Abstract
Purpose of Review
Chronic migraine (CM) is a recalcitrant subtype of migraine which causes high degrees of disability, poor treatment responses, and frequent recurrences in sufferers. However, the pathophysiological mechanisms underlying the development and chronification of migraine attacks remain incompletely understood. A validated animal model could help to decipher the pathogenic mechanism of the disease, facilitating the development of possible therapeutic strategies for CM. In this review, we aimed to summarize current animal models of CM and discuss the validity of these models.
Recent Findings
Several methods have been available to induce recurrent headache-like behaviors or biochemical changes in rodents, including repeated dural application of inflammatory soup, chronic systemic infusion of nitroglycerin, repeated administration of acute migraine abortive treatment to simulate medication overuse headache, or genetic modification. These models exhibit some features that are believed to be associated with migraine; however, none of the model can recapitulate all the clinical phenotypes found in humans and each has its own weakness.
Summary
The complex features of CM increase the difficulty of constructing a proper animal model. Nonetheless, currently available models are valid to certain degrees. Future directions might consider simulating the spontaneity and chronicity of migraine by combining known genetic substrates and allostatic loads into the same model.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Natoli JL, Manack A, Dean B, Butler Q, Turkel CC, Stovner L, et al. Global prevalence of chronic migraine: a systematic review. Cephalalgia. 2010;30(5):599–609.
Stark RJ, Ravishankar K, Siow HC, Lee KS, Pepperle R, Wang SJ. Chronic migraine and chronic daily headache in the Asia-Pacific region: a systematic review. Cephalalgia. 2013;33(4):266–83.
The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1–211.
Lipton RB. Tracing transformation: chronic migraine classification, progression, and epidemiology. Neurology. 2009;72(5 Suppl):S3–7.
•• May A, Schulte LH. Chronic migraine: risk factors, mechanisms and treatment. Nat Rev Neurol. 2016;12(8):455–64. A comprehensive review for the clinical features and proposed pathophysiology of chronic migraine
Denuelle M, Fabre N, Payoux P, Chollet F, Geraud G. Hypothalamic activation in spontaneous migraine attacks. Headache. 2007;47(10):1418–26.
Welch KM, et al. Periaqueductal gray matter dysfunction in migraine: cause or the burden of illness? Headache. 2001;41(7):629–37.
Cernuda-Morollon E, et al. Increased VIP levels in peripheral blood outside migraine attacks as a potential biomarker of cranial parasympathetic activation in chronic migraine. Cephalalgia. 2015;35(4):310–6.
Cernuda-Morollon E, Larrosa D, Ramon C, Vega J, Martinez-Camblor P, Pascual J. Interictal increase of CGRP levels in peripheral blood as a biomarker for chronic migraine. Neurology. 2013;81(14):1191–6.
Melo-Carrillo A, Lopez-Avila A. A chronic animal model of migraine, induced by repeated meningeal nociception, characterized by a behavioral and pharmacological approach. Cephalalgia. 2013;33(13):1096–105.
Schwedt TJ, Schlaggar BL, Mar S, Nolan T, Coalson RS, Nardos B, et al. Atypical resting-state functional connectivity of affective pain regions in chronic migraine. Headache. 2013;53(5):737–51.
Coppola G, Iacovelli E, Bracaglia M, Serrao M, di Lorenzo C, Pierelli F. Electrophysiological correlates of episodic migraine chronification: evidence for thalamic involvement. J Headache Pain. 2013;14:76.
Burstein R, Jakubowski M, Garcia-Nicas E, Kainz V, Bajwa Z, Hargreaves R, et al. Thalamic sensitization transforms localized pain into widespread allodynia. Ann Neurol. 2010;68(1):81–91.
De Felice M, et al. Triptan-induced latent sensitization: a possible basis for medication overuse headache. Ann Neurol. 2010;67(3):325–37.
De Felice M, et al. Triptan-induced enhancement of neuronal nitric oxide synthase in trigeminal ganglion dural afferents underlies increased responsiveness to potential migraine triggers. Brain. 2010;133(8):2475–88.
Green AL, Gu P, de Felice M, Dodick D, Ossipov MH, Porreca F. Increased susceptibility to cortical spreading depression in an animal model of medication-overuse headache. Cephalalgia. 2014;34(8):594–604.
Bigal ME, Lipton RB. What predicts the change from episodic to chronic migraine? Curr Opin Neurol. 2009;22(3):269–76.
Supornsilpchai W, le Grand SM, Srikiatkhachorn A. Cortical hyperexcitability and mechanism of medication-overuse headache. Cephalalgia. 2010;30(9):1101–9.
Schulte LH, Sprenger C, May A. Physiological brainstem mechanisms of trigeminal nociception: an fMRI study at 3T. NeuroImage. 2016;124(Pt A):518–25.
Weiller C, May A, Limmroth V, Jüptner M, Kaube H, Schayck RV, et al. Brain stem activation in spontaneous human migraine attacks. Nat Med. 1995;1(7):658–60.
Akerman S, Holland PR, Goadsby PJ. Diencephalic and brainstem mechanisms in migraine. Nat Rev Neurosci. 2011;12(10):570–84.
Lai TH, Fuh JL, Lirng JF, Lin CP, Wang SJ. Brainstem 1H-MR spectroscopy in episodic and chronic migraine. J Headache Pain. 2012;13(8):645–51.
Aurora SK, et al. Brainstem dysfunction in chronic migraine as evidenced by neurophysiological and positron emission tomography studies. Headache. 2007;47(7):996–1003. discussion 1004–7
Bergerot A, Holland PR, Akerman S, Bartsch T, Ahn AH, MaassenVanDenBrink A, et al. Animal models of migraine: looking at the component parts of a complex disorder. Eur J Neurosci. 2006;24(6):1517–34.
Jansen-Olesen I, Tfelt-Hansen P, Olesen J. Animal migraine models for drug development: status and future perspectives. CNS Drugs. 2013;27(12):1049–68.
Munro G, Jansen-Olesen I, Olesen J. Animal models of pain and migraine in drug discovery. Drug Discov Today. 2017;22(7):1103–11.
Storer RJ, Supronsinchai W, Srikiatkhachorn A. Animal models of chronic migraine. Curr Pain Headache Rep. 2015;19(1):467.
Eikermann-Haerter K, Moskowitz MA. Animal models of migraine headache and aura. Curr Opin Neurol. 2008;21(3):294–300.
Chen SP, Ayata C. Novel therapeutic targets against spreading depression. Headache. 2017;57(9):1340–58.
Hoskin KL, Goadsby PJ. Comparison of more and less lipophilic serotonin (5HT1B/1D) agonists in a model of trigeminovascular nociception in cat. Exp Neurol. 1998;150(1):45–51.
Williamson DJ, Shepheard SL, Hill RG, Hargreaves RJ. The novel anti-migraine agent rizatriptan inhibits neurogenic dural vasodilation and extravasation. Eur J Pharmacol. 1997;328(1):61–4.
Goadsby PJ, Edvinsson L. Joint 1994 Wolff Award Presentation. Peripheral and central trigeminovascular activation in cat is blocked by the serotonin (5HT)-1D receptor agonist 311C90. Headache. 1994;34(7):394–9.
Bigal ME, et al. Migraine in the triptan era: lessons from epidemiology, pathophysiology, and clinical science. Headache. 2009;49(Suppl 1):S21–33.
Zagami AS, Goadsby PJ, Edvinsson L. Stimulation of the superior sagittal sinus in the cat causes release of vasoactive peptides. Neuropeptides. 1990;16(2):69–75.
Buzzi MG, Carter WB, Shimizu T, Heath H 3rd, Moskowitz MA. Dihydroergotamine and sumatriptan attenuate levels of CGRP in plasma in rat superior sagittal sinus during electrical stimulation of the trigeminal ganglion. Neuropharmacology. 1991;30(11):1193–200.
Goadsby PJ, Edvinsson L. The trigeminovascular system and migraine: studies characterizing cerebrovascular and neuropeptide changes seen in humans and cats. Ann Neurol. 1993;33(1):48–56.
Olesen J, Diener HC, Husstedt IW, Goadsby PJ, Hall D, Meier U, et al. Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine. N Engl J Med. 2004;350(11):1104–10.
Ho TW, Ferrari MD, Dodick DW, Galet V, Kost J, Fan X, et al. Efficacy and tolerability of MK-0974 (telcagepant), a new oral antagonist of calcitonin gene-related peptide receptor, compared with zolmitriptan for acute migraine: a randomised, placebo-controlled, parallel-treatment trial. Lancet. 2008;372(9656):2115–23.
Voss T, Lipton RB, Dodick DW, Dupre N, Ge JY, Bachman R, et al. A phase IIb randomized, double-blind, placebo-controlled trial of ubrogepant for the acute treatment of migraine. Cephalalgia. 2016;36(9):887–98.
Dodick DW, Goadsby PJ, Silberstein SD, Lipton RB, Olesen J, Ashina M, et al. Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine: a randomised, double-blind, placebo-controlled, exploratory phase 2 trial. Lancet Neurol. 2014;13(11):1100–7.
Bigal ME, Edvinsson L, Rapoport AM, Lipton RB, Spierings ELH, Diener HC, et al. Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of chronic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study. Lancet Neurol. 2015;14(11):1091–100.
Bigal ME, Dodick DW, Rapoport AM, Silberstein SD, Ma Y, Yang R, et al. Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of high-frequency episodic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study. Lancet Neurol. 2015;14(11):1081–90.
Sun H, Dodick DW, Silberstein S, Goadsby PJ, Reuter U, Ashina M, et al. Safety and efficacy of AMG 334 for prevention of episodic migraine: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol. 2016;15(4):382–90.
Dodick DW, Goadsby PJ, Spierings ELH, Scherer JC, Sweeney SP, Grayzel DS. Safety and efficacy of LY2951742, a monoclonal antibody to calcitonin gene-related peptide, for the prevention of migraine: a phase 2, randomised, double-blind, placebo-controlled study. Lancet Neurol. 2014;13(9):885–92.
•• Silberstein SD, et al. Fremanezumab for the preventive treatment of chronic migraine. N Engl J Med. 2017;377(22):2113–22. A phase 3 trial showing that CGRP monoclonal antibody is effective for chronic migraine, which might serve as a positive control to test the predictive validity of animal models
Belzung C, Lemoine M. Criteria of validity for animal models of psychiatric disorders: focus on anxiety disorders and depression. Biol Mood Anxiety Disord. 2011;1(1):9.
Liu HY, Fuh JL, Lin YY, Chen WT, Wang SJ. Suicide risk in patients with migraine and comorbid fibromyalgia. Neurology. 2015;85(12):1017–23.
Kao CH, Wang SJ, Tsai CF, Chen SP, Wang YF, Fuh JL. Psychiatric comorbidities in allodynic migraineurs. Cephalalgia. 2014;34(3):211–8.
Chen YC, Tang CH, Ng K, Wang SJ. Comorbidity profiles of chronic migraine sufferers in a national database in Taiwan. J Headache Pain. 2012;13(4):311–9.
Hamelsky SW, Lipton RB. Psychiatric comorbidity of migraine. Headache. 2006;46(9):1327–33.
Oh K, et al. Combination of anxiety and depression is associated with an increased headache frequency in migraineurs: a population-based study. BMC Neurol. 2014;14:238.
Peterlin BL, Katsnelson MJ, Calhoun AH. The associations between migraine, unipolar psychiatric comorbidities, and stress-related disorders and the role of estrogen. Curr Pain Headache Rep. 2009;13(5):404–12.
Wang SJ, Chen PK, Fuh JL. Comorbidities of migraine. Front Neurol. 2010;1:16.
Bigal ME, Lipton RB. Overuse of acute migraine medications and migraine chronification. Curr Pain Headache Rep. 2009;13(4):301–7.
Bigal ME, Serrano D, Buse D, Scher A, Stewart WF, Lipton RB. Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Headache. 2008;48(8):1157–68.
Wang SJ, Fuh JL, Lu SR, Juang KD. Chronic daily headache in adolescents: prevalence, impact, and medication overuse. Neurology. 2006;66(2):193–7.
Ferrari LF, Levine JD, Green PG. Mechanisms mediating nitroglycerin-induced delayed-onset hyperalgesia in the rat. Neuroscience. 2016;317:121–9.
Tipton AF, Tarash I, McGuire B, Charles A, Pradhan AA. The effects of acute and preventive migraine therapies in a mouse model of chronic migraine. Cephalalgia. 2016;36(11):1048–56.
Oshinsky ML, Sanghvi MM, Maxwell CR, Gonzalez D, Spangenberg RJ, Cooper M, et al. Spontaneous trigeminal allodynia in rats: a model of primary headache. Headache. 2012;52(9):1336–49.
Boyer N, Dallel R, Artola A, Monconduit L. General trigeminospinal central sensitization and impaired descending pain inhibitory controls contribute to migraine progression. Pain. 2014;155(7):1196–205.
De Felice M, et al. Capturing the aversive state of cephalic pain preclinically. Ann Neurol. 2013;74(2):257–65.
Oshinsky ML, Gomonchareonsiri S. Episodic dural stimulation in awake rats: a model for recurrent headache. Headache. 2007;47(7):1026–36.
Sufka KJ, Staszko SM, Johnson AP, Davis ME, Davis RE, Smitherman TA. Clinically relevant behavioral endpoints in a recurrent nitroglycerin migraine model in rats. J Headache Pain. 2016;17:40.
Zhang M, Liu Y, Zhao M, Tang W, Wang X, Dong Z, et al. Depression and anxiety behaviour in a rat model of chronic migraine. J Headache Pain. 2017;18(1):27.
Chanda ML, Tuttle AH, Baran I, Atlin C, Guindi D, Hathaway G, et al. Behavioral evidence for photophobia and stress-related ipsilateral head pain in transgenic Cacna1a mutant mice. Pain. 2013;154(8):1254–62.
Baliki MN, Apkarian AV. Nociception, pain, negative moods, and behavior selection. Neuron. 2015;87(3):474–91.
Kuner R, Flor H. Structural plasticity and reorganisation in chronic pain. Nat Rev Neurosci. 2016;18(1):20–30.
Dodick D, Silberstein S. Central sensitization theory of migraine: clinical implications. Headache. 2006;46(Suppl 4):S182–91.
Malick A, Burstein R. Peripheral and central sensitization during migraine. Funct Neurol. 2000;15(Suppl 3):28–35.
Dodick D, Silberstein S. Central sensitization theory of migraine: clinical implications. Headache: J Head Face Pain. 2006;46:S182–91.
Pietrobon D, Moskowitz MA. Pathophysiology of migraine. Annu Rev Physiol. 2013;75:365–91.
Goadsby PJ, Lipton RB, Ferrari MD. Migraine—current understanding and treatment. N Engl J Med. 2002;346(4):257–70.
Bolay H, Reuter U, Dunn AK, Huang Z, Boas DA, Moskowitz MA. Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model. Nat Med. 2002;8(2):136–42.
Burstein R, Yarnitsky D, Goor-Aryeh I, Ransil BJ, Bajwa ZH. An association between migraine and cutaneous allodynia. Ann Neurol. 2000;47(5):614–24.
Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35(17):6619–29.
Noseda R, Burstein R. Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, cortical spreading depression, sensitization, and modulation of pain. Pain. 2013;154(Suppl 1):S44–53.
De Felice M, Ossipov MH, Porreca F. Update on medication-overuse headache. Curr Pain Headache Rep. 2011;15(1):79–83.
Silberstein SD, Lipton RB, Dodick DW, Freitag FG, Ramadan N, Mathew N, et al. Efficacy and safety of topiramate for the treatment of chronic migraine: a randomized, double-blind, placebo-controlled trial. Headache. 2007;47(2):170–80.
Whiteside GT, Adedoyin A, Leventhal L. Predictive validity of animal pain models? A comparison of the pharmacokinetic-pharmacodynamic relationship for pain drugs in rats and humans. Neuropharmacology. 2008;54(5):767–75.
Berge O-G. Predictive validity of behavioural animal models for chronic pain. Br J Pharmacol. 2011;164(4):1195–206.
Rice AS, Cimino-Brown D, Eisenach JC, Kontinen VK, Lacroix-Fralish ML, Machin I, et al. Animal models and the prediction of efficacy in clinical trials of analgesic drugs: a critical appraisal and call for uniform reporting standards. Pain. 2008;139(2):243–7.
Stucky NL, Gregory E, Winter MK, He YY, Hamilton ES, McCarson KE, et al. Sex differences in behavior and expression of CGRP-related genes in a rodent model of chronic migraine. Headache. 2011;51(5):674–92.
Fried NT, et al. Region-specific disruption of the blood-brain barrier following repeated inflammatory dural stimulation in a rat model of chronic trigeminal allodynia. Cephalalgia. 2018;38(4):674–89.
• Pradhan AA, et al. Characterization of a novel model of chronic migraine. Pain. 2014;155(2):269–74. The first mouse model showing that repetitive nitroglycerin infusion could elicit prolonged mechanical hyperalgesia simulating the behavior during the chronification of migraine
Kim SJ, et al. Differential development of facial and hind paw allodynia in a nitroglycerin-induced mouse model of chronic migraine; role of capsaicin sensitive primary afferents. Biol Pharm Bull. 2018;41(2):172–81.
Ben Aissa, M., et al., Soluble guanylyl cyclase is a critical regulator of migraine-associated pain. Cephalalgia, 2017: p. 333102417737778.
Yisarakun W, Chantong C, Supornsilpchai W, Thongtan T, Srikiatkhachorn A, Reuangwechvorachai P, et al. Up-regulation of calcitonin gene-related peptide in trigeminal ganglion following chronic exposure to paracetamol in a CSD migraine animal model. Neuropeptides. 2015;51:9–16.
Harris HM, Carpenter JM, Black JR, Smitherman TA, Sufka KJ. The effects of repeated nitroglycerin administrations in rats; modeling migraine-related endpoints and chronification. J Neurosci Methods. 2017;284:63–70.
Becerra L, Bishop J, Barmettler G, Xie Y, Navratilova E, Porreca F, et al. Triptans disrupt brain networks and promote stress-induced CSD-like responses in cortical and subcortical areas. J Neurophysiol. 2016;115(1):208–17.
Wanasuntronwong A, Jansri U, Srikiatkhachorn A. Neural hyperactivity in the amygdala induced by chronic treatment of rats with analgesics may elucidate the mechanisms underlying psychiatric comorbidities associated with medication-overuse headache. BMC Neurosci. 2017;18(1):1.
Sukhotinsky I, Dilekoz E, Wang Y, Qin T, Eikermann-Haerter K, Waeber C, et al. Chronic daily cortical spreading depressions suppress spreading depression susceptibility. Cephalalgia. 2011;31(16):1601–8.
Chen SP, Tolner EA, Eikermann-Haerter K. Animal models of monogenic migraine. Cephalalgia. 2016;36(7):704–21.
Diener HC, Dodick DW, Goadsby PJ, Lipton RB, Olesen J, Silberstein SD. Chronic migraine—classification, characteristics and treatment. Nat Rev Neurol. 2012;8(3):162–71.
Goadsby PJ, Hargreaves R. Refractory migraine and chronic migraine: pathophysiological mechanisms. Headache. 2008;48(9):1399–405.
Goadsby PJ. Pathophysiology of migraine. Ann Indian Acad Neurol. 2012;15(Suppl 1):S15–22.
Schulte LH, Allers A, May A. Hypothalamus as a mediator of chronic migraine: evidence from high-resolution fMRI. Neurology. 2017;88(21):2011–6.
Xie JY, de Felice M, Kopruszinski CM, Eyde N, LaVigne J, Remeniuk B, et al. Kappa opioid receptor antagonists: a possible new class of therapeutics for migraine prevention. Cephalalgia. 2017;37(8):780–94.
Anttila V, et al. Genome-wide meta-analysis identifies new susceptibility loci for migraine. Nat Genet. 2013;45(8):912–7.
Chen, S.P., et al., Genome-wide association study identifies novel susceptibility loci for migraine in Han Chinese resided in Taiwan. Cephalalgia, 2018;38(3):466–75.
Borsook D, Maleki N, Becerra L, McEwen B. Understanding migraine through the lens of maladaptive stress responses: a model disease of allostatic load. Neuron. 2012;73(2):219–34.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Tse-Ming Chou and Shih-Pin Chen declare no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Chronic Daily Headache
Rights and permissions
About this article
Cite this article
Chou, TM., Chen, SP. Animal Models of Chronic Migraine. Curr Pain Headache Rep 22, 44 (2018). https://doi.org/10.1007/s11916-018-0693-5
Published:
DOI: https://doi.org/10.1007/s11916-018-0693-5