Modern Migraine Treatment: Molecular Mechanisms, Neuromodulation, and Precision Medicine

Today, migraine can be controlled better than ever before. But the real secret lies not in suppressing individual symptoms, but in understanding its systemic dynamics. Migraine is much more than a headache. It is a complex neurological systemic disorder that connects neural networks, vascular mechanisms, immune processes, and genetic predispositions. Despite decades of research, it has long been misunderstood-as an isolated pain phenomenon, a psychosomatic reaction, or a mere vascular disorder. This book traces the scientific transformation of our understanding of migraine-from early vascular hypotheses to the discovery of the CGRP system to modern network models of the brain. It analyzes the role of cortical spreading depression, the dynamics of chronicity, mechanisms of central sensitization, and the complex interaction between the brainstem, thalamus, and cortex. A particular focus is placed on the therapeutic innovations of recent years: CGRP antibodies, gepants, ditans, neuromodulatory procedures, and personalized prevention strategies. The work not only highlights mechanisms of action, but also clinical studies, regulatory developments, and the prospects for future precision medicine. This book shows how an episodic disorder can become a chronic network phenomenon-and how modern medicine is beginning to modulate this process in a targeted manner. Bremen University Press has published over 5,500 specialized books in various languages since 2005. February 2026