Migraine is a chronic neurological condition affecting more than 1.2 billion people worldwide and is the second leading cause of disability globally.
Despite its profound impact on everyday life, the biological mechanisms behind migraine remain only partially understood. For decades, the condition was underestimated or misunderstood. Today, however, scientific research increasingly recognises migraine as a complex disorder rooted in the nervous system rather than a simple headache.
For many sufferers, migraine attacks manifest as intense, throbbing pain on one side of the head, often radiating behind the eye and towards the jaw. Attacks may also be accompanied by sensitivity to light and sound, nausea, fatigue, dizziness, or changes in appetite.
If medication is delayed, both the duration and severity of symptoms tend to worsen. Recurrent attacks can significantly disrupt work, social interactions, and mental wellbeing.
From stigma to science
For centuries, migraine was wrongly portrayed as a form of “hysterical” pain, often associated with women. This perception limited serious scientific inquiry and delayed progress in understanding the condition.
Modern research now confirms that migraine has a strong genetic basis. Studies show that individuals with a family history of migraine, including parents or grandparents, are significantly more likely to develop the condition themselves.
Large-scale genetic analyses have identified dozens of genetic risk markers that affect nerve signalling and blood vessel function. Many of these markers are also associated with other conditions, including depression and diabetes, reinforcing the view that migraine is part of a broader neurological and systemic picture.
Why migraine has been so difficult to study
According to reporting by the BBC, migraine research has been hindered for centuries by stigma and persistent misconceptions.
From the 18th and 19th centuries onwards, migraine was often framed as a feminine whim, believed to affect only intelligent, charming and beautiful women said to have so-called “migraine personalities”. Although around three-quarters of people living with migraine are women, this stereotype had serious consequences.
The condition was frequently dismissed as a manifestation of hysteria rather than recognised as a genuine neurological disorder. As a result, migraine research remained chronically underfunded and sidelined in comparison with other neurological diseases.
“People thought of it as a disease of hysteria,” says Teshamae Monteith, chief of the headache division at the University of Miami Health System in the United States.
She notes that even today, only a limited number of universities worldwide have dedicated migraine research centres. Investment in migraine research remains disproportionately low, despite the scale of disability the condition causes globally.
A disorder that goes far beyond pain
Neurologists stress that migraine is not confined to head pain alone. It involves a complex cascade of neurological and physiological processes.
One of the key mechanisms identified is cortical spreading depression, a slow wave of abnormal electrical activity that travels across the brain’s cortex. This process activates pain pathways and triggers inflammatory responses.
The meninges, the protective membranes surrounding the brain, also play a central role. Immune cells within these tissues release inflammatory molecules that intensify pain and sensitivity, contributing to the wide range of symptoms experienced during an attack.
A wide and often misunderstood spectrum of symptoms
Migraine symptoms vary widely and may include nausea, vertigo, sensitivity to light and sound, extreme fatigue, excessive yawning, and cravings for specific foods.
Factors such as lack of sleep, stress, hormonal changes, or certain foods are often described as triggers. However, scientists increasingly suggest that these may instead be early warning signs of an oncoming attack rather than its cause.
For example, cravings for chocolate or cheese may represent an early phase of migraine activity, not the trigger that initiated the attack. This distinction has important implications for how patients understand and manage their condition.
New treatments and emerging hope
A major breakthrough in migraine treatment came with the discovery that levels of the protein CGRP increase significantly during migraine attacks. This finding led to the development of targeted therapies that block CGRP or its receptors.
These newer treatments have shown promising results. Clinical studies indicate that around 70 percent of patients can reduce the frequency of their migraine attacks by up to 75 percent, while approximately 23 percent experience complete remission.
A condition still being unravelled
Despite these advances, migraine remains a multifactorial and chronic condition that continues to affect quality of life for millions of people worldwide.
Ongoing research into genetic predisposition, nerve signalling, blood vessel function, and the role of the meninges is steadily reshaping scientific understanding of migraine. This growing body of knowledge offers hope for more personalised therapies and improved long-term management strategies for those living with the condition.
Sources: BBC, lifo.gr