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The pathophysiological mechanism of migraine induced by 5-HT. (1) Platelet aggregation trigger release of 5-HT and ADP in blood plasma. (2) High level of plasma 5-HT causes reversible vasoconstriction followed by conversion of 5-HT to its metabolite 5-HIAA. The latter is excreted in urine. (3) Low level of plasma 5-HT stimulates perivascular neurons to release neuropeptides (NO, PG, SP, NKA, CGRP) causing vasodilation of cerebral veins. The latter leads to migraine symptoms.
