Serial systemic immune inflammation indices: markers of acute migraine events or indicators of persistent inflammatory status?

The Journal of Headache and Pain, Journal Year: 2025, Volume and Issue: 26(1)

Published: Jan. 10, 2025

Migraine is the most common complex neurological disorder, affecting over a billion people worldwide. Neurogenic inflammation has long been recognized as key factor in pathophysiology of migraine though little research directed to investigating whether greatest with aura or without, and permanent state an event related transitory state. Thus, primary aim this single-centre, retrospective study was explore potential clinical utility Serial Systemic Immune-Inflammatory Indices (SSIIi) comparative measure duration severity derived from routine blood cell counts patients no-aura both within acute inpatient setting outpatients. Specifically, we assessed role two serial white calculate SSIIi using formula: neutrophil count x platelet count/lymphocyte count) between at time admission tertiary care centre Melbourne, Australia, following 24 h post versus comparable measures 20 out ongoing symptoms. A analysis conducted medical records baseline demographics brain imaging findings 186 hospitalized in-patients who had least sets drawn their emergency department Western Health center 18-month period. Patients were categorized having (MA) (N = 67) without (MO) 119) according ICHD-3 criteria compared 2 stable in-community migraineur controls 20). mixed-design ANOVA showed significant main effect during presentation, comparison convenience sample outpatients (MA MO). levels significantly lower (MA), MO. MA greater, non-significant, decrease measurements those outpatient controls, whose remained consistently higher. The control group displayed similar MO inpatients, suggesting persistent systemic subset regardless patient presentation highlighting need for future studies more rigorously evaluate pathophysiology, chronicity, progression multiple phases including interictal phase.

Language: Английский

---

White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

The Journal of Headache and Pain, Journal Year: 2020, Volume and Issue: 21(1)

Published: Jan. 2, 2020

Abstract Background White matter alterations have been observed in patients with migraine. However, no microstructural white found particularly episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of patients. Methods Fifty-one healthy controls, 55 57 were recruited underwent brain T1-weighted diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity axial compared different groups. On one hand, all against controls. other from each group them also Correlation analysis clinical features (duration years, time onset months, where applicable, headache frequency, applicable) Diffusion Tensor Imaging measures was performed. Results Fifty 54 56 finally included analysis. Significant decreased ( p < .05 false discovery rate by number contrasts corrected) to 38 regions Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. positive correlation anisotropy bilateral external capsule, negative capsule. Conclusions These findings suggest global structural differences Patients could present axonal integrity impairment first months respect changes after might reflect a set maladaptive plastic changes.

Language: Английский

---

Is aerobic exercise helpful in patients with migraine? A systematic review and meta‐analysis

Scandinavian Journal of Medicine and Science in Sports, Journal Year: 2020, Volume and Issue: 30(6), P. 965 - 982

Published: Jan. 6, 2020

To assess the effects of aerobic exercise (AE) on patients with migraine in terms pain intensity, frequency and duration migraine, quality life.A systematic review meta-analysis randomized controlled trials were conducted. Standardized mean differences (SMDs) 95% confidence intervals (CIs) calculated for relevant outcomes pooled a using random-effects model.A total 10 articles from 1950 to 2019 included, involving 508 patients. The showed statistically significant decrease intensity (five studies, n = 166; SMD 1.25; CI 0.47-2.04), (six 214; 0.76; 0.32-1.2) (four 106; 0.41; 0.03-0.8), short-term. In addition, increase life 150; 2.7; 1.17-4.24), even though Egger's test suggested evidence publication bias analysis (intercept 5.81; t 6.97; P .02).There is low- moderate-quality that AE can also life.

Language: Английский

---

Long-term safety and tolerability of eptinezumab in patients with chronic migraine: a 2-year, open-label, phase 3 trial

BMC Neurology, Journal Year: 2021, Volume and Issue: 21(1)

Published: March 19, 2021

Abstract Background Eptinezumab, an anti-calcitonin gene-related peptide monoclonal antibody recently approved in the United States for preventive treatment of migraine adults, was found to be well tolerated double-blind, placebo-controlled studies patients with episodic and chronic migraine. The objective PREVAIL study evaluate long-term safety, immunogenicity, impact on patient-reported outcomes repeat doses eptinezumab Methods open-label, phase 3 trial comprising a 48-week followed by second phase. Adults received 300 mg 30-min intravenous administration every 12 weeks up 8 doses. Patients were 20 after final infusion (end-of-study visit at week 104). Results Overall, 128 adults (mean age, 41.5 years) included. During 2 years, most frequently reported treatment-emergent adverse events nasopharyngitis (14.1%), upper respiratory tract infection (7.8%), sinusitis influenza (6.3%), bronchitis (5.5%), (5.5%). rate study-drug discontinuation due 6.3%, which included infusion-related hypersensitivity. incidence anti-eptinezumab antibodies peaked 24 declined despite continued dosing, nondetectable levels 104. Improvements observed first assessment (week 4) generally sustained through Conclusion In migraine, demonstrated favorable safety profile, limited early reductions migraine-related burden, improvements health-related quality life over years. Trial registration ClinicalTrials.gov (Identifier: NCT02985398 ).

Language: Английский

---

Management of chronic migraine

BMJ, Journal Year: 2022, Volume and Issue: unknown, P. e067670 - e067670

Published: Oct. 10, 2022

ABSTRACT Chronic migraine is a neurologic disorder associated with considerable disability, lost productivity, and profound economic burden worldwide. The past five years have seen dramatic expansion in new treatments for this often challenging condition, among them calcitonin gene related peptide antagonists neuromodulatory devices. This review outlines the epidemiology of diagnostic criteria risk factors chronic migraine. It discusses evidence based drug non-drug treatments, their advantages disadvantages, principles patient centered care adults migraine, attention to differential diagnosis comorbidities, clinical reasoning, initiation monitoring, cost, availability. international guidelines on treatment evaluates including behavioral complementary therapies lifestyle modifications. Finally, it management special populations, pediatrics, pregnancy, older people, considers future questions emerging research field.

Language: Английский

---

Central Sensitization in Migraine: A Narrative Review

Journal of Pain Research, Journal Year: 2022, Volume and Issue: Volume 15, P. 2673 - 2682

Published: Sept. 1, 2022

Abstract: Central sensitization (CS) is an increase in the responsiveness of nociceptive neurons central nervous system to their normal afferent input. As a result, even minor irritation can induce severe pain, leading chronicity and severity various diseases, such as neurological disorders. CS associated with migraine, which major disorder that inflicts high disability daily life. Specifically, thought be involved pathogenesis cutaneous allodynia well chronification migraine. In this article, we reviewed association between including pathophysiological aspects evidence from clinical studies. We suggest appropriate screening management migraine could further improve quality life patients. Keywords: sensitization, allodynia, restless legs syndrome

Language: Английский

---

Sex and Gender Considerations in Episodic Migraine

Current Pain and Headache Reports, Journal Year: 2022, Volume and Issue: 26(7), P. 505 - 516

Published: June 9, 2022

Abstract Purpose of Review We seek to update readers on recent advances in our understanding sex and gender episodic migraine with a two part series. In 1, we examine epidemiology the context gender, differences symptomatology, influence hormones pathophysiology (including CGRP). 2, focus practical clinical considerations for by addressing menstrual controversial topic hormone-containing therapies. make note data applicable minority populations, when available, summarize knowledge affirming hormone therapy management transgender individuals. Finally, briefly address health disparities, socioeconomic considerations, research bias. Recent Findings Migraine is known be more prevalent, frequent, disabling women. There are also co-morbidities symptomatology. For instance, women likely experience associated symptoms such as nausea, photophobia, phonophobia. influenced hormones, e.g., estrogen withdrawal trigger migraine. Other progesterone testosterone less well studied. Relationships between CGRP (the target new acute preventive treatments) have been established both animal human model studies. The natural course throughout lifetime suggests contribution from hormonal changes, puberty pregnancy menopause/post-menopause. Treatment use therapies remains controversial. Re-evaluation reveals that stroke risk an dose- aura frequency-dependent phenomenon. limited minorities. Gender may change unique risks ischemic high dose estrogen). Summary key thought driven at least which lifetime. More effective specific treatments needed. A careful examination nuanced approach issue estrogen-containing contraception replacement warranted. Our evolving, but growing relationship migraine, treatment people

Language: Английский

---

From CGRP to PACAP, VIP, and Beyond: Unraveling the Next Chapters in Migraine Treatment

Cells, Journal Year: 2023, Volume and Issue: 12(22), P. 2649 - 2649

Published: Nov. 17, 2023

Migraine is a neurovascular disorder that can be debilitating for individuals and society. Current research focuses on finding effective analgesics management strategies migraines by targeting specific receptors neuropeptides. Nonetheless, newly approved calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) have 50% responder rate ranging from 27 to 71.0%, whereas CGRP receptor inhibitors 56 71%. To address the need novel therapeutic targets, researchers are exploring potential of another secretin family peptide, pituitary adenylate cyclase-activating polypeptide (PACAP), as ground-breaking treatment avenue migraine. Preclinical models revealed how PACAP affects trigeminal system, which implicated in headache disorders. Clinical studies demonstrated significance migraine pathophysiology; however, few clinical trials remain inconclusive: 1 mAb, AMG 301 showed no benefit prevention, while ligand Lu AG09222 significantly reduced number monthly days over placebo phase 2 trial. Meanwhile, vasoactive intestinal (VIP) gaining interest new target. In light recent advances research, we emphasize promising target treatment, highlighting member antimigraine armamentarium, especially patients who do not respond or contraindicated anti-CGRP therapies. By updating our knowledge its unique contribution pathophysiology, pave way reinforcing other peptides, including VIP, option migraines.

Language: Английский

---

A causal effects of gut microbiota in the development of migraine

The Journal of Headache and Pain, Journal Year: 2023, Volume and Issue: 24(1)

Published: July 17, 2023

The causal association between the gut microbiome and development of migraine its subtypes remains unclear.The single nucleotide polymorphisms concerning were retrieved from gene-wide study (GWAS) MiBioGen consortium. summary statistics datasets migraine, with aura (MA), without (MO) obtained GWAS meta-analysis International Headache Genetics Consortium (IHGC) FinnGen Inverse variance weighting (IVW) was used as primary method, complemented by sensitivity analyses for pleiotropy increasing robustness.In IHGC datasets, ten, five, nine bacterial taxa found to have a MA, MO, respectively, (IVW, all P < 0.05). Genus.Coprococcus3 genus.Anaerotruncus validated in datasets. Nine, twelve, seven entities identified respectively. still exists family.Bifidobacteriaceae order.Bifidobacteriales MO after FDR correction. heterogeneity confirmed robustness IVW results.Our demonstrates that microbiomes may exert effects on MO. We provide novel evidence dysfunction gut-brain axis migraine. Future is required verify relationship risk illustrate underlying mechanism them.

Language: Английский

---

Future targets for migraine treatment beyond CGRP

The Journal of Headache and Pain, Journal Year: 2023, Volume and Issue: 24(1)

Published: June 27, 2023

Abstract Background Migraine is a disabling and chronic neurovascular headache disorder. Trigeminal vascular activation release of calcitonin gene-related peptide (CGRP) play pivotal role in the pathogenesis migraine. This knowledge has led to development CGRP(-receptor) therapies. Yet, substantial proportion patients do not respond these treatments. Therefore, alternative targets for future therapies are warranted. The current narrative review provides comprehensive overview pathophysiological possible non-CGRP Findings We covered metabotropic receptors (pituitary adenylate cyclase-activating polypeptide (PACAP), vasoactive intestinal (VIP), amylin, adrenomedullin), intracellular (nitric oxide (NO), phosphodiesterase-3 (PDE3) -5 (PDE5)), ion channels (potassium, calcium, transient receptor potential (TRP), acid-sensing (ASIC)). majority were able induce migraine-like attacks, except (i) calcium channels, as it yet directly target elucidate their precise involvement migraine; (ii) TRP which can non-migraine headache; (iii) ASICs, inducing migraine attacks been investigated thus far. Drugs that its exist PACAP, NO, potassium, TRP, ASIC channels. No selective drugs other targets, however, some existing (migraine) treatments appear indirectly antagonize responses adrenomedullin, against potassium only PAC 1 antibody have tested treatment, albeit with ambiguous results. Conclusion While research on drug efficacious therapies, human provocation studies using provided valuable insight into underlying mechanisms headaches auras. Further needed non-responders targeted ultimate aim pave way towards headache-free all patients.

Language: Английский

---