This article summarizes the current understanding of the pathophysiology of migraine, including some controversial aspects of the underlying mechanisms of the disorder.
Recent functional neuroimaging studies focusing on the nonpainful symptoms of migraine have identified key areas of the central nervous system implicated in the early phases of a migraine attack. Clinical studies of spontaneous and provoked migraine attacks, together with preclinical studies using translational animal models, have led to a better understanding of the disease and the development of disease-specific and targeted therapies.
Our knowledge of the pathophysiology of migraine has advanced significantly in the past decades. Current evidence supports our understanding of migraine as a complex cyclical brain disorder that likely results from dysfunctional sensory processing and dysregulation of homeostatic mechanisms. This article reviews the underlying mechanisms of the clinical manifestations of each phase of the migraine cycle.