Cortical Spreading Depression and Estrogen


  • Katharina Eikermann-Haerter MD,

  • Chiho Kudo DDS, PhD,

  • Michael A. Moskowitz MD

  • From Department of Radiology, Stroke and Neurovascular Regulation Laboratory, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA (Drs. Eikermann-Haerter and Kudo); Harvard Medical School, Massachusetts General Hospital, Neuroscience Center, Charlestown, MA, USA (Dr. Moskowitz).

  • Manuscript 2 of 3 submitted as a supplement to Headache: The Journal of Head and Face Pain

Address all correspondence to Michael A. Moskowitz, MD, Professor of Neurology, Harvard Medical School, Affiliate Member of the Faculty, Harvard-MIT Division of Health & Science Technology, Massachusetts General Hospital, Neuroscience Center, 149 13th Street, Room 6403, Charlestown, MA 02129.


Cortical spreading depression (CSD) is an electrophysiological phenomenon characterized by a wave of excitation followed by inhibition. The aura phase that precedes migraine headache in about 20-30% of migraineurs shares overlapping characteristics with CSD. Studies of rare autosomal-dominant forms of migraine with aura provide strong evidence that the threshold for evoking CSD and aura are related to neuronal excitability. Although the relationship between CSD and migraine without aura is not completely understood, the molecular abnormalities that predispose to migraine with aura illustrate the importance of physiologic events associated with neuronal hyperexcitability, and provide a basis for understanding a more generalized view of migraine.