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

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 clo...

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Main Authors: Ľubica Joppeková, Maria João Pinto, Mariana Dias da Costa, Richard Boček, Gabriele Berman, Yones Salim, Dinara Akhtanova, Aizhana Abzalbekova, Antoinette MaassenVanDenBrink, Christian Lampl, European Headache Federation School of Advanced Sciences (EHF-SAS)
Format: Article
Language:English
Published: BMC 2025-07-01
Series:The Journal of Headache and Pain
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Online Access:https://doi.org/10.1186/s10194-025-02080-6
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author Ľubica Joppeková
Maria João Pinto
Mariana Dias da Costa
Richard Boček
Gabriele Berman
Yones Salim
Dinara Akhtanova
Aizhana Abzalbekova
Antoinette MaassenVanDenBrink
Christian Lampl
European Headache Federation School of Advanced Sciences (EHF-SAS)
author_facet Ľubica Joppeková
Maria João Pinto
Mariana Dias da Costa
Richard Boček
Gabriele Berman
Yones Salim
Dinara Akhtanova
Aizhana Abzalbekova
Antoinette MaassenVanDenBrink
Christian Lampl
European Headache Federation School of Advanced Sciences (EHF-SAS)
author_sort Ľubica Joppeková
collection DOAJ
description 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
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spelling doaj-art-4fcdf74aabf3495c9426e579a67cf2602025-08-20T03:46:25ZengBMCThe Journal of Headache and Pain1129-23772025-07-0126112210.1186/s10194-025-02080-6What does a migraine aura look like?—A systematic reviewĽubica Joppeková0Maria João Pinto1Mariana Dias da Costa2Richard Boček3Gabriele Berman4Yones Salim5Dinara Akhtanova6Aizhana Abzalbekova7Antoinette MaassenVanDenBrink8Christian Lampl9European Headache Federation School of Advanced Sciences (EHF-SAS)Faculty of Medicine, Masaryk UniversityNeurology Department, Hospital Universitário de São JoãoNeurology, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Unidade Local de Saúde Santa MariaNeurology Department, Military University HospitalBirmingham Neuro-Ophthalmology, University Hospitals Birmingham, NHS Foundation TrustDepartment of Neurology and Experimental Neurology, Charité-Universitätsmedizin BerlinSchool of Medicine, Nazarbayev UniversityNeurology Department, Health Nation Rehabilitation CenterDivision of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical CenterDepartment of Neurology, Koventhospital Barmherzige BrüderAbstract 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 Abstracthttps://doi.org/10.1186/s10194-025-02080-6Migraine with auraTypical aura with headacheTypical aura without headacheCortical spreading depression
spellingShingle Ľubica Joppeková
Maria João Pinto
Mariana Dias da Costa
Richard Boček
Gabriele Berman
Yones Salim
Dinara Akhtanova
Aizhana Abzalbekova
Antoinette MaassenVanDenBrink
Christian Lampl
European Headache Federation School of Advanced Sciences (EHF-SAS)
What does a migraine aura look like?—A systematic review
The Journal of Headache and Pain
Migraine with aura
Typical aura with headache
Typical aura without headache
Cortical spreading depression
title What does a migraine aura look like?—A systematic review
title_full What does a migraine aura look like?—A systematic review
title_fullStr What does a migraine aura look like?—A systematic review
title_full_unstemmed What does a migraine aura look like?—A systematic review
title_short What does a migraine aura look like?—A systematic review
title_sort what does a migraine aura look like a systematic review
topic Migraine with aura
Typical aura with headache
Typical aura without headache
Cortical spreading depression
url https://doi.org/10.1186/s10194-025-02080-6
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