Brain stem activation in spontaneous human migraine attacks

Nat Med. 1995 Jul;1(7):658-60. doi: 10.1038/nm0795-658.


Evidence from animal experiments shows that the brain stem is involved in the pathophysiology of migraine. To investigate human migraine, we used positron emission tomography to examine the changes in regional cerebral blood flow as an index of neuronal activity in the human brain during spontaneous migraine attacks. During the attacks, increased blood flow was found in the cerebral hemispheres in cingulate, auditory and visual association cortices and in the brain stem. However, only the brain stem activation persisted after the injection of sumatriptan had induced complete relief from headache and phono- and photophobia. These findings support the idea that the pathogenesis of migraine is related to an imbalance in activity between brain stem nuclei regulating antinociception and vascular control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Auditory Cortex / blood supply
  • Auditory Cortex / drug effects
  • Auditory Cortex / physiopathology
  • Brain Stem / blood supply
  • Brain Stem / diagnostic imaging
  • Brain Stem / physiopathology*
  • Cerebrovascular Circulation* / drug effects
  • Female
  • Gyrus Cinguli / blood supply
  • Gyrus Cinguli / drug effects
  • Gyrus Cinguli / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / diagnostic imaging
  • Migraine Disorders / drug therapy
  • Migraine Disorders / physiopathology*
  • Receptor, Serotonin, 5-HT1D
  • Receptors, Serotonin / drug effects
  • Serotonin Receptor Agonists / pharmacology
  • Serotonin Receptor Agonists / therapeutic use
  • Sumatriptan / pharmacology
  • Sumatriptan / therapeutic use
  • Tomography, Emission-Computed*
  • Vasoconstrictor Agents / pharmacology
  • Vasoconstrictor Agents / therapeutic use
  • Visual Cortex / blood supply
  • Visual Cortex / drug effects
  • Visual Cortex / physiopathology


  • Receptor, Serotonin, 5-HT1D
  • Receptors, Serotonin
  • Serotonin Receptor Agonists
  • Vasoconstrictor Agents
  • Sumatriptan