Studies on Mechanisms of Development and Electrostimulation Approaches to Migraine Therapy

Migraine with its high prevalence, complex pathogenesis, includingchanges in the nervous, immune, cardiovascular systems, and limitedeffectiveness of drug treatment, is one of the urgent problems of modernmedicine. The search for new pharmaceutical targets and developmentof pharmacological agents is required. Since the end of the 20thcentury, studies have shown the possible involvement of the brain’sdopaminergic system in the pathogenesis of migraine. Migraine painis often combined with premonitory yawning and drowsiness, accompaniedby nausea and vomiting, postdromal drowsiness, euphoria and polyuria,which may be related to dopaminergic activity. The study of dopaminergic mechanismsof migraine development may form the basis of future drug linesfor the therapy of cephalgia. One of the problems in modern clinicalpractice is the selection of therapy for the treatment and preventionof migraine. Excessive uncontrolled use of analgesics for pain attacksincreases the risk of transition of episodic migraine into a chronicform. In this regard, recently great importance has been given tothe study of non-drug treatment methods, among which neuromodulationoccupies a special place. Electrical stimulation of the cervicalspinal cord has shown high efficacy in chronic migraine in the clinic,but the mechanisms of migraine neuromodulation have not been determined.This review describes the current understanding of the role of dopaminein the development of migraine, considers a new experimental modelfor studying the mechanisms of its development—animals with dopaminergic dysregulation,with dopamine transporter knockout (DAT-KO), describes possiblemechanisms, prerequisites and experience of using spinal electricalstimulation for the treatment of migraine.