Drug Targets of Migraine and Neuropathy: Treatment of Hyperexcitability

Author(s): Laszlo Vecsei, Zsofia Majlath, Anna Balog, Janos Tajti.

Journal Name: CNS & Neurological Disorders - Drug Targets

Volume 14 , Issue 5 , 2015

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Abstract:

Migraine and neuropathic pain are common causes of chronic pain. The exact pathomechanism has not been fully clarified for either disorder, but their pathophysiological backgrounds involve several similar mechanisms. Peripheral sensitization occurs in the neuronal elements of the dorsal root ganglion or the trigeminal ganglion, while central sensitization appears in the second-order neurons in the dorsal horn of the spinal cord or the trigeminal nucleus caudalis. Central neuronal hyperexcitability has been implicated in both disorders, and the emerging evidence suggests alterations in the glutamatergic neurotransmission and N-methyl-D-aspartate-receptor activation. Migraine and neuropathic pain additionally share certain clinical features, such as enhanced sensitivity to sensory stimuli and cutaneous allodynia. The pharmacotherapy of both diseases is often challenging, but several antiepileptic drugs that target hyperexcitability are beneficial for both migraine and neuropathic pain. Kynurenine pathway metabolites are capable of influencing the glutamate receptors, and might therefore be novel candidates for future drug development.

Keywords: Allodynia, glutamate, hyperexcitability, migraine, neuropathic pain, sensitization.

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Article Details

VOLUME: 14
ISSUE: 5
Year: 2015
Page: [664 - 676]
Pages: 13
DOI: 10.2174/1871527314666150429114040
Price: $58

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