Pathophysiological targets for non-pharmacological treatment of migraine

Gianluca Coppola, Cherubino Di Lorenzo, Mariano Serrao, Vincenzo Parisi, J. Schoenen, Francesco Pierelli

Research output: Contribution to journalReview article

Abstract

Background Migraine is the most prevalent neurological disorder worldwide and ranked sixth among all diseases in years lived with disability. Overall preventive anti-migraine therapies have an effect in one patient out of two at the most, many of them being endowed with disabling adverse effects. No new disease-modifying drugs have come into clinical practice since the application to migraine of topiramate and botulinum toxin, the latter for its chronic form. There is thus clearly a need for more effective treatments that are devoid of, or have acceptable side effects. In recent years, scientific progress in migraine research has led to substantial changes in our understanding of the pathophysiology of migraine and paved the way for novel non-drug pathophysiological-targeted treatment strategies. Overview Several such non-drug therapies have been tested in migraine, such as oxidative phosphorylation enhancers, diets and non-invasive central or peripheral neurostimulation. All of them are promising for preventive migraine treatment and are quasi-devoid of side effects. Their advantage is that they can in theory be selected for individual patients according to their pathophysiological profile and they can (and probably should) be combined with the classical pharmacological armamentarium. Conclusion We will review here how knowledge of the functional anatomy and physiology of migraine mechanisms holds the key for more specific and effective non-pharmacological treatments.

Original languageEnglish
Pages (from-to)1103-1111
Number of pages9
JournalCephalalgia
Volume36
Issue number12
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • diets
  • migraine pathophysiology
  • neurostimulation
  • Non-pharmacological treatment
  • nutraceuticals

ASJC Scopus subject areas

  • Clinical Neurology

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