{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T22:04:05Z","timestamp":1782252245059,"version":"3.54.5"},"reference-count":104,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Studies suggest that migraine pain has a vascular component. The prevailing dogma is that peripheral vasoconstriction activates baroreceptors in central, large arteries. Dilatation of central vessels stimulates nociceptors and induces cortical spreading depression. Studies investigating nitric oxide (NO) donors support the indicated hypothesis that pain is amplified when acutely administered. In this review, we provide an alternate hypothesis which, if substantiated, may provide therapeutic opportunities for attenuating migraine frequency and severity. We suggest that in migraines, heightened sympathetic tone results in progressive central microvascular constriction. Suboptimal parenchymal blood flow, we suggest, activates nociceptors and triggers headache pain onset. Administration of NO donors could paradoxically promote constriction of the microvasculature as a consequence of larger upstream central artery vasodilatation. Inhibitors of NO production are reported to alleviate migraine pain. We describe how constriction of larger upstream arteries, induced by NO synthesis inhibitors, may result in a compensatory dilatory response of the microvasculature. The restoration of central capillary blood flow may be the primary mechanism for pain relief. Attenuating the propensity for central capillary constriction and promoting a more dilatory phenotype may reduce frequency and severity of migraines. Here, we propose consideration of two dietary nutraceuticals for reducing migraine risk: L-arginine and aged garlic extracts.<\/jats:p>","DOI":"10.3390\/nu12082487","type":"journal-article","created":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T09:22:31Z","timestamp":1597828951000},"page":"2487","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A Paradoxical Vasodilatory Nutraceutical Intervention for Prevention and Attenuation of Migraine\u2014A Hypothetical Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7376-0209","authenticated-orcid":false,"given":"Devahuti Rai","family":"Chaliha","sequence":"first","affiliation":[{"name":"Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia"},{"name":"School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-318X","authenticated-orcid":false,"given":"Mauro","family":"Vaccarezza","sequence":"additional","affiliation":[{"name":"Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia"},{"name":"School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6359-3382","authenticated-orcid":false,"given":"Ryu","family":"Takechi","sequence":"additional","affiliation":[{"name":"Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia"},{"name":"School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lam","sequence":"additional","affiliation":[{"name":"Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia"},{"name":"School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5648-8311","authenticated-orcid":false,"given":"Eric","family":"Visser","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Notre Dame, Fremantle 6160, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Drummond","sequence":"additional","affiliation":[{"name":"College of Science, Health, Engineering and Education (SHEE), Murdoch University, Murdoch 6150, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Charles Louis","family":"Mamo","sequence":"additional","affiliation":[{"name":"Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia"},{"name":"School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1468-1331.2005.01202.x","article-title":"Cost of disorders of the brain in Europe","volume":"12","author":"Wittchen","year":"2005","journal-title":"Eur. 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