Migraine and the Brain: Men and Women are Different

ImageRecent research conducted at Harvard Medical School in Boston has shed light on the differences in both brain structure and function for men and women with migraine headaches.  We have long known that pain disorders are more prevalent among females than males and that about twice as many females than males suffer from migraines. Are there differences in the brains of men and women that reflect these differences?

Maleki, Linnman, Brawn, Burstein, Becerra and Borsook matched female and male subjects who suffer from migraines for age, age their migraines began, medication type and the frequency of their migraine attacks. The study also included healthy controls. Maleki and his colleagues assessed pain threshold and tolerance for the subjects using a heated bar. They used MRI scans to examine the brains of their subjects when they were at rest and not having a migraine attack. They also did MRI scans when the heated bar was applied to their subjects’ hands to cause some level of pain. They wanted to investigate both differences in the brain at rest and when some type of painful stimulation was provided.

Maleki and his colleagues report that for the migraine sufferers, two areas of the brain, the insula and precuneus, differed significantly between females and males. The females had thicker gray matter in the insula and precuneus. Maleki and his colleagues also observed significant differences between females and males when painful heat was applied to their hands. They report that for females, two areas of the brain were more responsive, the amygdale and parahippocampus. These areas are involved in emotional processing including stress and anxiety. This means that the women tended to have a more significant emotional response to the pain. Maleki and his colleagues report that the female migraine sufferers reported that their pain was more unpleasant than the males.

This study indicates that female and male migraine sufferers have brain differences and that their brains respond differently to pain. Emotional connections tend to be involved to a greater degree for females than males.

Research like this may help us not only understand sex differences in pain perception and experience but eventually lead to more refined treatment of migraine and other pain problems for men and women. The treatments may need to be different depending on the sex of the pain patient.

(Original Article: Maliki, Nasim, Linnman, Clas, Brawn, Jennifer, Burstein, Rami, Becerra, Lino and Borsook, David. Her versus his migraine: multiple sex differences in brain function and structure. Brain, 135, 2012, 2546-2559. Abstract.)

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