Health & Wellness
Migraine Science Quiz
Aura, CGRP, and 1 in 7 people — how well do you understand migraines?
Aura, CGRP, and 1 in 7 people — how well do you understand migraines?
During a migraine aura, a wave of cortical spreading depression moves across the brain at roughly 3 millimeters per minute — a phenomenon first visualized by Hubert Airy in 1870 when he sketched his own scintillating scotoma, and later measured by Karl Lashley in 1941. This quiz explores 50 questions about the science, treatment, and lived reality of migraines, which affect roughly 1 in 7 people worldwide.
Migraines involve the trigeminovascular system, where the trigeminal nerve releases neuropeptides — particularly calcitonin gene-related peptide (CGRP) — that cause neurogenic inflammation and blood vessel dilation around the brain. The condition has a strong genetic component; familial hemiplegic migraine has been linked to specific genes including CACNA1A, ATP1A2, and SCN1A. Triggers include stress, hormonal changes, sleep disruption, certain foods (aged cheese, red wine), and weather changes.
Migraine aura affects 25-30% of migraine sufferers and typically occurs before the headache phase. The most common visual aura is a scintillating scotoma — a shimmering, zigzag arc of light that gradually expands across the visual field. This is caused by cortical spreading depression, a wave of neuronal excitation followed by inhibition that moves across the brain's cortex at approximately 3mm per minute.
Triptans are serotonin (5-HT1B/1D) receptor agonists that work by constricting dilated blood vessels around the brain, inhibiting the release of inflammatory neuropeptides, and blocking pain signal transmission in the trigeminal nerve. Sumatriptan, the first triptan, was approved in 1992. Newer treatments include gepants (CGRP receptor antagonists like ubrogepant, approved 2019) and monoclonal antibodies targeting CGRP or its receptor (erenumab/Aimovig, the first, approved 2018).