It turns out to be trickier than it seems. The idea is to trigger a migraine in people who seem to have clear conditions that start one off and then get them in a scanner as soon as possible.
Unfortunately, this doesn’t always work very reliably.
However, one notable success was someone who had migraines triggered by basketball:
Michael Moskowitz and his colleagues at the Massachusetts General Hospital Neuroscience Center in the Boston area described the most famous report of a controlled study involving a person experiencing aura in a lab in 2001. They identified a patient, named Patrick, who could reliably induce his aura by playing basketball. The researchers arranged for Patrick and his wife to shoot hoops next door to their research center at a YMCA gym. After about an hour of exercise, Patrick then jumped into a functional MRI machine at the clinic and waited for his aura to begin. In this way, Moskowitz and his team tracked changes in Patrick’s brain before, during and after self-described aura attacks on two separate occasions.
The article noted that it’s a mystery why basketball was a trigger for migraine but these very specific triggers are often also present in epilepsy.
Called ‘reflex epilepsy‘ it involves seizures that can be triggered by specific situations such as reading, eating, urination, being startled, hearing certain songs and pretty much anything else you can think of (including, believe it or not, thinking itself).
This is probably due to the activities setting up specific patterns of brain activity that interact with pre-existing weakness in neural networks leading to instability that triggers seizures.
Think of it as being like living in a city where the public transport only grinds to a halt when there’s a football match between two very specific teams – due to the influx of fans from specific directions affecting a key road junction which happens to be an important traffic hub.
These very specific triggers are rare, but interestingly, when they do occur tend to more commonly occur in epilepsy and migraine, probably telling us something about how both conditions are related to spreading patterns of activity across the brain.
Anyway, much more in the Nature Medicine piece which discusses the fascinating topic of migraine aura in more detail.
Link to ‘Aura of mystery’ from Nature Medicine.