Rationale for use of onabotulinum toxin A (BOTOX) in chronic migraine

被引：20

作者：

Barbanti, P. ^{[1
]}

Egeo, G. ^{[1
]}

Fofi, L. ^{[1
]}

Aurilia, C. ^{[1
]}

Piroso, S. ^{[1
]}

机构：

[1] IRCCS San Raffaele Pisana, Dept Neurol Motor & Sensorial Sci, Headache & Pain Unit, I-00163 Rome, Italy

来源：

NEUROLOGICAL SCIENCES | 2015年 / 36卷

关键词：

Chronic migraine; Onabotulinum toxin A; Treatment; Migraine; Disability; PLACEBO-CONTROLLED PHASE; BOTULINUM NEUROTOXIN-A; DOUBLE-BLIND; ANTINOCICEPTIVE ACTION; RELEASE; HEADACHE; NEURONS; INHIBITION; PREDICTORS; EXOCYTOSIS;

D O I：

10.1007/s10072-015-2195-0

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Chronic migraine is a severely disabling headache evolving from episodic migraine as a result of different transforming factors and characterized by atypical pain modulation and peripheral and central sensitization. Discovered by serendipity, onabotulinum toxin A (BoNTA) represents the only drug specifically approved for CM prophylaxis. According to the dominant opinion, BoNT-A acts peripherally, impairing the exocytosis of neuropeptide and neurotransmitter and the delivery of receptors and ion channels on the cell surface of peripheral trigeminal endings, thereby indirectly reducing central sensitization. However, it is not excluded that BoNT-A has also a central antinociceptive action, probably associated with an enhanced opioidergic and GABA-ergic transmission. This review discusses the rationale for use of BoNT-A in CM including its mechanisms of action and molecular targets and provides suggestions for a more tailored BoNT-A prophylaxis in patients with CM.

引用

页码：S29 / S32

页数：4

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