MM · Menstrual migraine: understanding its pathophysiology and developing precision treatment strategies

Females experience 3 times more migraine attacks than males, with menstrual migraine affecting 60% of these females. They occur before or during menses and are associated with oestrogen (E2) withdrawal, dramatically affecting a patients quality of life. Menstrual migraines are poorly understood, limiting novel treatment strategy discovery. Recently, I demonstrated that E2 withdrawal increases the function and forward membrane trafficking of specific potassium channels (Kv7) in systemic arteries. If present within the cerebrovascular system, E2 withdrawal will increase sensitivity to endogenous migraine-inducing vasodilators, such as calcitonin gene-related peptide (CGRP), contributing to migraine onset.This project is split into two objectives. 1.) Investigate oestrus cycle-dependent changes in rodent cerebrovascular reactivity via molecular, functional and electrophysiological techniques, with a focus on E2 mediated changes in Kv7 subcellular trafficking via novel G-protein coupled oestrogen receptor, GPER1. 2.) Translate pre-clinical basic science research generated in objective 1 into a model of mensural migraine. International collaboration with Prof. Geoffrey Abbott at the University of California, Irvine, allows for access to in vivo Hemodynamic Perturbation Monitoring (HPM) and a novel CRISPR/Cas9 Kv7 knockout rat. HPM allows for simultaneous measurement of cerebral blood flow and migraine onset (induced by CGRP). We will investigating if female rats are more susceptible to migraine induction when E2 is low, and and whether they are protected from migraine induction by GPER1 stimulation or Kv7 knockout.Our project has the potential to reveal novel pathophysiological mechanisms underlying menstrual migraine allowing the development of novel precision treatment strategies. My hosts and I are experts in the field of vascular Kv7 physiology, and are the ideal candidates to carry out this project.