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The Journal of Headache and Pain

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Open Access 01-12-2022 | Obesity | Review

Alterations in metabolic flux in migraine and the translational relevance

Authors: Olivia Grech, Matilde Sassani, Gisela Terwindt, Gareth G. Lavery, Susan P. Mollan, Alexandra J. Sinclair

Published in: The Journal of Headache and Pain | Issue 1/2022

Abstract

Background

Migraine is a highly prevalent disorder with significant economical and personal burden. Despite the development of effective therapeutics, the causes which precipitate migraine attacks remain elusive. Clinical studies have highlighted altered metabolic flux and mitochondrial function in patients. In vivo animal experiments can allude to the metabolic mechanisms which may underlie migraine susceptibility. Understanding the translational relevance of these studies are important to identifying triggers, biomarkers and therapeutic targets in migraine.

Main body

Functional imaging studies have suggested that migraineurs feature metabolic syndrome, exhibiting hallmark features including upregulated oxidative phosphorylation yet depleted available free energy. Glucose hypometabolism is also evident in migraine patients and can lead to altered neuronal hyperexcitability such as the incidence of cortical spreading depression (CSD). The association between obesity and increased risk, frequency and worse prognosis of migraine also highlights lipid dysregulation in migraine pathology. Calcitonin gene related peptide (CGRP) has demonstrated an important role in sensitisation and nociception in headache, however its role in metabolic regulation in connection with migraine has not been thoroughly explored. Whether impaired metabolic function leads to increased release of peptides such as CGRP or excessive nociception leads to altered flux is yet unknown.

Conclusion

Migraine susceptibility may be underpinned by impaired metabolism resulting in depleted energy stores and altered neuronal function. This review discusses both clinical and in vivo studies which provide evidence of altered metabolic flux which contribute toward pathophysiology. It also reviews the translational relevance of animal studies in identifying targets of biomarker or therapeutic development.

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Title: Alterations in metabolic flux in migraine and the translational relevance
Authors: Olivia Grech
Matilde Sassani
Gisela Terwindt
Gareth G. Lavery
Susan P. Mollan
Alexandra J. Sinclair
Publication date: 01-12-2022
Publisher: Springer Milan
Keywords: Obesity
Migraine
Obesity
Insulins
Aura
Headache
Insulins
Published in: The Journal of Headache and Pain / Issue 1/2022
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-022-01494-w

At a glance: The STEP trials

Springer Medicine

Alterations in metabolic flux in migraine and the translational relevance

Abstract

Background

Main body

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Main body

Conclusion

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