The yawning, fatigue, photophobia, hunger, and other symptoms of premonitory phase of migraine are providing important new clues to the disorder’s underlying pathophysiology and potential new drug targets, according to a presentation at the annual meeting of the American Headache Society.
But rather than think of these premonitory symptoms as being caused by “triggers” in the external environment, the current view is that they are generated internally by changes in the brain state, and they are as much a part of the migraine as the headache itself, said Peter Goadsby, MD, PhD, professor of neurology at King’s College, London and the University of California, San Francisco, who presented an overview of basic and clinical research advances in understanding the premonitory phase of migraine.
In recent years, he said, the field has begun to gain a greater understanding of the underlying mechanisms prompting these symptoms. “The beauty of being able to explore the biology of just yawning is that it allows us to dig down into role of dopamine. Asking why people get hungry brings us to the role of the hypothalamus and neuropeptide Y,” Dr. Goadsby said. “We’re in a state of real learning around this. We can now link what the patients are telling us (about their symptoms) with the underlying biology.
July 7, 2016