TY - JOUR
T1 - Dysautonomia in the pathogenesis of migraine
AU - Gazerani, Parisa
AU - Cairns, Brian Edwin
PY - 2018
Y1 - 2018
N2 - INTRODUCTION: Migraine is a common complex neurological disorder involving multiple brain areas that regulate autonomic, affective, cognitive, and sensory functions. This review explores autonomic nervous system (ANS) dysfunction in migraine headache sufferers. Areas covered: Reference material for this review was obtained through PubMed searches. Migraine attacks can present with up to 4 phases (premonitory, aura, headache, postdrome) each with distinguishable signs and symptoms. Altered ANS tone can be found from the premonitory through the postdrome phases. Features of the migraine attack that are indicative of altered autonomic function, which include nausea, vomiting, diarrhea, polyuria, eyelid edema, conjunctival injection, lacrimation, nasal congestion, and ptosis, are discussed and putative mechanisms explored. In addition, alteration of ANS function by endogenous and exogenous stressors, such as bright lights, hunger, poor sleep quality, menses, and special dietary components is discussed. The influence of currently employed pharmacological treatments on altered autonomic function during the migraine attack is explored. Expert Commentary: Migraine-related alterations in ANS function have a complex pattern, but, in general, an imbalance occurs between sympathetic and parasympathetic tone. Through an improved understanding the role of autonomic changes in pathogenesis of migraine, it may be possible to develop even more effective treatments for migraine sufferers.
AB - INTRODUCTION: Migraine is a common complex neurological disorder involving multiple brain areas that regulate autonomic, affective, cognitive, and sensory functions. This review explores autonomic nervous system (ANS) dysfunction in migraine headache sufferers. Areas covered: Reference material for this review was obtained through PubMed searches. Migraine attacks can present with up to 4 phases (premonitory, aura, headache, postdrome) each with distinguishable signs and symptoms. Altered ANS tone can be found from the premonitory through the postdrome phases. Features of the migraine attack that are indicative of altered autonomic function, which include nausea, vomiting, diarrhea, polyuria, eyelid edema, conjunctival injection, lacrimation, nasal congestion, and ptosis, are discussed and putative mechanisms explored. In addition, alteration of ANS function by endogenous and exogenous stressors, such as bright lights, hunger, poor sleep quality, menses, and special dietary components is discussed. The influence of currently employed pharmacological treatments on altered autonomic function during the migraine attack is explored. Expert Commentary: Migraine-related alterations in ANS function have a complex pattern, but, in general, an imbalance occurs between sympathetic and parasympathetic tone. Through an improved understanding the role of autonomic changes in pathogenesis of migraine, it may be possible to develop even more effective treatments for migraine sufferers.
KW - Autonomic nervous system
KW - dysautonomia
KW - headache
KW - migraine
KW - neuromodulation
KW - non-pharmacological
KW - parasympathetic
KW - pharmacological
KW - sympathetic
UR - http://www.scopus.com/inward/record.url?scp=85041293665&partnerID=8YFLogxK
U2 - 10.1080/14737175.2018.1414601
DO - 10.1080/14737175.2018.1414601
M3 - Review article
C2 - 29212396
SN - 1473-7175
VL - 18
SP - 153
EP - 165
JO - Expert Review of Neurotherapeutics
JF - Expert Review of Neurotherapeutics
IS - 2
ER -