Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-19T22:57:01.340Z Has data issue: false hasContentIssue false

Migraine: A Border Between Psychiatry and Neurology

Published online by Cambridge University Press:  07 November 2014

Abstract

In spite of the fact that migraine seems to have been present throughout the history of man (Areteus of Cappadocia gave a detailed description of it in the first century AD) and has a high prevalence, its pathophysiology is poorly understood. This is probably due to the fact that it is an episodic and self-limiting, although discomforting, disorder.

It is only in the last few decades that migraine has undergone systematic investigation exploring possible genetic, hormonal, biochemical, and psychological factors. As a result, its nature is now becoming less enigmatic, and some comprehensive models on the underlying mechanisms are available.

We review the most intriguing hypotheses related to the pathophysiology of migraine, focusing especially on theories of serotonin dysfunction, which may also explain the high prevalence of psychiatric disorders detected in migraine patients.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. International Headache Society. Classification and criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8(suppl. 7):196.Google Scholar
2. Olesen, J, Tfelt-Hansen, P, Welch, KMA. The Headache. New York: Raven Press; 1993.Google Scholar
3. Liveing, E. On Megrim. Sick-Headache and Some Alliede Disorders: A Contribution to the Pathology of Nerve Storms. London: J&A Churchill; 1873.Google Scholar
4. Leao, AAP. Spreading depression of activity in cerebral cortex. J Neurophysiol. 1944;7:359390.CrossRefGoogle Scholar
5. Wolff, HG. Headache and Other Head Pain. ed 2.New York: Oxford University Press; 1963.Google Scholar
6. Welch, KMA. Migraine: a biobehavoral disorder. Arch Neurol. 1987;44:323327.CrossRefGoogle Scholar
7. Olesen, J, ed. Migraine and Other Headaches: The Vascular Mechanisms. New York: Raven Press; 1991.Google Scholar
8. Sicuteri, F, Testi, A, Anselmi, B. Biochemical investigations in headache: increase in the hydroxyindoleacetic excretion during migraine attacks. Int Arch Aller Appl Immunol. 1961;19:5558.CrossRefGoogle Scholar
9. Curran, DA, Hinterberger, H, Lance, JW. Total plasma serotonin, 5-hydroxyindoleacetic acid and p-hydroxy-m-methoxymandelic acid excretion in normal and migrainous subjects. Brain. 1965;88:9971010.CrossRefGoogle ScholarPubMed
10. Anthony, M, Hinterberger, HJ, Lance, JW. The possible relationship of serotonin to the migraine syndrome. Res Clin Stud Headache. 1969;2:2959.Google Scholar
11. Much-Seler, D, Deanovic, Z, Dupelj, M. Serotonin-releasing factors in migrainous patients. Adv Neurol. 1982;33:257264.Google Scholar
12. Ferrari, MD, Odink, J, Tapparelli, C, Van Kempen, R, Pennings, JM, Bruyn, GW. Serotonin metabolism in migraine. Neurology. 1989;39:12391242.CrossRefGoogle ScholarPubMed
13. Lance, JW, Anthony, M, Hinterberger, H. Serotonin and migraine. Trans Am Neurol Assoc. 1967;92:128131.Google ScholarPubMed
14. Curzon, G, Barrie, M, Wilkinson, IP. Relationships between headache and amine changes after administration of reserpine to migrainous patients. J Neurol Neurosurg Psychiatry. 1969;32:555561.CrossRefGoogle ScholarPubMed
15. Brandt, J, Celentano, D, Stewart, W, Linet, M, Folstein, M. Personality and emotional disorders in a community sample of migraine headache sufferers. Am J Psychiatry. 1990;147:303308.Google Scholar
16. Sicuteri, F. 5-Hydroxytryptophan in the prophylaxis of migraine. Pharmacol Res Communications. 1972;4:213218.CrossRefGoogle Scholar
17. Kangasniemi, P, Falck, B, Lanvik, VA, Hyyppa, MT. Levotryptophan treatment in migraine. Headache. 1978;18:161166.CrossRefGoogle ScholarPubMed
18. Bono, G, Criscuoli, M, Martignoni, E, Salmon, S, Nappi, G. Serotonin precursors in migraine prophylaxis. Adv Neurology. 1982;133:357363.Google Scholar
19. Peroutka, SJ, Sleight, AJ, McCarthy, BG, Pierce, PA, Schmidt, AW, Hekmatpanah, CR. The clinical utility of pharmacological agents that act at serotonin receptors. J Neuropsychiatry. 1989;1:253262.Google ScholarPubMed
20. Brewerton, TD, Murphy, DL, Mueller, EA, Jimerson, DC. Induction of migraine-like headaches by the serotonin agonist m-cholorophenylpiperazine. Clin Pharmacol Ther. 1988;43:605609.CrossRefGoogle Scholar
21. Stahl, SM. The human platelets. A diagnostic and research tool for the study of biogenic amines in psychiatric and neurological disorders. Arch Gen Psychiatry. 1977;34:509516.CrossRefGoogle Scholar
22. Hilton, BP, Cummings, JN. 5-Hydroxytryptamine levels and platelet aggregation responses in subjects with acutemigraine headache. J Neurol Neurosurg Psychiatry. 1972;35:505509.CrossRefGoogle Scholar
23. Glover, V, Peatfield, R, Zammit-Pace, R, et al. , Platelet monoamine oxidase activity in headache. J Neurol Neurosurg Psychiatry. 1981;44:786790.CrossRefGoogle ScholarPubMed
24. Sandler 1982Google Scholar
25. Dalsgaard-Nielsen, T, Genefke, IK. Serotonin release and uptake in platelets from healthy persons and miograine patients in attack-free intervals. Headache. 1974;14:2632.CrossRefGoogle ScholarPubMed
26. Malmgren, R, Olsson, P, Tornling, G, Unge, G. The 5-hydroxytryptamine take-up mechanisms in normal platelets and platelets from migraine and asthmatic patients. Thromb Res. 1980;18:733741.CrossRefGoogle ScholarPubMed
27. Waldelind, E, Ross, SB, Saaf, J, Ekbom, K, Wetterberg, L. Concentration and uptake of 5-hydroxytryptamine in platelets from cluster headache and migraine patients. Cephalalgia. 1985;5:4554.CrossRefGoogle Scholar
28. Geaney, DP, Rutterford, MG, Elliott, JM, et al. , Decreased platelet 3H-imipramine binding in classical migraine. J Neurol Neurosurg Psychiatry. 1984; 7:720723.CrossRefGoogle Scholar
29. Jarman, J, Fernandez, M, Glover, V, Steiner, TJ, Clifford-Rose, F, Sandler, M. Platelet 3H-imipramine binding in migraine and tension headache in relation to depression. J Psychiat Res. 1991;25:205211.CrossRefGoogle ScholarPubMed
30. Marazziti, D, Bonuccelli, U, Nuti, A, et al. , Platelet 3H-imipramine binding and sulphotransferase activity in primary headache. Cephalalgia. 1994;14:210214.CrossRefGoogle ScholarPubMed
31. Stewart, WF, Linet, MS, Celentano, DD. Migraine headaches and panic attacks. Psychosomatic Med. 1989;51:559569.CrossRefGoogle ScholarPubMed
32. Merikangas, KR, Angst, J, Isler, H. Migraine and psychopathology. Results of the Zurich cohort study of young adults. Arch Gen Psychiatry. 1990;47:849853.CrossRefGoogle ScholarPubMed
33. Robins, LN, Regier, DA. Psychiatric Disorders in America. New York: The Free Press; 1991.Google Scholar
34. Bellantuono, C, Fiorio, R, Zanotelli, R, Tansella, M. Psychiatric screening in general practice in Italy. Soc Psychiatry. 1987;22:113117.CrossRefGoogle ScholarPubMed
35. Endicott, NA. Psychophysiological correlates of bipolarity. J Affect Dis. 1989;17:47561.CrossRefGoogle ScholarPubMed
36. Glover, V, Jarman, J, Sandler, M. The role of 5-hydroxytryptamine in migraine: disentangling the links with depression, in 5-hydroxytryptamine. In: Sandler, M, Coppen, A, Harwett, S (eds). Psychiatry: a spectrum of ideas. Oxford: Oxford Medical Publication; 1991;9097.Google Scholar
37. Gordon, ML, Brown, SL, Lipton, RB, et al. , Serotonergic parallels in migraine, depression and anxiety. In: Nappi, G, Bono, G, Sandrini, G, Martignoni, E, Miceli, G (eds). Headache and Depression. New York: Raven Press; 1991;2141.Google Scholar
38. Merikangas, KR, Risch, RJ, Merikangas, NR, Weissman, MM, Kidd, KK. Migraine and depression: association and familial transmission. J Psychiatr Res. 1988;22:119129.CrossRefGoogle ScholarPubMed
39. Winokur, G. The concept of secondary depression and its relation to comorbidity. Psychiatr Clin North Am. 1990;3:567583.CrossRefGoogle Scholar
40. Maser, JD, Cloninger, CR. Comorbidity of Mood and Anxiety Disorders. Washington DC: American Psychiatric Press; 1990.Google Scholar