Migraine is often used as shorthand for a severe headache, but the term “migraine” actually refers to a neurological condition that affects about 39 million people in the United States.

Research and imaging studies have suggested that certain structures and functions of the “migraine brain” might differ slightly from those of the “typical” brain. More definitive research may eventually provide insight into the nature of migraine headaches, as well as other common migraine symptoms like migraine aura and sensitivity to light.

While it’s too early to draw any conclusions from the existing research, it’s possible that migraine may be associated with minor injuries to brain tissue. This possibility only underscores the importance of developing new migraine treatment and prevention options.

Studies using advanced neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), are helping researchers understand more about how migraine develops and how the condition affects brain structure and function over time.

Some small studiesTrusted Source have noted varied differences in the brains of people with episodic and chronic migraine headaches.

Chronic migraine is defined as having headaches at least 15 days per month, while episodic migraine involves migraine headaches 14 or fewer days per month.

But researchTrusted Source suggests that this dividing line may not adequately address the complex nature of migraine, which may exist on a spectrum between episodic and chronic episodes.

Several research studies that used advanced neuroimaging techniques have detected differences between the brains of people with migraine compared to people without migraine. But the studies were all very small, and the results varied.

Pons

The pons is part of the brainstem, the region that connects the base of the brain to the spinal cord. The pons is responsible for several unconscious brain functions, including sleep and breathing.

In a 2019 study involving 64 people, researchers found that participants with migraine tended to have weaker function connectivity between the posterior pons and the left superior parietal lobe, the left temporal gyrus, and the left middle frontal gyrus. The reason for this difference was unclear, but the researchers did suggest that a deficit in pain processing could play a role in migraine.

Perivascular spaces

Perivascular spaces are fluid-filled passageways in the brain that play a role in fluid regulation and drainage. There are a lot of unanswered questions about the relevance of these spaces in neurologic, inflammatory, and vascular conditions. But researchers believeTrusted Source that the normal function of perivascular spaces is important to brain health.

A very small 2022 study on migraine noted a handful of cases where MRI images revealed a slight enlargement of the perivascular spaces in a region of the brain called the centrum semiovale. Many other conditions and factorsTrusted Source, such as age, play a role in the shape, size, and number of perivascular spaces, so there is not nearly enough evidence to suggest a connection to migraine. But connections could be explored in larger-scale studies at some point in the future.

Hypothalamus

The hypothalamus is a part of the brain that manages hormones and other body systems, including sleep, hunger, sex drive, blood pressure, and temperature.

A 2020 study suggested that the hypothalamus-brainstem network might also play an important role in the migraine brain. The study found heightened activation of the hypothalamus during the headache phase of episodic migraine, suggesting that migraine headaches could originate in the hypothalamus.

Other parts of the hypothalamus appear to play a role in migraine chronification, which is the transition from episodic migraine to chronic migraine.

Pain network

The brain’s pain network, also known as the pain matrix, includes several brain regions, including the thalamus, anterior cingulate cortex, basal ganglia, and prefrontal cortices.

A 2021 studyTrusted Source suggested that people with migraine may have less connectivity and greater segregation among the regions of the pain network compared with people who don’t have migraine.

Cortical thickness

The brain’s cortex is the outer layer of the cerebrum, the largest region of the brain. The somatosensory cortex region of the brain, located in the parietal lobe, is responsible for processing pain and many other sensations.

Some small studiesTrusted Source have found increased thickness in people who have migraine compared with those who don’t. This development may also explain why people with migraine also experience other symptoms, such as jaw or neck pain.