Rationale for use of onabotulinum toxin A (BOTOX) in chronic migraine

Research output: Contribution to journalArticlepeer-review

Abstract

Chronic migraine is a severely disabling headache evolving from episodic migraine as a result of different transforming factors and characterized by atypical pain modulation and peripheral and central sensitization. Discovered by serendipity, onabotulinum toxin A (BoNT-A) represents the only drug specifically approved for CM prophylaxis. According to the dominant opinion, BoNT-A acts peripherally, impairing the exocytosis of neuropeptide and neurotransmitter and the delivery of receptors and ion channels on the cell surface of peripheral trigeminal endings, thereby indirectly reducing central sensitization. However, it is not excluded that BoNT-A has also a central antinociceptive action, probably associated with an enhanced opioidergic and GABA-ergic transmission. This review discusses the rationale for use of BoNT-A in CM including its mechanisms of action and molecular targets and provides suggestions for a more tailored BoNT-A prophylaxis in patients with CM.

Original languageEnglish
Pages (from-to)29-32
Number of pages4
JournalNeurological Sciences
Volume36
DOIs
Publication statusPublished - May 30 2015

Keywords

  • Chronic migraine
  • Disability
  • Migraine
  • Onabotulinum toxin A
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Dermatology

Fingerprint Dive into the research topics of 'Rationale for use of onabotulinum toxin A (BOTOX) in chronic migraine'. Together they form a unique fingerprint.

Cite this