Hallmarks of primary headache: part 1 - migraine

Area of Science:

• Neurology
• Genetics
• Public Health

Background:

• Migraine is a prevalent and disabling neurological disorder, impacting 15.2% of the global population and ranking as a leading cause of disability, particularly among women.
• Despite its prevalence, migraine is frequently underdiagnosed and undertreated, highlighting a gap in current healthcare approaches.
• Specialized headache centers and neurologists possess expertise, but a comprehensive overview is beneficial for those less frequently treating migraine patients.

Purpose of the Study:

• To provide a comprehensive overview of migraine, encompassing its genetic basis, diagnostic markers, and treatment options.
• To elucidate the specific features that characterize migraine and differentiate it from other headache disorders.
• To discuss the societal impact of migraine and emphasize the importance of tailored management strategies.

Main Methods:

• Review of current literature on migraine genetics, clinical manifestations, and therapeutic interventions.
• Analysis of factors contributing to migraine heterogeneity, including genetic and molecular underpinnings.
• Examination of patient-specific factors, lifestyle habits, and their influence on migraine management.

Main Results:

• Migraine presents with both common and individual characteristics, exhibiting heterogeneity in attack frequency, aura presence, treatment response, and comorbidities.
• The diverse genetic and molecular basis of migraine contributes to its varied clinical presentation.
• A wide array of acute and prophylactic treatments exist, yet identifying the optimal therapy for each patient remains a challenge.

Conclusions:

• Personalized treatment plans, combining pharmacological and non-pharmacological approaches, are crucial and depend on recognizing individual migraine hallmarks.
• A multidisciplinary, cross-specialty approach is essential for managing the complex and heterogeneous nature of migraine.
• Health education plays a vital role in promoting brain health and reducing the burden on specialized care by empowering patients in daily migraine management.