Behind the Science of Migraine:

Understanding calcitonin gene-related peptide (CGRP) may help provide a more complete picture of the disease process.

What is a migraine?

Migraine is a complex neurological disease associated with recurrent and often debilitating headaches, often associated with changes within the central nervous system (CNS) and peripheral nervous system (PNS).

The trigeminovascular system consists of structures located in the PNS and CNS.  Trigeminal nerves within the trigeminovascular system in the PNS relay pain signals to the brain, which are thought to play a key role in migraine pathophysiology.

Recent findings have revealed tha the neuropeptide calcitonon gene-related peptide or CGRP, is found in the trigeminal system and may be involved in the pathophysiology or migraine.

What is the role of CGRP in migraine?

CGRP receptors are localized at several sites within the trigeminal pathway. The interaction of CGRP with CGRP receptors within the troigeminal pathway is believed to contribute to migraine pathophsiology.

While it is not firmly established where migraine initiates, evidence suggests that the trigeminovasular system plays a critical role in peripheral and central events that ultimately lead to the experience of migraine pain.

Neuropeptide release: Neuropeptides including CGRP are released from trigeminal sensory nerves during the pain of migraine.

What is the role of CGRP in migraine?

Pain signaling, perception and modulation:

*Activation of nociceptive trigeminal neurones is thought to relay the migraine pain signal through the brainstem into the central nervous system, leading to the experience of migraine pain.

Vasodilation and neurogenic inflammation:

*The role of CGRP in migraine may include vasodilation, neurogenic inflammation and peripheral sensitization.

*Neurogenic inflammation may be associated with nociceptive nerve ending sensitization, often leading to pain. Research has yet to determine which of these processes plays a causal role or if they occur as a result of or in parallel with migraine.

What are CGRP and the CGRP receptor (CGRP-R)?

CGRP

*37 amino acid neuropeptide.

*Produced in central and peripheral neurons.

*Elevated levels of peripheral CGRP have been observed during a migraine attack.

*IV infusion of CGRP was found to induce moderate to severe headaches in patients with migraine.

CGRP-R:

*Abundant in the trigeminal system.

*Found in multiple areas of the CNS and PNS.

*Activation in the trigeminal pathway can facilitate peripheral and central sensitization.

Learn more about migraine pathophysiology and the role of CGRP at DeeperLookatMigraine.com.

Disclaimer: This information was taken directly from the Amgen Inc. pamphlet on migraines. Please call or email them from the above numbers for more information.