What does a migraine aura look like?—A systematic review

Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological disturbances, primarily visual, but also includes sensory, speech, motor, and brainstem symptoms. The underlying pathophysiology is closely tied...

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Published inJournal of headache and pain Vol. 26; no. 1; pp. 149 - 22
Main Authors Joppeková, Ľubica, Pinto, Maria João, da Costa, Mariana Dias, Boček, Richard, Berman, Gabriele, Salim, Yones, Akhtanova, Dinara, Abzalbekova, Aizhana, MaassenVanDenBrink, Antoinette, Lampl, Christian
Format Journal Article
LanguageEnglish
Published Milan Springer Milan 01.07.2025
Springer Nature B.V
BMC
Subjects
Aphasia
Brain stem
Cortical spreading depression
Differential diagnosis
Epidemiology
Genes
Genome-wide association studies
Genomes
Headache
Headaches
Hot topics in headache and pain from the EHF-SAS
Humans
Internal Medicine
Medicine
Medicine & Public Health
Migraine
Migraine with aura
Migraine with Aura - diagnosis
Migraine with Aura - epidemiology
Migraine with Aura - genetics
Migraine with Aura - physiopathology
Mutation
Neural networks
Neuroimaging
Neurological complications
Neurological diseases
Neurology
Pain management
Pain Medicine
Pathophysiology
Phenotypes
Review
Structure-function relationships
Systematic review
Typical aura with headache
Typical aura without headache
Visual evoked potentials
Typical aura without headache
Migraine with aura
Typical aura with headache
Cortical spreading depression
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Abstract Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological disturbances, primarily visual, but also includes sensory, speech, motor, and brainstem symptoms. The underlying pathophysiology is closely tied to cortical spreading depression, which initiates neurovascular and inflammatory changes. Epidemiological studies show significant variations in the prevalence of migraine with aura across different demographics, with a more pronounced effect observed among women. Genetic research has identified both common and rare variants that influence susceptibility to migraine with aura, with genome-wide association studies revealing distinct risk loci. Neuroimaging studies indicate structural and functional alterations in cortical and subcortical areas, reinforcing the role of altered brain connectivity in migraine with aura. Additional studies, including various neurophysiological techniques (such as EEG, VEP, or TMS), are needed to potentially identify specific patterns within MA that would help better characterise clinical and electrophysiological phenotypes. Differential diagnosis is essential, as migraine aura symptoms may overlap with a wide range of primarily neurological paroxysmal disorders. While the treatment of migraine traditionally prioritises the headache, there is limited evidence for targeted therapies addressing aura symptoms; further research is warranted. This systematic review offers a comprehensive synthesis of aura types, epidemiology, genetics, pathophysiology, diagnosis, and management of migraine with aura, emphasising areas for future exploration. Graphical Abstract
AbstractList Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological disturbances, primarily visual, but also includes sensory, speech, motor, and brainstem symptoms. The underlying pathophysiology is closely tied to cortical spreading depression, which initiates neurovascular and inflammatory changes. Epidemiological studies show significant variations in the prevalence of migraine with aura across different demographics, with a more pronounced effect observed among women. Genetic research has identified both common and rare variants that influence susceptibility to migraine with aura, with genome-wide association studies revealing distinct risk loci. Neuroimaging studies indicate structural and functional alterations in cortical and subcortical areas, reinforcing the role of altered brain connectivity in migraine with aura. Additional studies, including various neurophysiological techniques (such as EEG, VEP, or TMS), are needed to potentially identify specific patterns within MA that would help better characterise clinical and electrophysiological phenotypes. Differential diagnosis is essential, as migraine aura symptoms may overlap with a wide range of primarily neurological paroxysmal disorders. While the treatment of migraine traditionally prioritises the headache, there is limited evidence for targeted therapies addressing aura symptoms; further research is warranted. This systematic review offers a comprehensive synthesis of aura types, epidemiology, genetics, pathophysiology, diagnosis, and management of migraine with aura, emphasising areas for future exploration.
Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological disturbances, primarily visual, but also includes sensory, speech, motor, and brainstem symptoms. The underlying pathophysiology is closely tied to cortical spreading depression, which initiates neurovascular and inflammatory changes. Epidemiological studies show significant variations in the prevalence of migraine with aura across different demographics, with a more pronounced effect observed among women. Genetic research has identified both common and rare variants that influence susceptibility to migraine with aura, with genome-wide association studies revealing distinct risk loci. Neuroimaging studies indicate structural and functional alterations in cortical and subcortical areas, reinforcing the role of altered brain connectivity in migraine with aura. Additional studies, including various neurophysiological techniques (such as EEG, VEP, or TMS), are needed to potentially identify specific patterns within MA that would help better characterise clinical and electrophysiological phenotypes. Differential diagnosis is essential, as migraine aura symptoms may overlap with a wide range of primarily neurological paroxysmal disorders. While the treatment of migraine traditionally prioritises the headache, there is limited evidence for targeted therapies addressing aura symptoms; further research is warranted. This systematic review offers a comprehensive synthesis of aura types, epidemiology, genetics, pathophysiology, diagnosis, and management of migraine with aura, emphasising areas for future exploration.Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological disturbances, primarily visual, but also includes sensory, speech, motor, and brainstem symptoms. The underlying pathophysiology is closely tied to cortical spreading depression, which initiates neurovascular and inflammatory changes. Epidemiological studies show significant variations in the prevalence of migraine with aura across different demographics, with a more pronounced effect observed among women. Genetic research has identified both common and rare variants that influence susceptibility to migraine with aura, with genome-wide association studies revealing distinct risk loci. Neuroimaging studies indicate structural and functional alterations in cortical and subcortical areas, reinforcing the role of altered brain connectivity in migraine with aura. Additional studies, including various neurophysiological techniques (such as EEG, VEP, or TMS), are needed to potentially identify specific patterns within MA that would help better characterise clinical and electrophysiological phenotypes. Differential diagnosis is essential, as migraine aura symptoms may overlap with a wide range of primarily neurological paroxysmal disorders. While the treatment of migraine traditionally prioritises the headache, there is limited evidence for targeted therapies addressing aura symptoms; further research is warranted. This systematic review offers a comprehensive synthesis of aura types, epidemiology, genetics, pathophysiology, diagnosis, and management of migraine with aura, emphasising areas for future exploration.
Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological disturbances, primarily visual, but also includes sensory, speech, motor, and brainstem symptoms. The underlying pathophysiology is closely tied to cortical spreading depression, which initiates neurovascular and inflammatory changes. Epidemiological studies show significant variations in the prevalence of migraine with aura across different demographics, with a more pronounced effect observed among women. Genetic research has identified both common and rare variants that influence susceptibility to migraine with aura, with genome-wide association studies revealing distinct risk loci. Neuroimaging studies indicate structural and functional alterations in cortical and subcortical areas, reinforcing the role of altered brain connectivity in migraine with aura. Additional studies, including various neurophysiological techniques (such as EEG, VEP, or TMS), are needed to potentially identify specific patterns within MA that would help better characterise clinical and electrophysiological phenotypes. Differential diagnosis is essential, as migraine aura symptoms may overlap with a wide range of primarily neurological paroxysmal disorders. While the treatment of migraine traditionally prioritises the headache, there is limited evidence for targeted therapies addressing aura symptoms; further research is warranted. This systematic review offers a comprehensive synthesis of aura types, epidemiology, genetics, pathophysiology, diagnosis, and management of migraine with aura, emphasising areas for future exploration. Graphical Abstract
Abstract Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological disturbances, primarily visual, but also includes sensory, speech, motor, and brainstem symptoms. The underlying pathophysiology is closely tied to cortical spreading depression, which initiates neurovascular and inflammatory changes. Epidemiological studies show significant variations in the prevalence of migraine with aura across different demographics, with a more pronounced effect observed among women. Genetic research has identified both common and rare variants that influence susceptibility to migraine with aura, with genome-wide association studies revealing distinct risk loci. Neuroimaging studies indicate structural and functional alterations in cortical and subcortical areas, reinforcing the role of altered brain connectivity in migraine with aura. Additional studies, including various neurophysiological techniques (such as EEG, VEP, or TMS), are needed to potentially identify specific patterns within MA that would help better characterise clinical and electrophysiological phenotypes. Differential diagnosis is essential, as migraine aura symptoms may overlap with a wide range of primarily neurological paroxysmal disorders. While the treatment of migraine traditionally prioritises the headache, there is limited evidence for targeted therapies addressing aura symptoms; further research is warranted. This systematic review offers a comprehensive synthesis of aura types, epidemiology, genetics, pathophysiology, diagnosis, and management of migraine with aura, emphasising areas for future exploration. Graphical Abstract
ArticleNumber 149
Author Boček, Richard
Berman, Gabriele
Abzalbekova, Aizhana
Lampl, Christian
Joppeková, Ľubica
Salim, Yones
Akhtanova, Dinara
MaassenVanDenBrink, Antoinette
da Costa, Mariana Dias
Pinto, Maria João
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  givenname: Christian
  surname: Lampl
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IsDoiOpenAccess true
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Issue 1
Keywords Typical aura without headache
Migraine with aura
Typical aura with headache
Cortical spreading depression
Language English
License 2025. The Author(s).
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PublicationSubtitle Official Journal of the "European Headache Federation", of "Lifting The Burden - The Global Campaign against Headache", and of the "Asian Regional Consortium for Headache"
PublicationTitle Journal of headache and pain
PublicationTitleAbbrev J Headache Pain
PublicationTitleAlternate J Headache Pain
PublicationYear 2025
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Springer Nature B.V
BMC
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SSID ssj0020385
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Snippet Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary neurological...
Abstract Migraine with aura is a prevalent neurological disorder that affects up to 30% of individuals experiencing migraines. It presents as temporary...
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StartPage 149
SubjectTerms Aphasia
Brain stem
Cortical spreading depression
Differential diagnosis
Epidemiology
Genes
Genome-wide association studies
Genomes
Headache
Headaches
Hot topics in headache and pain from the EHF-SAS
Humans
Internal Medicine
Medicine
Medicine & Public Health
Migraine
Migraine with aura
Migraine with Aura - diagnosis
Migraine with Aura - epidemiology
Migraine with Aura - genetics
Migraine with Aura - physiopathology
Mutation
Neural networks
Neuroimaging
Neurological complications
Neurological diseases
Neurology
Pain management
Pain Medicine
Pathophysiology
Phenotypes
Review
Structure-function relationships
Systematic review
Typical aura with headache
Typical aura without headache
Visual evoked potentials
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  providerName: Springer Nature
Title What does a migraine aura look like?—A systematic review
URI https://link.springer.com/article/10.1186/s10194-025-02080-6
https://www.ncbi.nlm.nih.gov/pubmed/40597581
https://www.proquest.com/docview/3226020031
https://www.proquest.com/docview/3226360645
https://pubmed.ncbi.nlm.nih.gov/PMC12210593
https://doaj.org/article/4fcdf74aabf3495c9426e579a67cf260
Volume 26
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