ReviewHeadache
Insights into the mechanism of onabotulinumtoxinA in chronic migraine.
Review in Headache. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 citations in OpenAlex.
- Beyond Conventional Analgesics: Updated Evidence Supporting Botulinum Toxin Type A for-Neuralgia Management.International journal of medical sciences · 2026Pooled it
- Monocentric Prospective Study into the Sustained Effect of Incobotulinumtoxin A (XEOMINToxins · 2018Trial
- Reduction in Bladder-Related Autonomic Dysreflexia after OnabotulinumtoxinA Treatment in Spinal Cord Injury.Journal of neurotrauma · 2016Trial
- Effects of OnabotulintoxinA on Habituation of Laser Evoked Responses in Chronic Migraine.Toxins · 2016Trial
- Trial
- OnabotulinumtoxinA Improves Sleep Quality in Patients with Chronic Migraine: A Prospective Real-World Study.Toxins · 2026Observational
- Review
- Real-World Safety and Efficacy of 156 U - 195 U OnabotulinumtoxinA in Adults With Chronic Migraine: Results From the REPOSE Study.BMC neurology · 2025Observational
- Advances in Migraine Treatment: A Comprehensive Clinical Review.Current protein & peptide science · 2025Review
- Onabotulinum toxin a treatment for posttraumatic trigeminal neuropathic pain: case series and literature review.Journal of oral & facial pain and headache · 2024Review
- Central Sensitization in Migraine: A Narrative Review.Journal of pain research · 2022Review
- Review of Interventional Therapies for Refractory Pediatric Migraine.Health psychology research · 2022Article
- Mild systemic inflammation enhances response to OnabotulinumtoxinA in chronic migraineurs.Scientific reports · 2021Article
- A Proposal for Botulinum Toxin Type A Injection Into the Temporal Region in Chronic Migraine Headache.Toxins · 2020Article
- Article
- Botulinum toxin A treatment for post-herpetic neuralgia: A systematic review and meta-analysis.Experimental and therapeutic medicine · 2020Article
- Erenumab in Chronic Migraine Patients Who Previously Failed Five First-Line Oral Prophylactics and OnabotulinumtoxinA: A Dual-Center Retrospective Observational Study.Frontiers in neurology · 2020Article
- Pregabalin as a Pain Therapeutic: Beyond Calcium Channels.Frontiers in cellular neuroscience · 2020Review
- Pathophysiological Mechanisms in Migraine and the Identification of New Therapeutic Targets.CNS drugs · 2019Review
- Hemicrania Continua: a Clinical Perspective on Diagnosis and Management.Current neurology and neuroscience reports · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
OnabotulinumtoxinA has recently been approved by regulatory agencies in the UK and United States for treatment of chronic migraine based on data generated from the PREEMPT studies. As such, onabotulinumtoxinA is the only prophylactic therapy specifically approved for chronic migraine. Most headache clinicians would agree that acute episodic migraine and chronic migraine differ in their pathophysiology, etiology, diagnosis, and response to pharmacological as well as nonpharmacological therapies. Of the 7 botulinum neurotoxin serotypes, botulinum neurotoxin type A (onabotulinumtoxinA) has been the most thoroughly investigated in preclinical and clinical studies. Based on preclinical studies, onabotulinumtoxinA is known to inhibit the release of excitatory neurotransmitters from both motor and sensory neurons by preventing vesicle fusion to the cell membrane. In addition to the well-documented myorelaxant effects of this neurotoxin, onabotulinumtoxinA can exert a direct analgesic effect that likely involves inhibition of primary and secondary nociceptive neurons. The inhibitory effects of onabotulinumtoxinA are also likely to involve suppressing the activity of myogenic trigger points and decreasing the persistent nociceptive barrage that promotes and maintains central sensitization. This article describes possible mechanisms to explain how onabotulinumtoxinA functions as a therapy for chronic migraine and considers why treatment with the neurotoxin is not effective in some chronic migraineurs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.