Impact of Biomarker Heterogeneity on Pediatric Migraine Pathophysiology and Treatment

Pediatric migraine affects roughly 10% of children and adolescents worldwide, representing a significant cause of reduced quality of life.Current diagnosis according to the International Classification of Headache Disorders, 3rd Edition (ICHD-3) is based on clinical symptoms.This approach may not entirely capture the physiology underlying migraine phenotype, severity, frequency, and treatment response due to the heterogeneity of biomarkers.Biomarkers may therefore complement clinical assessment by providing objective measures of biological processes underlying pediatric migraine.This literature review evaluates the current evidence for biomarkers associated with the pathophysiology and clinical characteristics of pediatric migraine and assesses their potential utility in diagnosis and patient characterization.PubMed and Google Scholar were searched for primary research studies and review articles examining biomarkers associated with pediatric migraine pathophysiology, clinical presentation, diagnosis, and treatment; the literature review emphasized studies published within the past ten years.The literature tracked the following biomarker classes: neuropeptides, inflammatory biomarkers, metabolic and mitochondrial biomarkers, oxidative-stress biomarkers, vitamin-related biomarkers, microRNAs, and vascular biomarkers.These findings identify several potential biomarker candidates (e.g.CGRP, inflammatory biomarkers) that may complement clinical assessment and, when evaluated in combination, may contribute to a multimarker diagnostic tool for pediatric migraine.Future research should prioritize larger longitudinal pediatric studies and standardized biomarker measurements to better translate biomarker profiles to clinically useful diagnostic and treatment strategies.