An American study published in «Neurology» explains the apparent paradox. In the wake of the 2012 earthquake, headaches (measured) were among the lowest in Italy
When you are a lot stressed out it doesn’t come to you heachache. It’s when stress drops that pain comes. We had the proof precisely in Italy when Professor Giancamillo Manzoni of the University of Parma verified that in the earthquake victims of Emilia in the wake of the earthquake, headaches were among the lowest in Italy and then subsequently increased.
This apparent contradiction always known to experts, finally finds a scientific explanation in a study just published on Neurology by the American neurologist Kathleen Merikangas of the National Institute of Mental Health in Bethesda. The researcher adopted a particular evaluation method which also confirms previous studies according to which have a bad night predisposes to a migraine awakening.
In fact, it was known that sleeping badly increases the so-called stress hormone corticotropin which in turn releases the CGRPacronym for Calcitonin Gene Related Peptide, i.e. peptide related to the gene calcitonin. This has been the case in recent years peptide was found to be the «primum movens» of migraine attacks, so much so that the development of new monoclonal drugs able to block it, it changed the lives of those who had up to two or three attacks a day and who with just one administration every two or three months saw them disappear as if by magic. In her studio, Merikangas introduced technological innovations that once couldn’t be used: smart devices equipped with apps that can monitor sleep, energy, emotions and stress levels.
Having started with the aim of defeating the anxious expectation that grips every migraine sufferer due to the unpredictability of the next attack, it managed to obtain precise forecast indices related in particular to the quality of sleep: a bad night increases the risk of migraine
the next day and, if it was the same subject who reported the impression of poor sleep quality, the risk is 18%. Lower because no one is ever an impartial judge of himself. If a decrease in energy the risk was 16% and, to support what has already been said, with an increase in stress levels, the risk rose by 17% only the following day, but not the day in which the subject was stressed.
The study was conducted on 477 subjects (there were 291 women) of all ages (from 7 to 84 years) half of whom were known cephalalgic patients who had to carry out 4 assessments per day of mood, energy, stress level and the appearance of headaches. Once a day they also had to give a subjective assessment of the quality of their sleep beyond the monitoring provided by the smart device which also tracked their daytime physical activity.
24 hour tracking of app allowed researchers to verify that it is of great importance in triggering attacks the disorganization of circadian cycles sleep/wake which turned out to be more important thananxiety or of depression which until now had been given a lot of importance, while they do not appear to be related to the attacks. Anxiety and perceived emotionality would tip the scales, that is, in other words, true stress does not derive from what happens to us, but from how we “interpret” it.
The role of resilience
In fact, in these mechanisms comes into play resiliencefrom English resilience, a term that indicates the ability of a material to resist deformations and impacts without breaking. Thanks to resilience we are able to adapt to critical and stressful situations such as heavy conflicts in the work environment or the serious illness of a loved one. There are those who have greater resilience and therefore know how to adapt better to difficult situations, but there are less resilient people who struggle more and are more vulnerable. Episodic migraine sufferers who do not become chronic are confirmation of the fact that those with greater resilience are better able to absorb the insults of stress.
Mindfulness can also help
«In our headache center at the Besta Neurological Institute in Milan we have been helping patients develop for a long time greater awareness of illness and more resilience through a path of mindfulness with which they learn to better accept their disease condition by developing attention to the present moment and gradually reducing the tendency to feel sorry for themselves, the so-called rumination so typical of migraine patients”, says Licia Grazzi, neurologist in charge of the Headache Center of the Carlo Neurological Institute Besta of Milan who has long studied the correlations between stress and headaches.
«Since the pandemic we have also been using mindfulness programs online to guarantee our patients continuity of treatment, a solution which has also allowed those far from Milan to benefit from it. A few years ago in a study conducted with some US colleagues as well as a significant reduction in the frequency of migraine episodes we also reported the parallel modification of various biological parameters related to stress. In light of Merikangas’ research, the use of the apps she uses could allow us to obtain even more significant results, allowing us to also keep the variable of stress from alteration of sleep cycles which the patient is unable to evaluate in a subjectively clear manner even if he has been instructed to think in terms of mindfulness”, he concludes.
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January 25, 2024 (modified January 25, 2024 | 07:19)
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