What causes migraine? Risk factors, triggers, and more

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According to the AMF, if one or both of a person’s parents have migraine, there is a 50–75% chance that they have it too.

Researchers of a 2021 study suggested that different gene mutations may act as an underlying cause of the different subtypes of migraine. For example, they noted that the genes CACNA1A, ATP1A2, and SCN1A may cause rare subtypes, such as familial hemiplegic migraine.

They also noted that more common forms of migraine may involve a variety of genes. These genes primarily affect blood vessel and neuron function.

The authors of a 2019 study found similar results. They concluded that the complexity of migraine directly reflects their genetic complexity.

Researchers will likely continue to explore how genes cause or contribute to a person’s risk of developing migraine.

Learn more about whether migraine is hereditary.

Experts propose that changes in the chemicals the brain produces cause migraine pain. They suggest that when certain substances increase in volume, it causes inflammation in the brain that makes blood vessels swell. The swollen blood vessels put pressure on the surrounding nerves, causing pain.

In a 2020 study, researchers suggested that chronic and episodic migraine is likely the result of a combination of structural and functional changes in the brain. They also noted that a person with chronic migraine may experience dysfunction in the pain inhibitory network as well as an increased sensitization of the central pain pathways. They suggested this may be why people with chronic migraine are more susceptible to migraine attacks.

Risk factors of chronic migraine include:

• ineffective acute migraine treatment
• stress
• overuse of acute migraine medication
• depression
• being female
• obesity
• low educational status
• age
• family history

Having one or more risk factors for migraine does not mean a person is certain to develop the condition. Similarly, a person with no apparent risk factors may develop migraine.

Triggers are any situation, substance, or another environmental factor that leads to a migraine attack. Due to the complexity of migraine and differences between people, triggers can vary greatly.

If a person experiences a variety of different triggers, rather than one, they are more likely to experience a migraine attack. However, triggers vary between people, and a person’s response to triggers can differ between migraine attacks.

Some commonly reported triggers include:

• skipping meals
• alcohol use
• stress
• sleeping too little or too much
• certain foods
• traumatic brain injuries
• hormonal changes, particularly during the menstrual cycle
• changes in weather or barometric pressure
• concussions

Foods, drinks, and substances that may trigger migraine attacks in some people include:

• caffeine withdrawal or consuming too much caffeine
• tyramine, which is a substance found in foods such as:
  • soy products
  • aged cheeses
  • smoked fish
  • hard sausages
• nitrates, which are substances found in foods such as lunch meats and hot dogs
• monosodium glutamate
• aspartame

Learn more about what can trigger a migraine.

A person likely cannot stop migraine from developing. However, they can take steps to reduce their risk of migraine attacks.

Preventive medication is available for migraine in adults, such as erenumab. A person should follow all instructions for medication carefully and speak with a healthcare professional about any potential side effects and drug interactions.

In addition, a person can aim to identify and avoid their triggers. The Office of Women’s Health suggests a person records the following details to help identify triggers or patterns of a migraine attack:

• time of day it started
• location and activity at the time of the attack
• all foods and drinks consumed in the 24 hours before the attack
• each day of their period

A person should speak with a doctor about their potential triggers to help identify which migraine treatments may work best for them.

Experts do not know the exact underlying cause of migraine. However, a combination of genetics and environmental triggers is a possible cause. Migraine pain likely occurs due to functional and structural changes in the brain and environmental triggers.

Several factors, including hormonal changes, age, and stress, may increase a person’s likelihood of developing migraine. Additionally, migraine attack triggers differ between people and can vary from attack to attack. A person may be able to reduce their risk of migraine attacks by identifying and avoiding their triggers.

People should speak with a healthcare professional for more information about migraine.