Neuromodulation and Non-Pharmacological Treatment of Migraine

Crossmark: check for updates

Authors

  • Mohtashem Samsam Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida 4364 Scorpius St., HPA-II, 320, Orlando, FL 32816, USA

DOI:

https://doi.org/10.17140/NOJ-3-e006

Keywords:

receptor, unsatisfactory

Abstract

Migraine is a chronic brain disorder that is believed to be due to dysfunction of the
brain and brainstem that result in dysmodulation of sensory processing of the head and vascular
tone. The exact pathomechanism of migraine is not known but some genes including mutations
in the sodium and calcium channels and Na+
/K+
pump have been implicated in migraine with
aura.1-8
Several drugs are currently used in the acute and preventive treatment of migraine.
These include the non-steroidal anti-inflammatory drugs, the triptan family, anti-epileptic
drugs, beta-blockers, calcium channel blockers, steroids, and recently antibodies against calcitonin gene-related peptide (CGRP) or its receptor among other drugs.5,9 Some other drugs are
under investigation and the CGRP receptor antagonists (the gepant family drugs), were discontinued although other drugs in this category are still under investigation.10-16 However, there are
some medically intractable headaches or unsatisfactory patient managemen

References

Weiller C, May A, Limmroth V, et al. Brain stem activation in spontaneous human migraine attacks. Nat Med. 1995; 1: 658-660. doi: 10.1038/nm0795-658

Goadsby PJ. Recent advances in understanding migraine mechanisms, molecules and therapeutics. Trends Mol Med. 2007; 13(1): 39-44. doi: 10.1016/j.molmed.2006.11.005

Akerman S, Holland PR, Goadsby PJ. Diencephalic and brainstem mechanisms in migraine. Nat Rev Neurosci. 2011; 12: 570-84. doi: 10.1038/nrn3057

Samsam M. Central nervous system acting drugs in treatment of migraine headache. Cent Nerv Syst Agents Med Chem. 2012; 12(3): 158-172. doi: 10.2174/187152412802430147

Samsam M. Drugs against calcitonin gene-related peptide and its receptor used in the treatment of migraine: What are the new progresses? Neuro Open J. 2015; 2: 79-91. doi: 10.17140/NOJ-2-117

Lauritzen M. Pathophysiology of the migraine aura: The spreading depression theory. Brain. 1994; 117 (Pt 1): 199-210. doi: 10.1093/brain/118.1.307

Tfelt-Hansen PC. History of migraine with aura and cortical spreading depression from 1941 and onwards. Cephalalgia. 2010; 30(7): 780-792. doi: 10.1111/j.1468-2982.2009.02015.x

Lauritzen M, Strong AJ. ‘Spreading depression of Leão’ and its emerging relevance to acute brain injury in humans. J Cereb Blood Flow Metab. 2016; pii: 0271678X16657092. doi: 10.1177/0271678X16657092

Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine revised report of an EFNS task force. Eur J Neurol. 2009; 16(9): 968-981. doi: 10.1111/j.1468-1331.2009.02748.x

Dodick DW, Goadsby PJ, Spierings EL, et al. Safety and efficacy of LY2951742, a monoclonal antibody to calcitonin gene-related peptide, for the prevention of migraine: A phase 2, randomized, double-blind, placebo-controlled study. Lancet Neurol. 2014; 13(9): 885-892. doi: 10.1016/S1474-4422(14)70128-0

Dodick DW, Goadsby PJ, Silberstein SD, et al. ALD403 study investigators. Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine: A randomized, double-blind, placebo-controlled, exploratory phase 2 trial. Lancet Neurol. 2014; 13(11): 1100-1107. doi: 10.1016/S1474-4422(14)70209-1

Bigal ME, Escandon R, Bronson M, et al. Safety and tolerability of LBR-101, a humanized monoclonal antibody that blocks the binding of CGRP to its receptor: Results of the Phase 1 program.Cephalalgia. 2013; 34(7): 483-492. doi: 10.1177/0333102413517775

Bigal ME, Dodick DW, Krymchantowski AV, et al. TEV-48125 for the preventive treatment of chronic migraine: Efficacy at early time points. Neurology. 2016; 87(1): 41-48. doi: 10.1212/WNL.0000000000002801

Bigal ME, Walter S, Rapoport AM. Therapeutic antibodies against CGRP or its receptor. Br J Clin Pharmacol. 2015; 79(6): 886-895.

Published

2016-12-30

How to Cite

Mohtashem Samsam. (2016). Neuromodulation and Non-Pharmacological Treatment of Migraine. Neuro, 3(1), 13–17. https://doi.org/10.17140/NOJ-3-e006

Issue

Section

Articles