/Video/What Happens to Your Brain During a Migraine?

What Happens to Your Brain During a Migraine?

A migraine can manifest through various symptoms, such as severe pain, light sensitivity, prolonged fatigue, and disrupted sleep.

Severe headaches are one of the most common signs, but the word “headache” alone doesn’t fully capture the experience a migraine can bring.

Changes in Hypothalamic Activity

Everyone’s experience differs; some people don’t even have headaches. So, what exactly is a migraine? What triggers it in the brain?

To uncover the structure of migraines, we must start with the moments leading up to them — the warning signs like fatigue, mood swings, sudden yawning, disturbed sleep, nausea, sensitivity to light and sound, or even increased thirst.

These signs point to one specific area of the brain: the hypothalamus.

The hypothalamus controls various mechanisms related to these symptoms, such as hormone balance, circadian rhythms, and fluid regulation.

It also connects widely across the brain and becomes particularly active in the days leading up to a migraine.

One common warning sign is the aura, which presents as temporary visual disturbances, tingling sensations, or difficulty speaking.

These occur due to electrical changes across cell membranes, which alter brain activity and blood flow. The cause of these changes remains unclear, but they can spread across the brain’s surface, triggering aura symptoms depending on the affected region.

For example, if they reach the visual cortex, they might cause spreading images or blind spots in the field of vision.

Role of the Trigeminal Nerve

During the headache phase, the trigeminal nerve plays a key role.

This nerve normally transmits sensations like touch and temperature from areas such as the face, parts of the scalp, and the blood vessels and membranes covering the brain. When activated, it sends pain signals.

During a migraine, the pain response becomes more sensitive, meaning the threshold for experiencing pain lowers. Even normally painless actions—like coughing, bending over, or exposure to sound and light—can become painful.

What We Still Don’t Know About Migraines

Migraines are both common and diverse, affecting 33% of women and 13% of men, yet there is still much we don’t understand.

We know migraines are a neurological disorder involving multiple brain regions, including the brainstem, both hemispheres, and the trigeminal nerve.

However, it remains unclear what triggers each phase of a migraine, why some people experience migraines while others don’t, why women are more prone to them than men, or why the nature of migraines can change throughout a person’s life.

Hormonal fluctuations are believed to play a role. Some women report a significant decrease in migraine frequency after menopause, as reproductive hormone fluctuations stabilize.

Conversely, migraines may worsen or new ones may appear before menopause, when these fluctuations increase.

People with migraines are also more prone to conditions such as depression, panic disorders, sleep disturbances, and even stroke. The relationship between these conditions seems complex—migraines could either contribute to these disorders or vice versa, or they might share a common genetic origin.

Genetics undoubtedly influence migraines, although no single gene causes them.

Certain genes regulate how neurons in the brain respond to environmental stimuli and transmit pain signals. It’s possible that the neurons in individuals with migraines are more easily triggered by external stimuli and less able to block pain signals.

While there is no simple explanation for what happens in the brain during this complex disorder, one thing is clear: a migraine is far more than just a headache.

Watch the full content on the TED-Ed YouTube channel, with nearly 21 million subscribers.

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