Pathophysiology and Therapy of Associated Features of Migraine

Villar-Martínez, María Dolores; Goadsby, Peter J.

doi:10.3390/cells11172767

Cited by 26 publications

(24 citation statements)

References 274 publications

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“…In addition, there was a substantial heterogeneity within patients, which could be associated with the individual predisposition and a personal biology more prone to exhibit typical migraine features (23). In our opinion, the activation of some intracranial structures within the migraine attack, or some secondary headaches, are responsible for the phenotypic manifestations (28). Unfortunately, evidence in this regard, and the precise association between the involved structures is still limited (29).…”

Section: Discussionmentioning

confidence: 98%

InfluenCEF study: Clinical phenotype and duration of headache attributed to influenza infection

García-Azorín,

Santana-López,

Lozano-Alonso

et al. 2023

Cephalalgia

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Introduction Headache is a frequent symptom of infections. We aimed to characterize the clinical phenotype and duration of headache attributed to influenza infection. Methods Prospective cohort study done in 53 primary care centers between January and April 2023. Patients were included if they had a confirmed influenza diagnosis, were older than 15 years and had a new-onset headache. Patients’ demographics, prior medical history, headache phenotype and duration, associated symptoms and patients’ outcomes were assessed. The International Classification of Headache Disorders criteria for headache attributed to a systemic viral infection, migraine and tension-type headache were assessed. Results Of the 478 patients 75 fulfilled eligibility criteria. The mean age was 43, 56% were men, and 27% had a prior headache history. The headache phenotype was a bilateral headache (52%), with frontal topography (48%), pressing quality (61%), moderate intensity, rhinorrhea (79%), nasal congestion (76%), and photophobia (59%). All patients fulfilled headache attributed to acute systemic viral infection criteria, 43% fulfilled migraine criteria and 31% tension-type headache criteria. The median duration of the headache was four (Inter-quartile range: two-six) days. Conclusion The clinical phenotype of headache attributed to influenza infection was similar to other infections, with more pronounced cranial autonomic symptoms. The headache was an early symptom and was self-limited within a few days. Trial Registration: The study protocol is registered in ClinicalTrial.gov (NCT05704335)

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Section: Discussionmentioning

confidence: 98%

InfluenCEF study: Clinical phenotype and duration of headache attributed to influenza infection

García-Azorín,

Santana-López,

Lozano-Alonso

et al. 2023

Cephalalgia

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“…Hopefully, more clinical studies will reveal the consequences of CGRP modulator administration to clarify its efficacy in those subtypes of pain disorders [ 222 , 223 , 224 , 225 , 226 ]. Different TRP ion channels play distinct roles in both migraine and NP [ 227 ]. Early phase clinical trials have begun studying the effect of TRPV-1 receptor antagonists, TRPM-8 receptor agonists, and TRPM-8 receptor antagonists in migraine and studying the effect of TRPV-1 receptor agonists and inhibitors, TRPV-3 receptor antagonists, and TRPM-8 receptor agonists in NP.…”

Section: Discussionmentioning

confidence: 99%

Exploring Novel Therapeutic Targets in the Common Pathogenic Factors in Migraine and Neuropathic Pain

Tajti

Delia

Csáti

et al. 2023

IJMS

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Migraine and neuropathic pain (NP) are both painful, disabling, chronic conditions which exhibit some symptom similarities and are thus considered to share a common etiology. The calcitonin gene-related peptide (CGRP) has gained credit as a target for migraine management; nevertheless, the efficacy and the applicability of CGRP modifiers warrant the search for more effective therapeutic targets for pain management. This scoping review focuses on human studies of common pathogenic factors in migraine and NP, with reference to available preclinical evidence to explore potential novel therapeutic targets. CGRP inhibitors and monoclonal antibodies alleviate inflammation in the meninges; targeting transient receptor potential (TRP) ion channels may help prevent the release of nociceptive substances, and modifying the endocannabinoid system may open a path toward discovery of novel analgesics. There may exist a potential target in the tryptophan-kynurenine (KYN) metabolic system, which is closely linked to glutamate-induced hyperexcitability; alleviating neuroinflammation may complement a pain-relieving armamentarium, and modifying microglial excitation, which is observed in both conditions, may be a possible approach. Those are several potential analgesic targets which deserve to be explored in search of novel analgesics; however, much evidence remains missing. This review highlights the need for more studies on CGRP modifiers for subtypes, the discovery of TRP and endocannabinoid modulators, knowledge of the status of KYN metabolites, the consensus on cytokines and sampling, and biomarkers for microglial function, in search of innovative pain management methods for migraine and NP.

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“…In addition, limitations exist due to ethical and practical issues for provocation studies, where migraines can be experimentally induced by infusion or injection of triggering factors, such as nitroglycerin [ 92 ]. In addition, a migraine is not just a headache and can affect multiple other organs [ 93 ]. Therefore, studying migraines requires more than brain imaging alone.…”

Section: Human Brain Organoids For Migrainementioning

confidence: 99%

Human Brain Organoids in Migraine Research: Pathogenesis and Drug Development

Gazerani

2023

IJMS

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Human organoids are small, self-organized, three-dimensional (3D) tissue cultures that have started to revolutionize medical science in terms of understanding disease, testing pharmacologically active compounds, and offering novel ways to treat disease. Organoids of the liver, kidney, intestine, lung, and brain have been developed in recent years. Human brain organoids are used for understanding pathogenesis and investigating therapeutic options for neurodevelopmental, neuropsychiatric, neurodegenerative, and neurological disorders. Theoretically, several brain disorders can be modeled with the aid of human brain organoids, and hence the potential exists for understanding migraine pathogenesis and its treatment with the aid of brain organoids. Migraine is considered a brain disorder with neurological and non-neurological abnormalities and symptoms. Both genetic and environmental factors play essential roles in migraine pathogenesis and its clinical manifestations. Several types of migraines are classified, for example, migraines with and without aura, and human brain organoids can be developed from patients with these types of migraines to study genetic factors (e.g., channelopathy in calcium channels) and environmental stressors (e.g., chemical and mechanical). In these models, drug candidates for therapeutic purposes can also be tested. Here, the potential and limitations of human brain organoids for studying migraine pathogenesis and its treatment are communicated to generate motivation and stimulate curiosity for further research. This must, however, be considered alongside the complexity of the concept of brain organoids and the neuroethical aspects of the topic. Interested researchers are invited to join the network for protocol development and testing the hypothesis presented here.

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Pathophysiology and Therapy of Associated Features of Migraine

Cited by 26 publications

References 274 publications

InfluenCEF study: Clinical phenotype and duration of headache attributed to influenza infection

InfluenCEF study: Clinical phenotype and duration of headache attributed to influenza infection

Exploring Novel Therapeutic Targets in the Common Pathogenic Factors in Migraine and Neuropathic Pain

Human Brain Organoids in Migraine Research: Pathogenesis and Drug Development

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