Alterations in metabolic flux in migraine and the translational relevance
ConclusionMigraine susceptibility may be underpinned by impaired metabolism resulting in depleted energy stores and altered neuronal function. This review discusses both clinical and in vivo studies which provide evidence of altered metabolic flux which contribute toward pathophysiology. It also reviews the translational relevance of animal studies in identifying targets of biomarker or therapeutic development. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 30, 2022 Category: Neurology Source Type: research

A c-Fos activation map in nitroglycerin/levcromakalim-induced models of migraine
ConclusionsOur study demonstrated the activation of mPFC and Sp5c in two CMMs. Olcegepant may alleviate hyperalgesia of the hind paw and periorbital area by attenuating brain activation in CMMs. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 30, 2022 Category: Neurology Source Type: research

Using natural language processing to automatically classify written self-reported narratives by patients with migraine or cluster headache
ConclusionsDifferences in lexical choices between patients with migraine and cluster headache are detected with NLP and are congruent with domain expert knowledge of the disorders. Our research shows that ML algorithms have potential to classify patients ’ self-reported narratives of migraine or cluster headache with good performance. NLP shows its capability to discern relevant linguistic aspects in narratives from patients with different headache disorders and demonstrates relevance in clinical information extraction. The potential benefits on t he classification performance of larger datasets and neural NLP methods ca...
Source: The Journal of Headache and Pain - September 30, 2022 Category: Neurology Source Type: research

Exploring the neurobiology of the premonitory phase of migraine preclinically – a role for hypothalamic kappa opioid receptors?
ConclusionOur studies in rodents identified the KOR in a hypothalamic region as a mechanism that promotes behaviors consistent with clinically-observed premonitory symptoms of migraine, including increased thirst and urination but not yawning. Importantly, these behaviors occurred in the absence of pain responses, consistent with the emergence of the premonitory phase before the headache phase. Early intervention for preventive treatment even before the headache phase may be achievable by targeting the hypothalamic KOR. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 30, 2022 Category: Neurology Source Type: research

Synaptic alterations in visual cortex reshape contrast-dependent gamma oscillations and inhibition-excitation ratio in a genetic mouse model of migraine
ConclusionsContrast-driven ɣ modulation in V1 activity occurs at a much higher frequency in FHM1. This is likely to play a role in the altered processing of visual information. Computational studies suggest that this shift is specifically due to enhanced cortical excitatory transmission. Our network model can help to shed li ght on the relationship between cellular and network levels of migraine neural alterations.Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 29, 2022 Category: Neurology Source Type: research

Development and validation of a novel model for characterizing migraine outcomes within real-world data
ConclusionOur findings indicate the feasibility of technology-enabled models for validated determination of soft outcomes such as migraine progression using the data elements typically captured in the real-world clinical setting, providing a scalable approach to credible EHR-based clinical studies.Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 21, 2022 Category: Neurology Source Type: research

Does MIDAS reduction at 3  months predict the outcome of erenumab treatment? A real-world, open-label trial
ConclusionMIDASRes only partly reflects the 12-month outcome of erenumab treatment in CM, as it excludes more than one third of responders. A criterion based on the alternative consideration of  ≥ 50% reduction in MIDAS score or MMDs in the first three months of treatment represents a more precise and inclusive option.Trial registrationThe trial was retrospectively registered atwww.clinicaltrials.gov (NCT05442008).Graphical AbstractCGRP: Calcitonin Gene Related Peptide. MIDAS: MIgraine Disability Assessment. MMDs: monthly migraine days. MIDASRes: Patients with a MIDAS score reduction of at least 50% at T3. MMDRes: Pa...
Source: The Journal of Headache and Pain - September 17, 2022 Category: Neurology Source Type: research

A systematic review of economic evaluations of pharmacological treatments for adults with chronic migraine
ConclusionsEvidence to support the cost-effectiveness of pharmacological treatments of chronic migraine in the adult population using Botox and Erenumab were identified. Our findings suggest that both Botox and Erenumab, are cost-effective compared to placebo; although Erenumab had more incremental economic benefits compared to Botox, the ICERs were above the most common willingness-to-pay thresholds. Hence, Erenumab might be an acceptable treatment for chronic migraine for patients whom other treatments such as Botox do not work. Further research is needed to help characterise the data to adequately structure and paramete...
Source: The Journal of Headache and Pain - September 16, 2022 Category: Neurology Source Type: research

Preventive treatment can reverse cognitive impairment in chronic migraine
ConclusionsThis study confirms poor cognitive performance that is not explained by migraine pain itself, as it occurs in the interictal period, irrespective of the patient ’s emotional status. Our findings show that these effects are reversible in some cases with preventive treatment of CM, reaffirming the important impact of this condition on the QoL of these patients, and the need to establish preventive treatment guidelines. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 15, 2022 Category: Neurology Source Type: research

Serum CGRP in migraine patients using erenumab as preventive treatment
ConclusionLower serum CGRP-LI 2 –4 weeks after starting treatment with erenumab was associated with a higher reduction in migraine days after three months of treatment. Although the underlying mechanisms remain to be determined, this suggests that changes in CGRP levels, shortly after starting erenumab, are important for its cli nical effect. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 12, 2022 Category: Neurology Source Type: research

Functional connectivity and structural changes of thalamic subregions in episodic migraine
ConclusionSelective functional hypoconnectivity in the thalamic subregions provides neuroimaging evidence supporting the important role of thalamocortical pathway dysfunction in episodic migraine, specifically, that it may modulate emotion and different personality traits in migraine patients. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 10, 2022 Category: Neurology Source Type: research

The prevalence of primary headache disorders in children and adolescents in Zambia: a schools-based study
ConclusionsHeadache disorders among young people are prevalent in Zambia. Among them, migraine is the most common, with UdH also highly prevalent. In this study there were diagnostic uncertainties, which rested to a large extent on the distinction between migraine and UdH among the many participants reporting headache of  <  2 h’ duration. Similar uncertainties occurred in the first study in SSA, in Ethiopia. Because of these, we conclude only that migraine affects at least 17.5% of these age groups in Zambia, which is still a large proportion, adult prevalence in an earlier study being 22.9%. Supplementary estim...
Source: The Journal of Headache and Pain - September 9, 2022 Category: Neurology Source Type: research

Efficacy and safety of monoclonal antibody against calcitonin gene-related peptide or its receptor for migraine patients with prior preventive treatment failure: a network meta-analysis
ConclusionsIt appears that CGRP mAbs, especially galcanezumab 240  mg, monthly fremanezumab, and eptinezumab 300 mg, seem to be the best choice for the treatment of migraine patients with previous treatment failures. This finding also calls for future research that examine the associations between these medications in migraine therapy among the same patient gr oup to testify the present findings. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 8, 2022 Category: Neurology Source Type: research

Amplitude of low-frequency fluctuation after a single-trigger pain in patients with classical trigeminal neuralgia
ConclusionsThe sALFF and dALFF values changed differently in multiple brain regions in triggering-5  s and triggering-30 min of CTN patients after a single trigger of pain, and dALFF is complementary to sALFF. The results might help explore the therapeutic targets for relieving pain and improving the quality of life of patients with CTN. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 8, 2022 Category: Neurology Source Type: research

Correction: Applying a biopsychosocial model to migraine: rationale and clinical implications
(Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - September 7, 2022 Category: Neurology Source Type: research