Friday, September 24, 2010

Migraine May Be Explained by Hyperexcitability of Brain Networks

Migraine May Be Explained by Hyperexcitability of Brain Networks

A new report, linked above, makes the argument "that migraine is a neuronally based disorder, not primarily a vascular condition". It is interesting, but, as often happens when you read a little further into the article than the title, you find that the facts may be more complicated. In this case, for example, the argument rests on the observation that migraine sufferers have more sensitivity in certain areas of their brains than non-migraine sufferers. Well good - case proved. Except, of course, that this sensitivity may be a result, rather than a cause, of migraine. It might be, for example, that repeated vascular induced inflammation causes increased sensitivity.

Now, I'm not a neurologist, or a doctor, I just read the articles and wonder why the authors don't explain their reasoning in greater detail. And we can but hope that sometime soon they'll come up with the proper explanation for migraines - and their cure.

Wednesday, September 22, 2010

Mainlining Aspirin?

There are a rash of news reports this week on intravenous aspirin and migraines. As far as I could see there was nothing particularly new in these reports, if patients were given IV aspirin they reported a decrease in pain. So - what else is new?

If you take aspirin by any route, ingestion, inhalation (not recommended), injection, suppository, you name it, you'll get aspirin in your blood stream, and you'll get pain relief. The only differences achieved in different routes might be the concentration in your blood (easily corrected for by taking more or less in the first place) or possibly the chemical form of the drug, if significant chemical reactions occur on route to the place of action. For example, it is possible the acid in your stomach might react with aspirin and change its chemical form before it gets into your blood stream. But, I don't believe that such changes are particular relevant in this case.

Hence, I think that this article is essentially saying that taking a painkiller reduces pain. Pretty typical of the information content obtained in most medical press releases. But take aspirin anyway - it works pretty well.

Saturday, December 5, 2009

What Causes Headaches - And Why It Is Hard to Know

As people who get migraines are only too well aware, the causes of migraines are subtle. A migraine is not like a bruise, you generally cannot identify the specific blow which triggers the damage. Instead there are a variety of triggers for each migraine sufferer. And on some occasions the triggers do not instigate a migraine attack, yet on others they do.

This is maddening for the migraine sufferer. Perhaps wine or beer is a possible trigger, as is lack of sleep, chocolate, and cigarette smoke. You then have four possible variables that you would like to study, to determine how they effect your headaches. For example, you might try 1-glass of wine, but an early night, no chocolate, and avoidance of smokers. With just 4 variables there are 10 possible patterns that you would need to work through, just visiting each of the patterns once. So, if you went to 10 parties, you could systematically work through each combination of drinking or not drinking wine, going to bed early or staying up late, eating or not eating chocolate, etc. Although this would be many parties, and possibly a lot of fun, or many headaches, you would only have included each of the variables at the grossest level, wine or no wine, for example. In practice you would probably also want to control the amounts, the number of minutes sleep lost, the number of glasses of wine, and so on.

And, unfortunately, the variables rapidly exceed our ability to manage them. In reality you will have many more than 4 possible triggers to consider. Stress will be a factor for example, are you worried about something in your job or your home life. Have you eaten citrus fruit, had coffee, or vitamin-C? The scaling of the problem, because you have to consider the variables in combination rather than isolation rapidly becomes unmanageable. If you just consider the presence of a variable, the number of permutations increases with the square of the number of variables (if N is the number of variables the number of patterns is N(N+1)/2). So, if you have 4 possible triggers to consider, you would need 10 experiments, and if you have 10 possible triggers, you would need 55 experiments. In order to insure consistency in your results, you would probably want to conduct each test at least twice, and as already mentioned, these tests would not consider the possibility that the amount of wine, or the quantity of chocolate play a role in triggering migraine.

Well, it is clear that it is hard for one person to conduct all those tests on themselves in an unbiased manner. And unfortunately, because the problem is hard, medical science has also not seen fit to address the problem of understanding migraine triggers either.

This is where the importance of keeping a migraine log comes in. This may enable you to avoid doing a systematic search among all the variables initially, and instead help you to identify the most important variables. Here is a list of the key variables that you should monitor:
  • All food intake
  • All drink intake
  • Mood
  • Stress
  • Hours of sleep
  • Weather, temperature, humidity
  • Work environment
  • Sound levels
  • Exercise
  • General health
  • Time and date, time of day, day of week, day of month, season
  • Time of day of occurrence of headaches
  • Description of headache
  • Age
As you see, there is a lot of amount of information that needs to be logged in order to look potential triggers. I am in the process of creating a spreadsheet which will allow me to track these variables and when it is completed I will link it here.

Please feel free to leave comments on your own triggers or theories about triggers.

Thursday, December 3, 2009

Migraine and Vitamin-C

Many years ago, impressed by the great chemist Linus Pauling, I decided that consuming vitamin-C in large quantities would be a wise thing to do. Admittedly I was a teenager at the time, and teenagers tend to engage in various forms of risky behavior and self-experimentation, yet vitamin-C became a habit. I was convinced, as many people are, that vitamin-C boosts the immune system and helps to prevent colds. If I had been wiser, I might well have been better off trying some other form of excess, as although Pauling was a great man, his faith in vitamin-C as a general cure all has not been generally borne out by experimental or theoretical evidence.

For example, as described in this article, mice that are fed large quantities of vitamin-C become more susceptible to skin cancers than mice that do not benefit from this nutritional supplement. Had I read such an article a decade or two earlier, I might have been more reluctant to take large vitamin-C doses (500mg) on an almost daily basis.

However, about a year ago I found that my employment changed radically. This resulted in a significant change in my daily routine and I gave up taking quite so much vitamin-C. I was curious as to the whether the vitamin-C reduction might perhaps reduce the frequency and severity of my headaches. So once I noticed the routine change, I decided to stop the vitamin-C altogether.

I found that the abrupt stop in vitamin-C consumption had no appreciable affect on headaches. These still came at a regular pace and followed their familiar pattern of starting on one side of the head, centered on the optic nerve, and then gradually re-materializing on the opposite side.

I did however, suspect other problems associated with vitamin-C, or rather its sudden absence from my system. My rate of aging seemed to increase! I also suffered a broken tooth. I wonder whether this could be because the mega-dose of vitamin was reducing my bodies ability to absorb vitamin-C, resulting in an short term stint of scurvy once the mega-does was removed. Vitamin-C is involved in collagen production (possibly related to the apparent age of skin tissues) and, I believe, in the maintenance of bones. Probably I was fortunate not to suffer a broken leg.

Well, I stopped taking my vitamin-C pills about one year ago. My headaches are unaffected, and like everyone else, I am a little older now. I don't think that I will start up with vitamin-C again. Reading the link above makes me suspect that the potential risks are not outweighed by the potential gains, even if vitamin-C does not seem to be the cause of my migraines.

What a shame I didn't pick up a form of risky experimental behavior, such as regular exercise, that might have had a better chance of being beneficial all those years ago!

Wednesday, December 2, 2009

Migraine Pain Thresholds

As I am generally optimistic, I often wonder - 'Why do migraines occur?' and 'Could it be that migraines provide some slight benefits to the sufferer?'. The optimistic side of me, you see, wants to see some kind of possible evolutionary cause for the migraine phenomenon.

For most of my life, I have answered this question with 'Migraines just don't seem to serve any useful purpose'. However, it is possible to think of evolutionary advantages that might accrue to migraine sufferers, for long enough for them to pass on the migraine curse to their offspring, at least.

As always, in the highly developed field of idle speculation, coming up with theories is simple, and testing those theories is the difficult part. Despite that, here are two untested theories, which might just be plausible.

Firstly, I have noticed that when I have a migraine people seem to like me better. This isn't a significant effect - I am not suddenly extremely popular. However, I seem to be a little more 'liked'. This might be because a migraine sufferer in the midst of an attack is transformed into a careful listener, rather than a gregarious chatter box, and people tend to like people who listen to them (on the grounds that such people are admirably discriminating and intelligent). Historically, perhaps it was the patient listening potential mate which passed on its genes, giving rise to widespread migraine suffering. (As migraine attacks are mistaken for periods of rapt attention by talkative mates).

Secondly, I have come to wonder whether migraines might be caused in part by low pain thresholds. This inability to tolerate pain might have been quite an evolutionary advantage as the affected cave dweller would have tended to stay away from the stinging, biting, and fighting parts of the community. A consequence of this aversion to being unnecessarily hurt might have been a longer lifetime to reproduce and, possibly, a reduced ability to tolerate headaches.

Now, of course, such theories are quite hard to test. Perhaps one could take a group of people and check their popularity with random groups before and after giving them headaches. The pain threshold idea might be easier to check. Simply get a test set together and determine how much torture each member of the set can endure, then correlate the result with a measure of the set's member's migraine proclivity. It may be that the US government has already much of the needed information.

We can wait for the test results to arrive. In the meantime it would certainly be interesting to know if a migraine gene has actually been observed and whether this might have some kind of neurological relevance. While I am waiting, perhaps I should try to build my pain threshold by enduring some form of physical torture, while enjoing the popularity of an excellent listener.

Tuesday, October 27, 2009

Reduced Pressure and Headaches

I went on a trip to the opposite coast recently. As usual I acquired a painful headache en route.

About a year ago, I went to a conference at a mountain resort. This was high enough above sea level to make you feel slightly out of breath all the time. And all the time, I had a headache.

So, I suspect that reduced atmospheric pressure gives me a headache. I am sure that airlines do not pressurize their planes as much as they can, in order to save money. Clearly, heading about a mile above sea level also reduces atmospheric pressure too.

Perhaps I should venture to wear a pressurized diving suit on my next business trip. Most likely the homeland security people would take a dim view of such an experiment, though.

Naturally, I thought that I had identified the air pressure migraine link myself. However, checking Google shows many articles like this which discuss scientific research into the effect. Unfortunately, it appears that although the link has been made, the underlying cause has not yet been understood, so this knowledge can't yet be used to prevent migraines from occurring.

For now my only solution is to always travel with pain killers and to take appropriate doses when the inevitable headache begins.

Wednesday, November 26, 2008

Criticism = A Guaranteed Headache

At any given moment I tend to have some pet theories as to what causes my headaches. But I think in recent weeks though I have found two clear causes. One cause is low atmospheric pressure. I will post on that in a few days time.

The second cause is criticism. Like many people I don't respond well to well intentioned criticism. And on occasion I receive an endless stream of comments about changes that I should be making. A stream of backseat driver input seems to be channeled directly into a headache, throbbing away on either side of my head.

Now I know that this is well intentioned input, intended to improve me in many and diverse directions, from appearance (dietary, grooming, cleanliness, tips, and advice), career (professional, technical, and managerial input), to social (friends, pass time, viewing, and hobby selection). However, my brain (or sub-conscious, no doubt) apparently internalizes this relentless stream of critical input into a headache.

If you have any tips on not responding in this negative fashion to relentless criticism, please let me know in comments belows!