Migraine as dysfunctional drive reduction: insight from electrophysiology

Abstract Migraine is a prevalent disease, which may cause significant discomfort and reduced functioning for days, including the preictal and postictal periods. During the interictal period, however, migraineurs seem to function normally. It is puzzling, therefore, that event-related potentials (ERPs) of migraine patients often differ at the group level also in the asymptomatic, interictal phase, both in early and later ERP waves. Furthermore both types of ERP waves demonstrate changes, which are often noticed 12-48 hours before a migraine attack and continue throughout it. On the basis of previous work, it might be possible to associate these ERP differences and their dynamics with changes in patient attention, which might be further associated with stress. This paper suggests that such stress-related dynamics can explain both the ERP findings as well as the dynamics in clinical symptoms throughout the migraine cycle. It further suggests that migraine can be viewed as a (dysfunctional) stress-reducing solution. In this sense migraine can be viewed as a representative case for other stress-related and psychopathological disorders, which are also stress-reducing solutions.