A new study shows that cellular-level changes in nerve structure and function may contribute to the development of migraine headaches, according to the American Society of Plastic Surgeons (ASPS).
According to the study, nerve specimens from patients with migraine show abnormalities of the myelin sheath that serves as “insulation” around the nerve fibers. These findings help to explain why a plastic surgery procedures provide effective pain relief for migraine patients—and may provide useful clues for developing new approaches to migraine treatment.
The study—conducted through collaboration by three independent departments at Case Western Reserve School of Medicine—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 Dr. Guyuron, who coauthored the study the study.
He likened the myelin sheath to the plastic coating used as insulation material around electrical wires and cables and states that 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.
Similarly, 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.
Dr Guyuron developed migraine surgery techniques after noticing that some migraine patients had reduced headache activity after cosmetic forehead-lifting, which involved removal of some muscle and vessel tissue surrounding the cranial nerves.
The new study lends some important new clues for understanding the mechanisms by which migraine headaches occur. It also 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.
By showing pathological changes of a cranial nerve involved in triggering migraine headaches, the study may help to explain why migraine surgery is effective. These findings may lead to other opportunities to treat patients with migraines in a non-invasive, or less-invasive manner.