Neurophysiology and neuromodulators.
Migraine is an episodic brain disorder that results in significant morbidity. Antiepileptic drugs (neuromodulators) are increasingly recommended for migraine prevention because of placebo-controlled double-blind trials that prove them effective. Cortical spreading depression (CSD) is thought to be the pathophysiological correlate of the neurological symptoms in migraine with aura and neuromodulators may act on mechanisms involved in the initiation of CSD itself. Inhibition of trigeminocervical complex directly, or neurons that modulate sensory input, are also plausible mechanisms for the actions of neuromodulators in preventive therapy in migraine. Although it is unlikely that a single phenomenon serves as the only link between migraine and epilepsy, the neuronal hyperexcitability that may contribute to each condition may explain the effect of these drugs for both conditions.
Aguggia
M
M
Neurological Department, Via E. Raggio 12, I-15057 Novi Ligure (AL), Italy. aguggiamarco@tiscali.it
D'Andrea
G
G
Bussone
G
G
D000818:Animals; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D015897:Comorbidity; D013181:Cortical Spreading Depression / Q000187:drug effects / Q000502:physiology; D004827:Epilepsy / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D009433:Neural Inhibition / Q000187:drug effects / Q000502:physiology; D009434:Neural Pathways / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D018377:Neurotransmitter Agents / Q000819:agonists* / Q000037:antagonists & inhibitors* / Q000378:metabolism; D014276:Trigeminal Nerve / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology
D000927:Anticonvulsants; D018377:Neurotransmitter Agents