Migraine overview and impact

Read on for current information about migraine and its disease burden.

World-renowned expert David Dodick MD discusses how migraine is more than just a headache in this short video.

Schwedt TJ, Chong CD, Functional imaging and migraine: new connections? Curr Opin Neurol, vol 28, issue 3, pp 265-270, https://insights.ovid.com/article/00019052-201506000-00010. Reproduced by permission of Wolters Kluwer Health, Inc

Video recorded at the Amgen/Novartis-supported live symposium “Delving deeper into the science of migraine”.

Held at Scottsdale, Arizona on November 22, 2019.

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Migraine is a major global health problem that affects over 10% of the population (~ 1 billion globally) and is the second leading cause of years lived with disability worldwide.1 In the US, prevalence is ~ 12% and peaks in middle life (30–49 years of age).2,3

Migraine can be divided into five phases: prodrome, aura, headache (ictal), postdrome, and interictal.4-8 In addition to the characteristic moderate-to-severe head pain experienced during the ictal period, each of these phases may be associated with a range of non-headache symptoms.4-14

Although not all phases are experienced by every patient or with every attack, the variety of symptoms associated with migraine can impact several aspects of a patient’s life.2,15-20

Migraine has a complex pathophysiology that is becoming better understood.21 Recent studies have shown that several anatomic regions and molecular pathways underlie the multifaceted symptoms across all phases of migraine.22-25

Learn more about the underlying pathophysiology here:

Clinical findings suggest that migraine can progress over time.26,27 Approximately 3% of migraine patients transition from episodic (<15 headache days/month) to chronic migraine (≥ 15 headache days/month for over 3 months, with features of migraine ≥ 8 days/month) every year.4,26,28 Several factors have been associated with this progression, including the presence of cutaneous allodynia, the presence of nausea and the effectiveness of acute medication, with less optimal responses increasing the likelihood of an individual’s disease progressing over time.29,30

There are two strategies for treating migraine, with distinct but complementary treatment goals:28,31

Individuals with migraine who have frequent and/or severe attacks may require both acute and preventive treatment approaches31,32

There are a number of drug classes used in the acute and/or preventive management of migraine:

*Use is not recommended28

One drug recommended for short-term prevention of menstrual migraine28

Migraine may have long term clinical and pathophysiologic implications for patients, including medication overuse headache (MOH) and neurologic sequelae.4,26,39,40 You can learn more about structural and functional brain alterations that have been observed in patients with uncontrolled migraine here: