Migraine is a neurological disorder characterized by recurrent attacks of headache usually accompanied by symptoms such as nausea, vomiting, photophobia and phonophobia. According to the Global Burden of Disease Study 2019 estimates, it affects more than 1.12 billion people worldwide and is a major cause of disability worldwide. Although migraine has been recognized for centuries, its pathophysiology has not been fully understood yet. Several theories have been proposed so far, the most recent being the neurovascular theory. Supported by the developments in neuroradiology and immunohistochemistry, the theory emphasizes the essential role of the trigeminovascular (TGV) system in migraine pathophysiology. It is obvious that the TGV system, regulating the cranial blood flow and nociceptive transmission, contributes to initiation and progression of serial complex events associated with migraine. The identification of vasoactive neuropeptides which had a role in migraine pathophysiology also created an opportunity for development of new treatment strategies in migraine. Calcitonin gene related peptide (CGRP) is one of the neurotransmitters that has attracted most attention since it is abundantly found in the TGV system and plays a significant role in different processes of migraine including vasodilation, neurogenic inflammation, peripheral and central sensitization. It became the focus of research in the last few decades and extensively investigated. Both small molecules antagonizing CGRP receptor and monoclonal antibodies targeting either CGRP or its receptor have been developed and used in migraine treatment. This article overviews the role of the TGV system in migraine pathophysiology and treatment with a specific focus on CGRP.
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Maniyar, Farooq Husain
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Sprenger, Till
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Sprenger, Till
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Monteith, Teshamae
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Monteith, Teshamae
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Schankin, Christoph
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Schankin, Christoph
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Goadsby, Peter James
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
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Friedrich Alexander Univ Erlangen Nurnberg, Inst Physiol & Pathophysiol, Erlangen, GermanyFriedrich Alexander Univ Erlangen Nurnberg, Inst Physiol & Pathophysiol, Erlangen, Germany
Messlinger, Karl
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Russo, Andrew F.
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Univ Iowa, Dept Mol Physiol & Biophys, Iowa City, IA USA
Iowa VA Hlth Care Syst, Iowa City, IA USAFriedrich Alexander Univ Erlangen Nurnberg, Inst Physiol & Pathophysiol, Erlangen, Germany
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Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USAHarvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USA
Noseda, Rodrigo
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Burstein, Rami
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Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USAHarvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USA
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Maniyar, Farooq Husain
;
Sprenger, Till
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Sprenger, Till
;
Monteith, Teshamae
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Monteith, Teshamae
;
Schankin, Christoph
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h-index: 0
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Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
Schankin, Christoph
;
Goadsby, Peter James
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h-index: 0
机构:
Univ Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USAUniv Calif San Francisco, Dept Neurol, Headache Grp, San Francisco, CA USA
机构:
Friedrich Alexander Univ Erlangen Nurnberg, Inst Physiol & Pathophysiol, Erlangen, GermanyFriedrich Alexander Univ Erlangen Nurnberg, Inst Physiol & Pathophysiol, Erlangen, Germany
Messlinger, Karl
;
Russo, Andrew F.
论文数: 0引用数: 0
h-index: 0
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Univ Iowa, Dept Mol Physiol & Biophys, Iowa City, IA USA
Iowa VA Hlth Care Syst, Iowa City, IA USAFriedrich Alexander Univ Erlangen Nurnberg, Inst Physiol & Pathophysiol, Erlangen, Germany
机构:
Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USAHarvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USA
Noseda, Rodrigo
;
Burstein, Rami
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USAHarvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USA