Chronic migraine and Botulinum Toxin Type A: Where do paths cross?

Daniele Martinelli, Sebastiano Arceri, Livio Tronconi, Cristina Tassorelli

Research output: Contribution to journalArticle

Abstract

Migraine is a highly prevalent and disabling disorder accounted among the primary headaches. It is the expression of a complex, and not yet fully understood, pathophysiology involving the sensitization of peripheral and central nociceptive pathways. In this review we succinctly illustrate the molecular, anatomical, and functional abnormalities underlying the migraine attack that are relevant for understanding in more depth the neurobiology behind the therapeutic effect of Botulinum Toxin Type A (BoNT-A). BoNT-A has proved effective in several neurological conditions and, more recently, also in chronic migraine. Its antimigraine mechanism of action was initially thought to be limited to the periphery and interpreted as an inhibitory activity on the processes associated to the local release of neuropeptides, with subsequent induction of peripheral sensitization. Increasing experimental evidence has become available to suggest that additional mechanisms are possibly involved, including the direct/indirect inhibition of sensitization processes in central nociceptive pathways.

Original languageEnglish
Pages (from-to)69-76
Number of pages8
JournalToxicon
Volume178
DOIs
Publication statusPublished - Apr 30 2020

Keywords

  • BoNT-A
  • Central sensitization
  • Chronic migraine
  • Migraine
  • Migraine managment
  • Periferal
  • Sensitization

ASJC Scopus subject areas

  • Toxicology

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