Pathophysiology of Migraine: A Disorder of Sensory Processing

Migraine affects over one billion people globally and is highly disabling. Its pathophysiology has evolved significantly from ancient theories to modern neurological understanding. Researchers consider three main questions about migraine: why, how, and when. The inherited tendency for the brain to mismanage sensory inputs explains why migraines occur. The trigeminal durovascular pathway explains how migraines develop and progress. Laboratory and clinical studies have explored this pathway, revealing crucial insights. Migraine attacks typically arise from sensory processing disorders in the brain. These disorders can cycle and are influenced by both genetics and environmental factors. During the premonitory phase, brain systems become dysfunctional, leading to symptoms like photophobia or phonophobia. Eventually, this progresses into the painful phase of migraine attacks. Research has identified effective treatments, including triptans and serotonin 5-HT receptor agonists, providing hope for better management of migraines. Clinical relevance: Understanding migraine's sensory processing issues could lead to improved treatment strategies for patients.