Gender differences in migraine

Excerpt

Both sexes share various features of migraine. There is its definition as a chronic disease, the size of the problem is 14% of the world population; in its natural history, 70–80% of patients improve or are cured, while in 20–30%, the disorder persists or changes; its pathophysiology includes altered cortical neuronal excitability, activation of the trigeminovascular system and cortical spreading depression (CSD)—also in migraines without aura—and the role of the calcitonin gene-related peptide (CGRP); the brain structures too involved in the production of pain are the same in both sexes: the thalamus, limbic system, hippocampus, temporal lobes, cingulate and prefrontal cortex, and periaqueductal gray matter (PAG). Diagnostic criteria follow the International Headache Society (IHS) classification (III ed. beta version); the clinical pattern of a symptomatological continuum involves not only headache but also neurovegetative and cognitive symptoms, which can lead to disability and have a heavy impact on the quality of life. …