Grant: Project Grant

Migraine is the second most prevalent and disabling disorder across the lifespan worldwide. Research suggests early treatment results in better long-term outcomes. However, migraine in children appears different than in adults, specifically treatments used for adult migraine are ineffective in children. In order to develop specific, evidence-based treatments, we need to better understand what is different about the brain in children and adolescents with migraine. Data suggests that there are imbalances in brain activity states in migraine. Activity states are based on brain chemistry and electrical activity. 'Excitation' reflects the active and reactive state. 'Inhibition' acts as the controlling state. Using three complimentary approaches/methods, this study will measure and compare inhibition and excitation in children and adolescents with and without migraine (aged 7-18 years). We will measure: (1) brain chemicals using a method called magnetic resonance spectroscopy; (2) the electrical responsivity of the brain using transcranial magnetic stimulation; and (3) inhibition and excitation in the brain indirectly through behavioral tasks. We expect the inhibition/excitation brain states to be different in migraine compared to age-matched controls. Secondly, we will perform follow-up measurements for 2 years to determine brain changes over time, comparing developmental differences in migraine to controls as well as changes in migraine severity. We expect there will be changes in brain state related to development and to changes in migraine burden. Finally, we will perform repeated measurements in children with migraine over a short period of time (2 weeks) to see how brain chemistry fluctuates throughout the migraine cycle. We expected the brain to become more excited as time to the next migraine approaches. The results of this project will provide foundational knowledge to improve therapies with the ultimate goal of reducing migraine burden across the lifespan.