March 22, 2022
I get horrible migraines; I lose vision, vomit, become noise- and light-sensitive, have horrible head pain, and am generally unpleasant to be around. Accordingly, I am very interested in possible treatments for them. I’ve talked about a somewhat unlikely mechanism before, and I’d like to discuss another.
The lingual gyrus, involved in information processing, seems to be overactivated in migraine patients. This overactivation is thought to be linked to the precense of aura - a flashing, pulsing, visual sensation - in a subset of patients. Photophobia is also linked to the overactivation of the lingual gyrus. To drive in the point, visual snow - a disorder which makes the world appear like a cathode-ray TV - is associated with more grey matter in the lingual gyrus. With that in mind, 59% of those with visual snow experience migraines. The evidence is not complete, but I’d hazard that the lingual gyrus is implicated in migraine symptoms among some patients.
What does the lingual gyrus usually do? From Clinical Neuroanatomy, the lingual gyrus processes visual stimuli; issues with this area can lead to loss of peripheal vision and visual snow. It is supplied with oxygen with the posterior cerebral artery. To further supplement the lingual gyrus theory, there is a very interesting paper linking the an event posterior cerebral artery to what the paper terms a “catastrophic migraine” - a migraine-like attack with chronic symptoms afterward. And, more specifically, research has found that migraines with auras are linked to an incomplete circle of Willis (a vascular system involving the posterior cerebral artery).
What treatments can interfere with processing in the lingual gyrus? If you can’t tell by the title of the article, mushrooms - specifically magic mushrooms, P. cubensis, anything containing psilocybin, etc. A study has found that psilocybin increases activation of the lingual gyrus; really, one would be able to guess this by anecdotal reports of hallucinations and fractals when tripping (since the brain is seeing things that aren’t there). Another paper found a reduced reaction to happy faces in the right lingual gyrus with administration of psilocybin.
Psilocybin is being investigated as a potential treatment for migraines, with a very promising study showing long-lasting effects on migraine treatment. Specifically, the paper believes that there is an interaction between the 5-HT2A receptor and migraines. Now, it would be very nice to link 5-HT2A receptors to the lingual gyrus as to complete the logical loop. I can’t find much information on this! Psilocybin is a agonist for several serotonin receptors, and some serotonin receptorts do seem to be overexpressed in the lingual gyrus, but frustratingly enough, the source does not show data for 5-HT2A/1A.
Our understanding of migraines is very limited, and it would be very interesting - and helpful - to know about them, as treatments are few and expensive. If mushrooms/psilocybin are an effective treatment, they would be much cheaper than pre-existing medicines. I am a big fan of self-experimentation; to that end, I took a small dose of psilocybin every three months for a year, and did not experience any migraines. After four months of not taking them, I experienced my first migraine in over twelve months in July of 2021, followed by several more in September, December, as well as February and March of 2022. This is a n=1 sample size, but the evidence does point at them being a potential treatment.
On February 27, 2022, I thought it would be a great idea to create some sort of content - writing, art, coding, etc. - every day of the next month. Luckily, the alliteration worked out. This should be the twenty-second post in the series.
