What is CSD in migraine?

Cortical SD (CSD) is considered the neurophysiological correlate of migraine aura. It is characterized by massive increases in both extracellular K+ and glutamate, as well as rises in intracellular Na+ and Ca2 +. These ionic shifts produce slow direct current (DC) potential shifts that can be recorded extracellularly.

What triggers CSD?

In human or animal tissue in vitro, or in animal models in vivo, CSD can be evoked by a wide variety of stimuli. These include local mechanical stimulation or injury, tetanic or D.C. electrical stimulation, KCl, hypo-osmotic medium, metabolic inhibitors, ouabain, glutamate receptor agonists, and endothelin.

How do you stop cortical spreading depression?

Vagus nerve stimulation suppresses cortical spreading depression – a trigger for migraine. According to a study led by scientists at Massachusetts General Hospital, Harvard Medical School1 published in the journal Pain, vagus nerve stimulation (VNS) was found to suppress cortical spreading depression (CSD2).

Why is it called cortical spreading depression?

Uses of the term Neuroscientists use the term cortical spreading depression to represent at least one of the following cortical processes: The spreading of a self-propagating wave of cellular depolarization in the cerebral cortex. The spreading of a wave of ischemia passing through an area of cortex.

What are spreading Depolarizations?

The term spreading depolarization describes a wave in the gray matter of the central nervous system characterized by swelling of neurons, distortion of dendritic spines, a large change of the slow electrical potential and silencing of brain electrical activity (spreading depression).

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Are triptans serotonin agonists?

The triptans are serotonin agonists with high affinity for the 5-HT1B and 5-HT1D receptors which are found on smooth-muscle cells of blood vessels. Simulation of the 5-HT1D receptor results in constriction of intracranial blood vessels.

What is spreading depression in migraine?

Spreading depression (SD) is a slowly propagating wave of near-complete depolarization of neurons and glial cells across the cortex. SD is thought to contribute to the underlying pathophysiology of migraine aura, and possibly also an intrinsic brain activity causing migraine headache.

What is a cortical migraine?

Cerebral cortex Migraine is associated with a variety of symptoms that can be attributed to changes in cortical function. The most prominent among these are the visual changes associated with migraine aura that arise from altered function in the occipital lobe.

What is cortisol spreading depression?

Cortical spreading depression (CSD) is a slowly propagating wave of altered brain activity that involves dramatic changes in neuronal, glial and vascular function. CSD has recently been extensively characterized in humans via recordings from the exposed brain surface in patients with brain injury.

Are migraines neurovascular?

Migraine is a highly prevalent and complex, neurovascular disorder that has been recognized since ancient times.

Why do I keep getting Retinal migraines?

There are no triggers that are specific to a retinal migraine, but the following factors can trigger a regular migraine: emotional stress, tension, and being overtired. sensitivity to ingredients in specific foods. too much caffeine or caffeine withdrawal.

How does CGRP cause migraine?

CGRP stands for calcitonin gene-related peptide, and it is a protein that is released around the brain. When CGRP is released, it causes intense inflammation in the coverings of the brain (the meninges), and for most migraine patients, causes the pain of a migraine attack.

Can migraines cause hemiparesis?

Hemiplegic migraine is a rare form of migraine where people experience weakness on one side of their body (hemiplegia) in addition to the migraine headache attack. The weakness is a form of migraine aura and occurs with other forms of typical migraine aura like changes in vision, speech or sensation.

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How long can a migraine prodrome last?

Prodrome. Also known as “preheadache” or the premonitory phase, prodrome can mark the beginning of a migraine attack. This phase can last several hours or may even occur over several days. Most people with migraine will experience prodrome, but not necessarily before every migraine attack.

What is fortification spectrum?

Fortification spectra or teichopsia are the bright, shimmering, jagged lines that can spread across the visual field. The name fortification spectra comes from the visual appearance that resembles the battlements or walls of archaic fortresses.

What is CSD in neurology?

Cortical spreading depression (CSD) is a wave of sustained depolarization (neuronal inactivation) moving through intact brain tissue and associated with brain ischemia, migraine aura, and seizures.

What is meant by depolarization?

1 : the process of depolarizing something or the state of being depolarized. 2 physiology : loss of the difference in charge between the inside and outside of the plasma membrane of a muscle or nerve cell due to a change in permeability and migration of sodium ions to the interior …

What is a Cortex in anatomy?

In anatomy and zoology, the cortex (plural cortices) is the outermost (or superficial) layer of an organ. Organs with well-defined cortical layers include kidneys, adrenal glands, ovaries, the thymus, and portions of the brain, including the cerebral cortex, the best-known of all cortices.

Can triptans make migraines worse?

Triptans can cause rebound headache, but their overuse is limited simply because the majority of insurance companies allot so few per prescription.

Can triptans cause anxiety?

Fortunately, serotonin syndrome appears to be rare among people taking triptans with SSRIs or SNRIs . The drugs have safely been used together for many years, which is significant because anxiety and depression are common in people with migraines and each condition needs to be treated appropriately.

Is it safe to take triptans daily?

In conclusion, daily triptans can be a highly effective and safe treatment for a small group of patients with chronic migraine headaches. They should not be prescribed for the prevention of migraines or for daily abortive use, unless other options (excluding barbiturate, caffeine, or narcotics) have been tried.

What is cutaneous allodynia?

Cutaneous allodynia (CA) refers to a pain provoked by stimulation of skin that would ordinarily not produce pain1. The underlying mechanism of CA includes sensitisation of the trigeminal nucleus caudalis, which receives afferent input from the meninges and periorbital skin regions2 , 3.

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Can you get a migraine without aura?

Some people experience an “aura,” which are transient sensory changes typically occurring before pain starts (most commonly an obstructive visual symptom lasting 5-60 minutes). More commonly, however, migraine presents without aura—about 70-75% of migraine patients do not experience aura.

What is cortical spreading depolarization?

Cortical spreading depolarization (CSD) is a spreading loss of ion homeostasis, altered vascular response, change in synaptic architecture, and subsequent depression in electrical activity following an inciting neurological injury.

What does the brain look like during a migraine?

Using MRI scans, researchers found that in specific brain regions related to pain processing, migraine sufferers showed a thinner and smaller cortex compared to headache-free adults. The cortex refers to the outer layer of the brain. It’s not clear what it all means.

Is migraine a brain disease?

Migraine is a neurological disease with extremely incapacitating neurological symptoms. It’s typically a severe throbbing recurring pain, usually on one side of the head. But in about 1/3 of attacks, both sides are affected.

Is a migraine inflammation of the brain?

It has always been believed that the pain of migraines comes from abnormal dilatation of the blood vessels in the brain. This has never been proven, however. In recent years, more and more research seems to be focusing on the fact that inflammation may indeed play a major role in the onset of migraine headaches.

Why does spreading depression occur?

Spreading depression (SD) is a neurophysiological phenomenon characterized by abrupt changes in intracellular ion gradients and sustained depolarization of neurons. It leads to loss of electrical activity, changes in the synaptic architecture, and an altered vascular response.

Where is the cortical?

The cerebral cortex is the outer covering of the surfaces of the cerebral hemispheres and is folded into peaks called gyri, and grooves called sulci. In the human brain it is between two and three or four millimetres thick, and makes up 40 per cent of the brain’s mass.