Andrea West remembers the first time that she heard about a new group of migraine headaches that can finish her pain. This was in 2021 and heard a radio scientist discussing Gepants, a group of drugs that seemed for the first time to prevent migraines. West followed news of these medications closely, and when I heard last year that Atogepant was approved for use in the UK, she went directly to her doctor.
The West may carry migraines for 70 years. Since she started taking the medicine, she had no one. They are great things. “I really changed my life,” she says.
Throughout the ages, migraine visualization was suffering with a little satisfaction. In ancient Egypt, doctors tied clay crocodiles to people’s heads and prayed for the best. In the late seventeenth century, surgeons who are bored in people’s skulls – some suggested – allowed migraines to leave. The twentieth century brought more effective treatments, but they did not work for a large part of almost a billion people with migraines around the world.
What causes migraines? A study “Brain Break” provides evidence
Now there is a new feeling of progress that passes through the field, resulting from developments on several fronts. Diana Kraos, a nervous drug at the University of California, Irvin, says that medical developments in the past few decades – including approval of sinuses and relevant treatments – have redefined migraines as “a treatment that can be controlled and controlled.”
At the same time, the research leads to a better understanding of the situation – and indicates future action trends. Studies have shown, for example, that migraine is a wide phenomenon that arises in the brain and can appear in many exhausted symptoms, including sensitivity and aura, brain fog and fatigue. “I used to think that the disability is transmitted with pain, and only when the pain becomes severe, people suffer from people’s weakness. Richard Lipton, a neurologist at Albert Medicine Einstein, New York City, New York City, says, this is not only a mistake, but we have treatments to do something However.
The researchers try to discover what leads to the brain exposed to migraines to turn it into an excessive state of activity, which causes a complete attack, or in this regard, which makes the brain vulnerable to this condition. Aarny May, a neurologist at the University Medical Center in Hamburg -Ebindorf in Germany, says a new and broader approach to research and treatment is needed. To completely stop migraines and not just headache pain, he says: “We need to create new frameworks to understand how the brain activates the entire migraines system.”
Drugs?
When May began searching for migraines in the 1990s, the leading hypotheses was that migraines were either a psychological issue or vascular headache disorder, with palpal pain caused by vascular expansion. Psychological associations came with the stigma, as Mai says. “One of the people with migraines did not believe, they thought they did not want to work. Almost all my patients at that time had to see a psychiatrist or a psychiatrist.” Kraos says that the field is still recovering from these ideas. Most doctors have abandoned the idea that the problem is psychological, but the idea that migraines resemble a very bad headache still exists yet.
Many changed in the 1990s, when May and others began performing brain scanning operations for people with migraines. The researchers saw for the first time to activate the brain areas during headache attacks, which indicates that it was more than just angical problem1. From that point onwards, many things changed. “This was the first time that someone could refer to migraines and says it is a biological disease,” May says.
The researchers found that the changes in the activity of the brain begin to appear in what is known as the initial stage, which starts from hours to days before the attack (see “periodic migraines”). The initial stage is characterized by areas of symptoms, including nausea, the desire for food, fainting, fatigue, yawning. This often follows the stage of migraine attack for a period of days, which comes with huge pain in the headache and other physical and psychological symptoms. After the attack declines, the post -convenience stage contains a group of associated symptoms that include depression, screening and fatigue. The overlapping stage represents the time between attacks and can also have symptoms.
Source: Karsan & PJ Goadsby Nature Neurol. 14699-710 (2018).
But the type, the severity and the causes of migraines can differ among people. Dom Horton, 53, an editor in the United Kingdom, never gets headache. But he suffers from other migraine symptoms all the time. He says: “The continuous roundabout and the swimming mind are always present,” and sometimes they build a severity that prevents him from leaving his home. Fiona Garcaid, 60 -year -old veterinary surgeon in Scotland, suffers from sensitivities from noise, light and movement, overwhelming awe and headache that becomes so severe that she sometimes loses consciousness, “and this is comfortable,” she says. The fully visual migraines can lead similar to the “live light repercussions” drawn by Hildgard von Bengen, a monastery in the twelfth century who was believed to have witnessed a case now called migraine headaches with the aura.
Despite a variety of symptoms, the research in the natural headache associated with the two Megreen was what led to revolutionary migraine treatments. Gepant medications and a handful of unilateral antibodies are designed to prevent genes -related peptide activity (CGRP). They came from contracts of research about CGRP in headaches, and they are the real “seat success story”, according to Peter Guadsby, the neuroscientist in Kings College London, who was a pioneer in searching with Lars Edfenson, the neuroscientist in Lund at Lund University and Sweden And collaborators in the eighties.
Chronic pain can be treated – so why are millions still suffering?
Headache begins when the sensory nerves called nocikeptors in the meninges become perceived, which sends information to the brain to stimulate pain. Goadsby’s work showed that CGRP is a major factor in educating those Nociceptors. The clinical trials of drugs that prevent peptide in people with migraines have proven effective in mitigating headaches and sometimes in preventing attacks from starting2. Goadsby says it was amazing to see the completion of people’s responses to Gepants. He says, “Patients return and let them literally,” he says. “They forgot before it was normal.”
From the successes of CGRP blockers, it is tempting CGRP width as “X” for migraines. However, it is clear that other elements are playing. CGRP blockers only work for a sub -group of people, such as one in five according to some studies3. For those who respond well to drugs, some migraine symptoms often continue. The West, for example, still has seizures of nausea although the drug you eat, atogepant, stops migraine attacks. Although Atogont has reduced the symptoms of Gartside, migraines still dominate her life. “There is a continuous mix between prevention and medicines, avoiding trigger, fatigue, fear, and expectations of attacks,” she says.
Migraines
Goadsby says the mixed results of CGRP blockers show a large gap in the biological understanding of migraines. “This tells us that there are other migraine frameworks that need to be discovered, and other paths,” he says. It may agree. He believes that the field needs a fundamental change in thinking to find new migraine mechanisms. “We focus a lot on migraines as a headache,” he says. “Thinking of most people stops at CGRP, but CGRP is not the only answer.” He says the problem is that scientists do not fully understand how migraine attack appears in the brain.
Studies have been strengthened in the past seven years or so the hypothalamus as a status center4. “It must include the coffee system, which is under the dihadist is the king,” May says. The load system is a group of interconnected brain structures that treat sensory information and regulate feelings. Studies that have surveyed the brains of migraines have shown every few days for several weeks that the hypocritical contact with different parts of the brain increases directly before the start of the migraine attack, then it collapses during the headache phase5.
The American pharmaceutical agency compatibility
May and others believe that under the hypothalamus loses control of the load system about two days before the start of the attack, and leads to changes to conscious experiences that may explain symptoms such as optical and sound sensitivity, or cognitive weakness. At the same time, the collapse of control over the hypothalamus puts a homogeneous balance of the body from Kilter, which explains the cause of symptoms such as fatigue, nausea, yawning, and a severe desire for food when migraines accumulate, says Cross.
Goadsby agrees that the hypothalamus is important, but it is believed to be more complicated than just losing control. The attack can begin when any part of the “migraine network”, including the hypothalamus, the mulch, and the coffee system. Gadesby says researchers still have researchers specifically identifying the brain areas, or “precisely arrangement of beating” when these areas are activated during the attack.
Prepare and players
Researchers in migraines are now talking about the virtual “migraine threshold” in which environmental or physiological activity is directed to an unorganized state.
List of potentially large operators. Migraines in the West are closely related to some foods, hunger, tension and hormonal changes. She used to get a terrible headache with her cycle, then after menopause she developed into migraines for three days. More than half of the women who suffer from migraines suffer from attacks every month during menstruation. Migraines are also three times more prevalent in women in men. It is the first case of CISGENDER in their reproductive years, and it seems equally prevalent in sexually transformed women who take hormone therapy.