Ultra-modern diagnostic procedures such as magnetic resonance imaging (MRI) and positron emission tomography (PET) now allow migraine and its effects on the brain to be visualised and even measured. Images of the brain recorded during a migraine attack show that a certain area of the midbrain is damaged in sufferers and is further damaged with each attack. This is the area of the brain thought to be the pain control centre. If it is damaged, it evidently no longer switches on to prevent pain and the "headache from hell" begins! Persistent headaches allow the damage to continue further, thereby derailing pain control even more. The experts suspect that this area of the brain is already functionally compromised in migraineurs, possibly because of a genetic predisposition. One thing that all the scientists are agreed on is that this damage is only one of several factors which can cause migraine.

Other factors have been discovered with the aid of molecular biology and genome research. It seems highly likely that pathological changes (mutations) of a certain gene are also responsible for the occurrence of migraine. Different mutations of this gene cause different diseases, such as the rare "familial hemiplegic migraine" which is accompanied by paralysis of one side of the body lasting from several hours to several days. There is also increasing evidence that mutations of this gene are also involved in the more common forms of migraine,

Meanwhile, we now know more about some of the so-called messenger substances produced by the body itself which play an important part in the "multifactorial" migraine process. There is serotonin, for example, a messenger substance known by many as the "happiness hormone". If someone has a deficiency of this messenger substance, they are quite likely to be unhappy as a result and almost bound to suffer a migraine attack. One of the functions of serotonin is to constrict or dilate the blood vessels in the brain. When there is a serotonin deficiency, the vessels in the brain constrict, thereby reducing the flow of blood, which is a reason for the nausea typical of migraine, for disorders of perception, irritability etc. A short time later the blood vessels dilate again and an increased supply of blood again flows into the brain - an explanation for the wave-like throbbing headache which migraineurs suffer in the main stage of an attack. An important role in the occurrence of migraine is now also ascribed to the messenger substance nitrogen oxide (NO) which is produced inside the human body. Like serotonin, the effect of NO is also to dilate the blood vessels. It also seems to have the function of intensifying pain. If, for any reason, the body produces more nitrogen oxide than "normal", this immediately leads to a migraine-type headache which, however, is much more severe in migraineurs than in healthy individuals. The precise mechanisms by which nitrogen oxide works still need to be elucidated.

What is certain, on the other hand, is that in some situations, so-called triggers cause changes in the brain, possibly also inflammation of the blood vessels. As a result of this inflammation, the pain receptors in the brain presumably become so sensitive that even the pulsating of the blood vessels produces the typical throbbing migraine headache. You can find out more about these triggers and tips on how to identify and eliminate them in this brochure.