Is migraine a disease?
The migraine attack is a reversible brain dysfunction characterized by pain autonomic symptoms and passive coping strategies consistent with sickness behavior. The migraine attack may be interpreted as an example of genetically determined adaptive behavioral response to internal or external stressors that it is orchestrated by a threatened brain. In this view, the migraine attack itself may not be categorized as a disease, i.e., a deviation from or interruption of the normal structure or function of the brain but it may turn into a disease in an allostatic perspective, when the repeated migraine attacks start maladaptive mechanisms (inefficient turning on or shutting off of the mechanisms underlying the migraine attack) that resulted in a chronic pain of the brain. In future, we should recognize and treat early all the conditions able to transform a normal response of the brain into a morbid state, i.e., we have to categorize migraine not only as a type of headache attack but also as a symptom of different syndromes.
Cortelli
Pietro
P
Dipartimento di Scienze Neurologiche, Center for the Study of Headaches, Alma Mater Studiorum-Università di Bologna, Bologna, Italy. pietro.cortelli@unibo.it
Pierangeli
G
G
Montagna
P
P
D052636:Allostasis; D001921:Brain / Q000503:physiopathology*; D013181:Cortical Spreading Depression; D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis* / Q000503:physiopathology