Migraine relief: Solutions from natural bioactive products of Traditional Chinese medicine

Migraine is a chronic and refractory primary neurological disorder that is characterized by recurrent and pulsating headache accompanied by reversible neurological or systemic symptoms, such as visual aura, phonophobia, and gastrointestinal symptoms. Natural bioactive products derived from traditional Chinese medicine (TCM) are regarded as promising candidates for migraine owing to multi-target and pathway synergistic effects.

This paper aims to systematically evaluate the therapeutic effects of natural bioactive products from TCM on migraine, elucidate the roles of neurons, microglia, and astrocytes in the pathogenesis of migraine, and propose novel therapies for migraine from TCM.

The publications were summarized from 2015 to 2025 in the Google Scholar, PubMed, and Web of Science databases. The keywords used for the search were "migraine", "neurons", "microglia", "astrocytes", "natural products", and "TCM". The bibliometrics was used to analyze the research hotspots of literature on TCM and migraine over the past decade. The Global Burden of Disease Study (2023) and network pharmacology analysis were conducted on migraine.

The abnormal communication between neurons and glial cells contributes to the pathological process of migraine, manifested as cortical spreading depression, neuroinflammation, and central sensitization. Correcting the vicious cycle of headache attacks to restore the disorder between neurons and glia cells is a promising strategy for migraine. TCM bioactive products, such as alkaloids, flavonoids, phenols, glycosides, etc., have been proven to relieve migraine by modulating the excitability of neurons, microglia activation, the increase in reactive astrocytes, and the abnormal cross-talk between neurons and glial cells. It is worth noting that the critical biological molecules targeted by natural bioactive products mainly include Nrf2, NF-κB, and HIF-1α signaling pathways, thereby suppressing inflammatory responses, reducing oxidative stress, ameliorating neurotransmitter disturbances, and restoring mitochondrial function in migraine.

The roles of neurons and glial cells in migraine, as well as the therapeutic effects of TCM bioactive products on migraine, provide a scientific foundation for a better understanding of the pathological mechanism of migraine and are expected to promote the development of novel therapies for migraine from TCM.