Migraine and cluster headache - the common link
- PMID: 30242519
- PMCID: PMC6755613
- DOI: 10.1186/s10194-018-0909-4
Migraine and cluster headache - the common link
Abstract
Although clinically distinguishable, migraine and cluster headache share prominent features such as unilateral pain, common pharmacological triggers such glyceryl trinitrate, histamine, calcitonin gene-related peptide (CGRP) and response to triptans and neuromodulation. Recent data also suggest efficacy of anti CGRP monoclonal antibodies in both migraine and cluster headache. While exact mechanisms behind both disorders remain to be fully understood, the trigeminovascular system represents one possible common pathophysiological pathway and network of both disorders. Here, we review past and current literature shedding light on similarities and differences in phenotype, heritability, pathophysiology, imaging findings and treatment options of migraine and cluster headache. A continued focus on their shared pathophysiological pathways may be important in paving future treatment avenues that could benefit both migraine and cluster headache patients.
Keywords: Anti-CGRP (receptor) monoclonal antibodies – mAbs; Calcitonin gene-related peptide (CGRP); Cluster headache; Hypothalamus; Migraine; Neuromodulation; Trigeminovascular system.
Conflict of interest statement
Prof Messoud Ashina is a consultant or scientific advisor for Allergan, Amgen, Alder, Eli Lilly, Novartis and Teva, primary investigator for Amgen 20,120,178 (Phase 2), 20,120,295 (Phase 2), 20,130,255 (OLE), 20,120,297 (Phase 3) and GM-11 gamma- Core-R trials, and reports grants from Lundbeck Foundation (R155–2014-171), Research Foundation of the Capital Region of Copenhagen, Danish Council for Independent Research, Medical Sciences and Novo Nordisk Foundation (NNF11OC101433). Prof Christian Lampl is a consultant or scientific advisor for Novartis and Teva. Other authors have no competing interests.
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References
-
- Schuster NM, Rapoport AM. New strategies for the treatment and prevention of primary headache disorders. Nat Rev Neurol. 2016;12:635–650. - PubMed
-
- Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343–349. - PubMed
-
- Rasmussen B. Epidemiology of headache. Cephalalgia. 2001;21:774–777. - PubMed
-
- Fischera M, Marziniak M, Gralow I, et al. The incidence and prevalence of cluster headache: a meta-analysis of population-based studies. Cephalalgia. 2008;28:614–618. - PubMed
-
- Bahra A, May A, Goadsby PJ. Cluster headache: a prospective clinical study with diagnostic implications. Neurology. 2002;58:354–361. - PubMed
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