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CGRP and its receptors provide new insights into migraine pathophysiology

Ho, Tony W.; Edvinsson, Lars LU and Goadsby, Peter J. (2010) In Nature Reviews Neurology 6(10). p.573-582
Abstract
Over the past 300 years, the migraine field has been dominated by two main theories-the vascular theory and the central neuronal theory. The success of vasoconstrictors such as ergotamine and the triptans in treating acute migraine bolstered the vascular theory, but evidence is now emerging that vasodilatation is neither necessary nor sufficient to induce a migraine attack. Attention is now turning to the core migraine circuits in the brain, which include the trigeminal ganglia, trigeminal nucleus, medullary modulatory regions, pons, periaqueductal gray matter, hypothalamus and thalamus. Migraine triggers are likely to reflect a disturbance in overall balance of the circuits involved in the modulation of sensory activity, particularly... (More)
Over the past 300 years, the migraine field has been dominated by two main theories-the vascular theory and the central neuronal theory. The success of vasoconstrictors such as ergotamine and the triptans in treating acute migraine bolstered the vascular theory, but evidence is now emerging that vasodilatation is neither necessary nor sufficient to induce a migraine attack. Attention is now turning to the core migraine circuits in the brain, which include the trigeminal ganglia, trigeminal nucleus, medullary modulatory regions, pons, periaqueductal gray matter, hypothalamus and thalamus. Migraine triggers are likely to reflect a disturbance in overall balance of the circuits involved in the modulation of sensory activity, particularly those with relevance to the head. In this Review, we consider the evidence pointing towards a neuronal mechanism in migraine development, highlighting the role of calcitonin gene-related peptide (CGRP), which is found in small to medium-sized neurons in the trigeminal ganglion. CGRP is released during migraine attacks and can trigger migraine in patients, and CGRP receptor antagonists can abort migraine. We also examine whether other drugs, such as triptans, might exert their antimigraine effects via their actions on the neuronal circuit as opposed to the intracranial vasculature. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Nature Reviews Neurology
volume
6
issue
10
pages
573 - 582
publisher
Nature Publishing Group
external identifiers
  • wos:000282643100009
  • scopus:77957922955
ISSN
1759-4766
DOI
10.1038/nrneurol.2010.127
language
English
LU publication?
yes
id
fa16932a-4ab3-49f3-81af-abbfb3371017 (old id 1726903)
date added to LUP
2010-12-01 14:14:51
date last changed
2018-07-15 03:10:15
@article{fa16932a-4ab3-49f3-81af-abbfb3371017,
  abstract     = {Over the past 300 years, the migraine field has been dominated by two main theories-the vascular theory and the central neuronal theory. The success of vasoconstrictors such as ergotamine and the triptans in treating acute migraine bolstered the vascular theory, but evidence is now emerging that vasodilatation is neither necessary nor sufficient to induce a migraine attack. Attention is now turning to the core migraine circuits in the brain, which include the trigeminal ganglia, trigeminal nucleus, medullary modulatory regions, pons, periaqueductal gray matter, hypothalamus and thalamus. Migraine triggers are likely to reflect a disturbance in overall balance of the circuits involved in the modulation of sensory activity, particularly those with relevance to the head. In this Review, we consider the evidence pointing towards a neuronal mechanism in migraine development, highlighting the role of calcitonin gene-related peptide (CGRP), which is found in small to medium-sized neurons in the trigeminal ganglion. CGRP is released during migraine attacks and can trigger migraine in patients, and CGRP receptor antagonists can abort migraine. We also examine whether other drugs, such as triptans, might exert their antimigraine effects via their actions on the neuronal circuit as opposed to the intracranial vasculature.},
  author       = {Ho, Tony W. and Edvinsson, Lars and Goadsby, Peter J.},
  issn         = {1759-4766},
  language     = {eng},
  number       = {10},
  pages        = {573--582},
  publisher    = {Nature Publishing Group},
  series       = {Nature Reviews Neurology},
  title        = {CGRP and its receptors provide new insights into migraine pathophysiology},
  url          = {http://dx.doi.org/10.1038/nrneurol.2010.127},
  volume       = {6},
  year         = {2010},
}