Cortical spreading depression as a site of origin for migraine: Role of CGRP.

Abstract

PREMISE:

Migraine is a complex neurologic disorder that leads to significant disability, yet remains poorly understood.

PROBLEM:

One potential triggering mechanism in migraine with aura is cortical spreading depression, which can activate the trigeminal nociceptive system both peripherally and centrally in animal models. A primary neuropeptide of the trigeminal system is calcitonin gene-related peptide, which is a potent vasodilatory peptide and is currently a major therapeutic target for migraine treatment. Despite the importance of both cortical spreading depression and calcitonin gene-related peptide in migraine, the relationship between these two players has been relatively unexplored. However, recent data suggest several potential vascular and neural connections between calcitonin gene-related peptide and cortical spreading depression.

CONCLUSION:

This review will outline calcitonin gene-related peptide-cortical spreading depression connections and propose a model in which cortical spreading depression and calcitonin gene-related peptide act at the intersection of the vasculature and cortical neurons, and thus contribute to migraine pathophysiology.

• Authors: Liesl N Close, Sajedeh Eftekhari, Minyan Wang, Andrew C Charles, Andrew F Russo
• Journal: Cephalalgia : an international journal of headache (Cephalalgia) Vol. 39 Issue 3 Pg. 428-434 (03 2019) ISSN: 1468-2982 [Electronic] England
• PMID: 29695168 (Publication Type: Journal Article, Review)

Chemical References

• Calcitonin Gene-Related Peptide Receptor Antagonists
• Receptors, Calcitonin Gene-Related Peptide
• Calcitonin Gene-Related Peptide

Topics

• Animals
• Calcitonin Gene-Related Peptide (antagonists & inhibitors, metabolism)
• Calcitonin Gene-Related Peptide Receptor Antagonists (pharmacology, therapeutic use)
• Cortical Spreading Depression (drug effects, physiology)
• Humans
• Migraine Disorders (drug therapy, metabolism)
• Receptors, Calcitonin Gene-Related Peptide (metabolism)
• Trigeminal Nerve (drug effects, metabolism)
• Vasodilation (drug effects, physiology)