Scientists have discovered genes that may be behind migraines, “opening the door to a cure”, reported the Daily Mirror. The newspaper said that these genes normally control the levels of a brain chemical called glutamate, but a variant form of the gene may lead to a build-up of glutamate within the nerve cells. According to the paper, halting this build-up could help stop migraines.
The study behind this story scanned the DNA of several thousand people with and without a history of migraine. It compared their genetics and identified a particular gene variant that was more common in migraine sufferers. The study adds to our understanding of the complex processes that lead to migraines and highlights that there may be genetic causes.
This is important research, but finding genes that are linked to a condition is very different from developing a safe treatment based on this knowledge. Overall, it is premature for newspapers to suggest that this research may soon produce a cure for migraines. Migraine is a complex condition in which the interaction between genes and the environment is likely to be important, meaning there may not be a single cause or cure.
Types of headache
The team found that patients with a particular DNA variant on chromosome 8 have a significantly greater risk for developing migraine. It appears that the associated DNA variant regulates levels of glutamate – a chemical, known as a neurotransmitter, which transports messages between nerve cells in the brain.
The results suggest that an accumulation of glutamate in nerve-cell junctions (synapses) in the brain may play a key role in the initiation of migraine attacks. Prevention of the build-up of glutamate at the synapse may provide a promising target for novel therapeutics to ease the burden of the disease.
Migraine affects approximately one in six women and one in 12 men, and has been estimated to be the most expensive brain disorder to society in Europe and the USA. A US report measures its economic costs as similar to those of diabetes and WHO lists it as one of the top 20 diseases with years lived with disability.
“This is the first time we have been able to peer into the genomes of many thousands of people and find genetic clues to understand common migraine,” said Dr Aarno Palotie, Chair of the International Headache Genetics Consortium at the Wellcome Trust Sanger Institute, which spearheaded the study.
The team carried out a genome-wide association study to identify differences that might account for an individual’s increased susceptibility to migraine. They compared the genomes of more than 3000 people from Finland, Germany and The Netherlands with migraine with the genomes of more than 10 000 people who do not suffer from the condition, recruited from pre-existing studies. To confirm the link, the team compared the genomes of a second group of more than 3000 patients with more than 40 000 apparently healthy people.
The statistical analysis revealed that a DNA variation found between the PGCP and MTDH/AEG-1 genes on chromosome 8 appears to be associated with increased susceptibility to common migraine. The variant appears to alter the activity of MTDH/AEG-1 in cells, which regulates the activity of the EAAT2 gene: the EAAT2 protein is responsible for clearing glutamate from brain synapses in the brain. EAAT2 has previously been linked with other neurological diseases, including epilepsy, schizophrenia, and various mood and anxiety disorders.
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September 4th, 2010 at 9:51 pm
Migraine is a neurological syndrome characterized by altered bodily perceptions, severe headaches, and nausea. Physiologically, the migraine headache is a neurological condition more common to women than to men.
The word migraine was borrowed from Old French migraigne (originally as “megrim”, but respelled in 1777 on a contemporary French model). The French term derived from a vulgar pronunciation of the Late Latin word hemicrania, itself based on Greek hemikrania, from Greek roots for “half” and “skull”.
The typical migraine headache is unilateral (affecting one half of the head) and pulsating, lasting from 4 to 72 hours;[2] symptoms include nausea, vomiting, photophobia (increased sensitivity to light), and phonophobia (increased sensitivity to sound).
Approximately one-third of people who suffer from migraine headaches perceive an aura—unusual visual, olfactory, or other sensory experiences that are a sign that the migraine will soon occur.
Initial treatment is with analgesics for the headache, an antiemetic for the nausea, and the avoidance of triggering conditions. The cause of migraine headache is unknown; the most common theory is a disorder of the serotonergic control system.
There are migraine headache variants, some originate in the brainstem (featuring intercellular transport dysfunction of calcium and potassium ions) and some are genetically disposed.Studies of twins indicate a 60 to 65 percent genetic influence upon their propensity to develop migraine headache.Moreover, fluctuating hormone levels indicate a migraine relation: 75 percent of adult patients are women, although migraine affects approximately equal numbers of prepubescent boys and girls; propensity to migraine headache is known to disappear during pregnancy, although in some women migraines may become more frequent during pregnancy.
September 15th, 2010 at 8:22 pm
A WOMAN who went to bed with a severe migraine woke up with a French accent.
Kay Russell had to quit her sales job after the change left her nervous about speaking and going out in public.
The 49-year-old, who has only been to France twice, was diagnosed with Foreign Accent Syndrome, a condition that affects how the brain forms speech and words. There are only 60 known cases worldwide.
September 20th, 2010 at 6:14 pm
Psychological treatments could offer migraine sufferers a confidence boost in their ability to self-manage their symptoms, according to a new study.
In the study, Elizabeth Seng and Dr. Kenneth Holroyd from Ohio University in the US compared the effects of various treatment combinations for severe migraine – drug therapy with or without behavioral management.
And they showed that those patients receiving the behavioural management program alongside drug therapy are significantly more confident in their ability to use behavioural skills to effectively self-manage migraines.
And surprisingly, the increase in confidence in self-management abilities is greatest among those who feel that they have very little control over their condition before treatment starts.
The researchers analyzed data for 176 participants in the US Treatment of Severe Migraine Trial.
Treatment programs included acute drug therapy for all, with either ß-blockers or placebo – each with or without behavioral migraine management.
The behavioural migraine management program consisted of demonstrations of migraine management skills during four monthly clinic visits, which were then applied between sessions by participants through workbooks, audiotape lessons, and guided home practice.
Their analyses showed that the addition of behavioral migraine management to drug therapy dramatically increased participants’ confidence in their ability to effectively self-manage migraine, compared to migraine drug therapy alone. Behavioral management also increased participants’ belief that migraines can be influenced by one’s own behaviour and decreased the belief that migraines are primarily influenced by chance or fate.
“Our exploratory analyses offer an optimistic message: brief psychological interventions for migraine management can effectively increase sufferers’ confidence in self-management and can be long-lasting,” concluded the authors.
Psychological interventions enhanced drug therapy, enabling participants to take a more active role in their treatment by using behavioral skills to manage migraines.
The findings are published online in Springer’s journal Annals of Behavioral Medicine.
September 20th, 2010 at 6:51 pm
A new study has shown that those who suffer from migraines with aura (temporary visual or sensory disturbances before or during a migraine headache) are at a higher risk of dying from heart disease or stroke.
A research team, led by Larus Gudmundsson from the University of Iceland, assessed the impact of mid-life migraine episodes in 18,725 men and women born between 1907 and 1935 who took part in the Reykjavik Study (set up in 1967 by the Icelandic Heart Association to study heart disease in Iceland). In total the research team explored over 470,000 person-years of data with a follow-up of 26 years.
Gudmundsson and colleagues used questionnaires to assess migraine with and without aura.
The results concluded that men and women who suffered from migraine with aura were at an increased risk of dying from all causes, as well as heart disease and stroke, while those with migraine without aura were not at increased risk.
Furthermore, the study says that women who experience migraine with aura are also at a higher risk of dying from causes other than cardiovascular disease or cancer.
“However, it remains to be seen which diseases drive the risk increase seen for women with migraine,” the researchers said.
The researchers concluded that the individual risk faced by migraine sufferers is low, and efforts to reduce heart disease deaths should focus on conventional risk factors such as high blood pressure, smoking and high cholesterol, regardless of migraine status.
They call for more research on the association between migraine and death from cardiovascular disease and all other causes.
“Finally, studies are needed to determine if reducing the frequency of attacks with migraine preventive treatment might reduce the risk of cardiovascular disease,” they said.
A second paper revealed that female sufferers of migraines with aura are also at a higher risk of haemorrhagic stroke (where bleeding occurs in the brain).
These account for around 20 percent of all strokes.
The research has been published on bmj.com.
September 22nd, 2010 at 1:35 pm
Aspirin in high doses can relieve severe headaches and migraine, according to a new research at the UCSF Headache Center.
Study participants administered aspirin through an IV and 25 percent of the time reported a more modest pain reduction about 40 percent of the time.
Aspirin also is non-toxic, non-addictive, non-sedating, has few side effects for adults, and is less expensive than drug regimens such as triptans that physicians typically prescribe to headache patients to combat severe pain.
To develop a successful treatment plan for these patients, physicians first turn to a hospital inpatient program where medication withdrawal can be overseen by a neurologist or pain specialist. High-dose intravenous aspirin can help patients manage headache pain while undergoing medication withdrawal, the study shows.
Further research is needed to understand how exactly the aspirin works to reduce headache pain, the UCSF team said, but the findings give neurologists a safe and effective treatment option for migraine sufferers that is less expensive than the alternative multi-drug alternative.
The study was published in the September 21, 2010, issue of Neurology.
September 26th, 2010 at 7:54 pm
Migraine sufferers could have their headaches switched off after researchers discoved a gene that acts like a pain thermostat in the brain.
The “once in a generation” finding could allow scientists to create a new generation of drugs that can simply turn down up the theshold at which the body fells pain.
The international study, including scientists at Oxford University, found that a gene called TRESK appears to be fundamental in causing migraines.
It is believed that it controls the sensitivity of pain nerves in the brain and if faulty can bring the threshold so low that just living is painful.
This is why migraine sufferers are so sensitive to light, sounds and even touch.
But the gene is also susceptible to being switched on and off with drugs which means that it could be altered to increase the threshold to such an extent it eliminates the feeling of pain altogether.
“We are really excited about this,” said Dr Zameel Cader, a consultant neurologist at the Medical Research Council Functional Genomics Unit at the University of Oxford.
“It is a once in a generation find that could one day lead to treatments that could prevent migraines. Potentially it is even more exciting than that.
“It could potentially lead to a treatment for pain in general. That could impact everybody.”
Around 18 per cent of women and eight per cent of men in Britain suffer from migraines which can last up to three days.
September 28th, 2010 at 5:00 pm
A jab made from liquid aspirin could be a powerful new treatment for migraine.
The drug is injected straight into the bloodstream rather than swallowed.
Each injection contains a high dose of one gramme of aspirin, more than ten times the amount most people would take to soothe a normal headache or joint pain.
New research shows pumping high doses of liquid aspirin into the blood can dampen down pain in patients struck down by migraines that are so severe they end up needing hospital treatment.
Doctors behind the study, carried out at the University of California in San Francisco, now hope the therapy can be used more widely to help thousands more sufferers with less severe headaches.
It could also lead to substantial savings for the NHS, as aspirin costs around a third of the price of more expensive migraine pills, known as triptans.
The news of research into the aspirin jab comes as scientists have also discovered a faulty gene linked to the agonising condition.
Researchers from Oxford University found the gene, called TRESK, in families of sufferers. When it is mutated it can more easily trigger the brain’s pain centres and cause severe headaches, says their report in the journal Nature Genetics.
Migraine affects around one in ten of the UK population, with women affected more than men.
Most people suffer with common migraine, which involves a severe throbbing headache, usually on one side of the head. Loss of appetite, nausea, constipation or diarrhoea are also common symptoms.
Sitting in a quiet, darkened room can help sufferers cope with an attack and over-the-counter painkilling tablets such as paracetamol and ibuprofen can ease mild cases.
October 6th, 2010 at 6:20 pm
A review has suggested that for people suffering from migraine headaches, over-the-counter ibuprofen – Advil and Motrin are well-known brands – might be enough to relieve the pain.
A new Cochrane review finds that about half of those with migraine headaches will have pain relief within two hours after taking ibuprofen.
Migraine headache is intense throbbing pain on one side of the head, and an attack can last anywhere between four and 72 hours. Symptoms such as nausea, vomiting, aura and increased sensitivity to light and sound often accompany migraines.
To relieve their headache pain, almost half (49 percent) of migraine sufferers use over-the-counter medication only, 20 percent use prescription medication and 29 percent use both, according to the Cochrane review.
Derry said she and her fellow reviewers conducted the Cochrane review to help provide a more definitive answer on whether ibuprofen is effective for migraine pain. They also wondered whether also taking an antiemetic to relieve nausea was better than taking an ibuprofen alone.
The reviewers evaluated nine studies with 4,373 adult participants who had a diagnosis of migraine headache. The average age of the participants was 30 to 40 years and all had a history of migraine for at least 12 months before entering the studies.
In total, 414 people with migraines underwent treatment with 200 milligrams of ibuprofen, 1,615 received a dose of 400 milligrams, 208 received a 600-milligram dose and 1,127 received a placebo.
Twenty-six percent of patients taking the 400-milligram dose were pain free within two hours, compared with 20 percent who took the smaller dose and 11 percent who received a placebo. In the same period, 57 percent who took 400 milligrams of ibuprofen had their pain reduced from moderate or severe to “no worse than mild,” compared with 25 percent taking a placebo.
“For those who experience these outcomes, ibuprofen is a useful, inexpensive and readily available treatment,” said review co-author Sheena Derry of the Pain Research and Nuffield Department of Anaesthetics at the University of Oxford.
The Cochrane Collaboration, an international organization that evaluates medical research, published the systematic review.