Migraine treatments: what have we learned from neuroimaging?

Neuroimaging has emerged as a powerful tool for understanding the mechanisms underlying migraine. Furthermore, neuroimaging studies have enhanced our understanding of migraine treatments and provided us with deeper insights into potential biomarkers for treatment response. Migraine disease is characterized by a complex interplay between the trigeminovascular system, cortical and subcortical networks, and various signaling molecules, a complexity addressed by neuroimaging’s versatility in assessing various parameters, including receptor expression, neurotransmitter dynamics, connectivity patterns, and cerebral hemodynamics. By examining how imaging studies have revealed the ways acute and preventive treatments work and identified potential indicators of treatment success, this chapter aims to highlight the current state of neuroimaging research in migraine treatments. However, this field of research is still in its early stages, and numerous aspects are expected to be clarified in the years ahead. Heterogeneity in study populations, small sample sizes, and inconsistent methodological approaches hinder the generation of robust and reliable findings. To overcome these limitations and fully realize the potential of neuroimaging, future research should prioritize standardized approaches, larger sample sizes, and interdisciplinary collaboration. Ultimately, by integrating neuroimaging with artificial intelligence and other biomarkers, we could develop personalized treatment strategies that optimize therapeutic outcomes and improve quality of life.