Migraine is a common disabling neurological disorder which is characterised by a
recurring headache associated with a variety of sensory and autonomic symptoms. The pathophysiology
of migraine remains not entirely understood, although many mechanisms involving
the central and peripheral nervous system are now becoming clear. In particular, it is
widely accepted that migraine is associated with energy metabolic impairment of the brain.
The purpose of this review is to present an updated overview of the energy metabolism involvement
in the migraine pathophysiology. Several biochemical, morphological and magnetic
resonance spectroscopy studies have confirmed the presence of energy production deficiency
together with an increment of energy consumption in migraine patients. An increment
of energy demand over a certain threshold creates metabolic and biochemical preconditions
for the onset of the migraine attack. The defect of oxidative energy metabolism in migraine is
generalized. It remains to be determined if the mitochondrial deficit in migraine is primary or
secondary. Riboflavin and Co-Enzyme Q10, both physiologically implicated in mitochondrial
respiratory chain functioning, are effective in migraine prophylaxis, supporting the hypothesis
that improving brain energy metabolism may reduce the susceptibility to migraine.
Keywords: Energy metabolism, mitochondrial dysfunction, migraine, oxidative phosphorylation, magnetic resonance
spectroscopy, bioenergetics defect.
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