Emory’s Woodruff Health Sciences Center Library recognizes June as National Migraine and Headache Awareness Month. According to the CDC, in 2021, 4.3% of adults aged ≥18 years reported being bothered a lot by headache or migraine in the past 3 months with the percentage among women (6.2%) higher than that among men (2.2%).
AI generated image from Pixlr from prompt “woman with migraine”
Taken from the 2023 StatPearls entry on the Migraine Headache, the pathogenesis of migraines involves multiple components of both the peripheral and central nervous systems, although it is not fully understood. The current suggestions pose that multiple primary neuronal impairments lead to a series of intracranial and extracranial changes that cause migraines, as described in Burstein 2015.
Following neuropeptides are believed to play a role in pathogenesis:
- Serotonin, released from the brainstem serotonergic nuclei, may play a role in migraine; however, the exact role of its mechanisms remains a matter of controversy. Most likely, serotonin levels are low between attacks because it may cause a deficiency in the serotonin pain inhibition system, therefore helping the activation of the trigeminal system. It could mediate by acting directly over the cranial vessels, in central pain control pathways, or by cortical projections of brainstem serotonergic nuclei.
- Calcitonin gene-related peptide (CGRP) is abundant in trigeminal ganglion neurons. It is released from the peripheral and central nerve terminals and secreted within the trigeminal ganglion. When released from the peripheral terminals, it initiates an increased synthesis of nitric oxide and later sensitization of trigeminal nerves. It is a strong vasodilator of cerebral and dura mater vessels, therefore, a component of neurogenic inflammation, and it also mediates trigeminal pain transmission from vessels to the central nervous system.
- Pituitary adenylate cyclase-activating polypeptide (PACAP) may also play an important role in mediating migraine attacks as its concentration is elevated during the attacks, and its infusion may trigger migraine in susceptible patients.
More information can be found at the Association of Migraine Disorders, including patient resources, current research from the Migraine Science Collaborative, and more.
Emory University and Healthcare users can access the point of care tool, DynaMed for additional resources on Migraines: Migraine in Adults
For support accessing any of these tools or resources, please reach out to Ask-A-Librarian.