Migraine: maladaptive brain responses to stress

Abstract

Migraine offers a unique model to understand the consequences of repeated stressors on the brain. Repeated stressors can alter the normal response of physiological systems, and this concept has been termed "allostatic load." In the case of the brain, the effects of repeated stress may lead to alteration in brain networks both functionally and structurally. As a result, the brain responds abnormally to environmental conditions (psychological or physiological). Here, we present an alternative perspective on migraine disease and propose that changes in brain states may occur as a result of repeated migraine attacks through maladaptive coping mechanisms. The cascade of these effects can lead to further deterioration of adaptation and thus lead to transformation or chronification of the disease.

Figure 1

Brain in the normal state responds adaptively (adaptive allostasis) to stressors ranging from physiologic to genetic in order to maintain the same brain state. In migraine the effect of stressors may be additive or cumulative and the brain’s response to the same stressors becomes maladaptive and thus changes to the brain may happen changing state of the brain to a new state.