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Migraine is a common chronic neurovascular disease, characterized by headaches. Calcitonin gene-related peptide (CGRP) signaling in the trigeminovascular system plays a critical role in the development of migraine. The monoclonal
antibodies against CGRP and its receptor have been used clinically for the prevention of migraine, however, they may not
be a cost-effective option for patients with low-frequency episodic migraine. Thus, it is quite valuable to search for an alternative strategy to downregulate CGRP signaling. Uncariae Ramulus Cum Uncis (UR) has a long-term history for the treatment of cardiovascular and central nervous systems disorders in China and Eastern Asia. Several clinical studies showed
that famous herbal formulas comprising UR were able to improve headaches in migraineurs. In addition, increasing in vivo
studies further indicated that migraine-related changes such as CGRP increase, inflammation, nitric oxide increase, and
spontaneous behavior problems can be reduced by UR extraction and its active constituents. In this review, we summarize
the pathophysiological factors affecting abnormal CGRP release in the trigeminovascular system during migraine, and for
the first time analyze the effects of UR on these factors and evaluate the potentials of UR for the treatment of migraine.