
“In this mini-review, we summarize recent discoveries and present new hypotheses on the role of
cannabinoids in controlling trigeminal nociceptive system underlying migraine pain.
Individual sections of this review cover key aspects of this topic, such as: (i) the current knowledge on the endocannabinoid system (ECS) with emphasis on expression of its components in migraine related structures; (ii) distinguishing peripheral from central site of action of
cannabinoids, (iii) proposed mechanisms of migraine pain and control of nociceptive traffic by
cannabinoids at the level of meninges and in brainstem, (iv) therapeutic targeting in migraine of monoacylglycerol lipase and fatty acid amide hydrolase, enzymes which control the level of endocannabinoids; (v) dual (possibly opposing) actions of
cannabinoids via anti-nociceptive CB1 and CB2 and pro-nociceptive TRPV1 receptors.
We explore the
cannabinoid-mediated mechanisms in the frame of the Clinical Endocannabinoid Deficiency (CECD) hypothesis, which implies reduced tone of endocannabinoids in migraine patients. We further discuss the control of cortical excitability by
cannabinoids via inhibition of cortical spreading depression (CSD) underlying the migraine aura.
Finally, we present our view on perspectives of Cannabis-derived (extracted or synthetized marijuana components) or novel endocannabinoid therapeutics in migraine treatment.”
https://www.ncbi.nlm.nih.gov/pubmed/29740328