Pathophysiology of migraine

Abstract

Migraine is a most common neurological disease that affects nearly 10% of the general population. However, the pathophysiology of migraine is obscure. Previously, it was believed that the pathophysiology of migraine could be explained entirely by the vascular theory, which is that all symptoms including aura of migraine and headache are caused by abnormal vascular responses. However, many subsequent researches have revealed that it is not possible to explain the symptoms of migraine only by abnormal vascular responses. Instead, functional abnormalities of the neuronal activities observed in the cortical spreading depression are thought to be also involved in the pathophysiology of migraine. Furthermore, it is reported the changes of functional connectivity in cerebral pain matrix system and functional abnormality of descending pain inhibitory system in migraine patients. In addition, it is also believed that the sensitization of the trigeminovascular neurons play an important roles in migraine pathophysiology. The present review discusses the recent findings of migraine pathophysiology.