How does the migraine brain respond differently to pain versus the brain of someone that does not have migraine?


The migraine brain responds to a greater extent to a painful stimulus resulting in an intensification of pain. Conversely, the area of the migraine brain that is responsible for blocking pain does not activate as it should.


“If you have migraine, when you are exposed to a painful stimulus, your brain is going to be hyperactive to that. So, regions of the brain which we know participate in pain processing, they activate to a greater extent if you have migraine, compared to if you don't. These are regions that facilitate pain, or perhaps make the pain experience worse.

Unfortunately, on the flip side, things aren’t quite normal either in that there are certain regions of the brain, mostly in the brainstem, that inhibit pain, or lessen pain, and unfortunately, those regions don't activate as much as they should, so you kind of have this unfortunate imbalance where regions which are responsible for worsening the pain are overactive, and regions of the brain which are supposed to be blocking the pain don't activate enough.”


Research shows that the areas of the brain that process pain are hyperactive in those with migraine resulting in a higher level of pain activation. At the same time, the areas of the brain that are responsible for blocking pain have been found to be underactive in those with migraine. All of this causes an imbalance in the brain of those with migraine with the end result being a heightened pain experience.

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Todd Schwedt, MD

Professor of Neurology
Mayo Clinic School of Medicine in Arizona

As a Professor of Neurology the Mayo Clinic School of Medicine in Arizona, Dr. Todd Schwedt has seen thousands of migraine patients and evaluated a large number of scans of our hypersensitive brains. His research using advanced MRI techniques has been widely published. He serves on the Board of Directors of the American Headache Society, is the Vice Chairman of the Headache and Facial Pain section of the American Academy of Neurology, is a member of the International Headache Society Classification Committee, and is an Associate editor of Headache, Cephalalgia and Pain Medicine journals.