TY - JOUR
T1 - Childhood Maltreatment in the Migraine Patient
AU - Tietjen, Gretchen E.
AU - Buse, Dawn C.
AU - Collins, Stuart A.
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2016/7
Y1 - 2016/7
N2 - Maltreatment during childhood increases vulnerability to a host of health disorders, including migraine. Putative mechanisms linking maltreatment and migraine include stress-induced dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, as well as disruption of other stress-mediating homeostatic systems, including those involving endocannabinoids, monoamine neurotransmitters, oxytocin, and inflammation. Prolonged elevation of glucocorticoids alters the neural architecture of the limbic system, resulting in the structural as well as functional changes described in both maltreatment and in migraine. Although treatment trials for migraine have not stratified participants by abuse history, strategies, such as cognitive behavioral therapy, which alter stress responsivity, may be particularly effective in this subgroup. Some therapies involving the endocannabinoid, serotonergic, oxytonergic, and inflammatory systems are under investigation for migraine. Anti-epileptic drugs such as valproate and topiramate, which are FDA approved for migraine treatment, are also known to interfere with epigenetic changes induced by stress. Discerning the role for this mechanism in treatment of maltreated migraineurs may introduce another therapeutic avenue.
AB - Maltreatment during childhood increases vulnerability to a host of health disorders, including migraine. Putative mechanisms linking maltreatment and migraine include stress-induced dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, as well as disruption of other stress-mediating homeostatic systems, including those involving endocannabinoids, monoamine neurotransmitters, oxytocin, and inflammation. Prolonged elevation of glucocorticoids alters the neural architecture of the limbic system, resulting in the structural as well as functional changes described in both maltreatment and in migraine. Although treatment trials for migraine have not stratified participants by abuse history, strategies, such as cognitive behavioral therapy, which alter stress responsivity, may be particularly effective in this subgroup. Some therapies involving the endocannabinoid, serotonergic, oxytonergic, and inflammatory systems are under investigation for migraine. Anti-epileptic drugs such as valproate and topiramate, which are FDA approved for migraine treatment, are also known to interfere with epigenetic changes induced by stress. Discerning the role for this mechanism in treatment of maltreated migraineurs may introduce another therapeutic avenue.
KW - Abuse
KW - Adverse childhood experiences
KW - Childhood maltreatment
KW - Cognitive behavioral therapy
KW - Epigenetics
KW - Genetics
KW - Hypothalamic–pituitary–adrenal axis
KW - Inflammation
KW - Migraine
KW - Oxytocin
KW - Serotonin
KW - Stress
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U2 - 10.1007/s11940-016-0415-4
DO - 10.1007/s11940-016-0415-4
M3 - Review article
AN - SCOPUS:84971201144
SN - 1092-8480
VL - 18
JO - Current Treatment Options in Neurology
JF - Current Treatment Options in Neurology
IS - 7
M1 - 31
ER -