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Migraine is one of the leading causes of disability worldwide.1 While the underlying pathophysiological mechanisms of migraine and other primary headache disorders are still being characterized, novel neurotherapeutics are being developed that have the potential to positively transform migraine management and reduce its burden.2

During the Hot Topics in Headaches and Related Disorders II: Migraine Pathophysiology, Brain Imaging and Therapeutic Advances at the AAN 2019 Annual Meeting in Philadelphia, Prof. Peter Goadsby (UCSF Medical Center) presented the latest advances in migraine therapy.

- Prof. Peter Goadsby

Prof. Goadsby started his presentation by reminding the audience that until recently, triptans— a class of serotonin 5-HT1B/1D receptor agonists—were the mainstay of the management of acute migraine attacks.2 Although originally developed as vasoconstrictors, the mechanism of action of triptans likely involves 5-HT1D receptor-mediated modulation of neural transmission independent of their vascular effects.2 Triptans seem to decrease the release of the neuropeptide CGRP via pathways that remains to be elucidated. Because the vasoconstrictive properties of triptans seem to be mediated by the activation of 5-HT1B receptors on the vascula