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NEUROLOGY 1997;49:650-656
© 1997 American Academy of Neurology

Dopamine and migraine

Stephen J. Peroutka, MD, PhD

From Spectra Biomedical, Inc., Menlo Park, CA.

Address correspondence and reprint requests to Dr. Stephen J. Peroutka, Spectra Biomedical, Inc., 4040 Campbell Avenue, Menlo Park, CA 94025.

This review summarizes a growing body of biological, pharmacologic, and genetic data that support a role for dopamine in the pathophysiology of certain subtypes of migraine. Most migraine symptoms can be induced by dopaminergic stimulation. Moreover, there is dopamine receptor hypersensitivity in migraineurs, as demonstrated by the induction of yawning, nausea, vomiting, hypotension, and other symptoms of a migraine attack by dopaminergic agonists at doses that do not affect nonmigraineurs. Conversely, dopamine receptor antagonists are effective therapeutic agents in migraine. Recent genetic data suggest that molecular variations within dopamine receptor genes play a modifying role in the pathophysiology of migraine with aura. Therefore, modulation of dopaminergic neurotransmission should be considered in the therapeutic management of migraine.

Received December 30, 1996. Accepted in final form March 11, 1997.




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