Alterations in metabolic flux in migraine and the translational relevance.
Author
Grech, OliviaSassani, Matilde
Terwindt, Gisela
Lavery, Gareth G
Mollan, Susan P
Sinclair, Alexandra J
Publication date
2022-09-30Subject
Neurology
Metadata
Show full item recordAbstract
Background: Migraine is a highly prevalent disorder with significant economical and personal burden. Despite the development of effective therapeutics, the causes which precipitate migraine attacks remain elusive. Clinical studies have highlighted altered metabolic flux and mitochondrial function in patients. In vivo animal experiments can allude to the metabolic mechanisms which may underlie migraine susceptibility. Understanding the translational relevance of these studies are important to identifying triggers, biomarkers and therapeutic targets in migraine. Main body: Functional imaging studies have suggested that migraineurs feature metabolic syndrome, exhibiting hallmark features including upregulated oxidative phosphorylation yet depleted available free energy. Glucose hypometabolism is also evident in migraine patients and can lead to altered neuronal hyperexcitability such as the incidence of cortical spreading depression (CSD). The association between obesity and increased risk, frequency and worse prognosis of migraine also highlights lipid dysregulation in migraine pathology. Calcitonin gene related peptide (CGRP) has demonstrated an important role in sensitisation and nociception in headache, however its role in metabolic regulation in connection with migraine has not been thoroughly explored. Whether impaired metabolic function leads to increased release of peptides such as CGRP or excessive nociception leads to altered flux is yet unknown. Conclusion: Migraine susceptibility may be underpinned by impaired metabolism resulting in depleted energy stores and altered neuronal function. This review discusses both clinical and in vivo studies which provide evidence of altered metabolic flux which contribute toward pathophysiology. It also reviews the translational relevance of animal studies in identifying targets of biomarker or therapeutic development.Citation
Grech O, Sassani M, Terwindt G, Lavery GG, Mollan SP, Sinclair AJ. Alterations in metabolic flux in migraine and the translational relevance. J Headache Pain. 2022 Sep 30;23(1):127. doi: 10.1186/s10194-022-01494-w.Type
ArticleAdditional Links
https://link.springer.com/journal/10194https://www.ncbi.nlm.nih.gov/pmc/journals/1613/
PMID
36175833Journal
The Journal of Headache and PainPublisher
BMCae974a485f413a2113503eed53cd6c53
10.1186/s10194-022-01494-w