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   TECHNOLOGYSCIENCE   
      
   Migraine Headaches, Especially With Aura, May Alter Structure Of The Brain:   
   Study   
      
      
   By Roxanne Palmer @rpalmerscience   
   on August 29 2013 9:31 AM EDT   
   261   
       
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   Migraines may cause lasting changes to the structure of a suffering person's   
   brain, according to a new study.   
      
   Scientists still aren't sure exactly what predisposes some people to suffer   
   from recurring migraine headaches, which tend to be concentrated on one side   
   of the head. Some migraines are heralded by an "aura," a pre-headache sensory   
   disturbance that often    
   manifests as visual hallucinations -- sparkling lights, gray areas or zigag   
   lines -- nausea, or sensitivity to light and sound.   
      
   A team of scientists from the University of Copenhagen and the Albert Einstein   
   College of Medicine in New York analyzed 19 other studies to see if migraine   
   patients were more likely to have abnormalities in their brains. They found   
   that people with    
   migraines have more abnormalities in the white matter of the brain, more brain   
   lesions and altered brain volumes than people that do not suffer from the   
   disorder. Brain abnormalities are even more likely to occur in people who   
   suffer from migraines with    
   aura, the researchers wrote in the journal Neurology.   
      
      
   Study co-author Richard Lipton, a neurologist at Montefiore Medical Center and   
   a professor of neurology at Albert Einstein, said in a phone interview that   
   the connection between aura and brain damage might be the underlying mechanism   
   of the aura itself.    
   It's thought that the aura that precedes a migraine results from a phenomenon   
   called a cortical spreading depression, where a wave of electric activity   
   passes over the surface of the brain. This wave first excites, then inhibits,   
   certain brain activities.   
      
   "It's a pretty dramatic event in the brain that involves reductions in   
   activity of nerve cells and reductions in blood flow," Lipton says. "In the   
   overwhelming majority of cases, these reductions in blood flow don't cause   
   brain damage, but it looks like    
   in a minority of cases those auras might cause damage to the brain."   
      
   But what about the brain damage seen in people without auras? Lipton   
   speculated that some patients classified as having migraines without auras   
   might actually be experiencing the same effect, but in a different part of the   
   brain. A spreading cortical    
   depression might affect areas associated with critical thinking as well as the   
   area responsible for vision. And while people might readily remember that they   
   saw zigzag lines right before a migraine, they might not necessarily report or   
   even notice that    
   they had clouded intuition before a headache struck.   
      
      
   While the significance of these brain abnormalities still isn't clear, "these   
   abnormalities are reported to increase with migraine frequency, which may   
   represent a form of anatomic progression of the disorder," Lipton and his   
   colleagues wrote in their    
   paper.   
      
   One positive takeaway from the study is that migraine patients may not need to   
   be particularly alarmed if a brain scan shows some white matter lesions -   
   small patches of dead cells in parts of the brain. Such phenomena, it turns   
   out, are not themselves    
   an abnormal symptom.   
      
   "The fact that white matter lesions are so common with migraines ought to   
   reassure patients; it's not necessarily associated with any bad outcome,"   
   Lipton says.   
      
      
   But the study also found that migraine patients with aura are more likely to   
   show signs of infarct-like lesions in the brain, which resemble tiny strokes.   
   These infarct-like lesions are all the more reason for migraine patients to do   
   what they can to    
   reduce their stroke risk, Lipton says.   
      
   To reduce stroke risk, Lipton advises quitting smoking, watching one's blood   
   pressure and keeping a diary of migraine attacks, which could illuminate a   
   pattern behind the headaches. Some people will find that red wine brings on a   
   migraine; for others, it'   
   s aspartame artificial sweeteners or stress.   
      
   Whatever a patient's particular situation is, "if you can manage your   
   triggers, you might reduce your frequency of headaches," Lipton says.   
      
   SOURCE: Bashir et al. "Migraine and structural changes in the brain: A   
   systematic review and meta-analysis." Neurology, 28 August 2013.   
      
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