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Researchers have identified cellular-level changes in nerve structure and function that may contribute to the development of migraine headaches.
Nerve specimens from patients with migraine show abnormalities of the myelin sheath that serves as “insulation” around the nerve fibres, researchers found.
The findings help to explain why a plastic surgery procedure provides effective pain relief for migraine patients - and may provide useful clues for developing new approaches to migraine treatment.
American Society of Plastic Surgeons (ASPS) Member Surgeon Bahman Guyuron of Case Western Reserve University, Cleveland and colleagues performed in-depth studies on tiny specimens of the trigeminal nerve (one of the cranial nerves), from 15 patients who underwent surgical treatment for migraine. Sample from 15 patients undergoing a cosmetic forehead lift procedure were studied for comparison.
The study included electron microscopy to assess nerve cell structure and proteomic analysis to assess the presence and function of proteins.
The results showed important differences in nerve structure between the migraine and cosmetic surgery patients.
“Essentially, the protective layer surrounding and insulating the normal nerves, called myelin, is missing or is defective on the nerves of the patients with migraine headaches,” said Guyuron.
He likened the myelin sheath to the plastic coating used as insulation material around electrical wires and cables.
“If the insulation becomes cracked or damaged by conditions in the environment, that’s going to affect the cable’s ability to perform its normal function,” said Guyuron.
“In a similar way, damage to the myelin sheath may make the nerves more prone to irritation by the dynamic structure surrounding them, such as muscle and blood vessels, potentially triggering migraine attacks,” Guyuron said.
Organisation of the cellular elements in nerve fibres also differed between groups. Healthy nerves were tightly organised with elements uniformly distributed through the nerve, while nerves from migraine patients showed discontinuous, “patchy” distribution.
The study adds new evidence that the peripheral nerves play an important role in triggering the complex cascade of migraine attacks that ultimately involve the central nervous system.
The study was published in the Plastic and Reconstructive Surgery, the official medical journal of ASPS.
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