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Migraine: multiple processes, complex pathophysiology.

Rami Burstein1, Rodrigo Noseda2, David Borsook3

  • 1Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, Harvard Medical School, Boston, Massachusetts 02115 rburstei@bidmc.harvard.edu.

The Journal of Neuroscience : the Official Journal of the Society for Neuroscience
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Migraine is a complex neurovascular headache disorder with genetic links. Research suggests altered brain structure and function, particularly in glutamate neurotransmission, contribute to its debilitating symptoms.

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Area of Science:

  • Neuroscience
  • Genetics
  • Neurology

Background:

  • Migraine is a common, disabling, hereditary neurovascular headache disorder.
  • Symptoms include prodromes, aura, throbbing head pain, nausea, and sensory sensitivities.
  • Migraine alters brain structure and function, leading to neuronal hyperexcitability.

Purpose of the Study:

  • To explore the underlying mechanisms of migraine.
  • To investigate the role of genetic predisposition and neuronal alterations.
  • To understand the trigeminovascular pathway's involvement in migraine pain.

Main Methods:

  • Review of current understanding of migraine pathophysiology.
  • Analysis of genetic factors influencing migraine.
  • Examination of neurovascular and central nervous system changes.

Main Results:

  • Genetic variants, especially those affecting glutamate neurotransmission and synaptic plasticity, are linked to migraine.
  • The migraine brain exhibits structural and functional abnormalities, contributing to hyperexcitability.
  • Activation of the trigeminovascular pathway is crucial for head pain in migraine.

Conclusions:

  • Migraine pathophysiology involves complex genetic and neurobiological factors.
  • Understanding these mechanisms is key to developing targeted therapies.
  • The trigeminovascular system plays a central role in migraine pain perception.