A9 Migraine (spread cortical depression)

Title

Migraine aura is associated with cortical spreading depression (CSD), a wave of slow depolarization that propagates through the cortex driven by the release and diffusion of extracellular K+, in a reaction-diffusion formalism analogous to that used for the epileptiform discharge of A01. When the concentration of extracellular K+ exceeds a local threshold, the wave is triggered, the speed of which depends on the diffusivity of the K+ and its release rate. CSD is accompanied by an initial phase of hypoperfusion followed by hyperemia (extension of the blood flow dynamics of E11), and activates the trigeminovascular system, releasing vasoactive peptides such as CGRP, responsible for meningeal vasodilation and progressive sensitization of the central pain pathways, a mechanism that is taken up more generally in the chronic neuropathic pain model (A13).

ID:4291