Although the exact pathophysiological mechanistic pathways that result in the initiation of migraine attacks remain unclear, there are some proposed mechanisms including neurogenic inflammation, trigeminovascular system activation, vascular dysfunction, and augmented release of nitric oxide (NO) and homocysteine (Hcy). Vitamin B12 is thought to be involved in important pathways that seem to be related to the pathogenesis of migraine including scavenging against NO and prevention of hyperhomocysteinemia. Therefore, the aim of the current study was to evaluate the serum vitamin B12 and methylmalonic acid (MMA) status in a group of migraine patients compared to healthy controls.
{"title":"Serum Vitamin B12 and Methylmalonic Acid Status in Migraineurs: A Case‐Control Study","authors":"M. Togha, Soodeh Razeghi Jahromi, Zeinab Ghorbani, Fahimeh Martami, Maryam Seifishahpar","doi":"10.1111/head.13618","DOIUrl":"https://doi.org/10.1111/head.13618","url":null,"abstract":"Although the exact pathophysiological mechanistic pathways that result in the initiation of migraine attacks remain unclear, there are some proposed mechanisms including neurogenic inflammation, trigeminovascular system activation, vascular dysfunction, and augmented release of nitric oxide (NO) and homocysteine (Hcy). Vitamin B12 is thought to be involved in important pathways that seem to be related to the pathogenesis of migraine including scavenging against NO and prevention of hyperhomocysteinemia. Therefore, the aim of the current study was to evaluate the serum vitamin B12 and methylmalonic acid (MMA) status in a group of migraine patients compared to healthy controls.","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75618093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trigeminal‐targeted treatments (TTTs), the most specific and selective therapeutic migraine approach to date, are effective in approximately 60% of patients regardless of treatment type or mechanism, at least if used alone. Sixty percent is also the proportion of migraineurs who develop migraine‐like episodes following experimental intravenous administration of trigeminal neuropeptides and roughly 60% is the percentage of patients with a unilateral migraine tracing the area of cutaneous distribution of the trigeminal ophthalmic branch. Hence, mechanisms other than the trigeminovascular activation are probably involved in the 40% of migraineurs who do not respond to TTTs. A closer cooperation between clinical and basic neuroscientists is needed to explore migraine models because only a careful appraisal of migraine endophenotypes may help to unravel their underlying multifaceted pathophysiological machinery.
{"title":"Trigeminal‐Targeted Treatments in Migraine: Is 60% the Magic Number?","authors":"P. Barbanti, G. Egeo, D. Mitsikostas","doi":"10.1111/head.13635","DOIUrl":"https://doi.org/10.1111/head.13635","url":null,"abstract":"Trigeminal‐targeted treatments (TTTs), the most specific and selective therapeutic migraine approach to date, are effective in approximately 60% of patients regardless of treatment type or mechanism, at least if used alone. Sixty percent is also the proportion of migraineurs who develop migraine‐like episodes following experimental intravenous administration of trigeminal neuropeptides and roughly 60% is the percentage of patients with a unilateral migraine tracing the area of cutaneous distribution of the trigeminal ophthalmic branch. Hence, mechanisms other than the trigeminovascular activation are probably involved in the 40% of migraineurs who do not respond to TTTs. A closer cooperation between clinical and basic neuroscientists is needed to explore migraine models because only a careful appraisal of migraine endophenotypes may help to unravel their underlying multifaceted pathophysiological machinery.","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80961086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claire H Sandoe, S. Sasikumar, C. Lay, Valerie Lawler
We present a case report of 2 migraine patients engaged in shift work, followed by a narrative review, to assess whether shift work influences headache‐related disability and chronification of migraine.
{"title":"The Impact of Shift Work on Migraine: A Case Series and Narrative Review","authors":"Claire H Sandoe, S. Sasikumar, C. Lay, Valerie Lawler","doi":"10.1111/head.13622","DOIUrl":"https://doi.org/10.1111/head.13622","url":null,"abstract":"We present a case report of 2 migraine patients engaged in shift work, followed by a narrative review, to assess whether shift work influences headache‐related disability and chronification of migraine.","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83731281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Slavin, Huilun Li, C. Frankenfeld, LawrenceJ Cheskin
The gastrointestinal symptoms of migraine attacks have invited numerous dietary hypotheses for migraine etiology through the centuries. Substantial efforts have been dedicated to identifying dietary interventions for migraine attack prevention, with limited success. Meanwhile, mounting evidence suggests that the reverse relationship may also exist – that the biological mechanisms of migraine may influence dietary intake. More likely, the truth involves some combination of both, where the disease influences food intake, and the foods eaten impact the manifestations of the disease. In addition, the gut's microbiota is increasingly suspected to influence the migraine brain via the gut‐brain axis, though these hypotheses remain largely unsubstantiated.
{"title":"What is Needed for Evidence‐Based Dietary Recommendations for Migraine: A Call to Action for Nutrition and Microbiome Research","authors":"M. Slavin, Huilun Li, C. Frankenfeld, LawrenceJ Cheskin","doi":"10.1111/head.13658","DOIUrl":"https://doi.org/10.1111/head.13658","url":null,"abstract":"The gastrointestinal symptoms of migraine attacks have invited numerous dietary hypotheses for migraine etiology through the centuries. Substantial efforts have been dedicated to identifying dietary interventions for migraine attack prevention, with limited success. Meanwhile, mounting evidence suggests that the reverse relationship may also exist – that the biological mechanisms of migraine may influence dietary intake. More likely, the truth involves some combination of both, where the disease influences food intake, and the foods eaten impact the manifestations of the disease. In addition, the gut's microbiota is increasingly suspected to influence the migraine brain via the gut‐brain axis, though these hypotheses remain largely unsubstantiated.","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81118903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Veracity in the Review Process","authors":"J. D. de Ru, T. Ward, J. Roberts","doi":"10.1111/head.13671","DOIUrl":"https://doi.org/10.1111/head.13671","url":null,"abstract":"","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83222586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Triptans remain a first-line therapy for acute migraine. Even 25 years after the commercialization of sumatriptan, clinicians still face challenges related to prescribing triptans for patients with cardiovascular risk factors or events. Our understanding of migraine and the triptans vis-a-vis cardiovascular risk factors and arterial physiology has evolved, but has this more detailed knowledge led to any meaningful change in clinical management? Case 1: Cardiovascular Risk Factors.—A 56-year-old male is sent to you for assessment of migraine without aura. He has a history of diabetes, hypertension, and smoking. He is using naproxen with partial success but still endures disabling attacks. Would you prescribe a triptan to this patient? How could you quantify his risk? Should he keep using naproxen? Case 2: Ischemic Stroke.—A 37-year-old woman presents with a history of migraine with aura since childhood. She reports a right anterior cerebral artery distribution ischemic stroke in the context of a cervical artery dissection 5 years ago. A CT scan of the brain with angiogram confirmed complete recanalization of the carotid artery, and she recovered fully from her symptoms. Non-steroidal anti-inflammatory drugs are not effective for her acute headaches, and she tried her sister's eletriptan with great success. Are you willing to prescribe eletriptan to her? Questions:
{"title":"Triptans for Migraine Patients With Vascular Risks: New Insights, New Options","authors":"E. Leroux, J. Rothrock","doi":"10.1111/head.13656","DOIUrl":"https://doi.org/10.1111/head.13656","url":null,"abstract":"Triptans remain a first-line therapy for acute migraine. Even 25 years after the commercialization of sumatriptan, clinicians still face challenges related to prescribing triptans for patients with cardiovascular risk factors or events. Our understanding of migraine and the triptans vis-a-vis cardiovascular risk factors and arterial physiology has evolved, but has this more detailed knowledge led to any meaningful change in clinical management? Case 1: Cardiovascular Risk Factors.—A 56-year-old male is sent to you for assessment of migraine without aura. He has a history of diabetes, hypertension, and smoking. He is using naproxen with partial success but still endures disabling attacks. Would you prescribe a triptan to this patient? How could you quantify his risk? Should he keep using naproxen? Case 2: Ischemic Stroke.—A 37-year-old woman presents with a history of migraine with aura since childhood. She reports a right anterior cerebral artery distribution ischemic stroke in the context of a cervical artery dissection 5 years ago. A CT scan of the brain with angiogram confirmed complete recanalization of the carotid artery, and she recovered fully from her symptoms. Non-steroidal anti-inflammatory drugs are not effective for her acute headaches, and she tried her sister's eletriptan with great success. Are you willing to prescribe eletriptan to her? Questions:","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90351523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Viana, R. De Icco, M. Allena, G. Sances, Jensen Rigmor Højland, Z. Katsarava, M. Láinez, R. Fadic, M. Goicochea, G. Nappi, C. Tassorelli
The International Classification of Headache Disorders lists different subtypes of medication overuse headache (MOH), according to the medication overused. The aim of this study is to evaluate whether the different subtypes correspond to clinically distinguishable phenotypes in a large population.
{"title":"Clinical Subtypes of Medication Overuse Headache – Findings From a Large Cohort","authors":"M. Viana, R. De Icco, M. Allena, G. Sances, Jensen Rigmor Højland, Z. Katsarava, M. Láinez, R. Fadic, M. Goicochea, G. Nappi, C. Tassorelli","doi":"10.1111/head.13641","DOIUrl":"https://doi.org/10.1111/head.13641","url":null,"abstract":"The International Classification of Headache Disorders lists different subtypes of medication overuse headache (MOH), according to the medication overused. The aim of this study is to evaluate whether the different subtypes correspond to clinically distinguishable phenotypes in a large population.","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"92 9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87753504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The American Headache Society Early Career Award","authors":"Jason Roberts","doi":"10.1111/head.13680","DOIUrl":"https://doi.org/10.1111/head.13680","url":null,"abstract":"","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84887843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dysautonomia and headache are 2 common diagnoses within pediatric neurology; in the case of dysautonomia, a lack of consideration may lead to misdiagnosis. Despite being common conditions, there is a lot to learn about each individually as well as collectively. Many of the symptoms between headache and dysautonomia patients overlap making the diagnosis difficult. Migraine patients often exhibit symptoms of dysautonomia, namely postural orthostatic tachycardia syndrome (POTS); yet these symptoms are overlooked or lumped in as a part of their migraine diagnosis. The distinction or coexistence between dysautonomia and headache is identified through a thorough history, a full exam, and an open mind. This is crucial for the treatment and outcomes of these patients. Struggles arise when critical treatment differences are overlooked because dysautonomia is not considered. In this review, we will look at the epidemiology of dysautonomia and headache with focus on POTS and migraine. We will then compare the clinical features of both conditions as well as some hypothesized pathophysiology overlaps. We will conclude by summarizing the diagnostic approach and multitiered treatment options for POTS and migraine.
{"title":"Dysautonomia and Headache in the Pediatric Population","authors":"Rebecca Wig, Christopher B. Oakley","doi":"10.1111/head.13659","DOIUrl":"https://doi.org/10.1111/head.13659","url":null,"abstract":"Dysautonomia and headache are 2 common diagnoses within pediatric neurology; in the case of dysautonomia, a lack of consideration may lead to misdiagnosis. Despite being common conditions, there is a lot to learn about each individually as well as collectively. Many of the symptoms between headache and dysautonomia patients overlap making the diagnosis difficult. Migraine patients often exhibit symptoms of dysautonomia, namely postural orthostatic tachycardia syndrome (POTS); yet these symptoms are overlooked or lumped in as a part of their migraine diagnosis. The distinction or coexistence between dysautonomia and headache is identified through a thorough history, a full exam, and an open mind. This is crucial for the treatment and outcomes of these patients. Struggles arise when critical treatment differences are overlooked because dysautonomia is not considered. In this review, we will look at the epidemiology of dysautonomia and headache with focus on POTS and migraine. We will then compare the clinical features of both conditions as well as some hypothesized pathophysiology overlaps. We will conclude by summarizing the diagnostic approach and multitiered treatment options for POTS and migraine.","PeriodicalId":12845,"journal":{"name":"Headache: The Journal of Head and Face Pain","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83985975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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