What happens to your brain during a migraine - Marianne Schwarz

TED-Ed www.youtube.com

Brief Summary

This TED-Ed video explains what migraines are, going beyond just headaches to explore the neurological processes involved. It covers the warning signs, the roles of the hypothalamus and trigeminal nerve, and the influence of genetics and hormones. The video highlights that migraines are a complex disorder affecting various parts of the brain and emphasizes that there's still much to learn about their causes and triggers.

  • Migraines involve more than just headaches, affecting various parts of the brain.
  • Warning signs can include fatigue, mood changes, and sensitivity to light and sound, pointing to the hypothalamus.
  • The trigeminal nerve plays a key role in the headache phase, becoming sensitized and transmitting pain signals.
  • Genetics and hormonal fluctuations are believed to contribute to migraines, but the exact mechanisms are still unclear.

Intro to Migraines

Migraines can manifest with symptoms like throbbing headaches, visual disturbances (zigzag lines), sensitivity to light, fatigue, and disrupted sleep. While a severe headache is a common symptom, the term "headache" doesn't fully capture the diverse experiences of a migraine. Each migraine is unique, and some don't even involve a headache at all. The video aims to explain what happens in the brain during a migraine.

Warning Signs and the Hypothalamus

In the hours or days leading up to a migraine, people often experience warning signs such as fatigue, mood changes, frequent yawning, sleep issues, nausea, sensitivity to light and sound, and increased thirst. These signs indicate activity in the hypothalamus, a brain region that regulates hormonal balances, circadian rhythms, and water regulation. The hypothalamus has extensive connections throughout the brain and becomes more active before a migraine.

Migraine Aura

Another common warning sign is the migraine aura, which can involve temporary visual changes, tingling sensations, or even difficulty speaking. These sensations arise from changes in electrical charge across cell membranes, leading to spreading changes in brain activity and blood flow. The trigger for this change in charge is unknown, but it can spread rapidly across the brain's surface, causing different aura symptoms depending on the affected area. For example, if it spreads over the visual cortex, it can cause visual disturbances like spreading images or blind spots.

The Role of the Trigeminal Nerve

During the headache phase of a migraine, the trigeminal nerve is crucial. This nerve normally transmits sensations like touch and temperature from the face, scalp, and blood vessels to the cerebral cortex. When activated, the trigeminal nerve transmits pain signals. During a migraine, this pain pathway becomes sensitized, lowering the threshold for pain. This means that normally painless sensations, like coughing, bending over, or exposure to light and sound, can become painful.

Understanding Migraines

Migraines are a common and diverse neurological disorder, affecting a significant portion of the population. However, much about them remains unknown. Migraines affect multiple brain regions, including the brainstem, cerebral hemispheres, and nerves. The exact triggers for each step in a migraine, why some people get them and others don't, why women are more affected than men, and why migraine patterns change over time are still unclear.

Hormones, Genetics, and Associated Conditions

Hormonal fluctuations are believed to play a role in migraines. Some women experience fewer migraines after menopause, when hormone fluctuations decrease. Conversely, some women experience worsening or new headaches just before menopause, when these fluctuations increase. People with migraines are more prone to depression, panic disorder, sleep disorders, and strokes. The relationship between these conditions is complex, possibly reflecting the impact of migraines on these diseases or vice versa, or a shared genetic basis. Genetics almost certainly contribute to migraines, although there's usually no single causative gene. Certain genes influence how easily neurons are excited by stimuli and how readily they transmit pain signals. It's possible that the neurons in the brains of people with migraines are more easily triggered and less likely to block pain signals.

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Transcript

Full transcript of “What happens to your brain during a migraine - Marianne Schwarz”. Click a timestamp to open the video at that moment. Need another video? Use the YouTube transcript generator.

0:07 A throbbing, pounding headache. Bright zigzagging lines across your field of vision. Sensitivity to light, lingering fatigue, disrupted sleep. A migraine can include any of these symptoms. While an incapacitating headache is one of the most common experiences of migraine, the word “headache” doesn’t really capture the wide array of experiences a migraine can entail. No two are alike, and some don’t even involve a headache. So what then is a migraine? What’s happening in the brain to cause it? To trace a migraine’s anatomy, we have to begin in the days and hours leading up to a migraine, when people often identify warning signs ranging from fatigue or mood changes,

0:52 to bursts of yawning, sleep disruption, nausea, light and sound sensitivity, or even increased thirst. These warning signs point to a particular part of the brain: the hypothalamus. The hypothalamus normally controls the systems behind these symptoms— our body’s internal hormonal balances, circadian rhythms and water regulation. It has wide connections throughout the brain, and is more active than usual in the days before migraine. Another common warning sign is the migraine aura, which can take the form of transient visual changes, tingling, or even trouble speaking. These sensations come from a change in charge across cell membranes that leads to spreading changes in brain activity and blood flow across the brain.

1:41 We don't know what triggers this change in charge, but it can spread quickly over the surface of the brain, causing different aura symptoms depending on the affected area. If it inches over the visual cortex, for example, it may cause an image or blind spot to spread over the visual field. During the headache phase, the trigeminal nerve plays a key role. The trigeminal nerve normally transmits touch, temperature, and other sensations from the skin to most of the face, part of the scalp, and some of the blood vessels and layers covering the cerebral cortex. Once activated, the trigeminal nerve transmits pain signals. During a migraine, this pain pathway becomes sensitized, meaning the threshold for provoking pain is lowered. Sensations that would usually be pain-free,

2:28 such as coughing, bending over, or light and sound, can become painful. Migraines are as common as they are diverse, affecting as many as 33% of women and 13% of men in their lifetimes. Still, there’s much we don’t know about them. We can see that migraine is a neurological disorder affecting multiple parts of the brain— the brainstem, cerebral hemispheres, and the nerves themselves. But we don't know for sure what exactly triggers each step, why some people get migraines and not others, why so many more women do than men, or why people’s migraine patterns sometimes change over their lifetimes. Hormonal fluctuations are thought to have a role in some of these things: some women experience a significant reduction in migraine frequency

3:17 after menopause, when sex hormone fluctuations are fewer. Meanwhile, just before menopause, these fluctuations increase, and some women experience worsening or new headaches. People with migraines are more likely to suffer from depression, panic disorder, sleep disorders, and strokes, among other illnesses. The relationship with these diseases is likely complex, possibly reflecting the effect of migraine on those diseases or vice versa, or reflecting their shared genetic basis. Genetics almost certainly play a role, although with a few exceptions, there’s no single gene that causes migraines. Certain genes control how easily our brains’ neurons are excited by environmental stimuli and how readily they transmit painful signals.

4:06 It’s possible that the neurons in the brains of people who experience migraines are more easily triggered by environmental stimuli and less likely to block painful signals. While there’s no simple way to explain what happens in our brains with this complex disorder, one thing is for sure: migraine is much more than a headache.

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