Is calcitonin gene-related peptide (CGRP) the missing link in food histamine-induced migraine? A review of functional gut-to-trigeminovascular system connections

de Mora, Fernando; Messlinger, Karl

doi:10.1016/j.drudis.2024.103941

Drug Discovery Today

2024

DOI: 10.1016/j.drudis.2024.103941

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Is calcitonin gene-related peptide (CGRP) the missing link in food histamine-induced migraine? A review of functional gut-to-trigeminovascular system connections

Fernando de Mora,

Karl Messlinger

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2024

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Insights from triggers and prodromal symptoms on how migraine attacks start: The threshold hypothesis

Sebastianelli,

Atalar,

Cetta

et al. 2024

Cephalalgia

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Background The prodrome or premonitory phase is the initial phase of a migraine attack, and it is considered as a symptomatic phase in which prodromal symptoms may occur. There is evidence that attacks start 24–48 hours before the headache phase. Individuals with migraine also report several potential triggers for their attacks, which may be mistaken for premonitory symptoms and hinder migraine research. Methods This review aims to summarize published studies that describe contributions to understanding the fine difference between prodromal/premonitory symptoms and triggers, give insights for research, and propose a way forward to study these phenomena. We finally aim to formulate a theory to unify migraine triggers and prodromal symptoms. For this purpose, a comprehensive narrative review of the published literature on clinical, neurophysiological and imaging evidence on migraine prodromal symptoms and triggers was conducted using the PubMed database. Results Brain activity and network connectivity changes occur during the prodromal phase. These changes give rise to prodromal/premonitory symptoms in some individuals, which may be falsely interpreted as triggers at the same time as representing the early manifestation of the beginning of the attack. By contrast, certain migraine triggers, such as stress, hormone changes or sleep deprivation, acting as a catalyst in reducing the migraine threshold, might facilitate these changes and increase the chances of a migraine attack. Migraine triggers and prodromal/premonitory symptoms can be confused and have an intertwined relationship with the hypothalamus as the central hub for integrating external and internal body signals. Conclusions Differentiating migraine triggers and prodromal symptoms is crucial for shedding light on migraine pathophysiology and improve migraine management.

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Insights from triggers and prodromal symptoms on how migraine attacks start: The threshold hypothesis

Sebastianelli,

Atalar,

Cetta

et al. 2024

Cephalalgia

View full text Add to dashboard Cite

show abstract

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Is calcitonin gene-related peptide (CGRP) the missing link in food histamine-induced migraine? A review of functional gut-to-trigeminovascular system connections

Cited by 1 publication

References 109 publications

Insights from triggers and prodromal symptoms on how migraine attacks start: The threshold hypothesis

Insights from triggers and prodromal symptoms on how migraine attacks start: The threshold hypothesis

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