Biological substrates of migraine

Excerpt

Migraine episodes are probably originated by central mechanisms in brain areas able to cause the classical neurological symptoms of prodromes and aura. Conversely, the headache phase begins with the activation of meningeal nociceptors at the origin of the trigeminovascular system. Recent information has postulated that the occurrence of aura can activate nociceptors in the meninges. Conversely, the mechanisms by which common prodromes initiate the headache phase or what sequence of events triggers activation of the meningeal nociceptors is not yet understood. However, a mechanistic analysis for a common factor in migraine clinical features strongly suggests a genetic predisposition to generalized neuronal hyperexcitability. …