migraines, a class of medicines called triptans, were thought to relieve migraine pain by constricting blood vessels in the brain. But past research suggested only 30 percent of people suffering from a migraine are pain-free two hours after taking a triptan, Ashina said.


In recent decades, researchers have wondered whether pain signals from sensory neurons in the brain may be the true cause of migraine pain.


Brain pain


To study migraines in real time, Ashina and his colleagues looked at 19 women who were experiencing migraines. Using a technique called magnetic resonance angiography, the scientists measured the blood flow in the women's brains, and found that only a few blood vessels inside the brain were modestly dilated.


Then, they gave patients a triptan, and their average pain levels reduced dramatically.


However, the triptans constricted blood vessels on the outside of the brain, not the vessels that were mildly dilated during the migraine. That suggests that the triptans relieved migraine pain not by constricting blood vessels, but by another mechanism -- possibly by quieting pain signals from neurons.


Future treatments


The findings cast doubt on vessel dilation as the primary cause of migraine pain, Ashina said.


"We think that the pain signals are coming from the neurons, and the modest dilation that we see -- it is a kind of consequence of this activation of these neurons," Ashina told MyHealthNewsDaily.


That's good news, because several potential migraine treatments -- which belong to a class of medicines called CGRP antagonists and are designed to specifically target the chemical signals implicated in migraine pain -- are already being developed, Ashina said.


Follow Tia Ghose on Twitter @tiaghose . Follow MyHealthNewsDaily @MyHealth_MHND, Facebook & Google+. Original article on MyHealthNewsDaily .



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Also on HuffPost:






  • Feverfew


    One of the oldest herbal remedies for migraines, this plant can be used in many forms, included steeped in tea or even eaten raw, according to Alexander Mauskop, M.D., a board-certified neurologist focused on headaches and the director and founder of the <a href="http://www.nyheadache.com/" target="_hplink">New York Headache Center</a>.

    That's because it contains a powerful chemical called <a href="http://www.webmd.com/vitamins-supplements/ingredientmono-933-FEVERFEW.aspx?activeIngredientId=933&activeIngredientName=FEVERFEW" target="_hplink">parthenolide</a>, which has been linked to warding off migraines, although Mauskop says science hasn't really offered an answer yet as to how or why,

    One of the first studies of the herb came out of Great Britain in the 1980s, and found that 70 percent of people who chewed a couple of feverfew leaves each day saw <a href="http://www.umm.edu/altmed/articles/feverfew-000243.htm#ixzz20Lk71tCK" target="_hplink">their symptoms improve and experienced fewer migraines</a>, according to the University of Maryland Medical Center.

    In supplement form -- as long as it contains at least 0.2 percent parthenolides -- 100 to 150 milligrams a day may do the trick, according to a HuffPost blog by Dr. Andrew Weil, because it can help "<a href="http://www.huffingtonpost.com/andrew-weil-md/a-better-route-to-migrain_b_526945.html" target="_hplink">prevent the release of substances that dilate blood vessels in the head</a>."




  • Butterbur


    Unlike feverfew, this herb is toxic in any form but the processed supplement, says Mauskop.

    However, its headache-preventing properties are equally impressive. The chemicals in butterbur are thought to <a href="http://www.webmd.com/vitamins-supplements/ingredientmono-649-BUTTERBUR.aspx?activeIngredientId=649&activeIngredientName=BUTTERBUR" target="_hplink">relieve spasms and decrease inflammation</a>, which can cause headaches, according to WebMD.

    A small 2004 study found that patients who took 75 milligrams of butterbur twice daily had <a href="http://www.neurology.org/content/63/12/2240.abstract" target="_hplink">48 percent fewer migraines</a>, compared to a 26 percent decrease experienced by people given only a placebo.

    While it's been predominantly researched as a preventive measure, there's some preliminary evidence that it can also help beat a migraine as it's happening. Taking <a href="http://www.psychologytoday.com/blog/complementary-medicine/200808/migraines-easy-prevent-naturally" target="_hplink">100 milligrams every three hours</a> (up to 300 milligrams in 24 hours) just might do the trick, according to <em>Psychology Today</em>.




  • Magnesium


    Mauskop's own research found that people with migraines and cluster headaches are often deficient in magnesium.

    He demonstrated that an infusion of the mineral helped to stop the pain. Of course, an infusion isn't the most practical of treatments when you're struck by a migraine at the office, say, but supplements can also help.

    One small study found daily magnesium supplements <a href="http://www.ncbi.nlm.nih.gov/pubmed/8792038" target="_hplink">reduced migraine frequency by nearly 42 percent</a>, compared to only about 16 percent in people given a placebo pill. Some people have trouble absorbing magnesium, says Mauskop, which can lead to the unpleasant side effect of diarrhea, but overall it's considered safe in 200 milligram daily doses, he says.

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  • Riboflavin


    This B vitamin -- <a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/957.html" target="_hplink">found naturally in foods like milk, meat, nuts and green veggies</a> -- was <a href="http://www.ncbi.nlm.nih.gov/pubmed/9484373" target="_hplink">linked to migraine prevention</a> in a small 1998 study, but in a very high dose, writes Weil, one that would <a href="http://www.huffingtonpost.com/andrew-weil-md/a-better-route-to-migrain_b_526945.html" target="_hplink">need to be prescribed by a doctor</a>.

    Riboflavin (and an <a href="http://www.webmd.com/heart-disease/heart-failure/tc/coenzyme-q10-topic-overview" target="_hplink">enzyme that acts similarly called CoQ10</a>) is involved in producing energy inside the cells of the body, Mauskop explains, so it's better to take in the morning to ward off migraines, in case it disrupts sleep.




  • Omega 3s


    A dose of these healthy fats can fight inflammation, which is a likely culprit in many headaches and possibly some migraines. Everyday Health recommends <a href="http://www.everydayhealth.com/headache-migraine-pictures/8-home-remedies-for-headaches-and-migraines.aspx#/slide-8" target="_hplink">flax seeds</a> but fish, like salmon, and <a href="http://www.huffingtonpost.com/2012/03/31/cause-of-headaches-foods_n_1392670.html#s829432&title=Tamer_Omega3_Fatty" target="_hplink">fish oil supplements may also help</a>.

    "There are so many other benefits of omega 3s, even if it doesn't help your headaches, there's no reason not to try it," says Mauskop.

    <em>Flickr photo by <a href="http://www.flickr.com/photos/samcatchesides/5419724548/" target="_hplink">http://www.samcatchesides.com/</a></em>




  • Sniff Peppermint


    As anyone who gets headaches knows, certain smells can trigger the pain. But peppermint in particular seems to have pain-<em>reducing</em> effects, says Mauskop. "It's very individual," he says, and may not work for everyone. Or, it could just mask less pleasant smells.




  • Ginger


    This spice is well-known for being friendly to <a href="http://www.huffingtonpost.com/2011/02/23/gingers-health-benefits_n_826795.html#s244432&title=Travel_Companion" target="_hplink">upset stomachs</a>, and it can ease migraine-related nausea, too, says Mauskrop. It may also ease pain thanks to some <a href="http://www.huffingtonpost.com/2011/02/23/gingers-health-benefits_n_826795.html#s244430&title=Cramp_Reliever" target="_hplink">anti-inflammatory properties</a>. Just be sure you're getting the real thing, he says -- ginger ale doesn't cut it.

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  • Rubbing The Temples


    There may not be a body of research to support a simple head rub, but there's no denying it feels good! People instinctively rub their temples in the throes of a headache, and if it works for them, why not? "Whatever feels good, do that!" says Mauskop.




  • Massage


    In a similar vein, a whole-body massage can help, too. Part of that is likely due to the stress relief, as tension is a known headache trigger.

    A small study found that frequent migraine sufferers had <a href="http://www.ncbi.nlm.nih.gov/pubmed/16827629" target="_hplink">fewer headaches following six weekly massage sessions</a>. However, it's likely that <a href="http://www.huffingtonpost.com/2011/10/30/headache-treatments_n_1064690.html" target="_hplink">you'd have to continue the relaxing practice</a> -- indefinitely -- which could get pricey!




  • Meditation


    One way to reap the stress-reducing benefits for free is a quiet meditation practice, says Mauskop, who lists meditation as one of his top two natural migraine treatments. There remains <a href="http://www.huffingtonpost.com/2011/10/30/headache-treatments_n_1064690.html" target="_hplink">little concrete evidence</a> that meditation in particular can ease the pain, Health.com reported, but it is certainly a <a href="http://www.mayoclinic.com/health/meditation/HQ01070/" target="_hplink">proven stress reliever</a>.




  • Drink More Water


    Plenty of headaches are triggered by dehydration -- so much so that Mauskop says he has patients who will quickly drink a few glasses of H2O when they feel a migraine coming on, and actually stop it in its tracks. "They know to catch it early," he says, "that definitely can help."

    Not a huge water fan? There are plenty of ways to snazz up a glass or trick yourself into sipping more throughout the day <a href="http://www.huffingtonpost.com/2012/05/07/drinking-water-week-more-water_n_1474999.html" target="_hplink">here</a>.

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  • Acupuncture


    There have been mixed results in the research examining this ancient Chinese medicine's effect on migraines. Most recently, a study questioned <a href="http://www.reuters.com/article/2012/01/09/us-acupuncture-sham-idUSTRE8081I920120109" target="_hplink">whether the traditional practice offered much more than a placebo effect</a>, perhaps due to the extra attention lavished by the acupuncturist. Proponents maintain that the needles trigger pain-reducing chemicals, Reuters reported, but all those visits could become time consuming and expensive, points out Mauskop.

    A DIY altnerative might be acupressure, he says. Try pressing on the webbed space between your thumb and pointer finger. It may only be temporary, but it can offer relief.




  • Caffeine


    "Caffeine is a double-edged sword," says Mauskop. If you're too dependent on multiple cups of coffee a day (or even frequent doses of certain headache medications formulated with caffeine) you're likely to experience <a href="http://www.huffingtonpost.com/2012/03/31/cause-of-headaches-foods_n_1392670.html#s829426&title=The_Jurys_Still" target="_hplink">rebound headaches when the jolt starts to wane</a>. However, in small doses, a little bit can help reduce pain.

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  • Regular Exercise


    Along with meditation, Mauskrop calls staying active one of his top two most effective ways to prevent and treat migraines. Of course, many people are in too much pain in the middle of a headache to even think about heading to the gym. But a few people have told him when they feel something coming on, they can go out for a jog and avoid the migraine altogether. "It relaxes you, it releases endorphins," he says.

    Last year, a small Swedish study attempted to find out just how good exercise is at preventing migraines and discovered a solid sweat session was <a href="http://www.sciencedaily.com/releases/2011/10/111010075500.htm" target="_hplink">just as effective as migraine medications</a> at keeping the debilitating headaches at bay.

    <em>Flickr photo by <a href="http://www.flickr.com/photos/dafydd359/2238925352/" target="_hplink">Dafydd359</a></em>




  • Cool Down -- And Warm Up


    Many people will feel a chill when they get a migraine, explains Mauskop, while at the same time their heads feel "hot and cloudy" he says. For some temporary relief, try reversing the feelings -- cool your head with an ice pack while warming the body in the bath, he suggests. Granted, it's not very practical unless you're at home and have plenty of time, he says, but dilating the blood vessels in the body may help blood flow away from the head and reduce some of the pain, he says.




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