Petasines, the active compounds found in Petasites hybridus (commonly known as butterbur), have been studied for their potential role in preventing migraine headaches. Multiple double-blind, placebo-controlled clinical trials and meta-analyses have found that standardized butterbur extracts (particularly those standardized to contain petasines and free of harmful pyrrolizidine alkaloids) can reduce the frequency of migraine attacks in both adults and children. For example, a pivotal 2004 study published in Neurology showed that a dose of 75 mg twice daily of butterbur extract significantly reduced migraine frequency compared to placebo. Systematic reviews and guidelines from organizations such as the American Academy of Neurology and the American Headache Society have cited moderate to strong evidence for butterbur’s efficacy in migraine prevention, though concerns over potential liver toxicity have led to recommendations that only certified PA-free extracts be used. While the exact mechanism is not fully understood, petasines are believed to exert anti-inflammatory effects and inhibit leukotriene synthesis, which may reduce neurogenic inflammation involved in migraine pathogenesis. Overall, scientific evidence supports the use of petasines-containing butterbur extract as an option for migraine prevention, though safety concerns require careful sourcing and medical supervision.