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

Models for Treating Post-traumatic Headache.

Joshua Kamins

Curr Pain Headache Rep 2021 Jun 14;25(8):52. Epub 2021 Jun 14.

Goldberg Migraine Program, Department of Neurology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.

Purpose Of Review: To discuss the treatment of post-traumatic headache (PTH) and how to choose pharmacotherapy based upon known pathophysiology.

Recent Findings: Preclinical models of traumatic brain injury are finally revealing some of the mechanisms of PTH, including the significant role that inflammatory neuropeptides like calcitonin gene-related peptide (CGRP) play in the initiation and persistence of symptoms. To effectively treat post-traumatic headache (PTH), one needs to understand the pathophysiology behind the initiation and persistence of symptoms. Read More

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Protein kinase C δ as a neuronal mechanism for headache in a chronic intermittent nitroglycerin model of migraine in mice.

Pain 2021 May 31. Epub 2021 May 31.

Department of Pharmaceutical Sciences and Center for Biomolecular Science, University of Illinois, Chicago, IL 60612 Division of Pharmacology and Toxicology, College of Pharmacy, University of Texas, Austin, Texas, USA Department of Neurology & Rehabilitation, University of Illinois, Chicago, IL 60612 Department of Bioengineering, University of Illinois, Chicago, IL 60607.

Abstract: Migraine is one of the most common neurological disorders characterized by recurrent attacks of typically throbbing and unilateral headaches, affecting up to 20 % of the population worldwide. Despite the high prevalence and severity of this primary headache disorder, it remains to be a challenge to fully understand and treat migraine headaches. By characterizing and validating a mouse migraine model, this study aimed to investigate the functional contribution of PKC isoforms in migraine. Read More

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Effectiveness and Safety of CGRP-mAbs in Menstrual-Related Migraine: A Real-World Experience.

Pain Ther 2021 Jun 9. Epub 2021 Jun 9.

Department of Advanced Medical and Surgical Sciences (DAMS), Headache Center, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.

Introduction: Migraine shows a significantly higher prevalence in women, especially during reproductive age when menstrual-related hormonal fluctuations represent the most common migraine trigger. Indeed, over 50% of patients report a higher occurrence of migraine attacks during the perimenstrual window. Menstrual migraine attacks are consistently referred to as more disabling, less responsive to symptomatic treatments, longer in duration, and more prone to relapse than non-menstrual migraine attacks. Read More

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Hypervigilance, Allostatic Load, and Migraine Prevention: Antibodies to CGRP or Receptor.

Neurol Ther 2021 Jun 2. Epub 2021 Jun 2.

Island Neurological Associates, Plainview, NY, USA.

Migraine involves brain hypersensitivity with episodic dysfunction triggered by behavioral or physiological stressors. During an acute migraine attack the trigeminal nerve is activated (peripheral sensitization). This leads to central sensitization with activation of the central pathways including the trigeminal nucleus caudalis, the trigemino-thalamic tract, and the thalamus. Read More

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Headache in Women.

Continuum (Minneap Minn) 2021 06;27(3):686-702

Purpose Of Review: Women are greatly overrepresented among patients seeking treatment for symptoms of headache pain in general and migraine in particular. Understanding the presentation of headache in women in relation to hormonal changes both during the menstrual cycle and throughout the life span is essential for appropriate diagnosis and treatment.

Recent Findings: Although perimenstrual migraine attacks are generally without aura, the diagnosis of migraine with aura has been added to the headache classification for menstrual migraine to account for women with the diagnosis of migraine with aura who experience menstrual migraine attacks. Read More

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The childhood migraine syndrome.

Nat Rev Neurol 2021 May 26. Epub 2021 May 26.

Neurology and Pediatrics, University of California San Francisco, San Francisco, CA, USA.

Migraine is a complex genetic brain disorder with an intricate pathogenesis and polymorphous clinical presentations, particularly in children. In this Perspective, we describe the different phenotypes of migraine in children, including conditions that have been referred to in the International Classification of Headache Disorders as "syndromes that may be related to migraine''. Evidence is presented for the integration of abdominal migraine, cyclical vomiting syndrome, benign paroxysmal vertigo, benign paroxysmal torticollis and infantile colic into the unified diagnosis of 'childhood migraine syndrome' on the basis of clinical and epidemiological characteristics, and shared inheritance. Read More

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The Evolution of Medication Overuse Headache: History, Pathophysiology and Clinical Update.

CNS Drugs 2021 May 17;35(5):545-565. Epub 2021 May 17.

Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand.

Medication overuse headache (MOH), the development or worsening of chronic headache resulting from frequent and excessive intake of medications used for acute treatment of headache, is a common secondary headache disorder and is associated with significant personal and societal burdens. The plausible physiologic mechanism is that chronic exposure to acute care migraine treatment leads to suppression of endogenous antinociceptive systems, consequently facilitating the trigeminal nociceptive process via up-regulation of the calcitonin gene-related peptide (CGRP) system. Recognizing and preventing its development is an integral aspect of migraine management, as medication overuse is a modifiable risk factor in the progression from episodic to chronic migraine. Read More

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Emerging role of glutamate in the pathophysiology and therapeutics of Gulf War illness.

Life Sci 2021 May 12:119609. Epub 2021 May 12.

Department of Neuroscience, College of Medicine, The Ohio State University, Columbus, OH, USA. Electronic address:

Gulf War illness (GWI) is a chronic and multi-symptomatic disorder affecting veterans who served in the Gulf War. The commonly reported symptoms in GWI veterans include mood problems, cognitive impairment, muscle and joint pain, migraine/headache, chronic fatigue, gastrointestinal complaints, skin rashes, and respiratory problems. Neuroimaging studies have revealed significant brain structure alterations in GWI veterans, including subcortical atrophy, decreased volume of the hippocampus, reduced total grey and white matter, and increased brain white matter axial diffusivity. Read More

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The Influence of Calcitonin Gene-Related Peptide on Cerebral Hemodynamics in Nonmigraine Subjects with Calcitonin Gene-Related Peptide-Induced Headaches.

Biomed Res Int 2021 24;2021:5540254. Epub 2021 Apr 24.

Department of Neurology, University Medical Center Ljubljana, Zaloška Cesta 2, 1000 Ljubljana, Slovenia.

Background: Calcitonin gene-related peptide (CGRP) is regarded as an important molecule in trigeminovascular sensitization (TVS). CGRP-induced headaches (CGRP-IH) are evoked by intravascular administration of CGRP in nonmigraine and migraine subjects. CGRP might be associated with vasodilatation of the middle cerebral artery (MCA). Read More

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Urinary Proteomics Reveals Promising Biomarkers in Menstrually Related and Post-Menopause Migraine.

J Clin Med 2021 Apr 24;10(9). Epub 2021 Apr 24.

Unit of Medical Toxicology, Headache Centre and Drug Abuse, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy.

Migraine is an invalidating neuro-vascular disorder largely spread in the world population. Currently, its pathophysiology is not yet completely understood. The purpose of this study was to investigate the urinary proteome of women suffering from menstrually related migraine (MM) and post-menopause migraine (PM) in comparison with non-headache women as controls, to search potential biomarkers of these migraine sub-types. Read More

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Migraine with Brainstem Aura Accompanied by Disorders of Consciousness.

J Pain Res 2021 20;14:1119-1127. Epub 2021 Apr 20.

Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, People's Republic of China.

Migraine with brainstem aura (MBA) accompanied by disorders of consciousness (DOC) is a rare subtype of migraine. The pathophysiology of MBA with DOC has not been elucidated yet. Some patients have a family history of migraine, and women are more affected than men. Read More

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Changes in the gene expression profile during spontaneous migraine attacks.

Sci Rep 2021 Apr 15;11(1):8294. Epub 2021 Apr 15.

Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark.

Migraine attacks are delimited, allowing investigation of changes during and outside attack. Gene expression fluctuates according to environmental and endogenous events and therefore, we hypothesized that changes in RNA expression during and outside a spontaneous migraine attack exist which are specific to migraine. Twenty-seven migraine patients were assessed during a spontaneous migraine attack, including headache characteristics and treatment effect. Read More

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Petasin and isopetasin reduce CGRP release from trigeminal afferents indicating an inhibitory effect on TRPA1 and TRPV1 receptor channels.

J Headache Pain 2021 Apr 13;22(1):23. Epub 2021 Apr 13.

Institute of Physiology and Pathophysiology, Friedrich-Alexander-University of Erlangen-Nürnberg, Universitätsstraße 17, 91054, Erlangen, Germany.

Background: Butterbur root extract with its active ingredients petasin and isopetasin has been used in the prophylactic treatment of migraine for years, while its sites of action are not completely clear. Calcitonin gene-related peptide (CGRP) is known as a biomarker and promoting factor of migraine. We set out to investigate the impact of petasins on the CGRP release from trigeminal afferents induced by activation of the calcium conducting transient receptor potential channels (TRPs) of the subtypes TRPA1 and TRPV1. Read More

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Prevalence and association of lifestyle and medical-, psychiatric-, and pain-related comorbidities in patients with migraine: A cross-sectional study.

Headache 2021 May 5;61(5):715-726. Epub 2021 Apr 5.

Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Background And Objectives: Migraine has been associated with many comorbidities. However, lifestyle factors and the presence of comorbid diseases have not previously been extensively studied in the same sample. This study aimed to compare the prevalence of unhealthy lifestyle factors and comorbid diseases between patients with migraine and migraine-free controls with subgroup analyses to determine the pathophysiology and possible consequences. Read More

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Migraine: Calcium Channels and Glia.

Int J Mol Sci 2021 Mar 7;22(5). Epub 2021 Mar 7.

Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego St., 60-355 Poznan, Poland.

Migraine is a common neurological disease that affects about 11% of the adult population. The disease is divided into two main clinical subtypes: migraine with aura and migraine without aura. According to the neurovascular theory of migraine, the activation of the trigeminovascular system (TGVS) and the release of numerous neuropeptides, including calcitonin gene-related peptide (CGRP) are involved in headache pathogenesis. Read More

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Evidence that blood-CSF barrier transport, but not inflammatory biomarkers, change in migraine, while CSF sVCAM1 associates with migraine frequency and CSF fibrinogen.

Headache 2021 Mar 16;61(3):536-545. Epub 2021 Mar 16.

Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, USA.

Objective: Our objective is to explore whether blood-cerebrospinal fluid (CSF) barrier biomarkers differ in episodic migraine (EM) or chronic migraine (CM) from controls.

Background: Reports of blood-brain barrier and blood-cerebrospinal fluid barrier (BCSFB) disruption in migraine vary. Our hypothesis is that investigation of biomarkers associated with blood, CSF, brain, cell adhesion, and inflammation will help elucidate migraine pathophysiology. Read More

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The complex relationship between estrogen and migraines: a scoping review.

Syst Rev 2021 03 10;10(1):72. Epub 2021 Mar 10.

Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Rd, Columbus, OH, 43212, USA.

Background: Migraines are a chronic disease for millions worldwide and have been hypothesized to be hormonally mediated due to their higher prevalence in females and menstrual associations. Estrogen has been commonly implicated in migraine pathogenesis, yet its exact role in the pathophysiology of migraines has yet to be fully understood.

Method: We conducted a scoping review of the literature regarding estrogen's role in migraine pathogenesis and included 19 studies out of an initial 202 in the final review. Read More

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Different dosage regimens of Eptinezumab for the treatment of migraine: a meta-analysis from randomized controlled trials.

J Headache Pain 2021 Mar 6;22(1):10. Epub 2021 Mar 6.

Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.

Background: Migraine is one of the most common neurological diseases around the world and calcitonin gene-related peptide (CGRP) plays an important role in its pathophysiology. Therefore, in the present study, we evaluated the efficacy of monoclonal antibodies blocking the CGRP ligand or receptor in episodic and chronic migraine.

Objective: The objective of our study is implementing a meta-analysis to systematically evaluate the efficacy and safety of eptinezumab for the treatment of migraine compared with placebo. Read More

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Evaluating rimegepant for the treatment of migraine.

Expert Opin Pharmacother 2021 Jun 10;22(8):973-979. Epub 2021 Mar 10.

Erasmus MC, Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Rotterdam, Netherlands.

Calcitonin gene-related peptide (CGRP) is a vasodilatory neuropeptide involved in the pathophysiology of migraine, a highly disabling neurovascular disorder characterized by severe headache attacks. Rimegepant is a small-molecule CGRP receptor antagonist approved by the FDA for acute treatment of migraine and currently under investigation for migraine prophylaxis. The authors summarize available data on safety and tolerability of rimegepant and provide insights on its use for acute migraine treatment. Read More

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[Endometriosis and chronic overlapping pain conditions].

Winfried Häuser

Schmerz 2021 Jun 11;35(3):179-182. Epub 2021 Feb 11.

Medizinisches Versorgungszentrum für Schmerzmedizin und seelische Gesundheit Saarbrücken - St. Johann, Saarbrücken, Deutschland.

Background: The concept of chronic overlapping pain conditions (COPC) is relatively unknown in German pain medicine.

Aims: Definition, prevalence, shared etiological and pathophysiological mechanisms of COPC. Summary of recommendations of the interdisciplinary S2k guidelines on diagnostics and treatment of endometriosis relevant for pain physicians. Read More

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Muscle endurance and cervical electromyographic activity during submaximal efforts in women with and without migraine.

Clin Biomech (Bristol, Avon) 2021 02 23;82:105276. Epub 2021 Jan 23.

Department of Health Sciences -Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

Background: Despite previous reports supporting cervical muscle weakness and altered motor control in migraine, the endurance under standardized submaximal loads has not been investigated. Therefore, this study aimed to assess the endurance and muscle activity of the cervical musculature during submaximal isometric contractions in women with migraine and those without headache.

Methods: Cervical muscle endurance tests were performed for flexors and extensors at 25%, 50%, and 75% of the output force during maximal isometric contraction using the Multi-Cervical Rehabilitation Unit with customized biofeedback. Read More

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February 2021

Rimegepant: acute treatment for migraine headaches.

Pain Manag 2021 May 8;11(3):259-266. Epub 2021 Feb 8.

Department of Pharmacy Practice, St. Louis College of Pharmacy, University of Health Sciences & Pharmacy in St Louis, 1 Pharmacy Place, St Louis, Missouri 63110, USA.

Migraine headache treatment is quickly evolving. There have been three new acute migraine treatment options (i.e. Read More

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An outlook on the trigeminovascular mechanisms of action and side effects concerns of some potential neuropeptidergic antimigraine therapies.

Expert Opin Drug Metab Toxicol 2021 Feb 20;17(2):179-199. Epub 2021 Jan 20.

Departamento de Farmacobiología, Cinvestav-Coapa , Ciudad de México, México.

: In addition to serotonin (5-hydroxytryptamine; 5-HT) and other (neuro)mediators, the role of neuropeptides in migraine pathophysiology is relevant. Indeed, while some molecules interfering with calcitonin gene-related peptide (CGRP) transmission have recently been approved for clinical antimigraine use, other neuropeptides with translational use are in the pipeline. Among others, hypothalamic neuropeptides such as pituitary adenylate cyclase-activating peptide (PACAP), oxytocin (OT), and orexins stand out as potential novel targets to treat this neurovascular disorder. Read More

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February 2021

Association between response to triptans and response to erenumab: real-life data.

J Headache Pain 2021 Jan 6;22(1). Epub 2021 Jan 6.

Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.

Background: Triptans and erenumab are both migraine-specific agents acting on the calcitonin gene-related peptide pathway. Therefore, response to triptans might be associated with response to erenumab.

Main Body: In our study, consecutive patients referring to the Headache Centers of the Abruzzo region from January 2019 to March 2020 and treated with erenumab were interviewed about past use and efficacy of triptans. Read More

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January 2021

Galcanezumab for the prevention of migraine.

Pain Manag 2021 Mar 9;11(2):101-112. Epub 2020 Dec 9.

Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas, TX 75390, USA.

Migraine is a common and disabling disorder affecting approximately 1.02 billion people worldwide. Calcitonin gene-related peptide (CGRP) has been identified as playing an important role in the pathophysiology of migraine and several migraine-specific therapies targeting the CGRP ligand or its receptor have been approved since 2018 for the acute and preventive treatment of migraine. Read More

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Transcutaneous auricular vagus nerve stimulation (taVNS) for migraine: an fMRI study.

Reg Anesth Pain Med 2021 Feb 1;46(2):145-150. Epub 2020 Dec 1.

Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

Background: Dysfunction of the thalamocortical connectivity network is thought to underlie the pathophysiology of the migraine. This current study aimed to explore the thalamocortical connectivity changes during 4 weeks of continuous transcutaneous vagus nerve stimulation (taVNS) treatment on migraine patients.

Methods: 70 migraine patients were recruited and randomized in an equal ratio to receive real taVNS or sham taVNS treatments for 4 weeks. Read More

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February 2021

Estrogen receptors α, β and GPER in the CNS and trigeminal system - molecular and functional aspects.

J Headache Pain 2020 Nov 10;21(1):131. Epub 2020 Nov 10.

Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet, Glostrup, Denmark.

Background: Migraine occurs 2-3 times more often in females than in males and is in many females associated with the onset of menstruation. The steroid hormone, 17β-estradiol (estrogen, E2), exerts its effects by binding and activating several estrogen receptors (ERs). Calcitonin gene-related peptide (CGRP) has a strong position in migraine pathophysiology, and interaction with CGRP has resulted in several successful drugs for acute and prophylactic treatment of migraine, effective in all age groups and in both sexes. Read More

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November 2020

Headache characteristics in COVID-19 pandemic-a survey study.

J Headache Pain 2020 Oct 13;21(1):121. Epub 2020 Oct 13.

Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Çapa, Istanbul, Turkey.

Background: Headache is the most common COVID-19-related neurological symptom. We aimed to reveal diagnostic clues of headache for COVID-19 infection and to investigate the course of primary headaches during the pandemic.

Methods: We developed a detailed web-based questionnaire screening the characteristics and course of headaches besides clinical COVID-19 features. Read More

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October 2020

An Evidence-Based Review of Galcanezumab for the Treatment of Migraine.

Neurol Ther 2020 Dec 3;9(2):403-417. Epub 2020 Oct 3.

Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA.

Purpose Of Review: This is a comprehensive review of the current literature on the usage of galcanezumab for migraine treatment. It reviews the biology, pathophysiology, epidemiology, diagnosis, and conventional treatment of migraines, then compares the literature available for galcanezumab with historical treatment options.

Recent Findings: Migraine is a common headache disorder and constitutes a significant source of distress from both a personal and societal perspective. Read More

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December 2020

A new era for migraine: The role of calcitonin gene-related peptide in the trigeminovascular system.

Prog Brain Res 2020 16;255:123-142. Epub 2020 Jun 16.

Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan. Electronic address:

There is a huge improvement in our understanding of migraine pathophysiology in the past decades. The activation of the trigeminovascular system has been proved to play a key role in migraine. Calcitonin gene-related peptide (CGRP) and CGRP receptors are widely distributed in the trigeminovascular system. Read More

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