Neurology Central

Advances in migraine genetics, neurobiology and treatment

Migraines are one of the most prevalent neurological disorders and are ranked the seventh most disabling disease globally [1]. They are estimated to affect 12–20% of the adult population and are more prevalent than diabetes, epilepsy and asthma combined [1–2]. Despite previous misconceptions, the most common being that migraines are a “bad headache”, a migraine is a sensory processing defect within the brain. This affects how the brain deals with incoming information, causing normally harmless inputs to be painful [3–4]. Over the past decade, the understanding of migraine pathophysiology has significantly advanced. Improved characterization and diagnosis of the symptoms have revealed migraines to be a complex disorder. Thus, the aim of this editorial is to shed light on the key advances in migraine genetics, their neurobiology and future outlook.

Headache vs migraine

Migraines are often mistaken for headaches; however, the latter is often a symptom of an attack. Difficulty to diagnose and characterize the wide range of migraine triggers and symptoms has been a long-standing issue, which has resulted in few effective treatments. The characterization of a migraine includes a severe re-occurring headache that can lead to other symptoms such as nausea, phonophobia and photophobia, where the most severe can lead to transient focal neurological symptoms termed auras [3]. Clinically there are several different types and stages of migraines and they were previously believed to be a vascular disorder. However, some essential elements that need to be considered are the genetics, physiological mechanisms and the anatomy of the migraine pain [4]. In recent years, a strong genetic basis for the neurobiology of migraines has been determined.

Advances in migraine genetics

Genome-wide studies have contributed significantly to identifying the genetic components involved in migraines, although the neuropathophysiological mechanisms remain a complex puzzle to solve. For centuries researchers have been working to prove or disprove four possible theories that could be the cause of migraines (see Table 1).

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