Migraine big bang

BLOG: Graue Substanz

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Graue Substanz

Our whole brain was in a hot stressed state,
Then nearly fourteen minutes ago
expansion started. Wait…
The skin began to cool,
The eyes began to fool,
The pain developed cruel,
We closed the door (we switched off the light),
Photophobia, phonophobia, nausea, raveling mysteries,
That all started with the big bang!

I have a recent paper in the The Journal of Mathematical Neuroscience that looks into the nucleation and subsequent growth processes of cortical ion imbalances (MAD and T. Isele: Transient localized wave patterns and their application to migraine. J. Math. Neurosci. 3,7 (2013)  open access).

We investigate transient cortical reaction-diffusion wave patterns with characteristic forms (shape, size, duration). These expanding patterns are formed by typical tipping point behavior, that is, the patterns are essentially coordinated large-amplitude fluctuations with critical slowing down. Thus, according to this theory, migraine not exactly starts in a big bang—though it may surely feel this way—but due to an imminent tipping point.

The transient dynamics poses challenging problems both in mathematical tractability and clinical observability. Similar wave patterns have been observed before with a combination of fMRI and symptoms reports of visual migraine aura (MAD and N. Hadjikhani: Migraine aura: retracting particle-like waves in weakly susceptible cortex:  PLoS ONE 4, e5007 (2009) open access). For our theory to be valuable it should not only be consistent with current data but make some predictions that can be verified. Our results support the controversial idea of ‘silent aura’ and we suggest that specific wave patterns cause this phase in the migraine cycle to stay clinically silent, which can be tested by fMRI.

Furthermore, these migraine waves collapse eventually in a characteristic way. Let stretch a bit our analogy. The universe will collapse in a Big Crunch.

It will cause the stars to go the other way,
Collapsing ever inward, we won’t be here, it won’t be heard*

Gravity eventually reverses expansion. When the universe collapses, this is not necessarily the end but reformation of the universe can start with another big bang. All to familiar to the migraineur, I guess.

Although there is really no overlap between these theories, the migraine reaction-diffusion waves also evolve in curved spaces, the gyrified human cortex. We are looking into nucleation and subsequent growth processes in curved spaces in a newly submitted manuscript. Later more on this.



* The theme song from the television series The Big Bang Theory also continues with the collapse of the universe (lyrics).




Markus Dahlem forscht seit über 20 Jahren über Migräne, hat Gastpositionen an der HU Berlin und am Massachusetts General Hospital. Außerdem ist er Geschäftsführer und Mitgründer des Berliner eHealth-Startup Newsenselab, das die Migräne- und Kopfschmerz-App M-sense entwickelt.

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