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Jan. 10, 2010
Researchers believe they know why light exacerbates the already debilitating pain of
migraines, even in some blind people.
A report published online Jan. 10 in Nature Neuroscience reveals how visual and
pain pathways in the brain converge to produce this phenomenon.
Although the findings are unlikely to help migraine patients in the near future, "this
gives us a little better insight as to the theory and mechanism behind migraine," said Dr.
Michael Palm, an assistant professor of neuroscience and experimental therapeutics and
internal medicine at Texas A&M Health Science Center College of Medicine, College Station,
and director of the Parkinson's and Headache programs at Texas Brain and Spine Institute
in Bryan.
"We are making progress in understanding this phenomenon," he said.
The Boston-based researchers report there are cells in a part of the brain called the
thalamus "where information from the visual system and information from the pain system
converge, and that anatomic convergence provides the first available explanation for how
it could be that light makes pain worse," added Dr. Richard Lipton, director of the
Montefiore Headache Center and professor of neurology and epidemiology at Albert Einstein
College of Medicine in New York City.
About 85 percent to 90 percent of all migraine sufferers report having photophobia, which
is when light makes the pain worse, said study senior author Rami Burstein, a professor of
anesthesia and neuroscience at Beth Israel Deaconess Medical Center and Harvard Medical
School in Boston.
"We had no clue in the world where in the world light and pain talk to each other in the
brain," Burstein said. "They have completely different pathways in the brain."
"For light to make pain, those pathways would have to converge at some level," Lipton
noted.
To solve the paradox, the team studied 20 blind individuals, all of whom suffered from
migraines. Six participants had no light perception at all and no functioning optic nerve.
These individuals also experienced no photophobia.
The remaining 14 people could sense light and dark and also experienced photophobia.
"This told us that the optic nerve is critically needed in order to produce photophobia or
exacerbation of the headache by light," Burstein explained.
The researchers next discovered that a set of photoreceptors called melanopsin project
onto neurons on the thalamus that also process pain signals.
"If we wanted to understand how light makes the pain worse, we needed to follow in the
brain the pathways that lead from the eye into the brain using the third group of
photoreceptors," Burstein said. "That is the connection so at that point we shifted to
animals."
The thalamus is the brain's sensory switchboard, receiving sensory signals from different
parts of the body then redirecting them to various sensory, motor and cognitive areas of
the cortex.
"We identified a new pathway in the brain that originates in the eye and goes to the brain
areas where neurons are found that are active during migraine attacks," Burstein said.
"The light can increase the electrical activity in neurons that are active to begin with."
The findings should put to rest any thoughts that patients exaggerate their sensitivity to
light, Lipton said. "This provides an anatomic and physiological basis for a common
experience - that light makes pain worse, not because you're a whiner, but because there
is an anatomic pathway that links the visual system to the pathway that produces head
pain," Lipton said. "That odd bit of clinical symptomatology has a firm basis in brain
science."
Symptoms of Migraine:
Migraine usually gives warning before it strikes, viz: black spots or a brilliant zig-zag
line appear before the eyes or the patient has blurring of vision or has part of his
vision blanked out. When the headache occurs the patient may feel tingling, numbness, or
weakness in an arm or leg.
Causes of Migraine:
In a migraine, the head and neck muscles, reacting to continuous stress, become
over-worked. The tightened muscles squeeze the arteries and reduce blood flow. When a
person relaxes suddenly, the constricted muscles expand, stretching the walls of the blood
vessel. With every heartbeat, the blood being pushed through these vessels expands them
further and causes incredible pain.
Treatment of Migraine by Nature Cure:
When a headache strikes, one should stay on one`s feet in the daytime and do simple
chores, which do not require too much concentration, or walk, move around and get some
fresh air.
Diet:
The best remedy to prevent headaches is to build up physical resistance through proper
nutrition, exercise and constructive thinking. Thus, a person should undertake a short
fast. During the fast, citrus fruit juices diluted with water may be taken six times daily.
After a short fast, the diet should be fixed in such a way as to put the least possible
strain on the digestion. The food should consists as follows:
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Morning:
Drink a glass of water (warm water in winter and cool water in summer) mixed with a
teaspoonful of honey the first thing in the morning.
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Breakfast:
It should consist of fruits, both fresh and dried.
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Lunch:
It should consist largely of protein foods. Starchy foods such as whole wheat bread,
cereals, rice, or potatoes should be taken at dinner along with raw salads. However, more
of spices, tomatoes, sour buttermilk and oily foodstuffs should be avoided.
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