Pathophysiology, epidemiology, and impact of migraine.
Despite a decade of progress, migraine headache remains prevalent, disabling, underdiagnosed, and undertreated in the United States. Migraine affects approximately 12% of the population, and the economic burden in terms of annual cost of labor lost to migraine disability is between $5.6 and $17.2 billion. The threshold for migraine may be genetically determined, although recent genetic and neurophysiologic studies point to migraine as possibly a channelopathy. Cerebral cortical and brain stem changes occur in migraine. Head pain and associated symptoms of migraine can be explained by activation of the trigeminal vascular system. Evidence has also been accumulated that suggests the release of nitric oxide is an important trigger mechanism. Introduction of the triptans has dramatically advanced acute migraine pharmacotherapy, and preventive therapy has greatly improved; however, public health initiatives may be needed to further advance diagnosis and treatment of this common and disabling disorder.
Houston Headache Clinic Houston, Texas, USA.
N T
NT
Mathew
D000293:Adolescent; D000328:Adult; D000368:Aged; D001933:Brain Stem / Q000503:physiopathology; D015220:Calcium Channels / Q000235:genetics / Q000378:metabolism; D002540:Cerebral Cortex / Q000503:physiopathology; D017281:Cost of Illness; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism; D006261:Headache / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000191:economics / Q000453:epidemiology* / Q000503:physiopathology*; D020325:Migraine with Aura / Q000503:physiopathology; D009569:Nitric Oxide / Q000378:metabolism; D015995:Prevalence; D014276:Trigeminal Nerve / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D020864:Calcium Channels, N-Type
D015220:Calcium Channels; D012739:Gonadal Steroid Hormones; D009569:Nitric Oxide; C105656:CACNA1A protein, human; D020864:Calcium Channels, N-Type