Nature Medicine
1, 658 - 660 (1995)
doi:10.1038/nm0795-658
Brain stem activation in spontaneous human migraine attacksC. Weiller1, 3, A. May1, V. Limmroth1, M. Jüptner1, H. Kaube1, R.V. Schayck1, H.H. Coenen2
& H.C. Dlener1, 3
1Department of Neurology, University of Essen, Hufelandstrasse 55, 45122 Essen, Germany.
2Department of Nuclear Medicine—Radiopharmacy Section, University of Essen, Hufelandstrasse 55, 45122 Essen, Germany.
3Correspondence should be addressed to H.C.D. & C.W. Evidence from animal experiments shows that the brain stem is involved in the pathophysiology of migraine. To investigate human migraine, we used positron emission tomography to examine the changes in regional cerebral blood flow as an index of neuronal activity in the human brain during spontaneous migraine attacks. During the attacks, increased blood flow was found in the cerebral hemispheres in cingulate, auditory and visual association cortices and in the brain stem. However, only the brain stem activation persisted after the injection of sumatriptan had induced complete relief from headache and phono- and photophobia. These findings support the idea that the pathogenesis of migraine is related to an imbalance in activity between brain stem nuclei regulating antinociception and vascular control.
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