Current Evidence on the Role of Epigenetic Mechanisms in Migraine: The Way Forward to Precision Medicine

Abstract

Interactions between genetic and environmental factors in migraine are well known and can potentially determine an individual’s susceptibility to disease and responsiveness to treatment. Consequently, several epigenetic studies have been conducted to determine if and how genes are activated or inactivated in response to a diverse range of environmental migraine triggers. The results, in turn, have helped elucidate how these factors can promote or inhibit migraine progression or therapeutic response and can guide development of precision medicines for migraine treatment. This review summarizes the current evidence and latest findings (accessible mainly through Medline-PubMed) that reveal epigenetic processes contributing to migraine pathogenesis acting via various distinct mechanisms. One of the most studied mechanisms, DNA methylation within the human methylome, may provide a potential epigenetic signature for migraine. Recent basic experimental data and clinical findings will be presented here to highlight that epigenetic studies hold great potential to explain risk factors, migraine chronification, and therapeutic responses. Current challenges and unmet needs are also addressed to promote further investigation of the role of migraine epigenetics in disease pathophysiology and to discover useful biomarkers to guide development of more effective therapeutics.