Arterial spin labeling MRI applied to migraine: current insights and future perspectives
ConclusionAlthough ASL studies have dramatically clarified quality and timing of perfusion abnormalities during migraine with aura attacks, the same cannot be said for perfusion changes during migraine attacks without aura and interictal periods. Future studies with more rigorous methodological approaches in terms of study protocol, ASL technique and sample selection and size are mandatory to exploit the possibility of better understanding migraine pathophysiology and identifying neuroimaging biomarkers of each migraine phase in different migraine phenotypes. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - June 16, 2023 Category: Neurology Source Type: research
Repeat mild traumatic brain injuries (RmTBI) modify nociception and disrupt orexinergic connectivity within the descending pain pathway
AbstractRepeat mild traumatic brain injuries (RmTBI) result in substantial burden to the public health system given their association with chronic post-injury pathologies, such as chronic pain and post-traumatic headache. Although this may relate to dysfunctional descending pain modulation (DPM), it is uncertain what mechanisms drive changes within this pathway. One possibility is altered orexinergic system functioning, as orexin is a potent anti-nociceptive neuromodulator. Orexin is exclusively produced by the lateral hypothalamus (LH) and receives excitatory innervation from the lateral parabrachial nucleus (lPBN). There...
Source: The Journal of Headache and Pain - June 14, 2023 Category: Neurology Source Type: research
The Registry for Migraine (REFORM) study: methodology, demographics, and baseline clinical characteristics
ConclusionThe REFORM study enrolled a population with a high migraine burden and frequent use of concomitant medications. The baseline characteristics were representative of patients with migraine in specialized headache clinics. Future publications will report the results of the investigations presented in this article.Trial registrationThe study and sub-studies were registered on ClinicalTrials.gov (NCT04592952; NCT04603976; and NCT04674020). (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - June 12, 2023 Category: Neurology Source Type: research
Revisiting dose-finding of monoclonal antibodies in migraine
We present a clinical case, i.e. a female migraine patient who mistakenly administered supratherapeutic (three-fold higher) doses of e renumab leading to more efficacious clinical responses without any side-effects. This example illustrates that the initial dosages might have been too low, resulting in a remaining undesired increased effect of CGRP. While a capsaicin forearm model has repeatedly been used to evaluate the pharmacoki netic-pharmacodynamic relationship of mAbs, we provide directions to revisit or reconsider dose-finding and dose-ranging of these drugs. These directions include (i) refinement and application o...
Source: The Journal of Headache and Pain - June 9, 2023 Category: Neurology Source Type: research
Prescription of therapeutic exercise in migraine, an evidence-based clinical practice guideline
AbstractThe main objective of this clinical practice guideline is to provide a series of recommendations for healthcare and exercise professionals, such as neurologists, physical therapists, and exercise physiologists, regarding exercise prescription for patients with migraine.This guideline was developed following the methodology and procedures recommended in the Appraisal of Guidelines for Research and Evaluation (AGREE). The quality of evidence and strength of recommendations were evaluated with the Scottish Intercollegiate Guidelines Network (SIGN). A systematic literature review was performed and an established apprai...
Source: The Journal of Headache and Pain - June 7, 2023 Category: Neurology Source Type: research
Sex-specific metabolic profiling to explain the increased CVD risk in women with migraine: a narrative review
ConclusionsThere is no general large dyslipidemia profile in migraine patients, in line with findings that the increased risk of CVD in migraine patients seems not to be due to (large artery) atherosclerosis. Sex-specific associations are indicative towards a less CVD-protective lipoprotein profile in women with migraine. Future studies into the pathophysiology of CVD and migraine need to take sex specific factors into account. By establishing the overlapping pathophysiological mechanism of migraine and CVD, and unraveling the associated effects these diseases exert on each other, better preventative measures can be identi...
Source: The Journal of Headache and Pain - June 6, 2023 Category: Neurology Source Type: research
SS-31 alleviated nociceptive responses and restored mitochondrial function in a headache mouse model via Sirt3/Pgc-1 α positive feedback loop
AbstractMigraine is the second highest cause of disability worldwide, bringing a huge socioeconomic burden. Improving mitochondrial function has promise as an effective treatment strategy for migraine. Szeto-Schiller peptide (SS-31) is a new mitochondria-targeted tetrapeptide molecule that has been shown to suppress the progression of diseases by restoring mitochondrial function, including renal disease, cardiac disease, and neurodegenerative disease. However, whether SS-31 has a therapeutic effect on migraine remains unclear. The aim of this study is to clarify the treatment of SS-31 for headache and its potential mechani...
Source: The Journal of Headache and Pain - June 5, 2023 Category: Neurology Source Type: research
PACAP6-38 improves nitroglycerin-induced central sensitization by modulating synaptic plasticity at the trigeminal nucleus caudalis in a male rat model of chronic migraine
ConclusionsOur results demonstrated that abnormal synaptic structure in the TNC of CM, which could be reversed by inhibition of PAC1R via down-regulating the ERK/CREB/BDNF signaling pathway. PACAP6-38 improves NTG-induced central sensitization by regulating synaptic plasticity in the TNC of CM rat, which may provide new insights into the treatments targeting PACAP/PAC1R in migraine. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - June 5, 2023 Category: Neurology Source Type: research
Correction: Characterization of the biochemical and behavioral effects of cannabidiol: implications for migraine
(Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - June 5, 2023 Category: Neurology Source Type: research
Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
ConclusionsAnti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice.Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - June 2, 2023 Category: Neurology Source Type: research
Estrogen modulation of cortical spreading depression
ConclusionsThese data suggest that females are more susceptible to CSD, and sexual dimorphism is abrogated by gonadectomy. Moreover, estrogen withdrawal after prolonged daily treatment enhances CSD susceptibility. These findings may have implications for estrogen-withdrawal migraine, although the latter tends to be without aura. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - May 26, 2023 Category: Neurology Source Type: research
The effect of Lu AG09222 on PACAP38- and VIP-induced vasodilation, heart rate increase, and headache in healthy subjects: an interventional, randomized, double-blind, parallel-group, placebo-controlled study
ConclusionsThis proof-of-mechanism study demonstrated that Lu AG09222 inhibited PACAP38-induced cephalic vasodilation and increases in heart rate, and reduced concomitant headache. Lu AG09222 may be a potential therapy against migraine and other PACAP-mediated diseases.Trial registrationClinicalTrials.gov: NCT04976309. Registration date: July 19, 2021. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - May 25, 2023 Category: Neurology Source Type: research
Neuropeptide Y in the medial habenula alleviates migraine-like behaviors through the Y1 receptor
ConclusionsTaken together, our data support that the NPY signaling in the MHb produces analgesic and anxiolytic effects through the Y1 receptor. These findings may provide new insights into novel therapeutic targets for the treatment of migraine.Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - May 25, 2023 Category: Neurology Source Type: research
Imaging the brain and vascular reactions to headache treatments: a systematic review
ConclusionSeveral aspects of headache treatments remain to be elucidated using imaging approaches, such as how pharmacological preventive therapies work, whether treatment-related brain changes may influence therapy effectiveness, and imaging biomarkers of clinical response. In the future, well-designed studies with homogeneous study populations, adequate sample sizes and statistical approaches are needed. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - May 24, 2023 Category: Neurology Source Type: research
Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study
ConclusionsOur results show that about 42.8% of anti-CGRP pathway mAb-non-responder benefit from switching to fremanezumab. These results suggest that switching to fremanezumab may be a promising option for patients experiencing poor tolerability or inadequate efficacy with prior other anti-CGRP pathway mAb use.Trial registrationFinesse Study is registered on the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (EUPAS44606).Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - May 23, 2023 Category: Neurology Source Type: research
