Treating a migraine, the brain’s ‘perfect storm’ A perfect storm: It can erupt at any time if a variety of factors interact just right. Stress, sleep deprivation, muscle tension, bright lights and strong smells work together — and against you — to stimulate pain pathways, bringing about a migraine attack. Dr. Paul Durham In the world of Dr. Paul Durham, professor of cell biology and director of the Center for Biomedical and Life Sciences at the Jordan Valley Innovation Center (JVIC), that is the “perfect storm” model. In this model, each factor plays a role in making the nerves more hyperactive and sensitive, until one of them tips the balance. “Instead of responding to a stimulus in a normal way and alerting you about it, the nervous system response becomes not physiological, but pathological,” Durham said. Durham is an expert on causes of pain, ways to treat it In the early 1990s, during his postdoctoral work at the University of Iowa, Durham became interested in calcitonin gene-related peptide (CGRP) — a protein made in nerve cells that is known to promote inflammation. As a cell biologist, he was intrigued that increased CGRP levels were correlated with the pain intensity of a migraine attack. Twenty years later, he is an international expert on the study of the trigeminal nerve and orofacial pain. The trigeminal nerve provides sensation to the head and face, so Durham studies the biological basis for migraines, headaches, temporomandibular joint (or TMJ) pain, jaw pain, toothaches, gum pain, sinus headaches and rhinosinusitis, among others. 28 WWW.M AG A ZIN E . M ISSO U RISTATE.EDU In his lab at the Jordan Valley Innovation Center, Durham researches why nerve cells become hyperactive and why they cause pain. Nerve cells are grown in culture dishes, allowing him and his fellow researchers to see how cells react with various drugs. He helps chronic pain patients break the ‘vicious cycle’ During the past couple of years, his research team took their quest for answers one step further: How and why does pain move from acute pain to chronic pain? “What we’re finding with chronic pain patients is they get themselves in a vicious cycle,” Durham said. “Once they start having pain, they usually don’t sleep as well, which usually causes them more pain. Then they begin to stress about it, and then they get depressed about that. All of these things keep snowballing. Pretty soon you have a system that is out of balance.” THE FACULTY A look at teaching, research, scholarly activities or service at Missouri State <<<<<<<<<<<<<<<<<<<<< Dr. Paul Durham Professor of cell biology; director of the Center for Biomedical and Life Sciences at JVIC <<<<<<<<<<<<<<<<<<<<< Story by Nicki Donnelson Photos by Bob Linder His lab often earns grants, tests pharmaceuticals Durham is involved with organizations such as the Society for Neuroscience, American Association for the Advancement of Science, American Headache Society, Inflammation Research Association, American Academy of Orofacial Pain and the American Pain Society. Partially because of these involvements, pharmaceutical companies often enlist his help in determining the viability and effectiveness of their products. Since JVIC opened in 2007, Durham has been awarded more than $9 million in grants, including funding from pharmaceutical companies and government agencies such as the National Institutes of Health. His work could have tremendous impact, as studies have shown that approximately 36 million Americans suffer from migraines. Chocolate may help migraines! “When you incorporate dark chocolate into your diet, you are basically quieting pain-conducting nerve cells,” Durham said. “The cocoa modulates a healthy response toward inflammatory and painful events. So the cocoa actually blunts the perfect storm that’s developing.”