About this Research Topic
Migraine pain is the epiphenomenon of a very complex cascade of mechanisms that is still elusive.
Although functional imaging and neurophysiological studies have recently added fundamental insights into the identification of brain structures and networks whose activation represent landmarks of migraine attacks, the real meaning of this cerebral circuitry is still debated. Besides, these experimental studies were performed for obvious technical reasons in a relatively limited number of patients not allowing to generalize the results in the clinically heterogeneous migraine population.
To increase complexity, the analysis of susceptibility genetic loci in 375000 migraine patients, reported an association with genes mainly expressed in the vascular and smooth muscle tissues. This result turns the spotlights back to the vascular system as historically hypothesized.
In this line, the first conceptualized and approved therapies for Migraine prevention, block CGRP pathways’ activation – This pathway is physiologically associated with vasodilation, even though this is not considered the primary mode of action. Nevertheless, even these specific drugs don’t seem to be resolutive in all patients, in line with past evidence suggesting that patients may benefit from therapy, targeting very different mechanisms, and further underlining the complexity of migraine physiopathology. In addition to this intricate scientific scenario, migraine is also clinically multifaceted.
While some patients report infrequent attacks, others may suffer from daily headaches. This further confirms migraine as one among the most disabling neurological diseases despite it spares permanent physical disabilities.
Finally, migraine can be comorbid with different conditions such as depression, obesity, epilepsy or represent a risk factor for diseases such as global transient amnesia and stroke.
The scope of this Research Topic is to outline the current knowledge of Migraine’s origin, its relation with other conditions and the physiological mechanisms leading to chronicization predisposition.
We encourage the submission of new findings, showing migraine’s different aspects (neurophysiological, vascular, psychological, neuroimaging) to draw different migraine patients’ profiles. In this respect, a multimodal approach addressing the complexity of this condition is encouraged. Studies addressing the subtending mechanisms for chronicization and explaining the related risk are also welcome.
Finally, this Research Topic also aims to paint all shades of migraine – allowing to create a picture able to predict the response to the new era of therapeutic approach also including non-pharmacological therapies.
Keywords: migraine, physiopathology, comorbidity, chronic migraine, Neurophysiology
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.