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What really causes migraine?
14th May, 2026 04:54 PM
Our understanding of migraine disorder is finally starting to shift, overturning ideas of what is a symptom and what is a trigger, and which part of the brain is key for developing effective treatments.
More than 1.2 billion people worldwide live with migraine disorder. It is one of the leading causes of disability globally, yet despite its common occurrence and debilitating effects, migraine remains poorly understood.
Researchers are now beginning to unravel what causes migraine and how it develops inside the brain. Through studies involving genes, blood vessels, electrical brain activity, and immune responses, scientists are slowly moving closer to understanding why migraine occurs and how it can be treated more effectively.
Why migraine has been difficult to study
Historically, migraine was often misunderstood and dismissed, especially because most patients are women. For centuries, it was incorrectly linked to emotional instability or “hysteria,” which contributed to limited funding and slow scientific progress.
Experts now stress that migraine disorder is much more than a headache.
Patients can experience nausea, vomiting, dizziness, stomach pain, sensitivity to light and sound, fatigue, food cravings, excessive yawning, and visual disturbances known as auras.
Researchers say migraine attacks are complex neurological events involving multiple body systems.
Scientists are also rethinking the idea of “triggers.” Foods such as chocolate or cheese, strong smells, bright light, or stress have long been blamed for triggering attacks. However, new research suggests many of these may actually be early symptoms already caused by changes occurring in the brain before the headache begins.
For example, increased sensitivity to smell may make perfumes seem unusually strong during the early stages of a migraine attack. Food cravings may also appear before the pain starts, making people wrongly assume the food itself caused the migraine.
The growing evidence behind genetics and brain activity
Studies on families and twins show migraine disorder has a strong genetic component.
Researchers estimate inherited genes contribute to migraine risk in about 30% to 60% of patients. Scientists have identified numerous small genetic differences linked to the condition, although the exact mechanisms remain complex.
Researchers have also found connections between migraine and other conditions such as depression and diabetes.
One of the leading theories suggests migraine involves abnormal electrical waves spreading across the brain, a process known as cortical spreading depression.
Scientists recently observed this wave in real time while monitoring a patient’s brain during surgery preparation. The electrical activity moved across different parts of the brain over more than an hour, helping explain symptoms such as visual auras, light sensitivity, fatigue, and brain fog.
Another important brain region being studied is the hypothalamus, which regulates sleep, stress, hormones, and body rhythms. Researchers believe unusual activity in this area may begin long before the headache phase starts.
Blood vessels, inflammation, and the search for better treatments
For many years, migraine was thought to be mainly caused by widening blood vessels in the brain.
Scientists now believe the process is far more complicated.
Attention has shifted toward the meninges, the protective membranes surrounding the brain. These membranes contain immune cells and pain sensitive nerves that may trigger inflammation during migraine attacks.
This inflammation may activate the trigeminal nerve system, which explains why migraine pain is often felt around the eyes, scalp, jaw, and face.
Researchers also believe environmental factors, allergies, hormonal fluctuations, and immune system responses may influence attacks.
One of the biggest scientific breakthroughs in recent years involves molecules called calcitonin gene related peptides, known as CGRPs.
Scientists discovered unusually high levels of these proteins during migraine attacks, leading to the development of newer medications that specifically block CGRP activity.
Studies show these treatments have significantly reduced migraine frequency in many patients, with some becoming almost attack free.
Despite these advances, experts say migraine disorder is still highly complex and likely involves multiple overlapping biological processes.
Researchers believe future treatments may become increasingly personalized as scientists continue uncovering how migraine affects the brain and body.
Although many mysteries remain, scientists say progress is accelerating and migraine disorder is finally beginning to receive the scientific attention it has long lacked.
