Concepts and mechanisms of migraine chronification

Marcelo E. Bigal, Richard B. Lipton

Research output: Contribution to journalArticlepeer-review

131 Scopus citations


Migraine is a chronic recurrent disorder with episodic manifestations that is progressive in some individuals. Migraine progresses clinically, physiologically, and anatomically. Progression may be a consequence of the mechanisms that generate the migraine attacks (eg, cortical spreading depression) or it may be a function of the activations generated by the attacks (eg, lesions in the periaqueductal gray area), a hypothesis supported by the increase in lesions with attack frequency. Progression may also be partially explained by common genetic or environmental risk factors. Finally, migraine with aura is associated with an elevated Framingham score and with risk factors for cardiovascular disease. Research on this issue is in its infancy and cautions are necessary before extrapolating this information into clinical practice.

Original languageEnglish (US)
Pages (from-to)7-15
Number of pages9
Issue number1
StatePublished - Jan 2008


  • Chronic migraine
  • Migraine progression
  • Transformation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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