What is migraine? Controversy and stalemate in migraine pathophysiology

Journal of Neurology
J Edmeads


Theories of migraine pathophysiology have evolved from the realms of the supernatural into the scientific arena but their further evolution seems delayed by unproductive controversy about whether or not migraine is primarily a vascular or a neurological dysfunction. This conceptual deadlock needs to be transcended by thinking beyond the neural and vascular systems, and by identifying mechanisms that could affect both to produce the characteristic clinical phenomena of migraine. One theoretical model envisages 5-hydroxytryptamine (serotonin; 5-HT) as a link between the neural and vascular systems, with global alteration of serotonergic neurotransmission affecting not only these systems, but the gastrointestinal tract as well, with incidental reverberations on platelet function. Such altered serotonergic transmission might originate from altered 5-HT receptor dynamics, a molecular change in turn produced by genetic mechanisms. Recognition of the importance of 5-HT receptor function in migraine, most notably that agonists of 5-HT1 receptors abort acute migraine and that antagonists of 5-HT2 receptors prevent migraine, may lead to significant therapeutic advances. The possibility that the "trigeminovascular system" might be the end...Continue Reading


Sep 1, 1979·Headache·M GawelF C Rose
Oct 1, 1975·Experimental Neurology·W F Windle
Jan 1, 1990·Headache·S J Peroutka
Nov 1, 1985·Headache·T J SteinerF C Rose
Aug 1, 1972·Journal of Neurology, Neurosurgery, and Psychiatry·B P Hilton, J N Cumings
Dec 1, 1969·Journal of Neurology, Neurosurgery, and Psychiatry·G CurzonM I Wilkinson
Oct 3, 1981·Lancet·E HaningtonB Wachowicz
Aug 1, 1984·Annals of Neurology·M A Moskowitz
Sep 1, 1982·Headache·G D'AndreaF F Milone
Feb 1, 1960·Neurology·R W KIMBALLE VALLEJO


Jan 1, 1991·Journal of Neurology·P P Humphrey
May 10, 2005·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J Berg, L J Stovner
Nov 26, 1998·The British Journal of Ophthalmology·C W StorimansJ A Oosterhuis
Jan 12, 2011·The Journal of Headache and Pain·Vinod Kumar Gupta
Jan 4, 2006·CNS Drug Reviews·G A Lambert
Jan 24, 2015·British Journal of Clinical Pharmacology·Marcelo E BigalAlan M Rapoport
Apr 1, 1995·Cephalalgia : an International Journal of Headache·H ChabriatM G Bousser
Nov 12, 2009·Expert Review of Neurotherapeutics·Vinod Kumar Gupta

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