University years

What is migraine?

For this week’s post I decided it is time to go back to the story of how I ended up doing a PhD in Germany and I will start talking about my Neurobiology master thesis, outlining in the SRF the medical problem that lead researchers, and my lab, working on it.

By the beginning of the second semester of the first year of Master, all the students needed to start looking for a lab where to work, in order to produce a new and innovative (despite small) research that will eventually lead to the writing of a thesis. After my experience for my bachelor thesis where I only had to do a literary search to find out gaps and pros and cons in the field of interest, I was very much eager to find a lab where I could finally put my hands on the lab bench and start doing science once and for all. Despite some initial difficulties in finding the lab (too many students for not so many labs available to take in bachelor students with little to no experience in lab work), I ended up in the laboratory of “Neurophysiology of Integrated Autonomic Systems” in the “Fondazione Mondino” clinic and research center in Pavia.

I have to admit that this really long name for a lab that was composed of just a couple of rooms (shared between my -unofficial- supervisor, one technician, one PhD student and me and another master student) did not mean much to me in the beginning. My initial choice was made only on the basis of the methods used by that lab (animal models of pathologies and biochemical essays) and on the subject of my research there (migraine). However, once there, I was able to understand all the different lines of research that the people were working on and what that really long name was actually standing for. Indeed, this lab was working on the physiopathological mechanisms of some neurological pathologies such as migraine, chronic pain and stroke, along with the search of new potential strategies, through the use of animal models of diseases.

I will go more into depth about my work experience there in the next weeks (and I will also talk about the paper that came out after I finished my work there), but for today I would like to move on to the SRF and talk about migraine, the medical problem that generated the research work of my master thesis.

“Science Related Fact” (SRF):

Let’s start by talking about pain. Pain is defined as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” by the International Association for the Study of Pain (IASP) (1986). Pain is composed of a perceptive and cognitive component: the perceptive component is the proper nociceptive component of pain, where the neurons transmit the information of pain to the brain with electric signals, that are then elaborated and integrated to make us feel the pain, while the cognitive component is the personal experience that we experience during pain, the psychic perception of an unpleasant sensation. We can distinguish two different types of pain: acute and chronic pain. Acute pain is physiological, a vital sign and a defensive system that signals to the organism a tissue damage, essential to activate mechanisms that can prevent a bigger damage. It is localised, it has short duration and it decreases with the healing. On the other end, chronic pain is long lasting, it is usually due to the persistence of the painful stimulus that keeps triggering the nociceptive system even when the initial damage is long gone, and it might eventually become a disease itself.

With the term “migraine” we define a frequent and debilitating primary headache (that means that is not a result of another medical condition). It affects up to the 12% of the occidental population and the ratio men to women is 1:3. Unfortunately, the aetiology of migraine is still unknown, even though we started to pinpoint some of its triggers, such as the menstrual cycle, physical and psychological stress, alcohol and some foods rich in tyramine (like cheese and red wine), but also exposition to climate changes or some smells and perfumes. Indeed, migraine is a complex pathology and, up to this date, we still do not know if migraine attacks are due to blood vessels or neurons, even though several theories are trying to explain it.

So far, the most used medications for migraine are the ones that soothe the pain once it appears and limit the appearance of the other symptoms (see picture below for a schematic of the migraine possible symptoms). These of drugs belong to the so called “acute phase therapy” (that consists in taking care of the symptoms, rather than the actual causes) and the most used ones are: analgesic and anti-inflammatory drugs (such as ibuprofen), that have an anti-pain effect and can decrease the other symptoms of migraine; ergotamine and derivatives, that act on some serotonin (have a look here if you want to know more about serotonin) receptors, and have a vasoconstrictor action (that is able to contrast the vasodilatation responsible of the appearance of migraine); triptans, that are used when the anti-pain drugs are not working anymore. Once more, triptans act on the serotonergic receptors and they have a pretty fast action that can decrease enormously the entity and duration of the symptoms.

Schematic of the migraine possible manifestations. Modified from healthmatters.nyp.org

However, thanks to the new discoveries and theories about the migraine physiopathology, drugs acting on new targets are continuously under developments and clinical trial. I will talk about the new promising drugs that started to be used in the migraine treatment in the next weeks’ posts, where I will also introduce the drug I tested in my master thesis and a bit of the methods I managed to learn and use.

2 thoughts on “What is migraine?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s