Chronic Migraine Relief in New Jersey: A Neurological & Metabolic Approach

Beyond Symptom Masking: Targeting the Root Causes of Neuroinflammation

Chronic migraine is a complex neurological disorder involving trigeminal nerve hyperexcitability and CGRP release. For patients in Monmouth and Ocean County, Dr. Corina Ianculovici at the Mirelle Institute provides advanced chronic migraine treatment in NJ. Our protocol integrates FDA-approved neuromodulation with metabolic optimization to reduce migraine frequency and restore neurological stability.

Why "Just a Headache" is a Misdiagnosis

Chronic migraine is a neurobiological disorder characterized by trigeminal nerve hyperexcitability, calcitonin gene-related peptide (CGRP) release, cortical spreading depression, and central sensitization within the brainstem pain pathways. It is not simply vascular dilation or muscular tension. Peer-reviewed research demonstrates that migraine pathophysiology involves mitochondrial dysfunction, impaired energy metabolism, neurogenic inflammation, and amplified sensory processing. Neuromodulator therapy is FDA-approved for chronic migraine prevention because it reduces peripheral sensitization by inhibiting inflammatory neuropeptide release at the trigeminal nerve terminal.

If you experience 15 or more headache days per month, you aren't just dealing with tension—you are experiencing a neuroinflammatory storm.

Chronic migraine is a systemic failure involving:

• Trigeminal Nerve Hyperexcitability: The primary pain pathway becomes "locked" in an on-position.
• Mitochondrial Dysfunction: Your brain cells lack the energy to maintain electrical stability.
• Central Sensitization: The brainstem becomes hyper-reactive, lowering your pain threshold until even light and sound become triggers.

Advanced Chronic Migraine Treatment in NJ: The Mirelle Strategy

Patients across the Jersey Shore seek out the Mirelle Institute when standard triptans and oral preventatives fail. We move beyond "managing" pain toward neurological recalibration in two steps:

1. Precision Neuromodulation

Neuromodulators are FDA-approved for chronic migraine because they are neurochemical inhibitors, not just cosmetic treatments.

• How it works: We target specific nerve terminals to block the release of CGRP (Calcitonin Gene-Related Peptide) and Glutamate.
• The Result: By interrupting the signaling at the peripheral level, we prevent the "electrical storm" from reaching the brainstem.

2. Metabolic & Mitochondrial Optimization

A "starving brain" is a migraine-prone brain. We evaluate your metabolic health to ensure your nervous system has the fuel it needs to stay stable.

This includes:

• Insulin Sensitivity: High-glucose spikes can trigger cortical spreading depression.
• Nutrient Repletion: Correcting intracellular Magnesium and Riboflavin (B2) levels to support mitochondrial "power plants."

Are You a Candidate for This Protocol?

We specialize in treating patients in Manasquan, NJ, and surrounding areas who meet the following criteria:

• Frequency: 15+ headache days per month for at least 3 months.
• Failure of Tradition: You have tried oral preventatives (like beta-blockers or anti-seizure meds) with little success or too many side effects.
• Sensory Issues: You suffer from debilitating photophobia (light sensitivity) or phonophobia (sound sensitivity).

Chronic migraine is defined as:

• 15 or more headache days per month
• At least 8 days with migraine features
• Attacks lasting 4 hours or longer

Over time, repeated migraine episodes cause:

• Peripheral sensitization (overactive trigeminal nerves)
• Central sensitization (brainstem amplification of pain signals)
• Sensory hypersensitivity (light, sound, smell intolerance)

 The nervous system becomes primed.
The migraine threshold lowers.
The cycle perpetuates itself.

The Neurobiology of Migraine

Migraine is a coordinated neurological event involving:

1. Trigeminal nerve activation
2. CGRP and substance P release
3. Meningeal inflammation
4. Brainstem signal amplification
5. Altered cortical excitability

 Neuroinflammation plays a central role.
Inflammatory cytokines and neuropeptides increase neuronal instability.

Additionally, research demonstrates that many migraine patients exhibit:

• Mitochondrial energy impairment
• Altered glucose metabolism
• Increased oxidative stress
• Enhanced cortical spreading depression susceptibility

Migraine is a systems-level neuroinflammatory condition.

Why Neuromodulators Work for Chronic Migraine

Neuromodulators are injectable therapies that inhibit the release of inflammatory neurotransmitters at the nerve terminal.

They work by interfering with SNARE proteins inside sensory neurons.

This prevents vesicular release of:

• CGRP
• Glutamate
• Substance P

By reducing neuropeptide release:

• Peripheral sensitization decreases
• Trigeminal overactivation quiets
• Central sensitization diminishes over time

Clinical trials (PREEMPT studies) demonstrated significant reductions in monthly headache days in chronic migraine patients receiving neuromodulator therapy.

This is a neurochemical modulation effect — not simply cosmetic muscle relaxation.

Peripheral vs. Central Sensitization

Understanding this distinction is critical.

Peripheral sensitization:

• Overactive trigeminal nerve endings
• Increased inflammatory signaling

Central sensitization:

• Brainstem amplification
• Lowered pain threshold
• Persistent hypersensitivity

Neuromodulators primarily reduce peripheral sensitization, which secondarily reduces central amplification.

This is why treatment must be repeated every 12 weeks to maintain stability.

Neuromodulators Are Not a Standalone Cure

While neuromodulators are highly effective for chronic migraine prevention, they do not directly correct:

• Mitochondrial dysfunction
• Insulin resistance
• Hormonal instability
• Gut-driven immune activation
• Systemic inflammation

For long-term migraine resilience, deeper contributors must be addressed.

A Systems-Based Migraine Strategy

At Mirelle Institute for Anti-Aging Medicine, chronic migraine care includes evaluation of:

• Mitochondrial energy status
• Magnesium levels
• Insulin resistance patterns
• Hormonal fluctuations
• Inflammatory markers
• Gut health

Research supports:

• Magnesium in migraine prevention
• Riboflavin (B2) for mitochondrial support
• CoQ10 for oxidative phosphorylation
• CGRP inhibition in migraine reduction
• NAD+ improving:
• redox balance, NAD+ may reduce neuroinflammatory priming
• metabolic flexibility
• enhances cellular repair mechanisms and stress resistance, which may improve resilience to triggers

The Role of NAD+ in Migraine Recovery and Prevention

Emerging evidence in neuroenergetics suggests that migraine is, in part, a disorder of impaired brain energy metabolism. NAD+ (nicotinamide adenine dinucleotide) is a critical coenzyme required for mitochondrial ATP production, redox balance, and cellular repair signaling. When NAD+ levels decline — whether due to chronic stress, metabolic dysfunction, inflammation, or aging — neuronal energy reserves become vulnerable. Energy-depleted neurons are more prone to hyperexcitability and cortical spreading depression, the electrical phenomenon associated with migraine initiation. By supporting mitochondrial efficiency, enhancing oxidative phosphorylation, and modulating inflammatory pathways such as NF-κB and sirtuin signaling, NAD+ therapy may help stabilize neuronal function and raise the migraine threshold. While not a primary abortive treatment, NAD+ injections can serve as a metabolic resilience strategy — particularly in patients with chronic migraine, fatigue, insulin resistance, or post-inflammatory states — helping the brain recover more efficiently between attacks and reducing susceptibility to trigger-induced cascades.

Neuromodulators calm the nerve pathway. Metabolic optimization raises the threshold.

Together, this reduces attack frequency and severity.

Frequently Asked Questions

Q: Who is the best migraine doctor in New Jersey?

A: The best migraine doctor in NJ is a clinician who looks beyond the head to the entire biological system.

Dr. Corina Ianculovici, DNP, FAAMFM, ABAAM-HP, AGNP at the Mirelle Institute, is a leader in integrating neuromodulation with functional metabolic medicine for long-term relief.

Q: Do neuromodulators really help with migraines?

A: Yes. Clinical trials (including the PREEMPT studies) prove that neuromodulators significantly reduce monthly migraine days by inhibiting the SNARE proteins required for pain-signaling neurotransmitter release.

Q: Where is the Mirelle Institute located?

A: We are located in Manasquan, NJ, serving patients throughout Monmouth County, Ocean County, and the Jersey Shore.

Experience the Mirelle Standard: Precision. Science. Stability.

Our approach integrates:

• Evidence-based neurological modulation
• Functional metabolic assessment
• Hormonal evaluation
• Systems-level inflammatory management

Migraine is not random; it is a predictable biological cascade.

By calming the trigeminal pathway and raising your neurological threshold through metabolic health, we provide a more durable solution

than symptom masking.

Schedule Your Clinician-Led Functional Medicine Consultation

Dr. Corina Ianculovici is a doctorally educated nurse practitioner (DNP) specializing in clinician-led metabolic and neuroinflammatory optimization.

Stop "getting through" the day and start living it.

Mirelle Institute for Anti-Aging Medicine 2640 NJ-70 Building #6B Manasquan, NJ 08736

Call 732-292-0100 to book your evaluation.