Understanding Brain Freeze Key to Migraine Treatment? Unlikely.
Recent headlines related to Migraine are replete with those related to brain freeze and ice cream headaches. Why? Because of a research poster presented Sunday afternoon at the Experimental Biology 2012 meeting in San Diego.
Some of the headlines have read:
- Now there's a cure for ice cream headaches too!
- Can Brain Freeze Solve the Mystery of Migraines?
- Brain Blood Flow Changes Could Trigger Brain Freeze, Migraines
- Understanding "Brain Freeze" May Be Key to Migraine Treatment, Says Study
The Research Poster:
For this research:
- 13 healthy volunteers triggered "brain freeze" by sipping ice water through a straw pressed against the upper palate (roof of the mouth). They raised their hands when they felt the freeze start and raised them again when the feeling ceased.
- Researchers monitored blood flow in their brains via a process similar to ultrasound.
Researchers reported that...
- they saw increased blood flow to the brain through the anterior cerebral artery, located in the middle of the brain behind the eyes.
- the increase in blood flow and the resulting vasodilation (dilation of that blood vessel) caused the pain of the "brain freeze."
- the pain stops when the artery constricts again, stopping the response to the increased blood flow.
Study researcher Jorge Serrador of Harvard Medical School stated:
"The brain is one of the relatively important organs in the body, and it needs to be working all the time... It's fairly sensitive to temperature, so vasodilation might be moving warm blood inside tissue to make sure the brain stays warm"1
He also explained that changes in blood flow to the brain may play a role in migraines and other types of headaches. If subsequent studies confirm these findings, they could have implications for treatment. Drugs that prevent the sudden arterial dilation could potentially be an effective remedy for these debilitating headaches.2
Summary and comments:
As I read the observations from the study and Serrador's comments, I felt they were interesting, but found myself wondering what all the excitement was about. The vascular theory of Migraine, the theory that after we encounter a Migraine trigger, changes in blood vessels are the first link in the chain of events that comprise a Migraine attack, has been disproven and abandoned. Migraines are no longer considered to be vascular headaches.
It turns out that some Migraine experts who were interviewed commented along the same lines. Dr. Joel Saper director of the Michigan Headache and Neurological Institute in Ann Arbor, said that the study doesn't seem to provide any evidence that the altered blood flow actually caused the pain, stating,
"It could be that the cold is irritating the nerve and it's causing pain, and maybe the blood flow is the result of the pain, or the result of something being that cold."2
"There aren't any primary headaches that are caused just by blood flow. Not all headaches are the same."2
Dr. Teshamae Monteith, director of the headache program at the University of Miami's Miller School of Medicine, commented,
"We have known for decades that migraine is caused by brain dysfunction. There may be vascular changes, but they are only secondary. Patients experience warning symptoms such as food cravings, frequent yawning, fatigue, and neck stiffness a day before the pain, suggesting that migraine is a state of brain dysfunction as opposed to one of vascular dysfunction."2
Monteith also commented that some of the more promising newer treatments are drugs that do not affect blood vessels and that medications that do target blood flow and are sometimes effective against migraines are not safe for everyone to use, such as people with a history of strokes or heart attacks.
Both Saper and Monteith said that while the study may be a great model for ice cream headaches, at this point, it's too big a leap to tie the findings to other types of headaches.
The bottom line? The media jumped on a research poster and made big headlines out of it - prematurely. The findings of this research have yet to be published in a peer-reviewed journal. As Dr. Saper and Dr. Monteith pointed out, it has now been shown that Migraines are not vascular headaches, so the headlines are incorrect at best.
To those who wrote those headlines - What? Was it a slow news day? Kudos to Kim Carollo whose interviews with Dr. Saper and Dr. Monteith brought current science into play when reporting on this research poster!
1 Welsh, Jennifer. "Cause of Brain Freeze Revealed." LiveScience. April 22, 2012.
2 Carollo, Kim. "Understanding Brain Freeze May Be Key To Migraine Treatment, Says Study." ABC News. April 23, 2012.
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