Studies on Mechanisms of Development and Electrostimulation Approaches to Migraine Therapy

Migraine with its high prevalence, complex pathogenesis, including changes in the nervous, immune, cardiovascular systems, and limited effectiveness of drug treatment, is one of the urgent problems of modern medicine. The search for new pharmaceutical targets and development of pharmacological agents is required. Since the end of the 20th century, studies have shown the possible involvement of the brain’s dopaminergic system in the pathogenesis of migraine. Migraine pain is often combined with premonitory yawning and drowsiness, accompanied by nausea and vomiting, postdromal drowsiness, euphoria and polyuria, which may be related to dopaminergic activity. The study of dopaminergic mechanisms of migraine development may form the basis of future drug lines for the therapy of cephalgia. One of the problems in modern clinical practice is the selection of therapy for the treatment and prevention of migraine. Excessive uncontrolled use of analgesics for pain attacks increases the risk of transition of episodic migraine into a chronic form. In this regard, recently great importance has been given to the study of non-drug treatment methods, among which neuromodulation occupies a special place. Electrical stimulation of the cervical spinal 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 dopamine in the development of migraine, considers a new experimental model for studying the mechanisms of its development—animals with dopaminergic dysregulation, with dopamine transporter knockout (DAT-KO), describes possible mechanisms, prerequisites and experience of using spinal electrical stimulation for the treatment of migraine.