New Insights into Migraine Pathophysiology
Cerebral TorqueShare
Cortical Spreading Depression (CSD)
Wave of Brain Activity Suppression
CSF Proteome Alterations
~11% of CSF proteome altered after CSD
Up-regulation of Trigeminal-activating Proteins
CGRP in CSF
Known to increase during migraine attacks
CSF Flow into Trigeminal Ganglion
Newly discovered pathway for pain signaling
New Zone without Epineural Sheath
Area in trigeminal ganglion allowing direct CSF contact
Nonsynaptic Brain-Trigeminal Signaling
Direct communication between the CNS and PNS via CSF
Altered CSF Contacts Trigeminal Neurons
Activation of Trigeminal Nerve Cells
Headache/Migraine Pain
Migraine Attack Symptoms Experienced
Temporary Process
CSF Proteome Normalizes
Decrease in Pain Signals
Migraine Attack Subsides
Reference: Rasmussen et al. (2024). Cortical spreading depression opens a paravascular space in the trigeminal ganglion. Science, 385(6320), 80-85. DOI: 10.1126/science.adq3498
