Migraine prodromes and migraine triggers

TY - CHAP

T1 - Migraine prodromes and migraine triggers

AU - Fischer-Schulte, Laura H

AU - Peng, Kuan-Po

N1 - Copyright © 2023 Elsevier B.V. All rights reserved, including those for text and data mining, AI training, and similar technologies.

PY - 2023

Y1 - 2023

N2 - Migraine is characterized by a well-defined premonitory phase occurring hours or even days before the headache. Also, many migraineurs report typical triggers for their headaches. Triggers, however, are not consistent in their ability to precipitate migraine headaches. When looking at the clinical characteristics of both premonitory symptoms and triggers, a shared pathophysiological basis seems evident. Both seem to have their origin in basic homeostatic networks such as the feeding/fasting, the sleeping/waking, and the stress response network, all of which strongly rely on the hypothalamus as a hub of integration and are densely interconnected. They also influence the trigeminal pain processing system. Additionally, thalamic and hormonal mechanisms are involved. Activity within all those networks is influenced by various endogenous and external factors and might even cyclically change dependent on physiological internal rhythms. This might affect the threshold for the generation of migraine headaches. Premonitory symptoms thus appear as the result of an already ongoing alteration within those networks, whereas triggers might in this special situation only be able to further stress the system over the threshold for attack generation as catalysts of a process already in motion.

AB - Migraine is characterized by a well-defined premonitory phase occurring hours or even days before the headache. Also, many migraineurs report typical triggers for their headaches. Triggers, however, are not consistent in their ability to precipitate migraine headaches. When looking at the clinical characteristics of both premonitory symptoms and triggers, a shared pathophysiological basis seems evident. Both seem to have their origin in basic homeostatic networks such as the feeding/fasting, the sleeping/waking, and the stress response network, all of which strongly rely on the hypothalamus as a hub of integration and are densely interconnected. They also influence the trigeminal pain processing system. Additionally, thalamic and hormonal mechanisms are involved. Activity within all those networks is influenced by various endogenous and external factors and might even cyclically change dependent on physiological internal rhythms. This might affect the threshold for the generation of migraine headaches. Premonitory symptoms thus appear as the result of an already ongoing alteration within those networks, whereas triggers might in this special situation only be able to further stress the system over the threshold for attack generation as catalysts of a process already in motion.

KW - Humans

KW - Migraine Disorders

KW - Hypothalamus

KW - Longitudinal Studies

KW - Thalamus

KW - Headache

U2 - 10.1016/B978-0-12-823356-6.00014-7

DO - 10.1016/B978-0-12-823356-6.00014-7

M3 - Chapter

C2 - 38043958

SN - 978-0-12-823356-6

VL - 198

T3 - Handb Clin Neurol

SP - 135

EP - 148

BT - Migraine Biology, Diagnosis, and Co-Morbidities

A2 - Swanson, Jerry W.

A2 - Matharu, Manjit

PB - Elsevier BV

ER -