New therapeutic approaches for the prevention and treatment of migraine

被引:130
作者
Diener, Hans-Christoph [1 ]
Charles, Andrew [2 ]
Goadsby, Peter J. [3 ]
Holle, Dagny [1 ]
机构
[1] Univ Duisburg Essen, Dept Neurol & Headache Ctr, D-45147 Essen, Germany
[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA
[3] Kings Coll London, NIHR Wellcome Trust Kings Clin Res Facil, London WC2R 2LS, England
关键词
TRANSCRANIAL MAGNETIC STIMULATION; VAGUS NERVE-STIMULATION; GENE-RELATED PEPTIDE; RANDOMIZED CONTROLLED-TRIAL; QUALITY STANDARDS SUBCOMMITTEE; CORTICAL SPREADING DEPRESSION; PROOF-OF-CONCEPT; DOUBLE-BLIND; RECEPTOR ANTAGONIST; EPISODIC MIGRAINE;
D O I
10.1016/S1474-4422(15)00198-2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The management of patients with migraine is often unsatisfactory because available acute and preventive therapies are either ineffective or poorly tolerated. The acute treatment of migraine attacks has been limited to the use of analgesics, combinations of analgesics with caffeine, ergotamines, and the triptans. Successful new approaches for the treatment of acute migraine target calcitonin gene-related peptide (CGRP) and serotonin (5-hydroxytryptamine, 5-HT1F) receptors. Other approaches targeting the transient receptor potential vanilloid (TRPV1) receptor, glutamate, GABA(A) receptors, or a combination of 5-HT1B/1D receptors and neuronal nitric oxide synthesis have been investigated but have not been successful in clinical trials thus far. In migraine prevention, the most promising new approaches are humanised antibodies against CGRP or the CGRP receptor. Non-invasive and invasive neuromodulation approaches also show promise as both acute and preventive therapies, although further studies are needed to define appropriate candidates for these therapies and optimum protocols for their use.
引用
收藏
页码:1010 / 1022
页数:13
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