Researchers have discovered a potential mechanism for triggering migraine which could explain why women get more migraines than men.
The study, published in the journal Frontiers in Molecular Biosciences, suggests that sex hormones affect cells around the trigeminal nerve and connected blood vessels in the head, with oestrogens – at their highest levels in women of reproductive age – being particularly important for sensitising these cells to migraine triggers.
The findings provide scientists with a promising new route to personalised treatments for migraine patients.
Study corresponding author Professor Antonio Ferrer-Montiel, of the Universitas Miguel Herná¡ndez in Spain, said: “We can observe significant differences in our experimental migraine model between males and females and are trying to understand the molecular correlates responsible for these differences.
“Although this is a complex process, we believe that modulation of the trigeminovascular system by sex hormones plays an important role that has not been properly addressed.”
Professor Ferrer-Montiel and his team reviewed decades of literature on sex hormones, migraine sensitivity and cells’ responses to migraine triggers to identify the role of specific hormones.
Some – such as testosterone – seem to protect against migraines, while others – such as prolactin – appear to make migraines worse.
Professor Ferrer-Montiel said they do so by making the cells’ ion channels, which control the cells’ reactions to outside stimuli, more or less vulnerable to migraine triggers.
He said some hormones need much more research to determine their role, but oestrogen stands out as a key candidate for understanding migraine occurrence.
It was first identified as a factor by the greater prevalence of migraine in menstruating women and the association of some types of migraine with period-related changes in hormone levels.
The research team’s evidence now suggests that oestrogen and changes in oestrogen levels sensitise cells around the trigeminal nerve to stimuli. That makes it easier to trigger a migraine attack.
But Professor Ferrer-Montiel said that the work is only preliminary.
He said the role of oestrogen and other hormones in migraine is complex and much more research is needed to understand it.
The researchers said that future studies should focus on the relationship between menstrual hormones and migraines. The current work relies on in vitro and animal models, which they said aren’t easy to translate to human migraine sufferers.
But Professor Ferrer-Montiel and his colleagues see a promising future for migraine medication.
They intend to continue their research using pre-clinical, human-based models which better reflect real patients.
Professor Ferrer-Montiel added: “If successful, we will contribute to better personalised medicine for migraine therapy.”