User:Markus A. Dahlem/Proposed/Computational models of migraine
Migraine is a chronic brain disorder with episodic manifestations. The pathological state in migraine episodes arises from physiological processes that interact over large temporal scales. On a time scale of weeks migraine shows a cycle of five stages including the attack-free interval. On a time scale of minutes to hours complex interactions occur between the cortex and subcortical brain structures especially brainstem structures and peripheral innervation of the cranial circulation. Finally, on the time scale milliseconds genetic defects, for example in a rare subtype of migraine, changes in the gating behavior of ion channels and other altered ion dynamics occur. We still lack a unifying theoretical framework in which to interpret these events to fully realise the potential of computational models in migraine. In this review the current state of the art is presented from (a) modeling tipping point behavior addressing the misinterpretation of early warning signs for triggers, to (b) the use of a migraine generator network, to (c) models of migraine with aura, including modeling visual hallucinations, and to (c) models that bridge the gap between migraine genotype to its cellular phenotype in a rare subtype of migraine. The challenge in the future will be to integrate these approaches into a tractable mathematical migraine model.