OF THE MIND
TECH INSTRUMENT CENTER
TO BLACK MOUNTAIN
MAY UNLOCK MAD COW DISEASE
SPEECH WASN'T FREE
Keith Parker has never suffered through the agony of a migraine headache. But the UM researcher has spent the past 25 years trying to shed light on why other people are subjected to the excruciating pain.
"I don't suffer from migraines myself," says Parker, an associate professor of pharmacology and toxicology. "But throughout my life, I've had a number of family members who have suffered. I really don't know what got me going on migraines, but I think it's because I saw the suffering in family members."
A migraine is a one-sided, pulsating headache that is often accompanied by nausea and sensitivity to light and sound. Some people who have the headaches see an unusual, colored light just before the headache kicks in.
"Although head pain dominates, the unpleasant experience is often more than that," Parker says. "It can be a whole body experience that is agonizing and debilitating."
What causes a migraine?
"There is no universally agreed upon cause," says Parker, a Billings native who has taught at UM since 1993.
"There is strong suspicion that certain nerve cells of sufferers may have problems with membrane proteins that regulate ion movements in and out of cells."
Heredity also plays a role in migraine attacks, Parker says. People are more likely to suffer from migraines if other family members get the headaches.
Other triggers of migraines include light, sound, certain foods, disrupted sleep patterns, and drugs and alcohol.
the symptoms of a migraine?
"Usually, although not always, migraines come and go. That's why it's called episodic," Parker says. "A person may have a severe attack and then be without an attack for days, weeks or, in some cases, even years."
When a migraine attack does occur, it is often accompanied by nausea and sometimes vomiting. Parker says migraine attacks can be severe enough to render people useless — forcing them to miss work, school and other activities.
"Sometimes the sufferer is just down, often prostrate in a dark room, unable to move for many, many hours," he says.
A migraine can plague just about anyone. But Parker says migraine headaches seem to be most common in Western Europe and the United States. They also seem to occur most frequently in middle-aged people and women.
"Women have a higher incidence com-pared to men by about 3 to 1," Parker says. "The reasons for this remain unknown.There are clearly some potential hormonal factors, but it is unclear if that's the whole story."
How do you treat a migraine?
"There are many different ways to treat a migraine headache," Parker says. "And these range from the unconventional to standard sorts of drug treatments."
Some people choose not to treat a migraine at all — going without medical advice or treatment. But that can be a painful way to go through life.
"There is still the impression that overall, migraine is under-reported and under-treated," Parker says.
Other approaches to migraine treatment center on lifestyle, nutrition, sleep patterns and "many, many other non-drug sorts of approaches," Parker says. But the best way to treat a migraine may be through drug treatment. Parker says over-the-counter medications such as aspirin, ibuprofen and other non-opiate pain relievers can be effective in treating some migraine attacks.
However, in severe cases, the over-the-counter remedies are rarely enough. Doctors may then resort to pain relievers such as codeine, morphine or Demerol.
"There are very legitimate indications for the use of these powerful drugs, but caution is warranted because of possible dependence," Parker says.
Over the past decade, advances in medicine have led to the successful use of drugs such as Sumatriptan — also known as Imitrex — and other related triptan drugs.
"These drugs are used exclusively for a headache already in progress," he says. "About two-thirds of sufferers will be helped by these drugs. But some people do not tolerate these drugs very well. These drugs are thought to work via some types of serotonin receptors.
Newer drugs, known as prophylactics, also are being successfully used to treat migraine headaches. Two of the most effective prophylactics available are beta blockers and calcium channel blockers.”
But Parker says there are still refinements that need to be made with the new drugs.
"These drugs reduce the severity and incidence of migraines over time," he says. "That is, they are used chronically to help in the prevention of headache. But there has not been a drug group that meets all the criteria of effectiveness and safety. Development of appropriate prophylactics is clearly the hope for the future."
If you do suffer from migraine headaches, Parker says it is important that you seek professional help.
"Excellent assistance is available both locally and nationally," Parker says. "Because of the complexity of migraines, an expert is often needed.
"Nevertheless, many general practitioners can provide excellent help, at least to get started. And I would recommend people approach a medical professional, and not a basic researcher like myself."
Parker says it also is important for each individual sufferer to learn what situations are likely to bring on a headache.
"It's especially important to know the signs that signal an oncoming headache. This is so important because if drug treatment is being used, that treatment needs to occur as rapidly as possible for best effect."