Calcitonin gene-related peptide and neurologic injury: An emerging target for headache management

Clin Neurol Neurosurg. 2022 Sep;220:107355. doi: 10.1016/j.clineuro.2022.107355. Epub 2022 Jun 27.

Abstract

Calcitonin gene-related peptide (CGRP) is a 37-amino acid neuropeptide known to be involved in the trigeminovascular system and to function as a potent vasodilator. Although it has emerged as a viable target for headache management with targeted treatments developed for migraine, a highly disabling neurovascular disorder, less is known about CGRP's role in other neurologic conditions such as traumatic brain injury and subarachnoid hemorrhage. The literature has shown that during these injury cascades, CGRP receptors are modulated in varying ways. Therefore, CGRP or its receptors might be viable targets to manage secondary injuries following acute brain injury. In this review, we highlight the pathophysiology of the CGRP pathway and its relation to migraine pathogenesis. Using these same principles, we assess the existing preclinical data for CGRP and its role in acute brain injury. The findings are promising, and set the basis for further work, with specific focus on the therapeutic benefit of CGRP modulation following neurologic injury.

Keywords: Calcitonin gene-related peptide; Headache; Subarachnoid hemorrhage; Traumatic brain injury; Treatment approaches.

Publication types

  • Review

MeSH terms

  • Brain Injuries*
  • Calcitonin Gene-Related Peptide
  • Headache
  • Humans
  • Migraine Disorders* / drug therapy
  • Receptors, Calcitonin Gene-Related Peptide / metabolism
  • Receptors, Calcitonin Gene-Related Peptide / therapeutic use

Substances

  • Receptors, Calcitonin Gene-Related Peptide
  • Calcitonin Gene-Related Peptide