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Carey D Balaban, Robert D Black, Stephen D Silberstein
BACKGROUND: The vestibular system is a multifaceted, integrative sensory system that is often referred to as the "multi-sensory" sense. There is an extensive literature about the vestibular sensory organs and afferent nerve pathways; however, this rich resource is often unknown to the headache specialist. AIMS: In this review, we highlight the significance of vestibular sensory processing beyond its role in the maintenance of balance. The role of the vestibular system in migraine pathophysiology is emphasized, not just in how it impacts dizziness or nausea, but also in its higher order effects on mood and cognition...
May 11, 2019: Headache
Stephanie Roses
No abstract text is available yet for this article.
May 11, 2019: Headache
David Yarnitsky, David W Dodick, Brian M Grosberg, Rami Burstein, Alon Ironi, Dagan Harris, Tamar Lin, Stephen D Silberstein
OBJECTIVE: To assess the efficacy and safety of a remote electrical neuromodulation (REN) device for the acute treatment of migraine. BACKGROUND: There is a significant unmet need for novel effective well-tolerated acute migraine treatments. REN is a novel acute migraine treatment that stimulates upper arm peripheral nerves to induce conditioned pain modulation - an endogenous analgesic mechanism in which conditioning stimulation inhibits pain in remote body regions...
May 9, 2019: Headache
Nils Skajaa, Szimonetta K Szépligeti, Fei Xue, Henrik Toft Sørensen, Vera Ehrenstein, Osa Eisele, Kasper Adelborg
BACKGROUND: Prevalence of migraine is high during the reproductive age. Although migraine often improves during pregnancy, the risk of adverse pregnancy, birth, neonatal, and neurological outcomes in mother and offspring remains poorly understood. OBJECTIVE: To investigate the associations between maternal migraine and risks of adverse pregnancy outcomes in the mother, and birth, neonatal and postnatal outcomes in the offspring. METHODS: We used Danish population registries to assemble a cohort of pregnancies among women with migraine and an age- and conception year-matched comparison cohort of pregnancies among women without migraine...
May 8, 2019: Headache
James S McGinley, Dawn C Buse, Kenneth J Shulman, R J Wirth, Emmanuelle Hugentobler, Richard B Lipton
BACKGROUND: Consistency of response across multiple attacks is typically measured as the proportion of study participants who achieve a categorical endpoint over a specified number of attacks (ie, 2-hour pain-free response in 2 of 3 attacks). We applied a novel analytic approach for measuring consistency of response in the acute treatment of episodic migraine using data from the COMPASS study. METHODS: The COMPASS study (NCT01667679) was a multiple attack crossover study which compared AVP-825, a Breath Powered® intranasal delivery system for low-dose sumatriptan powder (22 mg), with 100-mg oral sumatriptan tablets in the acute treatment of migraine...
May 7, 2019: Headache
Anthony Berger, Jessica Litwin, Isabel Elaine Allen, William Qubty, Samantha Irwin, Maggie Waung, Amy A Gelfand
BACKGROUND: To date, there have not been reliable biomarkers to identify impending migraine episodes. A prior study in adults with migraine demonstrated a reduction in the urinary metabolic substrate of melatonin (urinary 6-sulfatoxymelatonin; aMT6s) during a migraine. The aim of this study was to examine whether evening urinary melatonin metabolite levels could predict migraine the next day in children and adolescents with migraine. METHODS: Twenty-one children and adolescents with migraine (aged 5-17 years) were recruited to this observational study conducted at UC San Francisco to provide urine samples for 10 days and maintain a prospective headache diary during the same period...
May 3, 2019: Headache
Lijun Liu, Yongpeng Yu, Jian He, Lei Guo, Hong Li, Jijun Teng
BACKGROUND: Multiple studies have evaluated the associations between 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms and migraine risk with conflicting results. Therefore, we conducted a meta-analysis on this theme. METHODS: We searched the electronic databases of PubMed, EmBase, ScienceDirect, and Cochrane Library for all relevant studies published until April 6, 2018. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) in allelic, dominant, recessive, homozygous, and heterozygous models were calculated using random effects model to assess the strength of associations...
May 2, 2019: Headache
Allison L Limmer, Levi C Holland, Brian D Loftus
OBJECTIVE: There is very little literature surrounding the prophylactic use of zonisamide in cluster headaches. The study aims to evaluate the effectiveness of zonisamide for prophylaxis of cluster headache in patients with chronic or episodic cluster headache. BACKGROUND: Both chronic and episodic cluster headaches are debilitating disorders which are often refractory to multiple prophylactic medication regimens. There is a scarcity of research in this area, and current prophylactic options for patients are fairly limited, which is troublesome for affected patients...
April 30, 2019: Headache
James S McGinley, R J Wirth, Carrie R Houts
OBJECTIVE: To introduce growth curve modeling for longitudinal headache research. BACKGROUND: Longitudinal data play an important role in the study of headache-related outcomes by allowing researchers to test hypotheses about change over time. However, headache researchers are often unfamiliar with the flexibility and power that growth curves can offer in analyzing longitudinal data. The goals of this paper are to introduce growth curve models within the multilevel modeling framework for analyzing longitudinal headache-related data and to show how these models can be applied in practice...
April 30, 2019: Headache
Nathan P Young, Lindsey M Philpot, Robert A Vierkant, Jordan K Rosedahl, Sudhindra G Upadhyaya, Ann Harris, Jon O Ebbert
OBJECTIVE: To inform migraine care model development by assessing differences between patients with chronic migraine (CM) and episodic migraine (EM) in the current state of treatment, disability, patient satisfaction, and quality improvement opportunities. BACKGROUND: Efficient and focused use of scarce resources will be needed to address challenges within large populations of migraine patients. METHODS: We deployed a cross-sectional survey study of randomly selected migraine patients within a community primary care practice...
April 29, 2019: Headache
Richard Hargreaves, Jes Olesen
Several lines of evidence pointed to an important role for CGRP in migraine. These included the anatomic colocalization of CGRP and its receptor in sensory fibers innervating pain-producing meningeal blood vessels, its release by trigeminal stimulation, the observation of elevated CGRP in the cranial circulation during migraine with normalization concomitant with headache relief by sumatriptan, and translational studies with intravenous (IV) CGRP that evoked migraine only in migraineurs. The development of small molecule CGRP receptor antagonists (CGRP-RAs) that showed clinical antimigraine efficacy acutely and prophylactically in randomized placebo-controlled clinical trials subsequently gave definitive pharmacological proof of the importance of CGRP in migraine...
April 25, 2019: Headache
Amy A Gelfand, Sara Pavitt, Kaitlin Greene, Christina L Szperka, Samantha Irwin, Barbara Grimes, Isabel E Allen
OBJECTIVE: To investigate whether later high school start time is associated with lower migraine frequency in high school students with migraine. BACKGROUND: Adequate sleep is thought to be important in managing adolescent migraine. The American Academy of Sleep Medicine recommends teenagers sleep ≥8 hours/night. Adolescents have a physiologically delayed sleep phase, going to bed, and waking later than children and adults. The American Academy of Pediatrics (AAP) accordingly recommends high schools start no earlier than 8:30 AM...
April 24, 2019: Headache
Kristine Woods, Sarah Ostrowski-Delahanty, Tami Cieplinski, Jonathan Winkelman, Pretti Polk, M Cristina Victorio
BACKGROUND: Approximately 10% of pediatric patients have recurrent headaches, with migraine being the most common headache type. If untreated, migraine may progress to status migrainosus, a debilitating condition of prolonged duration, high pain severity, and significant disability. There is high variability in the treatment of status migrainosus including medications used and treatment setting, which may occur in the emergency room, as an inpatient admission, or, less often, in an outpatient infusion center...
April 22, 2019: Headache
Bedia Samancı, Yavuz Samancı, Cömert Şen, Erdi Şahin, Mine Sezgin, Elif Kocasoy Orhan, Kadir Serkan Orhan, Betül Baykan
OBJECTIVE: Despite the lack of recognition in clinical practice, there is increasing evidence that patients with idiopathic intracranial hypertension may suffer from hyposmia. The current case-control study aims to evaluate olfactory dysfunction in a large series of patients with idiopathic intracranial hypertension. METHODS: All subjects, 44 idiopathic intracranial hypertension patients and 57 healthy controls, underwent olfactory function assessment using standardized "Sniffin' Sticks" test at a tertiary referral center of a university hospital...
April 18, 2019: Headache
Iraj Golikhatir, Hamed Cheraghmakani, Farzad Bozorgi, Fatemeh Jahanian, Mohammad Sazgar, Seyed Hosein Montazer
OBJECTIVE: The aim of this review was to evaluate the efficacy and safety of prochlorperazine (PCP) in patients with acute migraine headache in the emergency department (ED). METHODS: Electronic databases (Medline, Scopus, Web of Science, and Cochrane) were searched for randomized clinical trials that investigated the effect of PCP on headache relief. The outcomes were the number of patients without headache or with reduced headache severity, the number of adverse events, and the need for rescue analgesia...
April 16, 2019: Headache
Xiaona Wang, Yan Zhang, Hui You, Tienan Zhu, Daobin Zhou
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by thunderclap headaches and transient segmental cerebral arterial vasoconstriction. Many drugs have been identified as triggers of RCVS. However, RCVS induced by methotrexate (MTX), an antimetabolite agent, has never been reported. CASE: We report the first case of a 17-year-old Chinese student with a thunderclap headache after administration of high-dose methotrexate during the treatment of extranodal natural killer/T-cell lymphoma...
April 15, 2019: Headache
Jang Hun Kim, Haewon Roh, Won-Ki Yoon, Taek-Hyun Kwon, Kyuha Chong, Soon-Young Hwang, Jong Hyun Kim
BACKGROUND: Subdural hygromas are often found bilaterally in spontaneous intracranial hypotension (SIH). They frequently progress to chronic subdural hematomas (CSDHs), and if the hematomas are formed, it is difficult to consider SIH as an underlying cause. Whether SIH is underlying or not among the patients presenting bilateral subdural fluid collections (hygromas or CSDHs) is clinically important because the treatment strategy should be different between them. OBJECTIVES: We designed a retrospective case-control study to figure out differential clinical features of the patients presenting bilateral symptomatic subdural fluid collections owing to SIH...
April 15, 2019: Headache
Tommy L H Chan, Michael Mayich, Adrian Budhram, Yasmine Sallam, Werner J Becker
No abstract text is available yet for this article.
April 15, 2019: Headache
Smriti Iyengar, Kirk W Johnson, Michael H Ossipov, Sheena K Aurora
OBJECTIVE: The goal of this narrative review is to provide an overview of migraine pathophysiology, with an emphasis on the role of calcitonin gene-related peptide (CGRP) within the context of the trigeminovascular system. BACKGROUND: Migraine is a prevalent and disabling neurological disease that is characterized in part by intense, throbbing, and unilateral headaches. Despite recent advances in understanding its pathophysiology, migraine still represents an unmet medical need, as it is often underrecognized and undertreated...
April 14, 2019: Headache
Stephen D Silberstein, Peter McAllister, Xiaoping Ning, Nicola Faulhaber, Nicole Lang, Paul Yeung, Jimmy Schiemann, Ernesto Aycardi, Joshua M Cohen, Lindsay Janka, Ronghua Yang
OBJECTIVE: Presentation of pooled analysis of safety data for fremanezumab in patients with chronic (CM) or episodic migraine (EM) from 4 placebo-controlled phase 2b and phase 3 studies. BACKGROUND: There is a need for an effective, safe, and well-tolerated preventive therapy that specifically targets the pathophysiology of migraine to reduce the frequency and severity of migraine attacks in patients with CM or EM who experience 4 or more migraine days per month...
April 12, 2019: Headache
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