Biobehavioral correlates in migraine: the role of hypersensitivity and information-processing dysfunction

In this paper we address the role of specific abnormal behavioral patterns (such as perfectionism or hypersensitivity) which have been described as psychological characteristics in migraine patients. We propose that behavioral abnormalities may be the result of a determined cortical hypersensitivity and an associated social learning process. New neuro(psycho)physiological data support the concept that migraine is a brainstem-related information-processing dysfunction that is characterized by cortical hypersensitivity and reduced habituation to stimuli. The cortical activity reflects a (time) periodicity and may be due to endogenous or exogenous factors. Based on the current understanding of behavioral and neurophysiological aspects of migraine, we postulate a two-process model of migraine aetiology: (i) a genetically determined hyperactivity of the central monoaminergic (catecholaminergic) system, which could be possibly modulated by learning processes and (ii) a homeostatic (counter) regulation and mobilization of reduced (mitochondrial) energy reserve.