Nerve excitability in sporadic migraine and monogenic familial hemiplegic migraine.
Migraine is very common, affecting almost 1 in 3 women and about 1 in 8 men and costs Australians about $36bn dollars a year. For many of the more severely affected, it is a constant struggle to function day by day. Many believe this disorder to be due to excessive sensitivity of the trigeminocervical system which conveys sensation from the head and neck. A genetic load may confer a vulnerability that contributes to a process of central sensitization.
There are three known monogenic (single gene disorder that on its own is responsible for the characteristics) causes of familial hemiplegic migraine, a form of migraine that can sometimes looks like a stroke. This population may have a disorder of ionic channels in the nerve membrane, and the technique of nerve excitability will be utilised to study the peripheral nerves of patients with this disorder, and compare them with patients with migraine without a defined genetic cause (the majority, as well with normal individuals.
We may in this way be able to discover what is happening at the nerve membrane level that makes nerves possibly ‘fire’ more often, and see if this can be predictive of medication response or modified by drugs.