https://researchopenworld.com/migraine-a-review-of-basic-clinical-and-translational-approaches-to-new-treatment/#

Abstract

Migraine is a debilitating neurological primary headache disorder characterized by recurring unipolar headaches lasting 4–72 hours with accompaniment of nausea and sensory sensitivities. Migraine is the most common headache disorder resulting in seeking of medical care [1, 2], in addition to being one of the most debilitating chronic disease conditions in terms of both morbidity and lost economic productivity. Migraine incidence has been observed since ancient times to disproportionately affect women, and most current epidemiological assessments put current incidence estimates at 12% overall for US populations, with an incidence of 18% in women and 6% in men when stratified by sex. This dimorphism of incidence is crucial when assessing overall health of a community, specifically when concerning women’s health and therefore must be taken into consideration when developing both clinical and basic models of migraine to enact the best possible outcomes of combined translational research efforts. While major recent advances have been made in the field of pharmacologic intervention for migraine with the recent approval of the anti CGRP and anti CGRP receptor antibody medications, prohibitive cost and limited access have made older treatments, such as the triptans and NSAIDs, still the most commonly utilized medications to combat migraine attacks. Current preclinical research models are heavily interested in modulation of the neuropeptide CGRP, and the phenomenon of cortical spreading depression (CSD), believed to be the underlying trigger of migraine with aura, via pharmacological intervention. Modulations of these phenomena has found to be correlated with menstrual events in women, tying back to the overarching theme of higher morbidity in women. With the advent of pharmacogenomics and personalized medicine, a new epoch of potential customizable treatments looms on the horizon, endearing those afflicted with this severely debilitating condition a new glimmer of hope as research progresses into its next phase. Acronyms: AMPP: American Migraine Prevalence and Prevention study. NIH: National Institute of Health. ICHD-3: International Classification of Headache Disorders, 3rd edition. NHIS: National Health Interview Survey. NSAID: Non-Steroidal Anti-Inflammatory Drug. CGRP: Calcitonin Gene Related Peptide. 5HT1: 5-Hydroxytryptamine (Serotonin) Receptor, Subfamily 1. FDA: Food and Drug Administration. CNS: Central Nervous System. MOH: Medication Overuse Headache. PGE2: Prostaglandin E2. CSD: Cortical Spreading depression. fMRI: Functional Magnetic Resonance Imaging. GWAS: Genome Wide Association Study. SNP: Single Nucleotide Polymorphism.