About this Research Topic
Migraine is one of the most diffuse and disabling disorders affecting the young adult population worldwide. Most of the complex pathophysiological mechanisms underlying migraine attacks involving both central and peripheral dysfunctions are still poorly understood, despite evolving research. The main developed and studied etiological theories have been the so-called "vascular theory" and "neuro-inflammatory" theory. Nevertheless, investigating the recent and current literature, new information continues to emerge on the mechanisms within the central and peripheral nervous systems that may contribute to migraine attacks. The glymphatic system – a network of paravascular tunnels through which cortical interstitial solutes are cleared from the brain - has been recently identified as the macroscopic waste clearance system for the CNS predominantly functioning during sleep states. Important implications for the glymphatic system exist for a significant proportion of neurological disorders, including traumatic brain injury, epilepsy, stroke, migraine, and Alzheimer's disease.
Several studies are exploring the role of the brain glymphatic in the pathophysiology of migraine. In particular, the involvement of brain immune cell modification during cortical spreading depression in migraine, with paravascular space closure and glymphatic flow impairment, has been suggested. Several techniques have been developed for the in vivo visualization and evaluation of the glymphatic system. More recently, advanced MRI techniques and sequences are proving promising for the non-invasive visualization approach compared to tracer studies.
The purpose of this Research Topic is to present the state-of-the-art of research and evidence in the translational and clinical field, regarding the role of human glymphatics in the pathophysiology and treatment of migraine. Robust critical reviews and research papers are fundamentals to understanding the cellular and biochemical basis underlying migraine pathophysiology and glymphatic anatomy and function. We are particularly interested in manuscripts that examine the links between migraine and CNS clearance from the clinical point of view, and the instrumental methods that allow the direct or indirect visualization of the anatomy and function of brain glymphatics. Moreover, insights on the therapeutic implications and perspectives targeting glymphatic disorders in migraine are essential contributions to the topic. Clinical trials, prospective clinical studies, topical reviews are preferred.
Keywords: migraine, cortical spread depression, brain glymphatic, MRI
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