Migraine in the triptan era: Lessons from epidemiology, pathophysiology, and clinical science

Marcelo E. Bigal, Michel Ferrari, Stephen D. Silberstein, Richard B. Lipton, Peter J. Goadsby

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

The triptan era has been a time of remarkable progress for migraine diagnosis and treatment. In this paper, we review some of the advances achieved in migraine science during this era focusing on 3 themes: lessons from clinical practice, lessons from epidemiology and lessons from pathophysiology. Science has shown that migraine is a disorder of the brain, and that the key events happen in the the trigeminal neuronal pathways, not on blood vessels. Clinical science has led to the observation that migraine sometimes progresses or remits. This in turn led to longitudinal epidemiologic studies focusing on factors that determine migraine prognosis. In addition, these studies raised questions about the mechanisms of migraine progression, including the role of allodynia, obesity, inflammation, and medications as determinants of progression. This in turn opens a new set of scientific questions about the neurobiologic determinants of migraine, as well as of its clinical course, and exciting opportunities to develop new therapies for this highly disabling brain disorder.

Original languageEnglish (US)
JournalHeadache
Volume49
Issue numberSUPPL. 1
DOIs
StatePublished - Feb 2009

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Tryptamines
Migraine Disorders
Epidemiology
Brain Diseases
Hyperalgesia
Blood Vessels
Longitudinal Studies
Epidemiologic Studies
Obesity
Inflammation

Keywords

  • Migraine epidemiology
  • Pathophysiology
  • Triptans

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Migraine in the triptan era : Lessons from epidemiology, pathophysiology, and clinical science. / Bigal, Marcelo E.; Ferrari, Michel; Silberstein, Stephen D.; Lipton, Richard B.; Goadsby, Peter J.

In: Headache, Vol. 49, No. SUPPL. 1, 02.2009.

Research output: Contribution to journalArticle

Bigal, Marcelo E. ; Ferrari, Michel ; Silberstein, Stephen D. ; Lipton, Richard B. ; Goadsby, Peter J. / Migraine in the triptan era : Lessons from epidemiology, pathophysiology, and clinical science. In: Headache. 2009 ; Vol. 49, No. SUPPL. 1.
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