Background: Disability from migraine has a profound impact on the world’s economy. Research has been ongoing to identify biomarkers to aid in diagnosis and treatment. Objective: The aim of this study was to highlight the purported diagnostic and therapeutic migraine biomarkers and their role in precision medicine. Methods: A comprehensive literature search was conducted using PubMed, Google Scholar, and clinicaltrials. gov using keywords: “migraine” OR “headache” combined with “biomarkers” OR “marker.” Other keywords included “serum,” “cerebral spinal fluid,” “inflammatory,” and “neuroimaging." Results: After a review of 88 papers, we find the literature supports numerous biomarkers in the diagnosis of migraine. Therapeutic biomarkers, while not as extensively published, highlight calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating peptide-38 (PACAP-38) as biomarkers with the most substantiated clinical relevance. Genetic markers mainly focusing on gene mutations with resultant biochemical alterations continue to be studied and show promise. Conclusion: Although there are several proposed biomarkers for migraine, continued research is needed to substantiate their role in clinical practice.
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