title: Pharmacological trials in migraine: it's time to reappraise where the headache is and what the pain is like.
abstract: Most pharmacological trials deal with migraine as if it were a clinically homogeneous disease, and when detailing its characteristics, they usually report only the presence, or absence, of aura and attack frequency but provide no information on pain location, a non-trivial clinical detail. The past decade has witnessed growing emerging evidence suggesting that individuals with unilateral pain, especially those with associated unilateral cranial autonomic symptoms, are more responsive than others to trigeminal-targeted symptomatic and preventive therapy with drugs such as triptans or botulinum toxin. A simple way for migraine research treatment to take a step forward might be to step back, reappraise, and critically evaluate easily obtainable patient-reported clinical findings along with current knowledge on pain features.
authors.affiliation: Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Barbanti
authors.forename: Gabriella
authors.initials: G
authors.lastname: Egeo
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy*; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy*; D058825:Serotonin 5-HT1 Receptor Agonists / Q000627:therapeutic use*; D018170:Sumatriptan / Q000627:therapeutic use*; D016896:Treatment Outcome; D014363:Tryptamines / Q000627:therapeutic use
chemical_list: D065087:Acetylcholine Release Inhibitors; D058825:Serotonin 5-HT1 Receptor Agonists; D014363:Tryptamines; D018170:Sumatriptan; D001905:Botulinum Toxins
keywords: botulinum toxin; migraine; pain location; treatment; trigemino-autonomic reflex; unilateral cranial autonomic symptom