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      Identifying Natural Subgroups of Migraine Based on Comorbidity and Concomitant Condition Profiles: Results of the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

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          Prevalence and Burden of Migraine in the United States: Data From the American Migraine Study II

          To describe the prevalence, sociodemographic profile, and the burden of migraine in the United States in 1999 and to compare results with the original American Migraine Study, a 1989 population-based study employing identical methods.
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            Is Open Access

            The role of calcitonin gene–related peptide in peripheral and central pain mechanisms including migraine

            Abstract Calcitonin gene–related peptide (CGRP) is a 37-amino acid peptide found primarily in the C and Aδ sensory fibers arising from the dorsal root and trigeminal ganglia, as well as the central nervous system. Calcitonin gene–related peptide was found to play important roles in cardiovascular, digestive, and sensory functions. Although the vasodilatory properties of CGRP are well documented, its somatosensory function regarding modulation of neuronal sensitization and of enhanced pain has received considerable attention recently. Growing evidence indicates that CGRP plays a key role in the development of peripheral sensitization and the associated enhanced pain. Calcitonin gene–related peptide is implicated in the development of neurogenic inflammation and it is upregulated in conditions of inflammatory and neuropathic pain. It is most likely that CGRP facilitates nociceptive transmission and contributes to the development and maintenance of a sensitized, hyperresponsive state not only of the primary afferent sensory neurons but also of the second-order pain transmission neurons within the central nervous system, thus contributing to central sensitization as well. The maintenance of a sensitized neuronal condition is believed to be an important factor underlying migraine. Recent successful clinical studies have shown that blocking the function of CGRP can alleviate migraine. However, the mechanisms through which CGRP may contribute to migraine are still not fully understood. We reviewed the role of CGRP in primary afferents, the dorsal root ganglion, and in the trigeminal system as well as its role in peripheral and central sensitization and its potential contribution to pain processing and to migraine.
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              The pathophysiology of migraine: implications for clinical management

              The understanding of migraine pathophysiology is advancing rapidly. Improved characterisation and diagnosis of its clinical features have led to the view of migraine as a complex, variable disorder of nervous system function rather than simply a vascular headache. Recent studies have provided important new insights into its genetic causes, anatomical and physiological features, and pharmacological mechanisms. The identification of new migraine-associated genes, the visualisation of brain regions that are activated at the earliest stages of a migraine attack, a greater appreciation of the potential role of the cervical nerves, and the recognition of the crucial role for neuropeptides are among the advances that have led to novel targets for migraine therapy. Future management of migraine will have the capacity to tailor treatments based on the distinct mechanisms of migraine that affect individual patients.
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                Author and article information

                Journal
                Headache: The Journal of Head and Face Pain
                Headache: The Journal of Head and Face Pain
                Wiley
                00178748
                July 19 2018
                Affiliations
                [1 ]Montefiore Headache Center; Bronx NY USA
                [2 ]Albert Einstein College of Medicine; Bronx NY USA
                [3 ]Vedanta Research; Chapel Hill NC USA
                [4 ]University of Cincinnati Headache and Facial Pain Center, University of Cincinnati College of Medicine; Cincinnati OH USA
                [5 ]Allergan plc; Irvine CA USA
                [6 ]NIHR-Wellcome Trust King's Clinical Research Facility, King's College London; London UK
                [7 ]Department of Neurology; University of California, San Francisco; San Francisco CA USA
                Article
                10.1111/head.13342
                30024028
                b0a6e5ac-ff2c-4ff4-9398-39b5173df47a
                © 2018

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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