An update on migraine: current understanding and future directions.
Migraine is a common brain disorder with high disability rates which involves a series of abnormal neuronal networks, interacting at different levels of the central and peripheral nervous system. An increase in the interest around migraine pathophysiology has allowed researchers to unravel certain neurophysiological mechanisms and neurotransmitter involvement culminating in the recent development of novel therapies, which might substantially change the clinical approach to migraine patients. The present review will highlight the current aspects of migraine pathophysiology, covering an understanding of the complex workings of the migraine state and the brain regions responsible for them. We will further discuss the therapeutic agents which have appeared in the most recent years for migraine care, from calcitonin gene-related peptide (CGRP) receptor antagonists, gepants; through serotonin 5-HT1Freceptor agonists, ditans, and CGRP or CGRP receptor monoclonal antibodies to invasive and non-invasive neuromodulation techniques.
Headache Group, Department of Basic and Clinical Neuroscience, King's College London, London, UK.|NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK.
Francesca
F
Puledda
Headache Group, Department of Basic and Clinical Neuroscience, King's College London, London, UK.|NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK.
Roberta
R
Messina
Headache Group, Department of Basic and Clinical Neuroscience, King's College London, London, UK. peter.goadsby@kcl.ac.uk.|NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK. peter.goadsby@kcl.ac.uk.
Peter J
PJ
Goadsby
D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism; D006801:Humans; D008881:Migraine Disorders / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D018015:Receptors, Calcitonin Gene-Related Peptide / Q000378:metabolism; D011985:Receptors, Serotonin / Q000378:metabolism
D018015:Receptors, Calcitonin Gene-Related Peptide; D011985:Receptors, Serotonin; D015740:Calcitonin Gene-Related Peptide
CGRP; Migraine; Neuromodulation; Pathophysiology; Treatment