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World J Clin Cases. Mar 26, 2021; 9(9): 2136-2145
Published online Mar 26, 2021. doi: 10.12998/wjcc.v9.i9.2136
Contributions of aversive environmental stress to migraine chronification: Research update of migraine pathophysiology
Tang-Hua Liu, Zhen Wang, Fang Xie, Yan-Qing Liu, Qing Lin
Tang-Hua Liu, Fang Xie, Department of Algology, The Third People's Hospital of Yibin, Yibin 644000, Sichuan Province, China
Zhen Wang, Qing Lin, Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, United States
Yan-Qing Liu, Department of Algology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Author contributions: Liu TH drafted the manuscript; Wang Z, Xie F, and Liu YQ reviewed articles and edited the manuscript; Lin Q designed the study and edited and approved the final version of the manuscript.
Supported by The Science and Technology Department of Yibin, No. 2016YZY004.
Conflict-of-interest statement: The authors declare no conflicts of interest in this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing Lin, MD, PhD, Department of Psychology, University of Texas at Arlington, 501 S. Nedderman Dr., Arlington, TX 76019, United States. qilin@uta.edu
Received: November 28, 2020
Peer-review started: November 29, 2020
First decision: January 24, 2021
Revised: February 3, 2021
Accepted: March 15, 2021
Article in press: March 15, 2021
Published online: March 26, 2021
Processing time: 117 Days and 18.3 Hours
Abstract

Clinical studies have suggested that internal and/or external aversive cues may produce a negative affective-motivational component whereby maladaptive responses (plasticity) of dural afferent neurons are initiated contributing to migraine chronification. However, pathophysiological processes and neural circuitry involved in aversion (unpleasantness)-producing migraine chronification are still evolving. An interdisciplinary team conducted this narrative review aimed at reviewing neuronal plasticity for developing migraine chronicity and its relevant neurocircuits and providing the most cutting-edge information on neuronal mechanisms involved in the processing of affective aspects of pain and the role of unpleasantness evoked by internal and/or external cues in facilitating the chronification process of migraine headache. Thus, information presented in this review promotes the understanding of the pathophysiology of chronic migraine and contribution of unpleasantness (aversion) to migraine chronification. We hope that it will bring clinicians’ attention to how the maladaptive neuroplasticity of the emotion brain in the aversive environment produces a significant impact on the chronification of migraine headache, which will in turn lead to new therapeutic strategies for this type of pain.

Keywords: Migraine chronification; Aversive environmental stress; Migraine pathophysiology; Migraine headache; Roles of unpleasantness; Emotion brain

Core Tip: In this article, neuronal plasticity for developing migraine chronicity and relevant neurocircuits were reviewed and discussed. Specifically, we focused on providing the most cutting-edge information on neuronal mechanisms involved in the processing of affective aspects of pain and the role of unpleasantness evoked by internal and/or external cues in facilitating the chronification process of migraine headache. New information collected from both preclinical and clinical studies on these aspects may advance our understanding on the chronic migraine pain mechanisms and lead to new strategies for pain treatment.