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Searching for the “Weak Link” in Migraine

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“Weak link” may work for a headline, but investigating and treating migraine is much more complex, because the body is incredibly complex. Think of a spider web. Or better, a whole city with all its roads and businesses and families.

Traffic routes

At first, it may seem that widening a particular road is the answer. After all, a certain number of cars travel down this road, so if it were double the size, the traffic would flow much quicker. Right? Well, of course you know it’s not that simple. To widen the road, you take land from something else. You encourage more people to use that route. You spend months in construction, changing people’s habits.

So we hear about various drugs that have different effects on the body. A beta-blocker. CGRP inhibitors. Cox-2 inhibitors. They’re all trying to fix a certain street – not to simply improve the traffic on that road, but to fix a city-wide problem. Migraine symptoms.

There has been some interesting research recently on one of these “roads” in your body – hyperpolarization-activated cation channels (actually a family of proteins in the heart and nervous system). This particular communication path in your body has a lot to do with inflammation. In fact, if you check out this study from several years ago, you might notice several words familiar to the migraine world – inflammation, hypersensitivity, and the temporomandibular joint. That last one is your jaw joint – the joint and nerves in the face are often implicated in migraine related headache pain.

So if this channel is part of the system that communicates inflammation and neuropathic pain, would this be a good “road to repair” in order to fight migraine? And how would you test that hypothesis?

A study in Denmark is trying to do just that. How? Well, we already have a hyperpolarization-activated, cyclic nucleotide-gated (HCN) channel blocker, called ivabradine (sold under the brand names Corlanor, Procoralan, and others). So the study will be testing ivabradine, not necessarily as a future migraine treatment itself (although that may be the case), but to see how effective it is. If effective, researchers may look at developing this type of medication specifically for migraine use.

It is interesting that ivabradine is a heart medication. It’s currently used to slow the heart rate in patients with certain types of chest pain or heart failure. There are several other heart medications that are used for migraine – such as beta blockers (think of metoprolol, propranolol, and timolol). In fact, patients that don’t respond well to beta blockers are sometimes given ivabradine.

To read more about the hypothesis and theory behind this clinical trial, just go to the trial page and look specifically at the “Detailed Description” – The Effects of Ivabradine on Levcromakalim-induced Migraine (ILMO). To go deeper into HCN channels, this article is from a few years ago but will give you an introduction: Hyperpolarization-Activated Cation Channels: From Genes to Function

Loneliness and Future Pain

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If you’re lonely today, if you’re missing out on social interaction, face to face contact – does that increase your risk of future physical pain?

Does loneliness cause future pain?

It’s certainly a relevant question. Actually, the connection between loneliness and pain is well known, but a recent study published in the journal Pain brings the discussion to a new level.

Taking a sample of 4906 people, the study took a look at the relationship between loneliness and pain over four years. It confirmed again that pain today may increase your risk of loneliness in the future. But also, loneliness today increases your risk of increased pain four years later.

Why? We might immediately think that a lonely person may be less likely to be active, or get exercise. Sure, that is a factor, and the study checked for that as well. Of course, if you’re inactive, there’s no doubt that your chances of future pain are increased.

But this study also tried to filter out various possible direct causes. For example, what if you take two people that are equally active, but one is lonely and one is not? It turns out that the lonely person is still significantly more likely to have more pain four years later.

What about actual depression? Yes, that’s a factor. But again, even if you’re lonely but not technically depressed, you’re still at risk for future pain.

Inflammation was also addressed in the study. Although inflammation at the beginning of the study did not increase chances of future loneliness (as pain in general does), it did, unsurprisingly, increase odds of more pain.

Social interaction is a very complex reality. There are so many factors – hearing a voice, laughter, touch, smell, empathy. Designing a study to nail down exactly what loneliness has to do with pain would be, in the end, virtually impossible.

But this and other studies to point out the importance of our social lives.

There are many reasons for loneliness. But we need to remember that it’s not just a temporary sad feeling. It can have consequences years later – consequences that may include more headaches, literally.

So don’t stop reaching out to others any way you can. You may not be a doctor, but you still may be able to alleviate pain in their lives. And remember that, even in your own life, loneliness should not be ignored.

Read the full study and discussion here: Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

The Link between Skin Rashes and Migraine

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If you suffer from both skin rashes and migraine, you’re not alone. And there may be an important connection between the two which we need to research.

Psoriasis (the “p” is silent) is a common skin disease, probably affecting about 1-2% of the population. There are various types of psoriasis, but it often shows up as red, scaly patches of skin. It can also show up in nails, or even as stiff joints. It flares up at various times, and can be either a small annoyance or a major condition.
Migraine, Psoriasis, and Heart Disease
Psoriasis can run in families, but it can also be brought on through an infection, obesity, and smoking.

A recent study in Italy found that people with psoriasis, women especially, were extremely likely to also suffer from migraine. Most often this was migraine with aura, but migraine without aura showed up very often as well.

Why the connection, and why should we care? Well, researchers suspect a biological relationship between the two, but further research will need to be done. Migraine is often associated with autoimmune diseases such as psoriasis, so in a way this isn’t a surprise.

But perhaps the biggest concern that researchers had is the link between both psoriasis and migraine – and heart diseases. Psoriasis itself, and perhaps even some of its treatments, can significantly increase the risk of high blood pressure, irregular heartbeat, and stroke, for example. Migraine also increases your risk of cardiovascular disease. So having both may increase your risk even further.

Be sure you tell your doctor if you notice symptoms of psoriasis. There are helpful treatments. You may want to especially consider having some good tests done on your levels of vitamin D. Omega-3 supplements may also be helpful for both migraine and psoriasis. You will also want to take a look at your risk of heart disease (read Migraine and Heart Disease: 7 Critical Things to Know Now).

There are a wide variety of treatments for psoriasis, as there are for migraine. Your doctor will help you decide which are best for you. Being aware of both diseases will help you assess symptoms and find treatments that work.

For more information:

Seasons and Genetics

If Your Pain Is Genetic – Could you “Control” Your Genes?

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Over the past few years, we’ve learned that there is a strong genetic component to migraine, to say the least. Genetics may go a long way toward explaining why those “triggers” cause contortions of pain in some people, and go unnoticed in others.

So is that it? Are we doomed, at least until some high-tech genetic splicing and dicing can be developed?

No, we’re not exactly doomed. There are a lot of excellent treatments out there. But recent research is raising new questions about our genes and how they work.

A study published in the journal Natural Communications investigated the activity of 22,822 genes in the body, and found that 5,136 of them – almost a quarter – changed their activity depending on the time of year.

What changes? A couple of examples are inflammation and immunity. Inflammation seems to be more “suppressed” in the summer months.

Seasons and GeneticsThe majority of these changes are probably just ways that the body responds to and adapts to environmental changes. More diseases out there? Time to ramp up the immune system.

But what exactly is causing the change of activity? Is it temperature changes? Humidity? Sunlight (and so more vitamin D)?

What if we found that certain genetic activity was triggering migraine attacks – and what if we could “control” that activity by controlling our environment – better lighting, perhaps, or more or less exposure to temperature changes.

If you think this sounds impossibly complicated, it might help to remember how far genetic research has come in the last decade. Besides, we may already be “controlling” genetic activity more than we realize, by recognizing and targeting triggers.

Professor Mike Turner, Head of Infection and Immunobiology at the Wellcome Trust, says:

This is an excellent study which provides real evidence supporting the popular belief that we tend to be healthier in the summer. Seasonal variation to this extent is a fascinating find – the activity of many of our genes, as well as the composition of our blood and fat tissue, varies depending on the seasons. Although we are still unclear of the mechanism that governs this variation, one possible outcome is that treatment for certain diseases could be more effective if tailored to the seasons.

For more information:

Chicken Tikka Masala for Migraine?

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A recent article in PainPathways was highlighting the importance of diet in fighting pain. Eating foods that are “anti-inflammatory”, such as cold water fish, fruits, and vegetables. Avoiding highly processed foods. Losing just a little weight.

One of the suggestions that was made was a greater focus on good spices. Sure enough, some spices do fight pain.

We’ve talked about some of these here before – cayenne, oregano, and ginger, for example.

Chicken Tikka Masala
Modified from this picture courtesy of Kelly Sue. License
The article focused especially on turmeric. Turmeric is actually related to ginger. Usually the underground stem of the plant is used in powdered form for culinary uses.

Readers in many parts of Asia are probably already using turmeric regularly. But we all will be glad to hear that turmeric is an anti-inflammatory, which has been used for osteoarthritis among other things.

For those of you who aren’t used to using turmeric, here are a few recipes to get you started, from the great community at allrecipes.

Remember, if you have a great migraine-fighting recipe, you can share it with the community here.

via Pain and Nutrition

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The articles on Headache and Migraine News are © 2004-2024 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.