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Throbbing Pain: Pulsations Arise from the Head, not the Heart

The throbbing quality of migraine pain many not result from changes in blood vessels as previously thought, but rather from brain waves.

Experts have long believed that the throbbing quality of pain is related to arterial pulsations and the rhythm of the heart. However, a team of researchers has shed new light on the “vascular” idea, which dates back to the days of Aristotle.

Researchers, led by Dr. Andrew Ahn, a neurologist at the University of Florida College of Medicine in Gainesville, began their research into better methods to ease pain.

“It turns out that we have been looking in the wrong place all along,” Dr. Ahn said.

As part of this study, Dr. Ahn and his colleagues encountered a patient who experienced a throbbing sensation that remained after her migraine headache had resolved. They recorded the patient’s sensation of the throbbing pain and her arterial pulse and found that they differed from one another. Then, through the use of an electroencephalogram, which measures the electrical activity of the brain, the team found that the throbbing quality correlated with a type of brain activity called alpha waves.

Scientists don’t know yet how alpha waves cause throbbing pain. But the current findings indicate that how people experience pain is linked to how the brain works, not to the pulsations of blood where the pain is located. Understanding this process will allow researchers to design new studies to discover better treatments for pain, Dr. Ahn said.

Dr. Arthur Elkind, the President of the National Headache Foundation, noted that findings from this study align with the current understanding of migraine medication. Early on, ergots and triptans—medications for relief of acute migraine—were thought to work by constricting blood vessels. However, experts currently believe the medications work by involving neurotransmitters, such as serotonin, in the brain and cranial nerves during a migraine attack. Additionally, he said, investigations with newer compounds that do not constrict the blood vessels have been under way for some time. These agents do not have vasoconstrictor activity but instead are aimed at reversing brain disturbances that occur with migraine.

This study appeared in the July issue of the journal Pain.

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