Novel Therapies for Migraine Treatment Based on Updates in Migraine Pathophysiology Explored by Dr. Andrew Charles, UCLA
The 2023 Scottsdale Headache Symposium featured a presentation by Dr. Andrew Charles, “The Future of Headache Therapeutics,” in which he examined how advances in the understanding of migraine pathophysiology are leading to novel therapeutic possibilities for migraine treatment. His presentation emphasized the following 9 categories of novel targets for migraine therapies:
- Hypothalamus
- Upper cervical nerves
- Patent foramen ovale (PFO)
- Adenosine receptors
- Potassium channel modulators
- Sodium channel modulators
- Peptide targets (PACAP and Amylin)
- Delta opioid receptors
- Glutamate receptors
Dr. Charles highlighted various study results that link these targets to migraine treatment:
- Functional imaging supports the role of the hypothalamus in migraine attacks.
- Adenosine receptor agonists mimic the therapeutic benefits of caffeine.
- Glutamate receptors act as mediators of migraine.
- Delta opioid receptor agonists inhibit migraine-related hyperalgesia.
He also explored interesting questions regarding these categories of migraine targets, such as
- “Does the association of migraine with aura and PFO explain the association of migraine and stroke?”
- “If migraine is a trigeminovascular disorder, why does migraine attack commonly start with neck pain?”
Dr. Charles notes that “people with migraine have more reason to hope for relief” due to the new therapeutic options that are being developed based on advances in migraine pathophysiology. Dr. Charles is director of the Goldberg Migraine Program and holds the Meyer and Renee Luskin Chair in Migraine and Headache Studies at the David Geffen School of Medicine at UCLA.