Abstract
Introduction: The current article reviews the latest information on epidemiology, clinical features, diagnosis, recent advancements in clinical management, current therapeutic novelties, and the prevention of migraines. In a narrative review, all studies as per developed MeSH terms published until February 2023, excluding those irrelevant, were identified through a PubMed literature search.
Methods: Overall, migraine affects more than a billion people annually and is one of the most common neurological illnesses. A wide range of comorbidities is associated with migraines, including stress and sleep disturbances. To lower the worldwide burden of migraine, comprehensive efforts are required to develop and enhance migraine treatment, which is supported by informed healthcare policy. Numerous migraine therapies have been successful, but not all patients benefit from them.
Results: CGRP pathway-targeted therapy demonstrates the importance of translating mechanistic understanding into effective treatment. In this review, we discuss clinical features, diagnosis, and recently approved drugs, as well as a number of potential therapeutic targets, including pituitary adenylate cyclase-activating polypeptide (PACAP), adenosine, opioid receptors, potassium channels, transient receptor potential ion channels (TRP), and acid-sensing ion channels (ASIC).
Conclusion: In addition to providing more treatment options for improved clinical care, a better understanding of these mechanisms facilitates the discovery of novel therapeutic targets.
[http://dx.doi.org/10.1038/s41582-022-00763-1] [PMID: 36693999]
[http://dx.doi.org/10.1111/j.1526-4610.2007.00671.x] [PMID: 17425705]
[http://dx.doi.org/10.1111/head.12803] [PMID: 27037903]
[http://dx.doi.org/10.1111/head.12150] [PMID: 23808666]
[http://dx.doi.org/10.1212/01.wnl.0000252808.97649.21] [PMID: 17261680]
[http://dx.doi.org/10.1177/0333102417738202]
[http://dx.doi.org/10.1016/S0140-6736(20)32342-4] [PMID: 33773612]
[http://dx.doi.org/10.1177/0333102413485658]
[http://dx.doi.org/10.1186/s10194-018-0839-1] [PMID: 29392600]
[http://dx.doi.org/10.1016/S0140-6736(20)32160-7] [PMID: 33773613]
[http://dx.doi.org/10.1177/0333102416678382] [PMID: 27837173]
[http://dx.doi.org/10.1097/j.pain.0000000000002275] [PMID: 34001771]
[http://dx.doi.org/10.1016/S0140-6736(20)30925-9]
[http://dx.doi.org/10.1212/01.wnl.0000325565.63526.d2] [PMID: 18779513]
[http://dx.doi.org/10.1111/j.1526-4610.2012.02223.x] [PMID: 22830411]
[http://dx.doi.org/10.1186/s10194-017-0787-1] [PMID: 28980171]
[http://dx.doi.org/10.1007/s11910-010-0175-6] [PMID: 21243447]
[http://dx.doi.org/10.1111/j.1526-4610.2008.01217.x] [PMID: 18808500]
[http://dx.doi.org/10.1212/WNL.0b013e31820d8af2] [PMID: 21270413]
[http://dx.doi.org/10.1111/head.12941] [PMID: 27731896]
[http://dx.doi.org/10.1111/head.13459] [PMID: 30589090]
[http://dx.doi.org/10.1016/j.ncl.2019.08.001] [PMID: 31563228]
[http://dx.doi.org/10.1111/head.12499] [PMID: 25600718]
[http://dx.doi.org/10.1212/WNL.0000000000002560] [PMID: 27164716]
[http://dx.doi.org/10.1186/s10194-019-0974-3]
[http://dx.doi.org/10.1212/WNL.0b013e3182535d20] [PMID: 22529202]
[http://dx.doi.org/10.1586/ecp.13.14] [PMID: 23656340]
[http://dx.doi.org/10.1111/head.12870] [PMID: 27322907]
[http://dx.doi.org/10.1016/S0025-6196(11)60561-2] [PMID: 19411439]
[http://dx.doi.org/10.1177/0333102419828967]
[http://dx.doi.org/10.1017/S0317167100118943] [PMID: 23968886]
[http://dx.doi.org/10.1111/j.1468-1331.2009.02748.x] [PMID: 19708964]
[http://dx.doi.org/10.1111/head.12154] [PMID: 23879870]
[http://dx.doi.org/10.1186/s10194-018-0899-2]
[http://dx.doi.org/10.1002/14651858.CD008039.pub3] [PMID: 23633348]
[http://dx.doi.org/10.1002/14651858.CD008041.pub3] [PMID: 23633350]
[http://dx.doi.org/10.1002/14651858.CD009108.pub2] [PMID: 24865446]
[http://dx.doi.org/10.1111/j.1468-2982.2005.01010.x] [PMID: 16426262]
[http://dx.doi.org/10.1002/14651858.CD008541.pub3] [PMID: 27096438]
[http://dx.doi.org/10.1046/j.1526-4610.2003.03073.x] [PMID: 12656709]
[http://dx.doi.org/10.4103/0972-2327.99998] [PMID: 23024562]
[http://dx.doi.org/10.1093/brain/123.1.9] [PMID: 10611116]
[http://dx.doi.org/10.1007/s11916-007-0220-6] [PMID: 17894928]
[http://dx.doi.org/10.1212/WNL.0000000000008095] [PMID: 31413171]
[http://dx.doi.org/10.1212/WNL.0000000000008105] [PMID: 31413170]
[http://dx.doi.org/10.1177/0333102412469740] [PMID: 23236098]
[http://dx.doi.org/10.1007/s10194-010-0197-0] [PMID: 20186561]
[http://dx.doi.org/10.1016/S1474-4422(20)30482-8] [PMID: 33600767]
[http://dx.doi.org/10.1186/1129-2377-14-7] [PMID: 23565873]
[http://dx.doi.org/10.1177/2053369117731172] [PMID: 28994639]
[http://dx.doi.org/10.1038/nrneurol.2015.29] [PMID: 25776823]
[http://dx.doi.org/10.1016/j.clinthera.2009.03.020] [PMID: 19393844]
[http://dx.doi.org/10.1002/14651858.CD002919.pub3] [PMID: 25829028]
[PMID: 22683887]
[http://dx.doi.org/10.1177/0333102413515348] [PMID: 24335848]
[http://dx.doi.org/10.1002/14651858.CD010610] [PMID: 23797676]
[http://dx.doi.org/10.1111/j.1526-4610.2006.00684.x] [PMID: 17300356]
[http://dx.doi.org/10.1371/journal.pone.0130733] [PMID: 26172390]
[http://dx.doi.org/10.1056/NEJMra010917] [PMID: 11807151]
[http://dx.doi.org/10.1111/j.1749-6632.1990.tb16912.x] [PMID: 2252337]
[http://dx.doi.org/10.1093/brain/awn321] [PMID: 19098031]
[http://dx.doi.org/10.1016/S0006-8993(01)02645-2] [PMID: 11478927]
[http://dx.doi.org/10.1046/j.1468-2982.2001.00208.x] [PMID: 11595000]
[http://dx.doi.org/10.1097/00001756-200106130-00015] [PMID: 11409721]
[http://dx.doi.org/10.1007/s13311-018-0615-6] [PMID: 29488143]
[http://dx.doi.org/10.1177/0333102410370873] [PMID: 20855361]
[http://dx.doi.org/10.2147/JPR.S152216] [PMID: 30323656]
[http://dx.doi.org/10.1517/13543784.2012.681044] [PMID: 22512641]
[http://dx.doi.org/10.1080/13543784.2019.1618830] [PMID: 31081399]
[http://dx.doi.org/10.1152/physrev.00034.2015] [PMID: 28179394]
[http://dx.doi.org/10.1016/S0140-6736(19)32504-8] [PMID: 31668411]
[http://dx.doi.org/10.1016/S0140-6736(18)32534-0] [PMID: 30360965]
[http://dx.doi.org/10.1016/S0140-6736(19)31946-4] [PMID: 31427046]
[http://dx.doi.org/10.1111/ene.14114] [PMID: 31692188]
[http://dx.doi.org/10.1016/j.tips.2016.06.002]
[http://dx.doi.org/10.1186/s10194-020-01127-0] [PMID: 32487102]
[http://dx.doi.org/10.1186/s10194-020-01143-0] [PMID: 32517693]
[http://dx.doi.org/10.1016/0006-291X(90)92140-U] [PMID: 2383262]
[http://dx.doi.org/10.1080/13543784.2020.1811966] [PMID: 32877252]
[http://dx.doi.org/10.1146/annurev-cellbio-101011-155833] [PMID: 24099085]
[http://dx.doi.org/10.1016/j.brainres.2007.07.068] [PMID: 17765209]
[http://dx.doi.org/10.1186/1744-8069-8-66] [PMID: 22971321]
[http://dx.doi.org/10.1177/0333102418821662] [PMID: 30661365]
[http://dx.doi.org/10.1111/head.13737] [PMID: 31985049]
[http://dx.doi.org/10.1038/386173a0] [PMID: 9062189]
[http://dx.doi.org/10.1038/nrn3529] [PMID: 23783197]
[http://dx.doi.org/10.1016/j.neuropharm.2015.01.005] [PMID: 25613302]
[http://dx.doi.org/10.1016/j.neuropharm.2017.04.042] [PMID: 28457973]
[http://dx.doi.org/10.1074/jbc.271.18.10433] [PMID: 8631835]
[http://dx.doi.org/10.1016/j.neuron.2010.09.001] [PMID: 20920791]
[http://dx.doi.org/10.1186/1744-8069-6-88] [PMID: 21143836]
[http://dx.doi.org/10.1038/s41582-018-0003-1] [PMID: 29691490]
[http://dx.doi.org/10.3988/jcn.2012.8.2.89] [PMID: 22787491]
[http://dx.doi.org/10.1093/brain/awy300]
[http://dx.doi.org/10.1016/j.pain.2010.06.028] [PMID: 20655661]
[http://dx.doi.org/10.1371/journal.pone.0087029] [PMID: 24466320]
[http://dx.doi.org/10.1038/nm.2216] [PMID: 20871611]
[http://dx.doi.org/10.1016/j.neuroscience.2010.02.063] [PMID: 20211697]
[http://dx.doi.org/10.1152/ajpheart.1991.261.3.H720] [PMID: 1909503]
[http://dx.doi.org/10.1093/cvr/cvn138] [PMID: 18522960]
[http://dx.doi.org/10.1152/physrev.00021.2009] [PMID: 20086079]
[http://dx.doi.org/10.1073/pnas.92.26.12441] [PMID: 8618917]
[http://dx.doi.org/10.1210/edrv.20.2.0361] [PMID: 10204114]
[http://dx.doi.org/10.1046/j.1440-1681.2002.03650.x] [PMID: 11985542]
[http://dx.doi.org/10.1016/j.yjmcc.2004.11.020] [PMID: 15910879]
[http://dx.doi.org/10.1111/head.13634] [PMID: 31535367]
[http://dx.doi.org/10.1093/brain/awab136] [PMID: 33768245]
[http://dx.doi.org/10.1093/brain/awz199] [PMID: 31292608]
[http://dx.doi.org/10.1016/S0163-7258(01)00152-8] [PMID: 11728606]
[http://dx.doi.org/10.1016/j.neuroscience.2015.10.031] [PMID: 26500181]
[http://dx.doi.org/10.1038/nrd1983] [PMID: 16518376]
[http://dx.doi.org/10.3389/fncel.2019.00124] [PMID: 30983976]
[http://dx.doi.org/10.3390/brainsci7030030] [PMID: 28335379]
[http://dx.doi.org/10.1016/j.jsps.2012.05.011] [PMID: 23960840]
[http://dx.doi.org/10.1124/mol.59.6.1533] [PMID: 11353815]
[http://dx.doi.org/10.3892/br.2016.591] [PMID: 26998280]
[http://dx.doi.org/10.1093/brain/awf141] [PMID: 12023327]
[http://dx.doi.org/10.1186/s10194-018-0867-x] [PMID: 29802484]
[http://dx.doi.org/10.1016/j.neuropharm.2018.12.017] [PMID: 30553828]
[http://dx.doi.org/10.1016/j.pbb.2006.09.012] [PMID: 17112570]
[http://dx.doi.org/10.1016/j.bbr.2014.10.029] [PMID: 25447299]
[http://dx.doi.org/10.1080/13543784.2017.1275562] [PMID: 28001096]
[http://dx.doi.org/10.1111/bph.14131] [PMID: 29278419]
[http://dx.doi.org/10.1111/bph.14353] [PMID: 29722902]
[http://dx.doi.org/10.1007/s40263-020-00738-0] [PMID: 32676977]
[http://dx.doi.org/10.1111/head.13791] [PMID: 32337726]
[http://dx.doi.org/10.3389/fphar.2017.00740] [PMID: 29089894]
[http://dx.doi.org/10.1111/j.1468-1331.2004.00813.x] [PMID: 15257686]
[http://dx.doi.org/10.1111/ane.13051] [PMID: 30428123]
[http://dx.doi.org/10.1002/14651858.CD002286.pub3] [PMID: 25892430]
[http://dx.doi.org/10.1002/ptr.6701] [PMID: 32310327]
[http://dx.doi.org/10.1136/bmj.m697] [PMID: 32213509]