Migraine and cluster headache - the common link

J Headache Pain. 2018 Sep 21;19(1):89. doi: 10.1186/s10194-018-0909-4.

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.

Publication types

  • Review

MeSH terms

  • Calcitonin Gene-Related Peptide / antagonists & inhibitors
  • Calcitonin Gene-Related Peptide / blood
  • Cluster Headache / blood*
  • Cluster Headache / diagnostic imaging*
  • Cluster Headache / therapy
  • Deep Brain Stimulation / statistics & numerical data
  • Humans
  • Implantable Neurostimulators / statistics & numerical data
  • Migraine Disorders / blood*
  • Migraine Disorders / diagnostic imaging*
  • Migraine Disorders / therapy
  • Nitroglycerin / adverse effects
  • Nitroglycerin / blood
  • Tryptamines / pharmacology
  • Tryptamines / therapeutic use

Substances

  • Tryptamines
  • Nitroglycerin
  • Calcitonin Gene-Related Peptide