Is migraine a neuropathic pain syndrome?
The understanding of migraine pathophysiology has evolved from the belief that migraine is a vascular disorder, to evidence that better defines migraine as a neurogenic disorder associated with secondary changes in brain perfusion. There is evidence to suggest that the early phase of migraine pain results from neurogenic inflammation affecting cranial blood vessels and dura. Allodynia, hyperalgesia, and expansion of nociceptive fields occur during most well-established migraine attacks. These clinical features of migraine are evocative of those traditionally associated with neuropathic pain. A hypothesis that defines migraine pain as a unique neuropathic pain disorder can imply the potential for neural plasticity and may provide insight into the mechanisms that underlie the transformation of episodic to chronic forms of migraine. The neuropathic pain model of migraine pathophysiology not only paves the way for mechanism-based treatment strategies that can improve the acute and preventive management of migraine attacks, but also opens the door for the discovery of novel therapeutic targets. It also lends momentum to an understanding of clinically intriguing topics such as opiate-induced hyperalgesia and medication-overuse headache (rebound headache), opioid resistance in the treatment of chronic headache, and disease modification in defending against the potential for migraine transformation.
Biondi
David M
DM
Headache Management Program, Spaulding Rehabilitation Hospital, 125 Nashua Street, Boston, MA 02114, USA. dbiondi@partners.org
D006801:Humans; D008881:Migraine Disorders / Q000209:etiology* / Q000503:physiopathology* / Q000628:therapy; D009437:Neuralgia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013577:Syndrome
Ann Neurol. 2004 Jan;55(1):19-26
14705108
Neurology. 2002 Apr 23;58(8):1316; author reply 1316-7
11971117
Cephalalgia. 1994 Dec;14(6):415-8
7697702
Nat Rev Drug Discov. 2003 Dec;2(12):973-85
14654796
Ann N Y Acad Sci. 2000;909:12-24
10911921
Cephalalgia. 2004;24 Suppl 1:9-160
14979299
Nature. 1996 Dec 12;384(6609):560-4
8955268
Arch Neurol. 2000 Nov;57(11):1631-4
11074796
Headache. 1998 Jul-Aug;38(7):497-506
15613165
Headache. 2005 Apr;45 Suppl 1:S14-24
15833086
Cephalalgia. 1992 Aug;12(4):221-8; discussion 186
1525797
J Neurol Neurosurg Psychiatry. 1960 Feb;23:23-32
14444681
Lancet. 1998 Apr 4;351(9108):1043-51
9546526
Cephalalgia. 2000 Sep;20(7):658-62
11128824
J Pharmacol Exp Ther. 2004 Apr;309(1):56-63
14718591
Pain. 1999 Apr;80(3):453-462
10342407
Ann Neurol. 1984 Aug;16(2):157-68
6206779
Headache. 2001 Jul-Aug;41(7):629-37
11554950
Nat Med. 2002 Feb;8(2):136-42
11821897
Cephalalgia. 2003 May;23(4):258-63
12716342
Headache. 2004 Oct;44(9):856-64
15447694
Nat Rev Neurosci. 2003 May;4(5):386-98
12728266
Neurology. 2004 May 25;62(10):1687-94
15159463
Brain. 2002 Jun;125(Pt 6):1392-401
12023327
Headache. 2003 Nov-Dec;43(10):1075-9
14629242
Anesth Analg. 2003 Sep;97(3):619-620
12933371
JAMA. 2005 Jun 22;293(24):3043-52
15972567
Pain. 1998 Feb;74(2-3):205-11
9520235
Ann Emerg Med. 1992 Aug;21(8):919-24
1497157
Cephalalgia. 2004 Jul;24(7):596-602
15196302
J Neurol Neurosurg Psychiatry. 2000 Oct;69(4):507-11
10990512
Neurology. 1997 Sep;49(3):650-6
9305317
Curr Opin Neurol. 2002 Jun;15(3):287-95
12045727
Ann Neurol. 2000 May;47(5):614-24
10805332
Ann Emerg Med. 1998 Aug;32(2):129-38
9701293
Pain. 1988 Apr;33(1):11-23
2454440
Proc Natl Acad Sci U S A. 2001 Apr 10;98(8):4687-92
11287655
CNS Drug Rev. 2005 Spring;11(1):69-76
15867953
Neurology. 1998 Jun;50(6):1741-5
9633720
Cephalalgia. 1998 Feb;18 Suppl 21:45-9
9533671
Headache. 2001 Jul-Aug;41(7):646-57
11554952
Headache. 2004 Jul-Aug;44(7):669-73
15209688
Headache. 1996 Jan;36(1):14-9
8666530
Cephalalgia. 2004 Nov;24(11):918-24
15482352
Cephalalgia. 1999 Jul;19(6):557-65; discussion 541
10448542
Microsc Res Tech. 2001 May 1;53(3):167-78
11301492
Arch Intern Med. 1999 Apr 26;159(8):813-8
10219926
Anesth Analg. 2003 Sep;97(3):785-790
12933403
Curr Pain Headache Rep. 2006 Feb;10(1):34-8
16499828
Ann Neurol. 2001 May;49(5):668-72
11357959
Curr Pain Headache Rep. 2003 Feb;7(1):67-75
12525274
Pain. 1988 Jan;32(1):77-88
3340425
Neurology. 1994 Jun;44(6 Suppl 4):S24-39
8008223
Headache. 2005 Sep;45(8):992-8
16109112
Science. 2000 Jun 9;288(5472):1765-9
10846153
Headache. 1992 Oct;32(9):439-45
1446987
Neurology. 2000 Sep 26;55(6):754-62
10993991
Mol Interv. 2005 Oct;5(5):304-11
16249526
Br J Anaesth. 2001 Jul;87(1):12-26
11460801
Neurology. 2001 Nov 13;57(9):1694-8
11706113
J Neurosurg Anesthesiol. 1997 Apr;9(2):146-8
9100184
Neurol Sci. 2003 May;24 Suppl 2:S51-6
12811592
Brain. 2000 Aug;123 ( Pt 8):1703-9
10908199
Cephalalgia. 2001 Dec;21(10):980-6
11843870
Headache. 2004 Oct;44(9):865-72
15447695
Headache. 1982 Mar;22(2):66-8
7085263
Pain. 2003 Nov;106(1-2):81-9
14581114
Neurology. 2002 Feb 26;58(4):554-63
11865132
Cephalalgia. 2003 Nov;23(9):877-86
14616929
Cephalalgia. 1996 Jun;16(4):231-8; discussion 215
8792034
Pain Med. 2000 Mar;1(1):7-23
15101960
Neurology. 1991 Jul;41(7):1024-8
1712433
Brain Res. 2001 Jul 13;907(1-2):117-24
11430892
Cephalalgia. 2005 Sep;25(9):735-42
16109056
Neurology. 2002 May 14;58(9 Suppl 6):S15-20
12011269
JAMA. 2004 Jan 28;291(4):427-34
14747499
Br J Anaesth. 2001 Jul;87(1):3-11
11460811
Pain. 2004 Jul;110(1-2):461-9
15275799
Clin Neurosci. 1998;5(1):34-7
9523056
Eur Neurol. 2001;45(4):229-35
11385260
Headache. 1991 Jun;31(6):365-71
1889975
Neurol Clin. 1997 Feb;15(1):1-13
9058393
Cephalalgia. 1995 Apr;15(2):159-60
7641253
Neurology. 2004 Mar 9;62(5):788-90
15007133
Cephalalgia. 2004;24 Suppl 2:24-30
15595991
J Neurol. 1989 Jan;236(1):9-14
2915233
Headache. 1999 Sep;39(8):552-8
11279970
Pain. 1993 Oct;55(1):93-97
8278214
Mayo Clin Proc. 2005 Jul;80(7):908-16
16007896
Cephalalgia. 2004 Nov;24(11):925-33
15482353