685 results match your criteria Pathophysiology and Treatment of Migraine and Related Headache


[Anxiety in neurological practice].

Zh Nevrol Psikhiatr Im S S Korsakova 2020 ;120(5):165-170

Scientific Research Institute of General Pathology and Pathophysiology, Moscow, Russia.

Anxiety and related disorders are the most common type of mental disorders in both the general population and the neurological clinic. A current typology of anxiety disorders includes panic disorder, agoraphobia, simple (specific) phobias, social anxiety disorder, and generalized anxiety disorder. Anxiety disorders often accompany diseases of the nervous system, worsen their course and impede treatment, and the degree of anxiety usually corresponds to the severity of neurological symptoms. Read More

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http://dx.doi.org/10.17116/jnevro2020120051165DOI Listing
January 2020

Evaluation of the Pharmacokinetic Interaction of Ubrogepant Coadministered With Sumatriptan and of the Safety of Ubrogepant With Triptans.

Headache 2020 Jun 23. Epub 2020 Jun 23.

Allergan plc, Madison, NJ, USA.

Objective: To evaluate the potential for pharmacokinetic interaction and the safety and tolerability when ubrogepant and sumatriptan are coadministered in a Phase 1 study in healthy participants, and to inform the safety and tolerability of ubrogepant alone and in combination with triptans in Phase 3 trials in participants with migraine.

Background: Calcitonin gene-related peptide is a potent vasodilatory neurotransmitter believed to play a key role in the pathophysiology of migraine. Ubrogepant (UBRELVY™) is a potent and selective antagonist of the human calcitonin gene-related peptide receptor approved for the acute treatment of migraine. Read More

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http://dx.doi.org/10.1111/head.13862DOI Listing

Lasmiditan mechanism of action - review of a selective 5-HT agonist.

J Headache Pain 2020 Jun 10;21(1):71. Epub 2020 Jun 10.

The Headache Center of Southern California, San Diego, CA, USA.

Migraine is a leading cause of disability worldwide, but it is still underdiagnosed and undertreated. Research on the pathophysiology of this neurological disease led to the discovery that calcitonin gene-related peptide (CGRP) is a key neuropeptide involved in pain signaling during a migraine attack. CGRP-mediated neuronal sensitization and glutamate-based second- and third-order neuronal signaling may be an important component involved in migraine pain. Read More

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http://dx.doi.org/10.1186/s10194-020-01132-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288483PMC

Galcanezumab: A Review in the Prevention of Migraine and Treatment of Episodic Cluster Headache.

Authors:
Lesley J Scott

Drugs 2020 Jun;80(9):893-904

Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.

Galcanezumab (Emgality) is a humanized monoclonal antibody targeting the calcitonin gene-related peptide (CGRP), thereby inhibiting its physiological activity, with CGRP playing a key role in the pathophysiology of migraine and headache disorders. In pivotal phase 3 trials, recommended dosages of subcutaneous galcanezumab once monthly were significantly more effective than placebo as preventive therapy in adults with episodic (EVOLVE-1 and -2; over 6 months) or chronic (REGAIN; over 3 months) migraine (±  aura), including in patients who had failed several prior preventive migraine drugs (CONQUER; over 3 months). The beneficial effects of galcanezumab preventive treatment in reducing the number of monthly migraine headache days (MHDs) and improving health-related quality of life (HR-QOL) were sustained during up to 1 year of treatment. Read More

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http://dx.doi.org/10.1007/s40265-020-01329-5DOI Listing

The current state of acute treatment for migraine in adults in the United States.

Postgrad Med 2020 May 27:1-9. Epub 2020 May 27.

University of Cincinnati, College of Medicine, Department of Internal Medicine , Cincinnati, OH, USA.

Migraine is a common and disabling disorder with substantial personal, social, and economic burden that affects 37 million people in the United States. Risk factors for migraine include age, sex, and genetics. The goal of acute treatment of migraine attacks is to stop the pain and associated symptoms of the migraine attack and return the patient to normal function. Read More

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http://dx.doi.org/10.1080/00325481.2020.1767402DOI Listing

Predictive role of gnathological techniques for the treatment of persistent idiopathic facial pain (PIFP).

Neurol Sci 2020 May 21. Epub 2020 May 21.

Igea Healthcare Institute, Milan, Italy.

Introduction/background: Persistent idiopathic craniofacial pain (PIFP) is a heterogeneous group of pain syndromes whose main characteristic is the daily presence of persistent pain for at least 3 months. The pathophysiology of PIFP is still not entirely known and probably related to biological and psychological factors. Although PIFP has been attributed to the central neuron activity, the importance of masticatory muscles as a possible pathogenic mechanism was recently demonstrated. Read More

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http://dx.doi.org/10.1007/s10072-020-04456-9DOI Listing

Dual Therapy With Anti-CGRP Monoclonal Antibodies and Botulinum Toxin for Migraine Prevention: Is There a Rationale?

Headache 2020 Jun 21;60(6):1056-1065. Epub 2020 May 21.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Objective: To narratively review the pathophysiological rationale of dual therapy with anti-calcitonin gene-related peptide monoclonal antibodies and botulinum toxin type A in treatment-resistant chronic migraine prevention.

Background: For the prevention of chronic migraine, several pharmacological therapies are available, including oral medications, botulinum toxin type A, and the newly approved monoclonal antibodies targeting calcitonin gene-related peptide or its receptor. However, monotherapy does not yield benefits in some affected individuals, which raises the question of whether dual therapy with monoclonal antibodies and botulinum toxin type A hold promise in patients with treatment-resistant chronic migraine. Read More

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http://dx.doi.org/10.1111/head.13843DOI Listing

Targeting CGRP for migraine treatment: mechanisms, antibodies, small molecules, perspectives.

Expert Rev Neurother 2020 Jun 2:1-15. Epub 2020 Jun 2.

Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila , L'Aquila, Italy.

Introduction: Calcitonin Gene-Related Peptide (CGRP) has gradually emerged as a suitable therapeutic target to treat migraine. Considering the social and economic burden of migraine, it is fundamental to optimize the disease management with efficacious and safe treatments. In this scenario, drugs targeting GCRP, monoclonal antibodies (MoAbs) and gepants, represent new therapeutic strategies. Read More

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http://dx.doi.org/10.1080/14737175.2020.1772758DOI Listing

Erenumab Efficacy on Comorbid Cluster Headache in Patients With Migraine: A Real-World Case Series.

Headache 2020 Jun 2;60(6):1187-1195. Epub 2020 May 2.

Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.

Background: Monoclonal antibodies (mABs) against calcitonin gene-related peptide (CGRP) or its receptor have emerged as effective and well-tolerated preventive medications for migraine. The key role played by CGRP has been recently demonstrated also in the pathophysiology of cluster headache (CH), paving the way for studies aimed to investigate the effectiveness of mABs targeting CGRP also in CH. However, no trials have been conducted so far to test the efficacy and tolerability of erenumab as CH preventive treatment. Read More

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http://dx.doi.org/10.1111/head.13832DOI Listing

Efficacy and Safety of Galcanezumab for the Preventive Treatment of Migraine: A Narrative Review.

Adv Ther 2020 May 21;37(5):2034-2049. Epub 2020 Apr 21.

Department of Family Medicine, Mercer University School of Medicine, Savannah, GA, USA.

Migraine is a debilitating neurologic disease. People who experience migraine can have substantial disability, impaired functioning and a decreased quality of life (QoL). Expert recommendations suggest that people with frequent migraine attacks or severe impairment related to attacks may benefit from preventive treatment. Read More

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http://dx.doi.org/10.1007/s12325-020-01319-9DOI Listing

CGRP pathway monoclonal antibodies for cluster headache.

Expert Opin Biol Ther 2020 Apr 28:1-7. Epub 2020 Apr 28.

NIHR-Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre, King's College Hospital, London, UK.

: The involvement of the calcitonin gene-related peptide (CGRP) pathway in primary headache disorders, especially migraine, had led to recent success in the development of new migraine therapies. The CGRP pathway also plays a role in the pathophysiology of cluster headache, so CGRP pathway monoclonal antibodies have been studied in the prevention of cluster headache attacks.: This review will outline the trials of fremanezumab and galcanezumab, the two CGRP pathway monoclonal antibodies that have undergone trials in cluster headache prevention. Read More

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http://dx.doi.org/10.1080/14712598.2020.1751114DOI Listing

Migraine Pathophysiology.

Pediatr Neurol 2020 Jun 4;107:1-6. Epub 2020 Feb 4.

Department of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine, Houston, Texas.

Migraine is the leading cause of years lost due to disability in individuals aged 15 to 49 years. Much has changed over the last three decades about our understanding of this complex neurological disorder. Various phases of migraine have been characterized and are the focus of this review. Read More

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http://dx.doi.org/10.1016/j.pediatrneurol.2019.12.014DOI Listing

Galcanezumab: a humanized monoclonal antibody for the prevention of migraine and cluster headache.

Drugs Today (Barc) 2020 Jan;56(1):5-19

Neumentum Inc., Palo Alto, California, USA; NEMA Research Inc., Naples, Florida, USA.

Migraine is a common, painful and highly disabling neurological condition that has plagued mankind for millennia, but its pathophysiology remained largely obscure until recently. The clinical success of triptans for treating migraine and the discovery that calcitonin gene-related peptide (CGRP) plays a prominent role in migraine led to increased research interest into this disease. An important improvement has been the development of monoclonal antibodies, including galcanezumab, that bind to CGRP or to its receptor, preventing its activation. Read More

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http://dx.doi.org/10.1358/dot.2020.56.1.3069863DOI Listing
January 2020

Low-dose interleukin-2 reverses behavioral sensitization in multiple mouse models of headache disorders.

Pain 2020 Jun;161(6):1381-1398

Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States.

Headache disorders are highly prevalent and debilitating, with limited treatment options. Previous studies indicate that many proinflammatory immune cells contribute to headache pathophysiology. Given the well-recognized role of regulatory T (Treg) cells in maintaining immune homeostasis, we hypothesized that enhancing Treg function may be effective to treat multiple headache disorders. Read More

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http://dx.doi.org/10.1097/j.pain.0000000000001818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230033PMC
June 2020
5.213 Impact Factor

The Chronic Migraine Brain: What Have We Learned From Neuroimaging?

Front Neurol 2019 9;10:1356. Epub 2020 Jan 9.

Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Chronic migraine is a highly disabling disease with a great impact on socioeconomic functioning and quality of life of migraine patients. Chronic migraine usually evolves from episodic migraine that gradually increases in attack frequency, supporting the view of migraine as a spectrum disorder. Pathophysiological mechanisms responsible for migraine chronification are not fully understood. Read More

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http://dx.doi.org/10.3389/fneur.2019.01356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962293PMC
January 2020

Renin-Angiotensin-Aldosterone System and Migraine: A Systematic Review of Human Studies.

Protein Pept Lett 2020 ;27(6):512-519

Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.

Migraine is a common neurologic condition marked by recurrent episodes of headache. Its pathophysiology is highly complex involving neuronal, inflammatory and vascular mechanisms. The Renin-Angiotensin System (RAS) can modulate all these mechanism, being a potential pharmacological target for migraine treatment. Read More

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http://dx.doi.org/10.2174/0929866527666200129160136DOI Listing
January 2020

Characterization of Ubrogepant: A Potent and Selective Antagonist of the Human Calcitonin Gene‒Related Peptide Receptor.

J Pharmacol Exp Ther 2020 Jan 28. Epub 2020 Jan 28.

Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.

A growing body of evidence has implicated the calcitonin gene-related peptide (CGRP) receptors in migraine pathophysiology. With the recent approval of monoclonal antibodies targeting CGRP or the CGRP receptor, the inhibition of CGRP-mediated signaling has emerged as a promising approach for preventive treatments of migraine in adults. However, there are no small-molecule anti-CGRP treatments available for treating migraine. Read More

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http://dx.doi.org/10.1124/jpet.119.261065DOI Listing
January 2020

Menstrual migraine: what it is and does it matter?

J Neurol 2020 Jan 28. Epub 2020 Jan 28.

Clinica Neurologica, Dipartimento di Medicina, Azienda Ospedaliero-Universitaria di Perugia, Perugia, Italy.

The diagnostic criteria of menstrual migraine (MM), migraine related to menstruation and pure menstrual migraine, are placed in the appendix of the International Classification of Headache Disorders and are still primarily considered as research criteria that need validation. Although there is a great wealth of knowledge about the neurobiological processes underlying MM and its symptoms, the mechanisms by which an attack starts during the menstrual cycle remain baffling, and the disease is still undertreated. In this narrative review, we aim to summarize recent data on pathophysiology, epidemiology, burden of disease and treatment of MM. Read More

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http://dx.doi.org/10.1007/s00415-020-09726-2DOI Listing
January 2020

New discoveries in migraine mechanisms and therapeutic targets.

Authors:
Greg Dussor

Curr Opin Physiol 2019 Oct 18;11:116-124. Epub 2019 Oct 18.

School of Behavioral and Brain Sciences, Center for Advanced Pain Studies, The University of Texas at Dallas, Richardson, TX 75080.

Migraine is among the most common and most disabling disorders worldwide, yet its underlying pathophysiology is among the most poorly understood. New information continues to emerge on mechanisms within the central and peripheral nervous systems that may contribute to migraine attacks. Additionally, new therapeutics have recently become available and along with much needed relief for many patients, these drugs provide insight into the disorder based on their mechanism of action. Read More

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http://dx.doi.org/10.1016/j.cophys.2019.10.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6897325PMC
October 2019

Sherpas, Coca Leaves, and Planes: High Altitude and Airplane Headache Review with a Case of Post-LASIK Myopic Shift.

Curr Neurol Neurosci Rep 2019 11 28;19(12):104. Epub 2019 Nov 28.

DENT Neurological Institute, 3890 Sheridan Drive, Amherst, NY, 14226, USA.

Purpose Of Review: High altitude headache is a common neurological symptom that is associated with ascent to high altitude. It is classified by the International Classification of Headache Disorders, 3rd Edition (ICHD-3) as a disorder of homeostasis. In this article, we review recent clinical and insights into the pathophysiological mechanisms of high altitude and airplane headache. Read More

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http://dx.doi.org/10.1007/s11910-019-1013-0DOI Listing
November 2019

Late sodium current blocker GS967 inhibits persistent currents induced by familial hemiplegic migraine type 3 mutations of the SCN1A gene.

J Headache Pain 2019 Nov 15;20(1):107. Epub 2019 Nov 15.

Biophysics Institute, National Research Council, Via De Marini 6, Genoa, Italy.

Background: Familial hemiplegic migraine (FHM) is a group of genetic migraine, associated with hemiparesis and aura. Three causative different genes have been identified, all of which are involved in membrane ion transport. Among these, SCN1A encodes the voltage-gated Na channel Nav1. Read More

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http://dx.doi.org/10.1186/s10194-019-1056-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858687PMC
November 2019

Headache and Methemoglobinemia.

Headache 2020 Jan 14;60(1):291-297. Epub 2019 Nov 14.

The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA, USA.

Aim: This basic review is intended to summarize the current knowledge of methemoglobinemia as an important cause of secondary headache with the hope of generating a growing interest in studying this phenomenon.

Background: We describe the pathological underpinnings of headaches generated by hypoxia. Possible mechanisms include cerebral vasodilation-associated stretching of the vessel nociceptors, sensitization of perivascular nociceptors mediated by nitric oxide, cerebral calcitonin gene-related peptide, activation of the cyclic adenosine monophosphate pathway, cortical spreading depression, disruption of the blood-brain barrier, and neurogenic inflammation. Read More

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http://dx.doi.org/10.1111/head.13696DOI Listing
January 2020

The Role of Magnesium in Pathophysiology and Migraine Treatment.

Biol Trace Elem Res 2020 Aug 5;196(2):375-383. Epub 2019 Nov 5.

Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Migraine is one of the most common recurrent types of headache and is the seventh cause of disability. This neurological disorder is characterized by having pain in head and other various symptoms such as nausea, emesis, photophobia, phonophobia, and sometimes visual sensory disorders. Magnesium (Mg) is a necessary ion for human body and has a crucial role in health and life maintenance. Read More

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http://dx.doi.org/10.1007/s12011-019-01931-zDOI Listing
August 2020
1.748 Impact Factor

Fremanezumab in the treatment of migraines: evidence to date.

J Pain Res 2019 22;12:2589-2595. Epub 2019 Aug 22.

Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.

Calcitonin gene-related peptide (CGRP) is a major player in migraine pathophysiology, and CGRP monoclonal antibodies including fremanezumab may be a safe effective preventive therapy. Phase IIb studies in episodic migraine (EM) and chronic migraine (CM) demonstrated efficacy at both the monthly 225 mg and quarterly 675 mg doses. The Phase III trials for EM and CM both showed a reduction in the primary endpoint of monthly migraine days (MMD). Read More

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http://dx.doi.org/10.2147/JPR.S166427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709817PMC
August 2019
2 Reads

Novelty in Inflammation and Immunomodulation in Migraine.

Curr Pharm Des 2019 ;25(27):2919-2936

Neurology Unit, San Giacomo Hospital, Novi Ligure, ASL AL, Italy.

Background: Migraine is a diffuse and disabling disease. Its pathophysiology is complex and involves both central and peripheral dysfunctions.

Objective: This review will discuss the pathogenesis of migraine from the origin of the neuro-inflammatory theory, to the modern pathophysiological model and the latest therapies. Read More

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http://dx.doi.org/10.2174/1381612825666190709204107DOI Listing
April 2020
1 Read

Early Onset of Efficacy With Fremanezumab for the Preventive Treatment of Chronic Migraine.

Headache 2019 11 1;59(10):1743-1752. Epub 2019 Nov 1.

Teva Pharmaceutical Industries Ltd., Frazer, PA, USA.

Objective: To assess the onset of efficacy for fremanezumab in chronic migraine by evaluating pain-related clinical measures at different time points.

Background: Faster onset of efficacy of preventive treatments could benefit patients with migraine. Fremanezumab is a fully humanized monoclonal antibody that selectively targets calcitonin gene-related peptide, a neuropeptide involved in the pathophysiology of migraine. Read More

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http://dx.doi.org/10.1111/head.13654DOI Listing
November 2019
1 Read

PD-L1 and PD-1 expressed in trigeminal ganglia may inhibit pain in an acute migraine model.

Cephalalgia 2020 Mar 22;40(3):288-298. Epub 2019 Oct 22.

ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.

Background: Neurogenic inflammation, mediated by the activation of primary neurons, is thought to be an important factor in migraine pathophysiology. Programmed cell death ligand-1 (PD-L1) can suppress the immune response through the Programmed cell death-1 receptor. However, the role of PD-L1/PD-1 in migraine remains unclear. Read More

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http://dx.doi.org/10.1177/0333102419883374DOI Listing

Plasma levels of inflammatory mediators in vestibular migraine.

Int J Neurosci 2020 Apr 24;130(4):330-335. Epub 2019 Oct 24.

Faculty of Medicine, Department of Neurology, Dokuz Eylül University, Izmir, Turkey.

Vestibular migraine (VM) is an under-recognized entity with substantial burden for the individual and society. The underlying mechanism of VM and its distinction from other migraine mechanisms still remain unclear. Inflammatory pathways have been suggested to contribute to vestibular migraine. Read More

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http://dx.doi.org/10.1080/00207454.2019.1681994DOI Listing

Self-motion perception is sensitized in vestibular migraine: pathophysiologic and clinical implications.

Sci Rep 2019 10 4;9(1):14323. Epub 2019 Oct 4.

Jenks Vestibular Physiology Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.

Vestibular migraine (VM) is the most common cause of spontaneous vertigo but remains poorly understood. We investigated the hypothesis that central vestibular pathways are sensitized in VM by measuring self-motion perceptual thresholds in patients and control subjects and by characterizing the vestibulo-ocular reflex (VOR) and vestibular and headache symptom severity. VM patients were abnormally sensitive to roll tilt, which co-modulates semicircular canal and otolith organ activity, but not to motions that activate the canals or otolith organs in isolation, implying sensitization of canal-otolith integration. Read More

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http://dx.doi.org/10.1038/s41598-019-50803-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778132PMC
October 2019
2 Reads

Novel Medications for the Treatment of Migraine.

Headache 2019 10 26;59(9):1597-1608. Epub 2019 Sep 26.

Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA, USA.

Objective: To describe the new classes of medication for headache management and their roles in clinical practice.

Background: Calcitonin gene-related peptide (CGRP) is a key component in the underlying pathophysiology of migraine. Research focused on targeting CGRP for headache treatment has led to the development of entirely new classes of medications - the gepants and the CGRP monoclonal antibodies (mAbs) - for both acute and preventive treatment. Read More

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http://dx.doi.org/10.1111/head.13661DOI Listing
October 2019
1 Read

Maladaptive activation of Nav1.9 channels by nitric oxide causes triptan-induced medication overuse headache.

Nat Commun 2019 09 18;10(1):4253. Epub 2019 Sep 18.

Aix-Marseille-Université, CNRS, Laboratoire de Neurosciences Cognitives, UMR 7291, CS8011, Bd Pierre Dramard, 13344, Marseille, France.

Medication-overuse headaches (MOH) occur with both over-the-counter and pain-relief medicines, including paracetamol, opioids and combination analgesics. The mechanisms that lead to MOH are still uncertain. Here, we show that abnormal activation of Nav1. Read More

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http://dx.doi.org/10.1038/s41467-019-12197-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751217PMC
September 2019
5 Reads

Vestibular migraine: An update on current understanding and future directions.

Cephalalgia 2020 01 8;40(1):107-121. Epub 2019 Aug 8.

Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: Vestibular migraine is among the most common causes of recurrent vertigo in the general population. Despite its prevalence and high impact on healthcare cost and utilization, it has remained an under-recognized condition with largely unknown pathophysiology. In the present article, we aim to provide an overview of the current understanding of vestibular migraine. Read More

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http://dx.doi.org/10.1177/0333102419869317DOI Listing
January 2020
2 Reads

Why is the therapeutic effect of acute antimigraine drugs delayed? A review of controlled trials and hypotheses about the delay of effect.

Br J Clin Pharmacol 2019 11 4;85(11):2487-2498. Epub 2019 Sep 4.

Institute of Physiology and Pathophysiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.

In randomised controlled trials (RCTs) of oral drug treatment of migraine attacks, efficacy is evaluated after 2 hours. The effect of oral naratriptan 2.5 mg with a maximum blood concentration (T ) at 2 hours increases from 2 to 4 hours in RCTs. Read More

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http://dx.doi.org/10.1111/bcp.14090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848898PMC
November 2019
2 Reads

Effect of Paeonia lactiflora, a traditional Chinese herb, on migraines based on clinical application and animal behavior analyses.

Biomed Pharmacother 2019 Oct 1;118:109276. Epub 2019 Aug 1.

Chinese Medicine Research Center, China Medical University, Taichung, 40402, Taiwan; Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan; Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, 40402, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung, 40447, Taiwan. Electronic address:

Background: Paeonia lactiflora (PL) was widely used for pain relief, but its effects on migraine headaches remain unclear.

Purpose: The aim of the present study was to investigate the effects of PL on migraine headaches.

Methods: First, we found that PL was frequently used in Taiwan for headache treatment based on data from Taiwan's National Health Insurance Research Database. Read More

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http://dx.doi.org/10.1016/j.biopha.2019.109276DOI Listing
October 2019
5 Reads

CGRP and Brain Functioning: Cautions for Migraine Treatment.

Headache 2019 09 21;59(8):1339-1357. Epub 2019 Jul 21.

Department of Psychology, University of Maine, Orono, ME, USA.

Background: Calcitonin gene-related peptide has emerged as a therapeutic target in migraine. Monoclonal antibodies and small molecule receptor antagonists (gepants) directed against CGRP have been approved or are in Phase II or III clinical trials. For monitoring the long-term safety of these drugs, it is helpful to consider the role of CGRP in brain functioning. Read More

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http://dx.doi.org/10.1111/head.13591DOI Listing
September 2019
2 Reads

Calcitonin gene-related peptide in migraine: from pathophysiology to treatment.

Neurologia 2019 Jul 17. Epub 2019 Jul 17.

Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea; VHIR; Universitat Autònoma de Barcelona, Barcelona, España.

Introduction: It has been observed in recent years that levels of such molecules as calcitonin gene-related peptide (CGRP) and, to a lesser extent, the pituitary adenylate cyclase-activating peptide are elevated during migraine attacks and in chronic migraine, both in the cerebrospinal fluid and in the serum. Pharmacological reduction of these proteins is clinically significant, with an improvement in patients' migraines. It therefore seems logical that one of the main lines of migraine research should be based on the role of CGRP in the pathophysiology of this entity. Read More

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http://dx.doi.org/10.1016/j.nrl.2019.03.013DOI Listing
July 2019
2 Reads

Targeting CGRP for the Prevention of Migraine and Cluster Headache: A Narrative Review.

Headache 2019 07;59 Suppl 2:20-32

Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA, USA.

Calcitonin-gene-related peptide (CGRP), a neuropeptide broadly distributed in neuronal and non-neuronal regions throughout the body, plays a fundamental role in migraine and cluster headache (CH) pathophysiology. CGRP functional blockade alleviates neurogenic inflammation and reduces pain pathway sensitization. Two types of CGRP function-blocking modalities, monoclonal antibodies (MAbs), and small molecules (gepants), have been designed to target the CGRP ligands and CGRP receptors. Read More

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http://dx.doi.org/10.1111/head.13583DOI Listing
July 2019
2 Reads

Targeting CGRP and 5-HT Receptors for the Acute Therapy of Migraine: A Literature Review.

Headache 2019 07;59 Suppl 2:3-19

Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Objective: To review and highlight current literature on emerging acute migraine treatments, focusing on CGRP receptor antagonists, gepants, and 5-HT receptor agonists (ditans).

Background: Current acute migraine therapy consists of nonspecific analgesia and triptans. Limitations to these medicines, including lack of efficacy in many patients, side effects and the contraindication of triptans in patients with cardiovascular disease, suggest that there is an unmet need for new treatments. Read More

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http://dx.doi.org/10.1111/head.13582DOI Listing
July 2019
4 Reads

Eptinezumab for prevention of chronic migraine: A randomized phase 2b clinical trial.

Cephalalgia 2019 Aug 24;39(9):1075-1085. Epub 2019 Jun 24.

8 Alder BioPharmaceuticals Ltd, Dublin, Ireland.

Background: Calcitonin gene-related peptide plays an important role in migraine pathophysiology. We evaluated eptinezumab, an intravenous (IV) anti-calcitonin gene-related peptide monoclonal antibody, for the prevention of chronic migraine.

Objective: To determine the safety, tolerability, and effectiveness of four dose levels of eptinezumab and to inform the phase 3 development program. Read More

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http://journals.sagepub.com/doi/10.1177/0333102419858355
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http://dx.doi.org/10.1177/0333102419858355DOI Listing
August 2019
7 Reads

A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs.

BMC Neurol 2019 Jun 22;19(1):136. Epub 2019 Jun 22.

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University Rof Rome Polo Pontino, Latina, Italy.

Background: A short ketogenic diet (KD) treatment can prevent migraine attacks and correct excessive cortical response. Here, we aim to prove if the KD-related changes of cortical excitability are primarily due to cerebral cortex activity or are modulated by the brainstem.

Methods: Through the stimulation of the right supraorbital division of the trigeminal nerve, we concurrently interictally recorded the nociceptive blink reflex (nBR) and the pain-related evoked potentials (PREP) in 18 migraineurs patients without aura before and after 1-month on KD, while in metabolic ketosis. Read More

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http://dx.doi.org/10.1186/s12883-019-1351-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588932PMC
June 2019
8 Reads

Sex differences in the expression of calcitonin gene-related peptide receptor components in the spinal trigeminal nucleus.

Neurobiol Pain 2019 Aug-Dec;6:100031. Epub 2019 Apr 24.

Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA.

Background And Purpose: Calcitonin gene-related peptide (CGRP) plays an important role in migraine pathophysiology. CGRP acts primarily by activating a receptor composed of 3 proteins: calcitonin receptor-like receptor (CLR), receptor activity-modifying protein 1 (RAMP1), and receptor component protein (RCP). We tested the hypothesis that sex differences exist in protein levels of two key components of this CGRP receptor: CLR and RCP. Read More

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http://dx.doi.org/10.1016/j.ynpai.2019.100031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565752PMC
April 2019
5 Reads

Fremanezumab for the preventive treatment of migraine in adults.

Expert Rev Clin Pharmacol 2019 Aug 26;12(8):741-748. Epub 2019 Jun 26.

f Department of Clinical and Molecular Medicine, Sapienza University of Rome , Rome , Italy.

: The Calcitonin Gene-Related Peptide (CGRP) has been implicated in migraine pathophysiology due to its role in neurogenic inflammation and transmission of trigeminovascular nociceptive signal. New molecules targeting CGRP and its receptor have been developed as migraine-specific preventative treatments. Fremanezumab (or TEV-48,125, LBR-101), a human monoclonal antibody against CGRP, has been recently approved for clinical use by FDA and EMA. Read More

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http://dx.doi.org/10.1080/17512433.2019.1635452DOI Listing
August 2019
13 Reads

Migraine: Experimental Models and Novel Therapeutic Approaches.

Int J Mol Sci 2019 Jun 15;20(12). Epub 2019 Jun 15.

IRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.

Migraine is a disorder affecting an increasing number of subjects. Currently, this disorder is not entirely understood, and limited therapeutic solutions are available. Migraine manifests as a debilitating headache associated with an altered sensory perception that may compromise the quality of life. Read More

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http://dx.doi.org/10.3390/ijms20122932DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628212PMC
June 2019
15 Reads

Fremanezumab for the preventive treatment of migraine.

Expert Opin Biol Ther 2019 08 1;19(8):763-771. Epub 2019 Jul 1.

b Teva Pharmaceutical Industries Ltd. , Frazer , PA , USA.

: The recent approval of monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway introduced the first preventive treatments for migraine that were specifically designed to target the underlying pathophysiology of the disease. Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) administered via subcutaneous injection, is the first approved monoclonal antibody that targets the CGRP ligand and offers both quarterly (once every 3 months) and monthly dosing. : An introduction to migraine, overview of the migraine preventive treatments that target CGRP or its receptor, background on CGRP, and details on the fremanezumab clinical development program in both chronic and episodic migraine. Read More

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http://dx.doi.org/10.1080/14712598.2019.1627323DOI Listing
August 2019
18 Reads

Diving Headache.

Curr Pain Headache Rep 2019 05 30;23(7):46. Epub 2019 May 30.

Jefferson Headache Center, Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

This review will focus on the most recent information regarding the ICHD-3 definition of diving headache as well as other important causes of diving headache that are not listed in the ICHD-3 classification system. The paper will discuss etiology, diagnosis, and management of these disorders, focusing, when possible, on the newest research available. ICHD-3 diving headache is due to hypercapnia and is treated accordingly with oxygen. Read More

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http://dx.doi.org/10.1007/s11916-019-0787-8DOI Listing
May 2019
11 Reads

Aura and Stroke: relationship and what we have learnt from preclinical models.

J Headache Pain 2019 May 29;20(1):63. Epub 2019 May 29.

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: Population-based studies have highlighted a close relationship between migraine and stroke. Migraine, especially with aura, is a risk factor for both ischemic and hemorrhagic stroke. Interestingly, stroke risk is highest for migraineurs who are young and otherwise healthy. Read More

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http://dx.doi.org/10.1186/s10194-019-1016-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734247PMC
May 2019
6 Reads

CSD-Induced Arterial Dilatation and Plasma Protein Extravasation Are Unaffected by Fremanezumab: Implications for CGRP's Role in Migraine with Aura.

J Neurosci 2019 07 24;39(30):6001-6011. Epub 2019 May 24.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02115,

Cortical spreading depression (CSD) is a wave of neuronal depolarization thought to underlie migraine aura. Calcitonin gene-related peptide (CGRP) is a potent vasodilator involved in migraine pathophysiology. Evidence for functional connectivity between CSD and CGRP has triggered scientific interest in the possibility that CGRP antagonism may disrupt vascular responses to CSD and the ensuing plasma protein extravasation (PPE). Read More

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http://dx.doi.org/10.1523/JNEUROSCI.0232-19.2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650995PMC

Patient selection for migraine preventive treatment with anti-CGRP(r) monoclonal antibodies.

Expert Rev Neurother 2019 08 29;19(8):769-776. Epub 2019 May 29.

a Department of Clinical and Molecular Medicine , Sapienza University , Rome , Italy.

: Migraine is the most common neurological disorder and represents the first cause of disability in under 50s in both genders. Available preventive drugs were primarily developed for indications other than migraine and with an unclear mechanism of action in migraine pathophysiology. : This article reviews current preventive treatments and their shortcomings and the road that, through the understanding of calcitonin gene-related peptide (CGRP) role in migraine pathophysiology, carried to the approval of the 3 first-in-class monoclonal antibodies (mAbs) acting on the CGRP pathway. Read More

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http://dx.doi.org/10.1080/14737175.2019.1621749DOI Listing
August 2019
35 Reads

Gepants for the treatment of migraine.

Expert Opin Investig Drugs 2019 06 17;28(6):555-567. Epub 2019 May 17.

a Department of Clinical and Molecular Medicine , Sapienza University , Rome , Italy.

Introduction: Migraine is the most common of all neurological disorders. A breakthrough in migraine treatment emerged in the early nineties with the introduction of 5-HT1B/D receptor agonists called triptans. Triptans are used as the standard of care for acute migraine; however, they have significant limitations such as incomplete and inconsistent pain relief, high rates of headache recurrence, class- specific side effects and cardiovascular contraindications. Read More

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http://dx.doi.org/10.1080/13543784.2019.1618830DOI Listing
June 2019
40 Reads

Ultra-high field MR angiography in human migraine models: a 3.0 T/7.0 T comparison study.

J Headache Pain 2019 May 6;20(1):48. Epub 2019 May 6.

Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark.

Background: Sildenafil and calcitonin gene-related peptide both dilate the intradural segments of the middle meningeal artery measured with 3.0 tesla (T) MR angiography. Here we hypothesized that an increase in field strength to 7. Read More

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http://dx.doi.org/10.1186/s10194-019-0996-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734314PMC
May 2019
7 Reads