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How Does Fasting Trigger Migraine? A Hypothesis

  • Turgay DalkaraEmail author
  • Kıvılcım Kılıç
Migraine (R Cowan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Migraine

Abstract

Fasting or skipping meals are well-characterized migraine triggers. However, mechanisms of the fasting-induced migraine headache are unclear. Here, we review the recent developments on brain glycogen metabolism and its modulation by sympathetic activity and propose that insufficient supply of glycogen-derived glucose at the onset of intense synaptic activity may lead to an imbalance between the excitatory and inhibitory terminals, causing collective depolarization of neurons and astrocytes in a network. This may activate perivascular trigeminal afferents by opening neuronal pannexin1 channels and initiating parenchymal inflammatory pathways. Depending on whether or not network depolarization spreads or remains local, fasting may trigger migraine headache with or without aura.

Keywords

Migraine Headache Fasting Hunger Glucose Hypoglycemia Adrenaline Noradrenaline Sympathetic nervous system Insulin Glucagon Cortisol Growth hormone Glycogen Glucose transporter Astrocyte Brain metabolism 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Turgay Dalkara and Dr. Kıvılcım Kılıç reported no potential conflicts of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Institute of Neurological Sciences and PsychiatryHacettepe UniversityAnkaraTurkey
  2. 2.Department of Neurology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
  3. 3.Department of Neurology, Faculty of Medicine and, Institute of Neurological Sciences and PsychiatryHacettepe UniversityAnkaraTurkey

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