Interaction between symptoms of brainstem disturbance, sensory disturbances and pain in migraine

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Migraine affects about 18% of women and 6% of men across their lifespan and usually peaks during the most productive years of life. Although serious neurological effects of migraine are rare, some sufferers are left with permanent physical disability after attacks of migraine-related stroke. More common are debilitating side effects of medication, and the psychological and social disruption of experiencing recurrent attacks of migraine. Apart from the pain and distress experienced during migraine, recurrent headaches are responsible for considerable health care costs and lost productivity. Thus, there are important economic and social reasons for developing new treatments, particularly treatments that reduce susceptibility to recurrent attacks. This project aims to investigate interactions among symptoms of migraine (head pain, nausea, and changes in facial blood flow), so that the sequence of symptom development can be studied systematically. We will induce motion sickness (which provokes nausea and many other symptoms of migraine), and then study the effects of head pain and strong sensory stimulation. We expect that migraine sufferers will report stronger symptoms and show greater physiological changes to these stimuli, either alone or in combination, than people who rarely suffer from headache. One of the most commonly recognized triggers of migraine is psychological stress. The aim of the second part of this project is to determine whether a substance released during stress (noradrenaline) heightens inflammation in scalp blood vessels, thus increasing the likelihood of migraine. We hope that this approach will help to identify the basis of the abnormality which increases susceptibility to migraine, so that it can be targeted for treatment.