Pathophysiology and Therapy of Associated Features of Migraine

TY - JOUR

T1 - Pathophysiology and Therapy of Associated Features of Migraine

AU - Villar-Martinez, Maria Dolores

AU - Goadsby, Peter J.

N1 - Funding Information: M.D.V.-M. has no conflict of interest. P.J.G. reports, over the last 36 months, grants and personal fees from Eli-Lilly and Company, a grant from Celgene, and personal fees from Aeon Biopharma, Allergan/Abbvie, Amgen, Biodelivery Sciences Intern, Biohaven Pharmaceuticals Inc., CoolTech LLC, Reddys, Epalex, Impel Neuropharma, Lundbeck, Novartis, Praxis, Sanofi, Satsuma and Teva Pharmaceuticals, and personal fees for advice through the Gerson Lehrman Group, Guidepoint, SAI Med Partners, Vector Metric, and fees for educational materials from CME Outfitters, Omnia Education, WebMD, and publishing royalties or fees from the Massachusetts Medical Society, Oxford University Press, UptoDate and Wolters Kluwer, and for medicolegal advice on headaches, and a patent magnetic stimulation for headaches (No. WO2016090333 A1) assigned to eNeura without fees. Funding Information: The research was funded, in part, by the National Institute for Health and Social Care Research (NIHR203970). The APC was funded by King’s College London. Publisher Copyright: © 2022 by the authors.

PY - 2022/9/5

Y1 - 2022/9/5

N2 - Migraine is a complex and debilitating disorder that is broadly recognised by its characteristic headache. However, given the wide array of clinical presentations in migraineurs, the headache might not represent the main troublesome symptom and it can even go unnoticed. Understanding migraines exclusively as a pain process is simplistic and certainly hinders management. We describe the mechanisms behind some of the most disabling associated symptoms of migraine, including the relationship between the central and peripheral processes that take part in nausea, osmophobia, phonophobia, vertigo and allodynia. The rationale for the efficacy of the current therapeutic arsenal is also depicted in this article. The associated symptoms to migraine, apart from the painful component, are frequent, under-recognised and can be more deleterious than the headache itself. The clinical anamnesis of a headache patient should enquire about the associated symptoms, and treatment should be considered and individualised. Acknowledging the associated symptoms as a fundamental part of migraine has permitted a deeper and more coherent comprehension of the pathophysiology of migraine.

AB - Migraine is a complex and debilitating disorder that is broadly recognised by its characteristic headache. However, given the wide array of clinical presentations in migraineurs, the headache might not represent the main troublesome symptom and it can even go unnoticed. Understanding migraines exclusively as a pain process is simplistic and certainly hinders management. We describe the mechanisms behind some of the most disabling associated symptoms of migraine, including the relationship between the central and peripheral processes that take part in nausea, osmophobia, phonophobia, vertigo and allodynia. The rationale for the efficacy of the current therapeutic arsenal is also depicted in this article. The associated symptoms to migraine, apart from the painful component, are frequent, under-recognised and can be more deleterious than the headache itself. The clinical anamnesis of a headache patient should enquire about the associated symptoms, and treatment should be considered and individualised. Acknowledging the associated symptoms as a fundamental part of migraine has permitted a deeper and more coherent comprehension of the pathophysiology of migraine.

KW - allodynia

KW - migraine pathophysiology

KW - nausea

KW - osmophobia

KW - phonophobia

KW - vertigo

UR - http://www.scopus.com/inward/record.url?scp=85137606185&partnerID=8YFLogxK

U2 - 10.3390/cells11172767

DO - 10.3390/cells11172767

M3 - Review article

C2 - 36078174

AN - SCOPUS:85137606185

SN - 2073-4409

VL - 11

JO - Cells

JF - Cells

IS - 17

M1 - 2767

ER -