Chemical Mediators of Migraine: Preclinical and Clinical Observations

• Published in: Headache Vol. 51; no. 6; pp. 1029 - 1045
• Main Authors: Gupta, Saurabh, Nahas, Stephanie J., Peterlin, B. Lee
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-06-2011; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: 5-HT; Biological and medical sciences; Brain Chemistry - drug effects; Brain Chemistry - physiology; Calcitonin Gene-Related Peptide - physiology; Cardiovascular system; CGRP; Drug therapy; Headaches; histamine; Histamine - physiology; Humans; Indexing in process; Medical research; Medical sciences; Migraine; Migraine Disorders - drug therapy; Migraine Disorders - pathology; Migraine Disorders - physiopathology; Neurology; Nitric Oxide - physiology; Pharmacology. Drug treatments; Serotonin - physiology; Vascular diseases and vascular malformations of the nervous system; Vasodilator agents. Cerebral vasodilators; Headache; NO; Nervous system diseases; Migraine; Cardiovascular disease; Chemical mediator; Asymptomatic; Cerebral disorder; Vascular disease; Histamine; Pain; Central nervous system disease; Neurological disorder; 5-HT; CGRP; Cerebrovascular disease
• ISSN: 0017-8748; 1526-4610
• DOI: 10.1111/j.1526-4610.2011.01929.x

Migraine is a neurovascular disorder, and although the pathophysiology of migraine has not been fully delineated, much has been learned in the past 50 years. This knowledge has been accompanied by significant advancements in the way migraine is viewed as a disease process and in the development therapeutic options. In this review, we will focus on 4 mediators (nitric oxide, histamine, serotonin, and calcitonin gene‐related peptide) which have significantly advanced our understanding of migraine as a disease entity. For each mediator we begin by reviewing the preclinical data linking it to migraine pathophysiology, first focusing on the vascular mechanisms, then the neuronal mechanisms. The preclinical data are then followed by a review of the clinical data which support each mediator's role in migraine and highlights the pharmacological agents which target these mediators for migraine therapy.