Migraines, Sensory Processing, Neuro-Diversity and Psychiatric Disorders

​Two BIG LINKS:

• Migraines are more and more associated with psychiatric disorders;
  • ​What is the link between migraine and psychiatric disorders? From epidemiology to therapeutics
• Sensory / Information Processing Differences and Disorders are associated with NEURO-DIVERSITY
  • Sensory processing related to attention in children with ASD, ADHD, or typical development: results from the ELENA cohort
    
  • ​Sensory hypersensitivity in Tourette syndrome: A review

A BIG PART OF BETTER TREATMENT IS BETTER PREVENTION & DIAGNOSTICS.

A BIG PART OF BETTER TREATMENT IS BETTER PREVENTION & DIAGNOSTICS.

People who are NEURO-DIVERSE and/or have MIGRAINES are at high risk for PSYCHIATRIC DISORDERS.

On the other hand, because of their SENSORY PROCESSING DIFFERENCES, NEURO-DIVERSE people often have BIG STRENGTHS in ACADEMIC, ATHLETIC and/or CREATIVE pursuits.

NEURO-DIVERSE people who can look like such OPPOSITES -- often have in common SENSORY PROCESSING DIFFERNCES that DIVERGE FROM THE NORM.  ​

​Pathophysiology of Migraine: A Disorder of Sensory Processing
​ (2017)

Affiliations

1. Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom;
2. Department of Neurology, University of California, San Francisco, San Francisco, California;
3. Department of Neurology, University of Hamburg-Eppendorf, Hamburg, Germany; and
4. ​Department of Neurology, University Hospital Bern-Inselspital, University of Bern, Bern, Switzerland.

Abstract
​
Plaguing humans for more than two millennia, manifest on every continent studied, and with more than one billion patients having an attack in any year, migraine stands as the sixth most common cause of disability on the planet.

The pathophysiology of migraine has emerged from a historical consideration of the "humors" through mid-20th century distraction of the now defunct Vascular Theory to a clear place as a neurological disorder.

It could be said there are three questions: why, how, and when?

Why:
migraine is largely accepted to be an inherited tendency for the brain to lose control of its inputs.

How:
the now classical trigeminal durovascular afferent pathway has been explored in laboratory and clinic; interrogated with immunohistochemistry to functional brain imaging to offer a roadmap of the attack.

When:
migraine attacks emerge due to a disorder of brain sensory processing that itself likely cycles, influenced by genetics and the environment.

In the first, premonitory, phase that precedes headache, brain stem and diencephalic systems modulating afferent signals, light-photophobia or sound-phonophobia, begin to dysfunction and eventually to evolve to the pain phase and with time the resolution or postdromal phase.

Understanding the biology of migraine through careful bench-based research has led to major classes of therapeutics being identified: triptans, serotonin 5-HT1B/1D receptor agonists; gepants, calcitonin gene-related peptide (CGRP) receptor antagonists; ditans, 5-HT1F receptor agonists, CGRP mechanisms monoclonal antibodies; and glurants, mGlu5 modulators; with the promise of more to come.

Investment in understanding migraine has been very successful and leaves us at a new dawn, able to transform its impact on a global scale, as well as understand fundamental aspects of human biology.