Migraines are a debilitating neurovascular disorder characterized by frequent headaches, nausea, and sensitivity to light and/or sound among other symptoms. The exact cause of migraines is still unknown but researchers know how some of the symptoms arise and how to target them for treatment. Because it is a neurovascular disorder, the blood vessels in the brain, particularly the Middle Meningeal Artery (MMA), are a big part of the etiology of migraines. When vessels such as the MMA become inflamed and dilated, it can trigger the start of a migraine. This leads to further inflammation of the area around the vessel which leads to the long-lasting headaches felt by migraine sufferers.
Although it is not really known for sure how inflammation of a cerebral blood vessel can cause all of the symptoms seen in migraines, it has become a target for drug makers in an effort to curb the effects of this devastating disorder. Common migraine treatments involve the use of several different drug types. Triptans are used to combat the inflammation and dilation of blood vessels such as the MMA. They work by activating serotonin receptors on the blood vessel to constrict it, as well as serotonin receptors on nerve endings surrounding the vessel to inhibit the release of pro-inflammatory signaling molecules. Because triptans are only treating the dilated and inflamed vessels they are not useful as a precautionary drug and only alleviate the symptoms once they being to take hold.
Some drugs that are in development now to be taken as preventative for migraines involve gepants and glutamate antagonists such as Topiramate. These medications bypass the blood vessel and act directly on the nerve endings to damping their signaling. This, in theory, inhibits the pain reception so migraines are more bearable. The problem with these drugs is that it is not addressing the problem and only working to damping the sensations felt during a migraine. The future of viable migraine treatment hinges on research into the cause of the inflamed blood vessels and a way to stop them from happening in the first place.
The Need for a New Migraine Treatment
