Neurobiology of migraine progression

Chronic migraine is one of the most devastating headache disorders. The estimated prevalence is 1.4–2.2% in the population. The factors which may predispose to the process of migraine progression include high frequency of migraine attacks, medication overuse, comorbid pain syndromes, and obesity. Se...

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Main Authors: Wanakorn Rattanawong, Alan Rapoport, Anan Srikiatkhachorn
Format: Article
Language:English
Published: Elsevier 2022-08-01
Series:Neurobiology of Pain
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2452073X22000113
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author Wanakorn Rattanawong
Alan Rapoport
Anan Srikiatkhachorn
author_facet Wanakorn Rattanawong
Alan Rapoport
Anan Srikiatkhachorn
author_sort Wanakorn Rattanawong
collection DOAJ
description Chronic migraine is one of the most devastating headache disorders. The estimated prevalence is 1.4–2.2% in the population. The factors which may predispose to the process of migraine progression include high frequency of migraine attacks, medication overuse, comorbid pain syndromes, and obesity. Several studies showed that chronic migraine results in the substantial anatomical and physiological changes in the brain. Despite no clear explanation regarding the pathophysiologic process leading to the progression, certain features such as increased sensory sensitivity, cutaneous allodynia, impaired habituation, identify the neuronal hyperexcitability as the plausible mechanism. In this review, we describe two main mechanisms which can lead to this hyperexcitability. The first is persistent sensitization caused by repetitive and prolonged trigeminal nociceptive activation. This process results in changes in several brain networks related to both pain and non-pain behaviours. The second mechanism is the decrease in endogenous brainstem inhibitory control, hence increasing the excitability of neurons in the trigeminal noceptive system and cerebral cortex. The combination of increased pain matrix connectivity, including hypothalamic hyperactivity and a weak serotonergic system, may contribute to migraine chronification.
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spelling doaj.art-0fddf23fd9e44b7a931335fe0bb8f3172022-12-22T02:58:55ZengElsevierNeurobiology of Pain2452-073X2022-08-0112100094Neurobiology of migraine progressionWanakorn Rattanawong0Alan Rapoport1Anan Srikiatkhachorn2Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, 10520, ThailandDepartment of Neurology, The David Geffen School of Medicine at UCLA, Los Angeles, USAFaculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, 10520, Thailand; Corresponding author.Chronic migraine is one of the most devastating headache disorders. The estimated prevalence is 1.4–2.2% in the population. The factors which may predispose to the process of migraine progression include high frequency of migraine attacks, medication overuse, comorbid pain syndromes, and obesity. Several studies showed that chronic migraine results in the substantial anatomical and physiological changes in the brain. Despite no clear explanation regarding the pathophysiologic process leading to the progression, certain features such as increased sensory sensitivity, cutaneous allodynia, impaired habituation, identify the neuronal hyperexcitability as the plausible mechanism. In this review, we describe two main mechanisms which can lead to this hyperexcitability. The first is persistent sensitization caused by repetitive and prolonged trigeminal nociceptive activation. This process results in changes in several brain networks related to both pain and non-pain behaviours. The second mechanism is the decrease in endogenous brainstem inhibitory control, hence increasing the excitability of neurons in the trigeminal noceptive system and cerebral cortex. The combination of increased pain matrix connectivity, including hypothalamic hyperactivity and a weak serotonergic system, may contribute to migraine chronification.http://www.sciencedirect.com/science/article/pii/S2452073X22000113Chronic migraineMigraine progressionTrigeminal systemNeuronal hyperexcitabilityEndogenous pain control systemHeadache
spellingShingle Wanakorn Rattanawong
Alan Rapoport
Anan Srikiatkhachorn
Neurobiology of migraine progression
Neurobiology of Pain
Chronic migraine
Migraine progression
Trigeminal system
Neuronal hyperexcitability
Endogenous pain control system
Headache
title Neurobiology of migraine progression
title_full Neurobiology of migraine progression
title_fullStr Neurobiology of migraine progression
title_full_unstemmed Neurobiology of migraine progression
title_short Neurobiology of migraine progression
title_sort neurobiology of migraine progression
topic Chronic migraine
Migraine progression
Trigeminal system
Neuronal hyperexcitability
Endogenous pain control system
Headache
url http://www.sciencedirect.com/science/article/pii/S2452073X22000113
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AT anansrikiatkhachorn neurobiologyofmigraineprogression