Current understanding of meningeal and cerebral vascular function underlying migraine headache

Levy, Dan; Labastida-Ramírez, Alejandro; MaassenVanDenBrink, Antoinette

doi:10.1177/0333102418771350

Cited by 98 publications

(82 citation statements)

References 190 publications

(255 reference statements)

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“…Neuropeptides released from sensory nerve endings contribute to vasodilation, plasma protein extravasation (PPE), and activation of immune cell traffic. 25 We evaluated dural mast cells and macrophages, which play a critical role in the generation of dural inflammation. Dural mast cell activation and degranulation can lead to the release of powerful pro-inflammatory mediators.…”

Section: Discussionmentioning

confidence: 99%

<p>Electroacupuncture Inhibits Hyperalgesia by Alleviating Inflammatory Factors in a Rat Model of Migraine</p>

Zhao¹,

Liu²,

Xu³

et al. 2020

JPR

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Objective: Acupuncture has a therapeutic effect similar to that of prophylactic drugs and can be considered a treatment option for migraineurs. However, the mechanism of acupuncture treatment's effect on migraine is uncertain. An approach based on anti-inflammatory effects is an important treatment strategy for migraine because non-steroidal anti-inflammatory drugs (NSAIDs) are usually used during migraine attacks. Meningeal inflammation is thought to be responsible for the activation of the trigeminovascular system. Our previous study found that electroacupuncture (EA) decreased neurogenic inflammation mediator expression in the trigeminal ganglion (TG) and alleviated hyperalgesia. The present study examined whether EA would inhibit hyperalgesia by alleviating neurogenic inflammatory factors.Methods: A rat model of migraine was established using dural electrical stimulation (DES). Five groups were analyzed in this study. The Model group received DES three times to mimic migraine attacks, a Control group had sham DES, and three groups received electroacupuncture after DES: a Non-Acu group at a non-acupuncture point, a GB20 group at GB20, and a GB20/34 group at GB20 and GB34 acupuncture points. We evaluated mechanical hyperalgesia using an electronic von Frey esthesiometer in the awake state. After sacrifice, the dura mater was analyzed using immunofluorescence. Serum calcitonin gene-related peptide, cyclooxygenase-2, brainderived neurotrophic factor, IL-1β, IL-6, and TNF levels were determined using enzymelinked immunosorbent assays to evaluate the anti-inflammatory effect of acupuncture. Results: After repeated DES, we observed facial and hind paw mechanical hyperalgesia, which was inhibited by electroacupuncture. Electrical stimulation increased the number of mast cells and macrophages and serum levels of inflammatory factors. GB20 and GB20/34 electroacupuncture significantly decreased the number of mast cells and macrophages and serum levels of inflammatory factors. Moreover, electroacupuncture at GB20/34 was superior to that at GB20 alone in inhibiting hyperalgesia and alleviating inflammatory factors. Conclusion: Electroacupuncture inhibits DES-induced hyperalgesia by alleviating inflammatory factors. Inhibition of dural mast cells, macrophages, and serum inflammatory factors may be one of the mechanisms involved in acupuncture treatment's effect on migraine.

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Section: Discussionmentioning

confidence: 99%

<p>Electroacupuncture Inhibits Hyperalgesia by Alleviating Inflammatory Factors in a Rat Model of Migraine</p>

Zhao¹,

Liu²,

Xu³

et al. 2020

JPR

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“…Still, at present there is an ongoing debate what is causing the hyperexcitability of second order neurons in the TCC during migraine. Levy et al noticed that sensory innervation of the cranial meninges and immune and vascular cells may have a major role, but evidence for neurogenic inflammation during migraine and its contribution to meningeal nociception is limited (52). Prolonged or ongoing peripheral nociceptive input via trigger points in pericranial or cervical myofascial structures may contribute to hyperexcitability of second-order neurons at the C1 and C2 dorsal horn of the TCC in TTH, but evidence for this hypothesis is limited (53).…”

Section: Generalized Hyperexcitabilitymentioning

confidence: 99%

A Neuroscience Perspective of Physical Treatment of Headache and Neck Pain

Castien

Hertogh

2019

Front. Neurol.

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The most prevalent primary headaches tension-type headache and migraine are frequently associated with neck pain. A wide variety of treatment options is available for people with headache and neck pain. Some of these interventions are recommended in guidelines on headache: self-management strategies, pharmacological and non-pharmacological interventions. Physical treatment is a frequently applied treatment for headache. Although this treatment for headache is predominantly targeted on the cervical spine, the neurophysiological background of this intervention remains unclear. Recent knowledge from neuroscience will enhance clinical reasoning in physical treatment of headache. Therefore, we summarize the neuro- anatomical and—physiological findings on headache and neck pain from experimental research in both animals and humans. Several neurophysiological models (referred pain, central sensitization) are proposed to understand the co-occurrence of headache and neck pain. This information can be of added value in understanding the use of physical treatment as a treatment option for patients with headache and neck pain.

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“…It is thought that sensitization of dural afferent fibers causes the head pain symptoms typically reported by migraine sufferers (Levy et al, 2018). Neurogenic inflammation, which results from a localized release of neurotransmitters, such as serotonin, histamine, and glutamate as well as neuropeptides, such as calcitonin gene-related peptide (CGRP) and substance P, may underlie this sensitization.…”

mentioning

confidence: 99%

Sex-Specific Pharmacotherapy for Migraine: A Narrative Review

Gazerani

Cairns

2020

Front. Neurosci.

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Migraine is a common neurological disorder characterized by recurrent headache episodes that accompany sensory-motor disturbances, such as higher sensitivity to touch and light, extremity heaviness or weakness, and speech or language disabilities. Worldwide, migraine is one of the top 10 causes of disability and hence poses a huge economic burden to society. On average, migraine occurs in 12% of population but its occurrence is sexually dimorphic, as it is two to three times more prevalent in women than in men. This female to male ratio of migraine prevalence is age-and sex hormone-dependent. Advancements in understanding migraine pathogenesis have also revealed an association with both genetics and epigenetics. The severity of migraine, in terms of its attack duration, headache intensity, frequency, and occurrence of migraineassociated symptoms, has generally been reported to be greater in women. Sex differences in migraine disability and comorbidities, such as psychiatric disorders, have also been noted in some population-based studies. However, research on sex-related differences in response to migraine treatments is relatively scarce. Although a general observation is that women consume more medication than men for migraine treatment, strategies for the use of abortive and preventive medications for migraine are generally similar in both sexes. This narrative review summarizes available findings on sexually distinct responses to abortive and prophylactic pharmacotherapy of migraine. Basic experimental data and clinical findings will be presented, and potential mechanisms underlying sex-based responses will be discussed to highlight the importance and value of sex-based treatment in migraine research and practice.

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Current understanding of meningeal and cerebral vascular function underlying migraine headache

Cited by 98 publications

References 190 publications

<p>Electroacupuncture Inhibits Hyperalgesia by Alleviating Inflammatory Factors in a Rat Model of Migraine</p>

<p>Electroacupuncture Inhibits Hyperalgesia by Alleviating Inflammatory Factors in a Rat Model of Migraine</p>

A Neuroscience Perspective of Physical Treatment of Headache and Neck Pain

Sex-Specific Pharmacotherapy for Migraine: A Narrative Review

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