Migraines
Migraine is much more than just a headache. A migraine attack can suddenly bring your daily life to a complete standstill.
Throbbing head pain, nausea, and a pronounced sensitivity to light, sound, or odors can make working, social activities, or even simple daily tasks temporarily impossible.
Migraine can also have a major impact between attacks. Some people are constantly faced with the uncertainty of when the next attack will occur.
Migraine is a neurological condition in which the processing of pain and other stimuli in the brain is altered.
Various brain regions and nerve networks play a role in this process.
Thanks to scientific research, we are gaining a better understanding of how these networks contribute to migraine. This has led not only to new medications but also to the development ofneuromodulation as an additional treatment option.
At BRAI3N, we investigate how these neuroscientific insights can be translated into personalized treatment, with the goal of reducing the frequency, intensity, and impact of migraines.
What is it?
What is migraine?
Migraine is a recurring neurological condition typically characterized by attacks of moderate to severe headache.
In adults, a migraine attack typically lasts four to 72 hours if left untreated.
The pain is often described as throbbing or pounding and is usually located on one side of the head, although both sides can be affected.
In addition to the headache, various symptoms may occur, including:
- Nausea and sometimes vomiting.
- Sensitivity to light, sound, and odors.
- Increased pain during routine physical activity.
- Dizziness or a feeling of instability.
- Difficulty concentrating and slowed thinking.
- Pronounced fatigue, both during and after the attack.
Migraine is more common in women than in men. Genetic predisposition, hormonal changes, and various environmental factors can play a role.
What is the progression of a migraine attack?
A migraine attack does not progress the same way for everyone. Different phases may follow one another or partially overlap.
1. The warning phase
Subtle changes can occur hours or sometimes even days before the headache begins.
Some patients experience sudden fatigue, difficulty concentrating, mood swings, neck stiffness, or a noticeable craving for certain foods.
Increased yawning or changes in thirst can also precede a migraine attack.
2. The aura phase
Some patients experience what is known as an aura.
These are temporary neurological symptoms that usually develop gradually and often last between five and sixty minutes.
A visual aura, for example, can manifest as flashes of light, zigzag lines, blind spots, or a distorted field of vision.
Tingling sensations or temporary language difficulties may also occur.
However, most people with migraine do not experience an aura.
3. The headache phase
The typical migraine headache occurs during this phase.
In addition to the pain, symptoms such as nausea, sensitivity to stimuli, and a strong need for rest may occur.
Some patients retreat to a quiet, darkened room during an attack.
4. The recovery phase
After the headache subsides, the nervous system may continue to feel dysregulated for some time.
Fatigue, difficulty concentrating, a heavy feeling in the head, and reduced stamina can persist for hours or sometimes longer.
How does a migraine develop in the brain?
Migraine is now considered a complex disorder of the brain networks involved in sensory processing, pain regulation, and autonomic body functions.
Various neurological systems work together in this process.
The hypothalamus: the body's rhythm
The hypothalamus helps regulate sleep, wakefulness, hormonal processes, and various automatic body functions, among other things.
Research shows that the activity and connectivity of the hypothalamus can change even before the onset of a migraine headache.
This may help explain why a migraine attack is often preceded by changes in sleep, energy, thirst, or appetite.
The brainstem: processing and influencing pain signals
The brainstem contains important nerve nuclei involved in pain regulation.
The locus coeruleus, the periaqueductal gray, and various trigeminal nerve nuclei, among others, play a role.
These areas are connected to other brain structures and help determine how pain signals are transmitted and influenced.
The trigeminovascular system: a key pain pathway
The trigeminal nerve, or fifth cranial nerve, plays a central role in sensory perception of the head and face.
The nerve is connected to, among other things, the meninges and blood vessels within the skull.
During a migraine, parts of this trigeminovascular system are activated. This leads to the release of signaling molecules, includingcalcitonin gene-related peptide(CGRP).
CGRP is involved in the transmission and amplification of migraine-related pain signals and is therefore an important target for modern migraine medication.
The thalamus and cerebral cortex: sensitivity to stimuli
The thalamus helps process and relay sensory information to the cerebral cortex.
During a migraine, changes can occur in the processing of light, sound, touch, and pain.
Various brain networks involved in attention, emotions, and pain regulation also show changes in their activity and connectivity during a migraine.
This helps explain why migraines can cause many more symptoms than just a headache.
What causes a migraine aura?
A migraine aura is associated with a phenomenon calledcortical spreading depression.
This involves a wave of altered electrical activity that slowly moves across a part of the cerebral cortex.
When this process affects the visual cortex, for example, it can cause flashes of light, zigzag lines, or visual field disturbances.
The worddepressionrefers here to a temporary change in nerve cell activity and has nothing to do with a depressed mood.
Why do some people experience migraines more and more frequently?
For some patients, the number of attacks gradually increases.
We refer to this aschronic migrainewhen someone has headaches for at least fifteen days a month for more than three months, with at least eight of those days showing migraine characteristics.
Changes in the processing and regulation of pain signals can contribute to this progression.
The nervous system can become more sensitive to certain stimuli, while processes that normally help suppress pain may function less efficiently.
This is being investigated, among other things, within the concept of central sensitization.
Other factors, such as sleep disorders, hormonal fluctuations, stress, and the overuse of acute migraine medication, can also influence the course of migraines.
In patients with long-term symptoms, mechanisms may also be involved that are being studied inchronic pain.
How to treat
Treating migraines: various options
Effective migraine treatment begins with recognizing the migraine pattern and assessing its impact on daily functioning.
With appropriate treatment, both the frequency of attacks and the severity of symptoms can be reduced.
Standard treatment includes acute medication and, when necessary, preventive medication.
In addition to traditional medications, there are now specific treatments that target CGRP or its receptor.
Depending on the type of migraine and the severity of symptoms, other treatments, such as botulinum toxin for chronic migraine, may also be useful.
However, some patients continue to experience attacks despite previous treatments. Others do not tolerate certain medications well or wish to limit their medication use whenever possible.
For these patients, neuromodulation can be an interesting additional treatment option.
Neuromodulation for migraine: targeted influence on the nervous system
Neuromodulation is a treatment method in which we attempt to influence the activity of nerves and brain networks in a targeted manner.
In the case of migraine, this approach is particularly interesting because various systems involved in the onset and maintenance of attacks are accessible to non-invasive stimulation.
Neuromodulation can target peripheral nerve pathways, the processing of pain signals in the brainstem, or brain networks involved in pain regulation and sensory sensitivity.
The goal is not only to influence pain during an attack but, in preventive applications, to also help reduce the number of migraine days and the impact of attacks.
Peripheral nerve stimulation
An important line of research focuses on nerves connected to the pain-processing systems in the brain.
This includes research into the trigeminal nerve, the vagus nerve, and nerves in the back of the head.
By electrically stimulating these nerves, it is possible to influence signals that are connected to various pain-regulating brain regions via the brainstem.
Various forms of peripheral neuromodulation are now used for migraine and have been included in international treatment guidelines.
Depending on the technique, stimulation can be aimed at reducing an acute migraine attack or preventing new ones.
Stimulation of the occipital region and the C2 system
The back of the head is a particularly interesting target for neuromodulation.
The nerve pathways originating from the upper cervical vertebrae, including the second cervical nerve (C2), are connected to the trigeminocervical complex.
This system is where pain signals from the head, face, and upper neck region converge.
Scientific research into occipital nerve stimulation has shown that influencing these nerve pathways can produce clinically relevant effects in certain patients with difficult-to-treat headaches.
At BRAI3N, we also work with non-invasive stimulation of the occipital and cervical regions, where the neurophysiological connections to pain-processing systems serve as an important starting point.
The results of various occipital stimulation techniques are not directly interchangeable. Therefore, we always assess which application offers sufficient scientific and clinical support for an individual's specific pattern of symptoms.
Neuromodulation of involved brain networks
In addition to stimulating peripheral nerve pathways, the activity of the brain itself can also be influenced.
Research into transcranial electrical stimulation (tES), including transcranial direct current stimulation (tDCS) and high-definition tDCS (HD-tDCS), shows that electrical stimulation can induce changes in brain regions and networks involved in migraine.
Transcranial magnetic stimulation (TMS) is also being researched for migraine and is clinically applied for certain forms of stimulation.
Potential targets include the motor cortex, the prefrontal cortex, and networks connected to the thalamus, brainstem, and pain-regulating systems.
For example, a 2024 randomized study demonstrated that HD-tDCS can cause changes in the functional connections between brain regions involved in migraine and the processing of pain signals.
This supports the scientific premise that neuromodulation does not necessarily work exclusively locally, but can also influence broader brain networks.
What does the treatment process at BRAI3N look like?
1. Assessment
We begin with a comprehensive evaluation of your migraine symptoms.
This includes looking at the number of migraine days, the severity of the attacks, any auras, triggers, medication use, and previous treatments.
Sleep, fatigue, stress, and other neurological complaints can also be relevant.
Where appropriate, aqEEG measurement and analysisprovide additional information about electrical brain activity. A qEEG is not a diagnostic test for migraine in itself and cannot independently determine which treatment will work best.
2. Targeted treatment
Based on the clinical assessment, we determine whether additional neuromodulation may be beneficial.
Depending on the individual situation, the treatment can focus on peripheral nerve pathways, the occipital region, or involved brain networks.
We discuss which treatment goals are realistic and what scientific evidence is available for the chosen approach.
3. Stabilization
During the treatment process, we systematically monitor how your migraine evolves.
We pay attention to the frequency and intensity of the attacks, the amount of acute medication used, and the impact of migraine on your daily life.
Depending on the effect, the treatment can be adjusted or discontinued.
4. Maintenance
When symptoms decrease, we evaluate what further follow-up is useful to maintain the achieved improvement as effectively as possible.
Not every patient requires maintenance treatments, and the progression varies from person to person.
Could neuromodulation be right for me?
Do you suffer from regular migraines, do your attacks persist despite previous treatments, or are you experiencing side effects from your medication?
Contact us for a no-obligation consultation or to schedule an appointment
Scientific Background
The scientific evidence supporting neuromodulation for migraine has expanded significantly in recent years.
In 2021, an international expert group published a scientific review in which transcranial direct current stimulation (tDCS) for migraine was classified asprobably effective (level B), based on the studies available at that time.
In 2025, the International Headache Society published a new international guideline on non-invasive neuromodulation for migraine.
This guideline identifies several specific neuromodulation devices as potential treatments for acute migraine attacks or as preventive therapy.
New treatment modalities are also being further investigated, with a focus on the activity and interconnections of the relevant brain networks.
At BRAI3N, these scientific insights form the foundation for applying neuromodulation in a careful and individualized manner.
We stay current with developments in scientific research and distinguish between established treatment options and applications for which clinical evidence is still being built.
International Headache Society Evidence-Based Guidelines on the Use of Non-Invasive Neuromodulation Devices for the Acute and Preventive Treatment of MigraineYuan H, Orr SL, Al-Karagholi MAM, et al. Cephalalgia. 2025;45(10). Corrected in March 2026.
Migraine: From Pathophysiology to TreatmentPuledda F, Martins Silva E, Suwanlaong K, Goadsby PJ. Journal of Neurology. 2023;270:3654–3666.
Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric DisordersFregni F, El-Hagrassy MM, Pacheco-Barrios K, et al. International Journal of Neuropsychopharmacology. 2021;24(4):256–313.
Neuromodulation Techniques for Acute and Preventive Migraine Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsMoisset X, Pereira B, Ciampi de Andrade D, Fontaine D, Lantéri-Minet M, Mawet J. The Journal of Headache and Pain. 2020;21:142.
High-Definition tDCS Over Primary Motor Cortex Modulates Brain Signal Variability and Functional Connectivity in Episodic MigraineLim M, Kim DJ, Nascimento TD, DaSilva AF. Clinical Neurophysiology. 2024;161:101–111.
Update on Neuromodulation for Migraine and Other Primary Headache Disorders: Recent Advances and New IndicationsCocores AN, Smirnoff L, Greco G, Herrera R, Monteith TS. Current Pain and Headache Reports. 2025;29:47.
Transcranial Direct Current Stimulation and Migraine—The Beginning of a Long JourneyAyache SS, Chalah MA. Journal of Clinical Medicine. 2020;9(4):1194.
Phenotype of Patients Responsive to Occipital Nerve Stimulation for Refractory Head PainPaemeleire K, Van Buyten JP, Van Buynder M, et al. Cephalalgia. 2010;30(6):662–673.
Noninvasive Neuromodulation in MigraineBlech B, Starling AJ. Current Pain and Headache Reports. 2020;24:78.
Low Intensity Transcranial Electric Stimulation: Safety, Ethical, Legal Regulatory and Application Guidelines (2017–2025: An Update)Antal A, et al. Clinical Neurophysiology. 2026;184:2111436.
Non-Invasive Neuromodulation for Migraine and Cluster Headache: A Systematic Review of Clinical TrialsReuter U, McClure C, Liebler E, Pozo-Rosich P. Journal of Neurology, Neurosurgery & Psychiatry. 2019;90:796–804.
Authored by Prof. Dr. Sven Vanneste, Prof. Dr. Dirk De Ridder and Jan Ost - 10/22/2026
Other conditions that we treat
Auditory and vestibular disorders
These disorders are related to hearing and balance and can have a major impact on your daily life.
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Neurological and cognitive disorders
These disorders affect brain function, which can lead to problems with attention, memory, and motor skills.
Mental and emotional disorders
Mental illness can be deeply rooted in neurobiological dysfunctions.
Chronic Pain and Fatigue Syndromes
Chronic pain and fatigue are often difficult to treat with conventional methods, especially when there is no obvious physical cause.
Fatigue syndromes and sleep disorders
Sleep and energy management are essential for brain function. Problems in these areas can lead to severe tiredness and difficulty concentrating.
Headache and facial pain disorders
Headaches and facial pain can result from complex neurological processes.
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