Cortical-spreading depression: at the razor’s edge of scientific logic

Excerpt

For over 60 years, cortical spreading depression (CSD) has mesmerized neurologists immersed in headache research. While science and logic are (or, at least, should be) inseparable, CSD—a largely experimental physiological reality—has dissociated the two in headache-related research. Although the need for a fresh pathophysiologic approach to migraine and other primary headaches unrelated to the neuronal (neural) or vascular theories has been voiced two decades ago [1, 2], and the issue has been questioned again recently [3, 4], the fascination for CSD as the basis for migraine remains largely undimmed. Currently, the pathogenetic role of CSD in migraine is widely accepted as an immutable fact or truth, and, any challenge to its role is regarded as almost heretical. …