Migraine and neuropeptides

Area of Science:

• Neuroscience
• Pharmacology
• Headache Medicine

Background:

• Migraine is a prevalent, disabling neurovascular headache disorder with an unclear pathomechanism.
• The trigeminovascular system, including the trigeminal ganglion and meningeal vasculature, is central to leading migraine hypotheses.
• Ongoing preclinical and clinical research aims to elucidate migraine's underlying mechanisms.

Purpose of the Study:

• To review the roles of sensory, sympathetic, and parasympathetic neuropeptides in the trigeminovascular system.
• To discuss the involvement of somatostatin, nociceptin, and orexins in migraine pathophysiology.
• To survey clinical findings on neuropeptide alterations and therapeutic strategies for migraine.

Main Methods:

• Literature review of preclinical and clinical studies on migraine neuropeptides.
• Analysis of neuropeptide functions within the trigeminovascular system.
• Examination of human clinical data on neuropeptide levels and therapeutic interventions.

Main Results:

• Sensory neuropeptides (calcitonin gene-related peptide, pituitary adenylate cyclase-activating polypeptide, substance P), sympathetic (neuropeptide Y), and parasympathetic (vasoactive intestinal peptide) peptides are implicated.
• These neuropeptides may contribute to neurogenic inflammation and sensitization within the trigeminal system.
• Alterations in neuropeptide levels in plasma, saliva, and cerebrospinal fluid during migraine attacks are observed.

Conclusions:

• Migraine pathophysiology involves complex interactions within the trigeminovascular system mediated by various neuropeptides.
• Neuropeptides present potential therapeutic targets for both acute and prophylactic treatment of migraine headaches.
• Further research into neuropeptide functions and alterations is crucial for advancing migraine management.