Neurological mechanisms of migraine: potential of the gap-junction modulator tonabersat in prevention of migraine
PL Durham & FG Garrett
Center for Biomedical and Life Sciences, Missouri State University, Springfield, MO, USA
Correspondence to Paul L. Durham PhD, Center for Biomedical and Life Sciences, Missouri State University, 225 Temple Hall, Springfield, MO 65897, USA. Tel. + 1-417-836-4869, fax + 1-417-836-4204, e-mail pauldurham@missouristate.edu
Copyright © 2009 International Headache Society
KEYWORDS
Connexins • cortical spreading depression • gap junctions • tonabersat • trigeminovascular
ABSTRACT
Migraine is a neurovascular disorder characterized by recurrent episodic headaches, and is caused by abnormal processing of sensory information due to peripheral and/or central sensitization. The exact pathophysiological mechanism underlying migraine is not fully understood; however, cortical spreading depression (CSD) is thought to provide the basis for migraine aura and may serve as a trigger of migraine pain. CSD depends on neuronal–glial cell communication, which is mediated by intercellular transfer of messengers through connexin-containing gap junctions, as well as messengers released into the extracellular space by non-junctional connexin-containing hemichannels. These processes are believed to be important in peripheral sensitization within the trigeminal ganglion and to lead to central sensitization. The novel benzopyran compound tonabersat binds selectively to a unique site in the brain. In preclinical studies, tonabersat markedly reduced CSD and CSD-associated events and inhibited gap-junction communication between neurons and satellite glial cells in the trigeminal ganglion. Together, these findings suggest that tonabersat should have clinical application in preventing migraine attacks.
Received 14 December 2008, accepted 20 January 2009
DIGITAL OBJECT IDENTIFIER (DOI)10.1111/j.1468-2982.2009.01976.x About DOI
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