CGRP, The Hot Topic In Migraines

In my previous blog, we talked about the role of inflammation in migraines. I mentioned that there are certain proteins called neuropeptides that are believed to play an important role in the neurogenic inflammation process of migraines. There are many proteins, that we are actively researching and learning more about every day. CGRP is one such protein.

CGRP is a neuropeptide that is also known as calcitonin gene related peptide. Migraine is a neurovascular disorder which has underlying processes involved with nerves, important centers of the brain, and blood vessels. We believe that the activation of certain nerves such as the trigeminal sensory nerve fibers can send signals to the important pain centers in the brain to contribute to migraines. However, activation of the same nerves can cause the release of some of these proteins such as CGRP. CGRP amongst other neuropeptides can contribute to neurogenic inflammation. This further can cause an increase activation of sensory nerves to lead to release more of these inflammatory proteins and pain impulse to the brain. It can create a snowball effect of the migraine process.

CGRP seems to be responsible for multiple pathways in the migraine process. It can act on blood vessels and contribute to the vascular component of migraines. It can cause immune cells called mast cells to release more inflammatory chemicals. It can act on the nerve to contribute to more pain input to the brain. Levels of CGRP are elevated in a patient during a migraine attack. Treatment of migraines with certain medications can show reduced levels of CGRP. Due to the research in trying to understand the migraine pathophysiology and CGRP, there are now medications that are available that act on CGRP and its receptors. We will discuss some of these new medications in an upcoming blog. Keeping checking out the blog to learn more about migraines and the various treatments.

Dr. Sharisse Stephenson Dr. Stephenson is a Neurologist and a Board Certified Headache Specialist and Brain Injury Medicine Specialist. She has postgraduate training in neurological disorders and stroke management from Tufts University in Boston.

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