While new migraine research is published regularly, much of it doesn’t make its way to the migraine community. Here, we’ll take the time to highlight some of that research, translating it into simple, everyday language that doesn’t require a PhD to understand.
The four studies below not only comprise some of the latest migraine research, but also point to interesting or nontraditional solutions that represent a new way of thinking about migraine management. In some cases, more research is needed to validate their findings. However, the results offer hope if you are seeking affordable, accessible relief from your symptoms.
Could these migraine headache research efforts lead to new treatments?
Not all colors of light exacerbate photophobia.
Brain Journal of Neurology
TL;DR
A specific narrow band of green light reduces migraine activity and soothes symptoms such as light sensitivity during an attack.
Summary
Light sensitivity, also known as photophobia, can be so crippling during a migraine attack that it makes virtually any task aside from escaping to a dark room seem unbearable. Yet despite the prevalence of photophobia among migraine patients (both with and without aura), it is only just recently that scientists demystified the physiology behind it — thanks to research from Dr. Rami Burstein and his team.
Working with blind migraine patients early on in their research, the team split participants into two groups: those who could sense the presence of light and those who couldn’t. Interestingly, they found that in those participants who could sense light, its presence aggravated migraine activity. However, light had no effect on the latter group. These findings led to the discovery of a previously unknown pathway which connects the retina to the area of the brain where neurons are most active during an attack.
With this novel understanding of the mechanisms connecting light to migraine pain came a new question: do all colors of light affect the migraine experience equally? The answer followed in 2016, when Burstein and his team published follow-up research. By exposing patients with normal eyesight to wavelengths of white (regular room light), blue, green, amber, and red lights during a migraine, the team found that most light aggravates migraine activity — but not all light. While white, blue, amber, and red lights increased headache intensity in migraine patients, a narrow band of green light soothed migraine symptoms.
What might this mean for your migraine?
For people with migraine, Dr. Burstein’s findings mean that photophobia doesn’t have to put a halt to your day’s activities — and relief doesn’t have to come in the form of a dark room, expensive prescription, or side effects. That’s because his findings have enabled modern migraine management solutions such as The Allay Lamp, a portable and affordable source of the specific band of green light proven to soothe migraine headaches.
What’s next?
Thanks to Dr. Burstein’s research, we now know that narrow-band green light therapy can soothe migraine symptoms. What we don’t yet know is the potential of green light even beyond migraine. New studies suggest that it may benefit those who suffer from anxiety, chronic pain, and beyond. In fact, a 2020 study published in Pain Medicine shows that green light could be a viable source of relief for fibromyalgia patients.
Ketogenic diets show potential in managing migraine.
European Journal of Neurology
TL;DR
The ketogenic diet may have the potential to reduce migraine symptoms and attack frequency, but more research is necessary.
Summary
The ketogenic diet, also known as the “keto” diet, has received a lot of attention in recent years. It is a regimen that severely restricts carbohydrates, which the body breaks down into the glucose it uses for fuel. Starved of glucose, the body turns to ketone bodies, a type of fuel produced by the liver via stored fat.
Keto is popular due to claims it can help dieters lose weight, but recent studies suggest it may have the potential to improve migraine while the body is in a state of ketosis (producing and using ketone bodies). In one study, 96 overweight female migraineurs were split into two parallel groups over six months. During that time, one group went on a keto diet for one month, followed by a standard low-calorie diet. The other group was put on the standard diet for the entire six months.
After the first month of diet, the keto group reported reductions in attack frequency (from 2.9 attacks per month to 0.71), number of days with headaches (from 5.11 days per month to 0.91), and tablet intake (from 4.91 doses per month to .51). During the second month, after switching to the standard low-calorie diet, the same group saw all three figures rise to 2.6 attacks, 3.6 days with headaches, and 3.07 doses of tablets by the end of the second month.
In the standard diet group, participants saw decreases in number of days with headache after three months, and a decrease in attack frequency at six months.
What might this mean for your migraine?
Much has been discussed about foods that are migraine triggers, but less is known about what shape a diet should take in order to supplement an effective migraine treatment protocol. This study suggests that taking a more regimented approach to food, with the oversight of a medical professional, could play a role in improving quality of life for migraine patients.
What’s next?
There’s still additional research that should be carried out to validate the long-term safety and effectiveness of the keto diet as a migraine treatment add-on. This study was very limited in its scope: it focused exclusively on overweight females, had the experiment group follow a keto protocol for just a single month, and was limited to fewer than 100 participants. This in itself begs the question of whether such a protocol would yield the same result in a sample including males or a sample consisting of average weight participants. It also does not address the long-term implications and efficacy of the diet beyond the first month.
Note: Before starting any sort of diet, consult your physician.
Yoga may be effective as an add-on to migraine therapy.
Neurology
TL;DR
Yoga as an add-on to traditional medical treatment for migraine may result in significant reductions in headache frequency, headache intensity, and pill count compared to medical treatment alone.
Summary
Yoga and mindfulness meditation have been touted as both migraine trends and natural ways to help migraines. This study, published in Neurology, analyzes the effectiveness of yoga as an add-on to conventional medical migraine treatment. 160 patients with episodic migraine were enrolled in the study, which was carried out at an academic hospital in New Delhi, India, between April 2017 and August 2018.
Patients were randomly assigned to two groups — one receiving only medical intervention and the other receiving medical intervention with a three-month, predesigned yoga intervention as an add-on. Baseline measures of headache frequency, headache intensity, and pill count were similar between the two groups, aside from a slightly higher average headache frequency in the yoga group.
At the end of the study, the yoga group showed a significant reduction in all three, demonstrating the potential of yoga as a safe add-on therapy that can be carried out alongside traditional medical intervention to amplify improvement.
What might this mean for your migraine?
In an age of ample YouTube yoga classes, yoga is an accessible and affordable practice that is easy to adopt and add to traditional treatment methods. Yoga is also appealing because it is extremely safe, with virtually zero negative side effects. There are a number of styles of yoga as well, ranging from Yin yoga - where stretches are held for extended periods of time to promote tension release - to the more athletic flows of Vinyasa yoga.
What’s next?
The study in question speaks to the efficacy of yoga as an add-on treatment, but does not look at yoga as a potential treatment in and of itself. More studies are needed to gauge whether yoga on its own could be an effective means of managing migraine and minimizing symptoms. For now, coupling yoga with the Allay Lamp can provide a soothing meditative approach to managing your migraines.
Triptans like Sumatriptan are more effective the earlier you take them.
Annals of Neurology
TL;DR
Administering triptans at the immediate onset of a migraine attack, as opposed to waiting until it gets worse, increases the effectiveness of these drugs in blocking symptoms.
Summary
Triptans such as sumatriptan are prescription drugs used to quiet down the pain nerves that are overactive during a migraine attack. In a 2004 study, Dr. Rami Burstein and Dr. Moshe Jakubowski examined whether triptans are able to prevent the activation and sensitization of neurons that carry the pain signals of migraine from the meninges (where they begin) to the cortex (where the perception of headache is generated).
In order to conduct the study, these doctors focused on the development of exaggerated skin sensitivity during migraine. Known as cutaneous allodynia, this sensitivity is characterized by the perception of pain in response to stimuli that are generally not painful. For example, some migraine patients may find that they experience pain when brushing their hair or having jewelry touch their skin — two actions that normally wouldn’t cause pain.
In the study, Burstein and Jakubowski treated two of the patients’ attacks with sumatriptan. In the first attack, they administered the sumatriptan shortly after the onset of the attack (within 1 hours or less), and in the second attack, they waited for 2-4 hours before administering the sumatriptan.
Ultimately, they found that late sumatriptan intervention did not terminate the migraine or reverse the skin hypersensitivity, whereas early treatment terminated the headache within an hour and prevented the development of the abnormal skin hypersensitivity. They concluded that early treatment (no later than 20 min after onset of headache) with this class of drugs (called triptans) should be recommended to all migraine patients, as it improves the chance that it will render them completely pain-free.
What does it mean for migraine?
While it might seem appealing to take a “wait and see” approach with triptans, this study shows that it may end up causing unnecessary pain that could have otherwise been avoided. If you take triptans such as sumatriptan for migraine, taking them at the immediate onset of a migraine attack is most effective and will help mitigate or even avoid debilitating symptoms that result from central sensitization.
What’s next?
Could timing play into the administration of other migraine treatments that work to terminate the attacks? The findings of this study could prompt similar work specific to different types of treatments that abort attacks when they occur. (Such drugs are approved by the FDA as acute migraine drugs.)
Answers are on the horizon.
New research on migraines promises to usher in a new paradigm for the treatment of this debilitating and all-too-common condition. Scientists may still not fully understand why migraines happen, but they may at long last be on the cusp of real answers, accessible treatments, and, most importantly, a better quality of life for those who suffer.
