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


Repeated inflammatory dural stimulation-induced cephalic allodynia causes alteration of gut microbial composition in rats.

J Headache Pain 2022 Jun 25;23(1):71. Epub 2022 Jun 25.

Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, 100853, Beijing, People's Republic of China.

Background: Gut microbial dysbiosis and gut-brain axis dysfunction have been implicated in the pathophysiology of migraine. However, it is unclear whether migraine-related cephalic allodynia could induce the alteration of gut microbial composition.

Methods: A classic migraine rat model was established by repeated dural infusions of inflammatory soup (IS). Read More

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A systematic review with expert opinion on the role of gepants for the preventive and abortive treatment of migraine.

Expert Rev Neurother 2022 Jun 27:1-20. Epub 2022 Jun 27.

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Introduction: Gepants are small molecules targeting the calcitonin gene-related peptide (CGRP) that have been recently introduced and are under additional clinical development as preventive and abortive treatment options for migraine.

Areas Covered: After providing a narrative overview of current preventive and acute treatment options for migraine and summarizing the pathophysiology of migraine attack and the role of CGRP, we performed a systematic review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, on trials on gepants in preventive and acute treatment of migraine. Studies and results were reviewed and discussed, and expert opinion was presented. Read More

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

Neurologia (Engl Ed) 2022 Jun 26;37(5):390-402. Epub 2021 May 26.

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

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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Ex vivo Release of Calcitonin Gene-Related Peptide from the Trigeminovascular System in Rodents.

J Vis Exp 2022 05 16(183). Epub 2022 May 16.

Danish Headache Center, Department of Neurology, Rigshospitalet, University of Copenhagen;

Calcitonin gene-related peptide (CGRP) was first discovered in the 1980s as a splice variant from the calcitonin gene. Since its discovery, its role in migraine pathophysiology has been well established, first by its potent vasodilator properties and subsequently by its presence and function as a neurotransmitter in the sensory trigeminovascular system. The migraine-provoking ability of CGRP gave support to the pharma industry to develop monoclonal antibodies and antagonists inhibiting the effect of CGRP. Read More

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Identification of Determinants of Biofeedback Treatment's Efficacy in Treating Migraine and Oxidative Stress by ARIANNA (ARtificial Intelligent Assistant for Neural Network Analysis).

Healthcare (Basel) 2022 May 19;10(5). Epub 2022 May 19.

Santa Lucia Foundation IRCSS, 00179 Roma, Italy.

Migraines are a public health problem that impose severe socioeconomic burdens and causes related disabilities. Among the non-pharmacological therapeutic approaches, behavioral treatments such as biofeedback have proven effective for both adults and children. Oxidative stress is undoubtedly involved in the pathophysiology of migraines. Read More

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Effectiveness of Transcranial Direct Current Stimulation and Monoclonal Antibodies Acting on the CGRP as a Combined Treatment for Migraine (TACTIC): Protocol for a Randomized, Double-Blind, Sham-Controlled Trial.

Front Neurol 2022 10;13:890364. Epub 2022 May 10.

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Background: Migraine is a recurrent headache disorder that has a still unclear pathophysiology, involving several circuits of both the central and peripheral nervous system. Monoclonal antibodies acting on the calcitonin gene-related (CGRP) pathway (CGRP-MAbs) are the first drugs specifically designed for migraine; those drugs act peripherally on the trigeminal ganglion without entering the blood-brain barrier. Conversely, neuromodulation techniques such as transcranial direct current stimulation (tDCS) act centrally by increasing or decreasing the neuronal firing rate of brain cortical areas. Read More

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Petasites for Migraine Prevention: New Data on Mode of Action, Pharmacology and Safety. A Narrative Review.

Front Neurol 2022 26;13:864689. Epub 2022 Apr 26.

Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA, United States.

Petasins are the pharmacologically active ingredients of butterbur and of therapeutic benefit in the treatment of migraine and tension headaches. Here, we summarize the pharmacology, safety and clinical efficacy of butterbur in the prevention of migraine attacks and present new data on its mode of action. We review published literature and study reports on the safety and clinical efficacy of the butterbur root extract Petadolex® and report new findings on petasins in dampening nociception by desensitizing calcium-conducting TRP ion channels of primary sensory neurons. Read More

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Brazilian descriptive study of 104 consecutive real-world migraine patients treated with monoclonal antibodies.

Postgrad Med 2022 May 27:1-5. Epub 2022 May 27.

Headache Center of Rio, Rio de Janeiro, Brazil.

Background: Migraine is a highly disabling and prevalent neurological disorder. A peptide, calcitonin gene-related peptide, was identified as involved in migraine pathophysiology and monoclonal anti-CGRP antibodies have been developed.

Aim: To describe the clinical characteristics and therapeutic response of migraine patients treated with monoclonal antibodies. Read More

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Sleep restriction alters cortical inhibition in migraine: A transcranial magnetic stimulation study.

Clin Neurophysiol 2022 Jul 20;139:28-42. Epub 2022 Apr 20.

Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.

Objective: Migraine is a primary headache disorder with a well-known association with insufficient sleep. However, both the underlying pathophysiology of the disease and the relationship with sleep is still unexplained. In this study, we apply transcranial magnetic stimulation to investigate possible mechanisms of insufficient sleep in migraine. Read More

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Role of Estrogens in Menstrual Migraine.

Cells 2022 04 15;11(8). Epub 2022 Apr 15.

Headache Science and Neurorehabilitation Center, National Neurological Institute C. Mondino Foundation, 27100 Pavia, Italy.

Migraine is a major neurological disorder affecting one in nine adults worldwide with a significant impact on health care and socioeconomic systems. Migraine is more prevalent in women than in men, with 17% of all women meeting the diagnostic criteria for migraine. In women, the frequency of migraine attacks shows variations over the menstrual cycle and pregnancy, and the use of combined hormonal contraception (CHC) or hormone replacement therapy (HRT) can unveil or modify migraine disease. Read More

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Is Persistent Post-COVID Headache Associated With Protein-Protein Interactions Between Antibodies Against Viral Spike Protein and CGRP Receptor?: A Case Report.

Front Pain Res (Lausanne) 2022 1;3:858709. Epub 2022 Apr 1.

Koç University Research Center for Translational Medicine, Istanbul, Turkey.

Background: After the acute pandemic of coronavirus disease 2019 (COVID-19), a wide variety of symptoms are identified under the term post-COVID syndrome, such as persistent headache. Post-COVID headache can be presented in a broad spectrum like headache attributed to systemic infection, chronification of already existing primary headache, or long-lasting, and also late-onset new daily persistent headache. Still, little is known about the pathophysiology of post-COVID headache, but activation of the trigeminovascular system may be one of the players. Read More

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The Arrival of Anti-CGRP Monoclonal Antibodies in Migraine.

Neurotherapeutics 2022 Apr 14. Epub 2022 Apr 14.

Department of Neurology, Jefferson Headache Center, Thomas Jefferson University, 900 Walnut Street, Suite 200, Philadelphia, PA, 19107, USA.

Remarkable advancements have been made in the field of migraine pathophysiology and pharmacotherapy over the past decade. Understanding the molecular mechanism of calcitonin gene-related peptide (CGRP) has led to the discovery of a novel class of drugs, CGRP functional blocking monoclonal antibodies (mAbs), for migraine prevention. CGRP is a neuropeptide inherently involved in migraine physiology where its receptors are found dispersed throughout the central and peripheral nervous systems. Read More

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Neck-specific strengthening exercise compared with placebo sham ultrasound in patients with migraine: a randomized controlled trial.

BMC Neurol 2022 Apr 2;22(1):126. Epub 2022 Apr 2.

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

Background: Migraine patients have musculoskeletal disorders and pain in the cervical. And, despite the pathophysiology demonstrating the relationship between migraine and the cervical spine, the effectiveness of craniocervical exercises in these patients has not been verified. So, the aimed of this study was verify the effectiveness of craniocervical muscle-strengthening exercise (CMSE) in reducing the frequency and intensity of headache in migraine patients. Read More

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Changes in Plasma Lipid Levels Following Cortical Spreading Depolarization in a Transgenic Mouse Model of Familial Hemiplegic Migraine.

Metabolites 2022 Mar 1;12(3). Epub 2022 Mar 1.

Department of Human Genetics, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands.

Metabolite levels in peripheral body fluids can correlate with attack features in migraine patients, which underscores the potential of plasma metabolites as possible disease biomarkers. Migraine headache can be preceded by an aura that is caused by cortical spreading depolarization (CSD), a transient wave of neuroglial depolarization. We previously identified plasma amino acid changes after CSD in familial hemiplegic migraine type 1 (FHM1) mutant mice that exhibit increased neuronal excitability and various migraine-related features. Read More

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Review on Headache Related to Dietary Supplements.

Curr Pain Headache Rep 2022 Mar 7;26(3):193-218. Epub 2022 Mar 7.

Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Purpose Of Review: The lifetime prevalence of headaches is 96%. Approximately 11% of the adult population worldwide has a migraine headache. Migraine is a complex disorder that is more than a simple headache. Read More

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Sex Differences in Chronic Migraine: Focusing on Clinical Features, Pathophysiology, and Treatments.

Curr Pain Headache Rep 2022 May 26;26(5):347-355. Epub 2022 Feb 26.

Neurological Institute, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou 112, Taipei, Taiwan.

Purpose Of Review: This review provides an update on sex differences in chronic migraine (CM), with a focus on clinical characteristics, pathophysiology, and treatments.

Recent Findings: Approximately 6.8-7. Read More

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Resting State Electrophysiological Cortical Activity: A Brain Signature Candidate for Patients with Migraine.

Curr Pain Headache Rep 2022 Apr 19;26(4):289-297. Epub 2022 Feb 19.

Brain Research Center, National Yang Ming Chiao Tung University, 155, Linong Str. Sec 2, Taipei, Taiwan.

Purpose Of Review: Studies on event-related evoked potentials have indicated that altered cortical processing of sensory stimuli is associated with migraine. However, the results depend on the experimental method and patients. Electrophysiology of resting state cortical activity has revealed compelling results regarding the pathophysiology of migraine. Read More

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Long-Term Effectiveness of Three Anti-CGRP Monoclonal Antibodies in Resistant Chronic Migraine Patients Based on the MIDAS score.

CNS Drugs 2022 02 11;36(2):191-202. Epub 2022 Feb 11.

Headache Center and Clinical Pharmacology Unit, Careggi University Hospital, Florence, Italy.

Background: Criteria, including clinical features and effective outcomes, for access and persistence of novel but costly treatments may vary between countries, thus affecting the health of patients. Monoclonal antibodies against the calcitonin gene-related peptide pathway (anti-CGRP mAbs) for migraine treatment are currently prescribed following strict criteria.

Objective: The aim was to assess the effectiveness and safety of three anti-CGRP mAbs (erenumab, galcanezumab, and fremanezumab) in consecutive resistant chronic migraine patients presenting at our Headache Center and the impact of criteria set by the Italian Medicines Agency to start and continue (achieving a ≥ 50% reduction in Migraine Disability Assessment [MIDAS] score) with treatment under the reimbursement program. Read More

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February 2022

Calcitonin gene-related peptide-targeting drugs for migraine: how pharmacology might inform treatment decisions.

Lancet Neurol 2022 03 31;21(3):284-294. Epub 2022 Jan 31.

Erasmus MC, University Medical Center Rotterdam, Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Rotterdam, Netherlands. Electronic address:

Migraine is the second most disabling disorder across all age groups worldwide. Since 2018, two classes of drugs that inhibit the actions of calcitonin gene-related peptide (CGRP), which is implicated in migraine pathophysiology, have become available: gepants (CGRP receptor antagonists) and monoclonal antibodies directed against CGRP or its receptor. Despite phase 3 clinical trials and some real world evidence, knowledge of the pharmacology and related clinical effects of these drugs is low, and trial data are not necessarily generalisable to all populations. Read More

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Calcitonin gene-related peptide and pituitary adenylate cyclase-activating polypeptide in migraine treatment.

Curr Opin Endocrinol Diabetes Obes 2022 04;29(2):225-231

Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen.

Purpose Of Review: To review the latest advances in migraine management with a focus on medications specifically developed for the treatment of migraine.

Recent Findings: Randomized clinical trials demonstrated the efficacy of calcitonin gene-related peptide (CGRP) mAbs for the preventive treatment of migraine and the small molecule CGRP receptor antagonist gepants for acute abortion and prevention of migraine attacks. Pituitary adenylate cyclase-activating polypeptide (PACAP) is another signaling molecule of interest and represents a potential new drug class of mechanism-based migraine medications. Read More

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Prolonged migraine aura resembling ischemic stroke following CoronaVac vaccination: an extended case series.

J Headache Pain 2022 Jan 21;23(1):13. Epub 2022 Jan 21.

Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Background: After the initiation of the COVID-19 vaccination program in Thailand, thousands of patients have experienced unusual focal neurological symptoms. We report 8 patients with focal neurological symptoms after receiving inactivated virus vaccine, CoronaVac.

Case Series: Patients were aged 24-48 years and 75% were female. Read More

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January 2022

Transient Global Amnesia.

Am Fam Physician 2022 01;105(1):50-54

Medical University of South Carolina, Greenwood, SC, USA.

Transient global amnesia (TGA) is a clinical syndrome characterized by anterograde amnesia, mild retrograde amnesia, and confusion up to 24 hours. Most commonly seen in patients older than 50 years, TGA results from the temporary impairment of short-term memory formation. Clinically, patients have time disorientation and often ask repeated questions regarding the day's events. Read More

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January 2022

Initial experience with novel CGRP-receptor inhibitor therapy in Migraine in the United Arab Emirates: a retrospective observational study.

BMC Neurol 2021 Dec 14;21(1):486. Epub 2021 Dec 14.

Mediclinic Dubai, Institute for Neuroscience, Dubai, United Arab Emirates.

Background: Erenumab is a calcitonin gene-related peptide (CGRP)-receptor antibody inhibiting CGRP function. CGRP is prominently involved in the pathophysiology of migraine through nociceptive modulation in the trigeminovascular system. This study aims to explore the treatment effect of erenumab in a real-life setting. Read More

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December 2021

The role of TRP ion channels in migraine and headache.

Neurosci Lett 2022 01 30;768:136380. Epub 2021 Nov 30.

Headache Center and Clinical Pharmacology Unit, Careggi University Hospital, Florence, Italy. Electronic address:

Migraine afflicts more than 10% of the general population. Although its mechanism is poorly understood, recent preclinical and clinical evidence has identified calcitonin gene related peptide (CGRP) as a major mediator of migraine pain. CGRP, which is predominantly expressed in a subset of primary sensory neurons, including trigeminal afferents, when released from peripheral terminals of nociceptors, elicits arteriolar vasodilation and mechanical allodynia, a hallmark of migraine attack. Read More

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January 2022

Ginger for Migraine.

J Clin Psychiatry 2021 11 30;82(6). Epub 2021 Nov 30.

Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore, India.

Many preclinical and clinical studies have examined the potential benefits of ginger extracts for a range of medical disorders. Ginger has been found to reduce both pain and nausea and has therefore also been studied in the context of migraine headache. One randomized controlled trial (RCT) found that ginger was no better than placebo for the prevention of migraine episodes. Read More

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November 2021

Constrictive pericarditis in the setting of repeated chest trauma in a mixed martial arts fighter.

BMC Cardiovasc Disord 2021 11 22;21(1):561. Epub 2021 Nov 22.

Division of Cardiovascular Medicine, Department of Medicine, University of Utah Health, 30 North 1900 East, Room 4A100, Salt Lake City, UT, 84132, USA.

Background: Constrictive pericarditis (CP) is characterized by scarring and loss of elasticity of the pericardium. This case demonstrates that mixed martial arts (MMA) is a previously unrecognized risk factor for CP, diagnosis of which is supported by cardiac imaging, right and left heart catheterization, and histological findings of dense fibrous tissue without chronic inflammation.

Case Presentation: A 47-year-old Caucasian male former mixed martial arts (MMA) fighter from the Western United States presented to liver clinic for elevated liver injury tests (LIT) and a 35-pound weight loss with associated diarrhea, lower extremity edema, dyspnea on exertion, and worsening fatigue over a period of 6 months. Read More

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November 2021

Evaluation and treatment of headache associated with moyamoya disease - a narrative review.

Cephalalgia 2022 05 17;42(6):542-552. Epub 2021 Nov 17.

Department of Neurosurgery, Mayo Clinic, Rochester, MN.

Background: Headache in patients with moyamoya disease is an under-addressed topic in the medical literature. Delay in the diagnosis of moyamoya disease or inappropriate treatment of headache could lead to devastating cerebrovascular outcome. With the evolving understanding of moyamoya disease, migraine pathophysiology, and various migraine-specific medications that have become available, it is crucial to provide an updated overview on this topic. Read More

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A rational approach to migraine diagnosis and management in primary care.

Ann Med 2021 12;53(1):1979-1990

Department of Internal Medicine, Wright State University, Dayton, OH, USA.

Migraine is a chronic neurologic disease estimated to affect approximately 50 million Americans. It is associated with a range of symptoms, which contribute to disability and substantial negative impacts on quality of life for many patients. Still, migraine continues to be underdiagnosed, undertreated, and optimising treatment for individual patients has proven difficult. Read More

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December 2021

Safety of anti-CGRP monoclonal antibodies in patients with migraine during the COVID-19 pandemic: Present and future implications.

Neurologia (Engl Ed) 2021 Oct;36(8):611-617

Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address:

Background And Objective: CGRP, a neuropeptide involved in migraine pathophysiology, is also known to play a role in the respiratory system and in immunological conditions such as sepsis. We analyzed the impact of the use of CGRP antagonists in patients with migraine during the COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus.

Methods: This is a multicentre cross-sectional study. Read More

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October 2021

Salivary CGRP can monitor the different migraine phases: CGRP (in)dependent attacks.

Cephalalgia 2022 03 4;42(3):186-196. Epub 2021 Oct 4.

Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain.

Background: CGRP plays a key role in the transmission and modulation of nociceptive signals and is a critical component in the pathogenesis of migraine.

Objective: To assess saliva as a substrate to measure CGRP by comparing interictal levels in patients with episodic migraine and controls; and to evaluate CGRP's temporal profile during migraine attacks.

Methods: This prospective observational pilot study included young women with episodic migraine and healthy controls. Read More

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