The hypothalamus, which plays a role in the proper functioning of the biological clock, is involved in the onset of migraine, both in the days preceding and during the attack itself
Every day I suffer from headaches that always appear at the same time, in the late afternoon: what could it be due to?
He answers Maria Clara Toninineurologist at the Center for the diagnosis and treatment of headaches, Clinica San Carlo, Paderno Dugnano (VAI AL FORUM)
The fact that his heachache introduce yourself everydayin the afternoon, and at the same time got me thinking about the complex circadian systema biological clock that rhythmically regulates – every day for 24 hours, based on the alternation of day and night, environmental and seasonal variations – our organism, not only on a behavioral level (circadian times of sleep, hunger, blood pressure, body temperature, heart rate, mood), but also in the involvement of specific brain areas which regulate the activation of important hormones, such as melatonin e
il cortisoland of particular genes of the so-called core circadian (genes controlled by the biological clock).
I geni clock
The biological clock, also referred to as the endogenous oscillator or core circadian, consisting of specific proteins (clock genes or clock genes) that allow maintain circadian rhythms; these oscillate with a periodicity of 24 hours depending on the various environmental changes (alternating day/night, temperature variations, approaching seasons), metabolic and physiological, allowing our body to synchronize and react to them. Clock genes are responsible for the synchronous functioning of the circadian biological clock and their alteration, due to mutations, responsible for a dysfunction or desynchronization of the endogenous clock (i.e. that originates within the body), which can in turn be the cause of various pathologies: sleep disorders, depression, cardiovascular disorders, hypertension, ulcers, epilepsy and headaches. Circadian cyclicity can also influence the therapeutic response, since the metabolic system changes rhythmically over time; choosing a circadian time in which to administer drugs could improve the effectiveness of the drugs themselves.
Cluster headache
L’hypothalamus the brain structure involved in the maintenance of homeostasis (self-regulation) of the biological clock and its alteration underlies the origin of the
cluster headachecharacterized by very painful, disabling attacks, lasting between 30 and 90 minutes, grouped at fixed times (particularly during the night, but also in the early afternoon), defined as clusters. Until recently, cluster headache was the only form associated with involvement of the circadian rhythm regulated by the hypothalamus. It has recently been demonstrated, through functional brain magnetic resonance studies, that the hypothalamus also involved in migraineboth in the days preceding the attack (drowsiness, hunger, yawning), and during the attack itself, because not only does the hypothalamus activate the trigeminal system – the cause of the headache -, but it controls the circadian rhythms of its onset.
Headache cyclicity
A recent literature review covering all studies on the relationship between migraine and circadian systemconducted by a group of researchers from the University of Texas, confirmed that 50% of 5,385 migraine sufferers complained headache at the same time of day. Also for this form of headachecompletely different – due to its clinical characteristics – from cluster headaches (pain attacks of medium-strong intensity, with a variable duration from a few hours to 2-3 days), is highlighted a cyclical: attacks in the late morning or late afternoon or during the night. You can then hypothesize a cyclicity of the headache also for other forms of headache which may be under the control of circadian biological rhythms influenced by a series of factors – stress, tiredness, anxiety, disturbed sleep, atmospheric, environmental and hormonal variations – which modulate the activity of the hypothalamus and they alter multiple genes of the core circadian. Future studies may give us more information on these mechanisms which are at the origin of the characteristics of a complex disease such as migraine, but probably also of other types of headaches, with the hope of improving the therapeutic approach, pharmacological and otherwise.
May 20, 2023 (change May 20, 2023 | 07:52)
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