Potent dual MAGL/FAAH inhibitor AKU-005 engages endocannabinoids to diminish meningeal nociception implicated in migraine pain
ConclusionsIn the meninges, high anti-nociceptive 2-AG levels can tonically counteract meningeal signalling, whereas AEA can be engaged on demand by local depolarization. AEA-mediated anti-nociceptive effects through CB1 receptors have therapeutic potential. Together with previously detected MAGL activity in trigeminal ganglia, dual MAGL/FAAH inhibitor AKU-005 appears promising as migraine treatment.Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - April 11, 2023 Category: Neurology Source Type: research
Cluster headache and kynurenines
ConclusionsOur results refer to a specifically altered Trp metabolism in CH patients. The onset of metabolic imbalance can be attributed to the interbout period, where the decreased KYN level is unable to perform its protective functions, while the concentration of QUINA, as a toxic compound, increases. These processes can trigger CH attacks, which may be associated with glutamate excess induced neurotoxicity, neuroinflammation and oxidative stress. Further studies are needed to elucidate the exact functions of these molecular alterations that can contribute to identify new, potential biomarkers in the therapy of CH. (Sour...
Source: The Journal of Headache and Pain - April 5, 2023 Category: Neurology Source Type: research
Cytokines in primary headache disorders: a systematic review and meta-analysis
ConclusionsThe higher levels of the proinflammatory cytokines IL-6, IL-8 and TNF- α in migraine compared to controls, and IL-1β during the ictal stage, suggest a role for inflammation in the pathophysiology of migraine, however prospective studies are required to confirm causality and investigate the mechanisms for the increase in cytokine levels identified. Cytokines may also have a role in tension-type headache. Due a lack of data, no conclusions can be made regarding cluster headache or NDPH. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - April 4, 2023 Category: Neurology Source Type: research
Headache impact and socioeconomic status: findings from a study of the German Migraine and Headache Society (DMKG)
ConclusionsSES is an important factor that should not be neglected in headache awareness campaigns and headache treatment. Longitudinal studies are needed in the future to investigate whether lifestyle interventions, such as weight reduction, can help to reduce headache impact in people in lower SES. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - April 4, 2023 Category: Neurology Source Type: research
Shared and independent roles of CGRP and PACAP in migraine pathophysiology
AbstractThe neuropeptides calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating polypeptide (PACAP) have emerged as mediators of migraine pathogenesis. Both are vasodilatory peptides that can cause migraine-like attacks when infused into people and migraine-like symptoms when injected into rodents. In this narrative review, we compare the similarities and differences between the peptides in both their clinical and preclinical migraine actions. A notable clinical difference is that PACAP, but not CGRP, causes premonitory-like symptoms in patients. Both peptides are found in distinct, but overlapp...
Source: The Journal of Headache and Pain - April 3, 2023 Category: Neurology Source Type: research
Is the right way to go in between?
AbstractIn the study by Johnston et al., gepants were meant to be taken to treat emergent migraine. It is tempting to speculate what the effect would be if patients were instructed to take a gepant as needed (PRN) or even prior to headache onset. While the latter sounds irrational at first glance, several studies have shown that a significant proportion of patients are quite proficient in predicting (or simply due to premonitory symptoms noting) their migraine attacks prior to the onset of actual headache. The study by Johnston et al. provides food for thought along these lines and should encourage us to further investigat...
Source: The Journal of Headache and Pain - March 30, 2023 Category: Neurology Source Type: research
Prolactin and oxytocin: potential targets for migraine treatment
We describe the physiological role of prolactin and oxytocin, its relationship to migraine and pain, and potential therapies targeting these hormones or their receptors.In summary, oxytocin and prolactin are involved in nociception in opposite ways. Both operate at peripheral and central levels, however, prolactin has a pronociceptive effect, while oxytocin appears to have an antinociceptive effect. Therefore, migraine treatment targeting prolactin should aim to block its effects using prolactin receptor antagonists or monoclonal antibodies specifically acting at migraine-pain related structures. This action should be loca...
Source: The Journal of Headache and Pain - March 27, 2023 Category: Neurology Source Type: research
Disease burden of migraine and tension-type headache in non-high-income East and Southeast Asia from 1990 to 2019
ConclusionsTo date, the threats from migraine and TTH in non-high-income East and Southeast Asia are still serious and ongoing, leading to prominently negative impacts on the daily life and work of local residents. Therefore, full attention and sound guidelines are urgently needed to obtain greater advantages in fighting against the burden of headache disorders in the future. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 27, 2023 Category: Neurology Source Type: research
Early and sustained efficacy of fremanezumab over 24-weeks in migraine patients with multiple preventive treatment failures: the multicenter, prospective, real-life FRIEND2 study
ConclusionsFremanezumab is characterized by an early and sustained efficacy in HFEM and CM patients with multiple preventive treatment failures in real-life, revealing an optimal safety and tolerability profile. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 23, 2023 Category: Neurology Source Type: research
A study on the correlation of the asymmetric regulation between the periaqueductal gray and the bilateral trigeminal nucleus caudalis in migraine male rats
ConclusionsThere is correlation between PAG, LTNC and RTNC in regulation of pain during acute migraine attack, and the regulation of LTNC and RTNC on pain is asymmetric. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 20, 2023 Category: Neurology Source Type: research
FGF-21 and GDF-15 are increased in migraine and associated with the severity of migraine-related disability
ConclusionSerum GDF-15 and FGF-21 levels are increased in patients with migraine and associated with the severity of migraine-related disability. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 20, 2023 Category: Neurology Source Type: research
A novel score to estimate thrombus burden and predict intracranial hypertension in cerebral venous sinus thrombosis
ConclusionsA simple and noninvasive CVST-Score can rapidly estimate the thrombus burden and predict the severity of intracranial hypertension in patients with CVST. The CVST-Score can aid in evaluating therapeutic responses and avoiding unnecessary invasive procedures at long-term follow-up.Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 17, 2023 Category: Neurology Source Type: research
Galcanezumab effects on incidence of headache after occurrence of triggers, premonitory symptoms, and aura in responders, non-responders, super-responders, and super non-responders
ConclusionsMechanistically, these findings suggest that even a mild decrease in migraine frequency is sufficient to partially reverse the excitability and responsivity of neurons involved in the generation of certain triggers and potentially premonitory symptoms of migraine.Trial registrationClinicalTrials.gov: NCT04271202. Registration date: February 10, 2020. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 16, 2023 Category: Neurology Source Type: research
The variability of diagnosed migraine epidemiology amongst different municipalities in southern Israel
ConclusionsHigh variability in the prevalence of diagnosed migraine suggests underdiagnosis. Resources for awareness and educational programs should be directed to low diagnosed prevalence communities.Graphical Abstract (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 13, 2023 Category: Neurology Source Type: research
Cross-sectional, hospital-based analysis of headache types using ICHD-3 criteria in the Middle East, Asia, and Africa: the Head-MENAA study
ConclusionsThe study showed that migraine is still the most common motive for admissions to NC in different regions. Furthermore, MOH, an avoidable disorder, is the most common secondary headache type and appears to be a significant problem in all regions. Remarkably, pain perception differs between regions, and pain intensity is lower in Africa than in other regions. (Source: The Journal of Headache and Pain)
Source: The Journal of Headache and Pain - March 13, 2023 Category: Neurology Source Type: research
