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Author Spotlight: Deciphering Electrical Networks Behind Complex Brain Activities and Disorders
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New targets for migraine therapy.

Amy R Tso1, Peter J Goadsby

  • 1Headache Group, Department of Neurology, University of California San Francisco, 2330 Post Street, 6th floor, San Francisco, CA, 94115, USA, amy.tso@ucsfmedctr.org.

Current Treatment Options in Neurology
|September 21, 2014
PubMed
Summary

Migraine treatment is evolving from vascular to neural targets. New therapies, including CGRP antagonists and neuromodulation, promise better migraine relief without vasoconstrictive effects.

Area of Science:

  • Neurology
  • Pharmacology
  • Neuroscience

Background:

  • Migraine understanding has shifted from a vascular to a brain disorder.
  • Triptans (5-HT1B/1D agonists) were a major advance but have vasoconstrictive limitations.
  • Limited research funding hinders the identification of new migraine targets.

Purpose of the Study:

  • To review novel therapeutic targets and approaches for migraine treatment.
  • To discuss emerging drug classes and non-pharmacological interventions.
  • To highlight the potential for improved, better-tolerated migraine therapies.

Main Methods:

  • Review of current literature on migraine pathophysiology and therapeutics.
  • Analysis of novel pharmacologic targets, including CGRP, 5-HT1F, and others.

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  • Exploration of non-invasive neuromodulation techniques.

    • Main Results:

    • Development of agents targeting calcitonin gene-related peptide (CGRP) receptors and 5-HT1F receptors offers non-vasoconstrictive options.
    • New potential targets identified include acid-sensing ion channels, glutamate receptors, orexin receptors, nitric oxide synthase (NOS), and transient receptor potential (TRP) channels.
    • Non-invasive neuromodulation techniques like transcutaneous neurostimulation and transcranial magnetic stimulation are emerging.

    Conclusions:

    • Future migraine therapy will likely involve multiple classes of drugs targeting diverse neural mechanisms.
    • Novel agents and neuromodulation offer hope for more effective and better-tolerated migraine treatments.
    • Continued research into migraine pathophysiology is crucial for developing next-generation therapies.