60 years of migraine research. Retrospective review and synopsis

At the end of the thirties, the first papers from Wolff and Graham represen ted the beginning of modern migraine research. Since that time advance is i mportant. Several medical disciplines and special fields in research such a s neurology, clinical and experimental neurophysiology, neuroradiology, psy chiatry, medical psychology, psychosomatics, biochemistry, genetics, pharma cology, epidemiology contributed to the new cognitions. Further exploration of genetics and of the interictal neuronal and neurovascular dysfunctions are the key for both understanding of migraine as disease and pathogenesis of migraine attacks. All together migraine may be defined as a specific dys function in neuronal information processing and neurovascular reagibility c orresponding with imbalance of certain neurotransmitters (NA, 5-HT) and lea ding to ictal reactions of brain areas and intracranial vessels in critical phases of hyperreagibility and hyperactivity. In the pathogenetical and pa thophysiological processings both genetic and acquired mechanisms might be involved. Aura symptoms result from abnormal vasoconstriction with oligemia or ischemia of the tissue as Wolff sup posed it. The headache phase follow s with delay because the pain inducing neurogenic inflammation in the vesse l walls need more time for clinical manifestation than the oligemic resp. i schemic brain symptoms.