Neurobiological Basis of Migraine

Abstract

Migraine is the most common disabling primary headache globally. Attacks often present with unilateral throbbing headache and an array of associated symptoms, including, nausea, multisensory hypersensitivity, and marked fatigue. The diverse symptomatology highlights the complexity of migraine as a whole nervous system disorder involving somatosensory, autonomic, endocrine, and arousal networks. While attempts to describe the entirety of migraine are complex and daunting, this chapter focuses on recent advances in the understanding of its pathophysiology and treatment. The chapter focuses on the underlying neuroanatomical basis for migraine-related headache and associated symptomatology and discusses key clinical and preclinical findings that indicate that migraine likely results from dysfunctional homeostatic mechanisms. Whereby abnormal central nervous system responses to extrinsic and intrinsic cues may lead to increased attack susceptibility. Finally, the chapter considers the recent translational success of targeted calcitonin gene-related peptide and serotonin 1F receptor (5-HT1F) modulation for migraine.