There is a new article just out on a theory: that bipolar and migraine both have, as an important component, inflammation: cytokines, part of the inflammatory process, are involved. They feel that possibly if we attack the inflammation we may help both conditions.
I was convinced before that inflammation, and the immune system, were crucial in migraine pathogenesis. I did a large article on the immune system, cytokines and helper/suppressor cells, in the journal Headache. That was about 1988. We actually found that those with migraine have higher helper to suppressor cells, somewhat the opposite of AIDS patients; therefore, once people have full blown AIDS, they can’t mount an inflammatory response, and theoretically their headaches should be better. There is actually evidence for this(a German study), but AIDS pts. get headaches from other causes.
I have published on bipolar(the immune articles and bipolar are on this site, Archived Articles), and there is evidence that inflammation may also be important in depression, as well as pain/headaches.
A major challenge will be to find safe treatments that influence the immune system; we do not want to use cortisone, due to the side effects, particularly long-term. Most immune-influencing drugs have long-term side effects, but not all. Further research in this area may lead to better treatments.
Along these lines, research into glial cells, the modulating(regulating) and supporting cells of the nervous system, has been accelerating. Glial cells influence the immune system, and are an important newer target for drug development; not just for headache, but for depression, and maybe multiple sclerosis and other CNS diseases.
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