Mild brain injury lowers threshold for aura-linked cortical spreading depression

A combined clinical and mouse study examined whether mild traumatic brain injury (mTBI) promotes migraine-like aura and post-traumatic headache (PTH). The researchers found that 32% of PTH patients without prior aura history developed new aura symptoms within 60 days of injury, and in mice, mTBI increased susceptibility to cortical spreading depression (CSD) and sensitized animals to stress-triggered CSD; optogenetically induced CSD produced prolonged periorbital and hind paw allodynia. Subcutaneous onabotulinumtoxinA did not change CSD susceptibility but abolished CSD-induced allodynia, which the study authors suggest indicates potential efficacy for treating PTH associated with aura.

Most relevant for: Patients who develop post-traumatic headache with new-onset aura following mild traumatic brain injury.

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