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Lookup NU author(s): Dr Will Sedley, Siobhan Jones, Professor Tim GriffithsORCiD, Dr Paul Goldsmith
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© 2024 The AuthorsUntil now, a satisfying account of the cause and purpose of migraine has remained elusive. We explain migraine within the frameworks of allostasis (the situationally-flexible, forward-looking equivalent of homeostasis) and active inference (interacting with the environment via internally-generated predictions). Due to its multimodality, and long timescales between cause and effect, allostasis is inherently prone to catastrophic error, which might be impossible to correct once fully manifest, an early indicator which is elevated prediction error (discrepancy between prediction and sensory input) associated with internal sensations (interoception). Errors can usually be resolved in a targeted manner by action (correcting the physiological state) or perception (updating predictions in light of sensory input); persistent errors are amplified broadly and multimodally, to prioritise their resolution (the migraine premonitory phase); finally, if still unresolved, progressive amplification renders further changes to internal or external sensory inputs intolerably intense, enforcing physiological stability, and facilitating accurate allostatic prediction updating. As such, migraine is an effective 'failsafe' for allostasis, however it has potential to become excessively triggered, therefore maladaptive.
Author(s): Sedley W, Kumar S, Jones S, Levy A, Friston K, Griffiths T, Goldsmith P
Publication type: Review
Publication status: Published
Journal: Neuroscience and Biobehavioral Reviews
Year: 2024
Volume: 157
Print publication date: 01/02/2024
Online publication date: 06/01/2024
Acceptance date: 03/01/2024
ISSN (print): 0149-7634
ISSN (electronic): 1873-7528
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.neubiorev.2024.105536
DOI: 10.1016/j.neubiorev.2024.105536
PubMed id: 38185265
