Cortical spreading depression in migraine

Cortical spreading depression (CSD) is associated with a dramatic failure o f brain ion homeostasis as well as efflux of excitatory amino acids from ne rve cells and increased energy metabolism. There is strong clinical and exp erimental evidence to suggest that CSD is involved in the mechanism of migr aine. This paper will, based on the experience related to the detection of CSD in humans, discuss pitfalls and possible strategies for detection of CS D in man. Development of reliable methods for detection of CSD in humans wi ll determine the extent to which the large body of experimental findings fr om animal studies of CSD can be applied to the investigation and treatment of human brain disease. The paper is based on the experience that has been gained from two decades of studies of CSD in relation to clinical neurologi cal diseases.