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Once viewed mainly as a vascular headache, migraine is now understood as a heterogeneous neurobiological syndrome arising from interactions among genetic susceptibility, hormonal influences, environmental exposures, and cortical, brainstem, trigeminovascular, and neuroinflammatory networks. Although calcitonin gene\u2010related peptide (CGRP)\u2010pathway therapies, gepants, and neuromodulation have transformed care, major gaps remain in disease stratification, prevention of chronification and management of special populations. Here, we review recent evidence on global and regional epidemiology, sex\u2010specific and environmental risk factors, and the transition from episodic to chronic migraine. We then examine current mechanistic models, focusing on cortical spreading depolarization, trigeminovascular signaling, CGRP biology, neurogenic inflammation, glial activation, and brain network dysfunction. We also assess acute and preventive treatment strategies, including ditans, gepants, monoclonal antibodies, and onabotulinumtoxinA, and discuss persistent challenges in pediatric, geriatric, and pregnancy\u2010associated migraine care. By integrating population, mechanistic and therapeutic perspectives, this review reframes migraine as a stratified brain network disorder rather than a uniform vascular pain syndrome. This synthesis highlights priorities for biomarker development, precision medicine, and more equitable implementation of effective migraine care.<\/jats:p>","DOI":"10.1002\/mco2.70933","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:38:12Z","timestamp":1788158292000},"source":"Crossref","is-referenced-by-count":2,"title":["Migraine: Epidemiology, Risk Factors, Pathophysiology, and Treatment"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1982-390X","authenticated-orcid":false,"given":"Weiwei","family":"Lu","sequence":"first","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Suzhou Medical College of Soochow University, Soochow University  Suzhou China"},{"name":"The First Affiliated Hospital of Soochow University, School of Basic Medical Sciences, Suzhou Medical College of Soochow University  Suzhou China"},{"name":"Jiangsu Key Laboratory of Drug Discovery and Translational Research For Brain Diseases Centre For Ion Channelopathy Soochow University  Suzhou China"},{"name":"The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou  Changzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Research Center of Neurological Disease Department of Geriatrics The Second Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Shi","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Soochow University, School of Basic Medical Sciences, Suzhou Medical College of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Tao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Soochow University, School of Basic Medical Sciences, Suzhou Medical College of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoxin","family":"Li","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Soochow University, School of Basic Medical Sciences, Suzhou Medical College of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufang","family":"Sun","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Soochow University, School of Basic Medical Sciences, Suzhou Medical College of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuhai","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The First Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0961-2671","authenticated-orcid":false,"given":"Dongsheng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Precision Research Center For Refractory Diseases Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrance P.","family":"Snutch","sequence":"additional","affiliation":[{"name":"Michael Smith Laboratories University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Tao","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Suzhou Medical College of Soochow University, Soochow University  Suzhou China"},{"name":"The First Affiliated Hospital of Soochow University, School of Basic Medical Sciences, Suzhou Medical College of Soochow University  Suzhou China"},{"name":"Jiangsu Key Laboratory of Drug Discovery and Translational Research For Brain Diseases Centre For Ion Channelopathy Soochow University  Suzhou China"},{"name":"The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou  Changzhou China"},{"name":"Biomedical Basic Research Center of Jiangsu Soochow University  Suzhou 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