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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2019

Open Access 01-12-2019 | Migraine | Review article

Aura and Head pain: relationship and gaps in the translational models

Authors: Hayrunnisa Bolay, Doga Vuralli, Peter J. Goadsby

Published in: The Journal of Headache and Pain | Issue 1/2019

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Abstract

Migraine is a complex brain disorder and initiating events for acute attacks still remain unclear. It seems difficult to explain the development of migraine headache with one mechanism and/or a single anatomical location. Cortical spreading depression (CSD) is recognized as the biological substrate of migraine aura and experimental animal studies have provided mechanisms that possibly link CSD to the activation of trigeminal neurons mediating lateralized head pain. However, some CSD features do not match the clinical features of migraine headache and there are gaps in translating CSD to migraine with aura. Clinical features of migraine headache and results from research are critically evaluated; and consistent and inconsistent findings are discussed according to the known basic features of canonical CSD: typical SD limited to the cerebral cortex as it was originally defined. Alternatively, arguments related to the emergence of SD in other brain structures in addition to the cerebral cortex or CSD initiated dysfunction in the thalamocortical network are proposed. Accordingly, including thalamus, particularly reticular nucleus and higher order thalamic nuclei, which functions as a hub connecting the visual, somatosensory, language and motor cortical areas and subjects to modulation by brain stem projections into the CSD theory, would greatly improve our current understanding of migraine.
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Metadata
Title
Aura and Head pain: relationship and gaps in the translational models
Authors
Hayrunnisa Bolay
Doga Vuralli
Peter J. Goadsby
Publication date
01-12-2019
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2019
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-019-1042-8

Other articles of this Issue 1/2019

The Journal of Headache and Pain 1/2019 Go to the issue

Research article

Physician and patient preferences for dosing options in migraine prevention

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The need for new acutely acting antimigraine drugs: moving safely outside acute medication overuse

Review article

Neuroimaging clues of migraine aura

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Effects of monoclonal antagonist antibodies on calcitonin gene-related peptide receptor function and trafficking

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Efficacy and safety of lasmiditan in patients using concomitant migraine preventive medications: findings from SAMURAI and SPARTAN, two randomized phase 3 trials

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C-fibers may modulate adjacent Aδ-fibers through axon-axon CGRP signaling at nodes of Ranvier in the trigeminal system