Figure 1.

Perturbations in metabolic pathways as demonstrated in patient and animal studies. Neuroimaging studies in patients have exhibited disturbances in the ATP-PCR pathway which indicate a low free energy availability coupled with an increased metabolic rate. Glucose hypometabolism has been noted in migraine patients in addition to increased lactate, a product of anaerobic glycolysis. In animal studies however glycolysis is increased due to the rapid increase in ATP demand following headache mechanisms. This rapid incline also results in rapid NADH oxidation, which may lead to tissue hypoxia and anaerobic respiration.