C. Rosignoli, Agnese Onofri, Federico De Santis, Simona Sacco, R. Ornello
Background: The greater occipital nerve block (GON-B) is used in clinical practice for treating different forms of headache. There is no standardized procedure to perform GON-B. This study evaluates the efficacy and feasibility of a low-volume GON-B protocol utilizing a pre-mixed solution of lidocaine (10 mg) and methylprednisolone (40 mg) across various headache disorders. Methods: This observational case series included patients receiving their first GON-B from November 2019 to February 2021. Participants were diagnosed with migraine, cluster headache, cervicogenic headache, or paroxysmal hemicrania. The primary outcome was the degree of response to the GON-B. Results: Thirty-nine patients with migraine underwent a first GON-B. Regarding headache frequency, 26% achieved substantial response and 33% partial response. For headache intensity, 26% reported substantial and 49% partial improvement. Migraine patients experienced a significant reduction in median monthly headache days from 25 to 13 (p=0.001) and in headache intensity from a median of 8 to 6 on the Numerical Rating Scale (NRS) scale (p<0.001). Of the 27 patients receiving a second GON-B, 33% had a substantial response, 48% a partial response, and 19% no response. Results from subsequent sessions were consistent with these findings. Ten patients with cluster headache underwent GON-B, showing a significant reduction in pain intensity from a median NRS score of 10 to 5 (p=0.008). Two patients with cervicogenic headache showed a partial response to GON-B, with pain intensity decreasing from 8 to 6 and 8 to 7 over 30 monthly episodes. A patient with paroxysmal hemicrania received seven GON-B injections, reducing daily attacks from 30 to 10 and pain intensity from 7 to 6 on the NRS scale. Conclusions: These outcomes affirm GON-B potential in interrupting pain pathways, even at a low dose, in a wide range of headache disorders.
{"title":"Efficacy and safety of greater occipital nerve block with a small volume of lidocaine and methylprednisolone in tertiary headache center","authors":"C. Rosignoli, Agnese Onofri, Federico De Santis, Simona Sacco, R. Ornello","doi":"10.4081/cc.2024.15770","DOIUrl":"https://doi.org/10.4081/cc.2024.15770","url":null,"abstract":"Background: The greater occipital nerve block (GON-B) is used in clinical practice for treating different forms of headache. There is no standardized procedure to perform GON-B. This study evaluates the efficacy and feasibility of a low-volume GON-B protocol utilizing a pre-mixed solution of lidocaine (10 mg) and methylprednisolone (40 mg) across various headache disorders. Methods: This observational case series included patients receiving their first GON-B from November 2019 to February 2021. Participants were diagnosed with migraine, cluster headache, cervicogenic headache, or paroxysmal hemicrania. The primary outcome was the degree of response to the GON-B. Results: Thirty-nine patients with migraine underwent a first GON-B. Regarding headache frequency, 26% achieved substantial response and 33% partial response. For headache intensity, 26% reported substantial and 49% partial improvement. Migraine patients experienced a significant reduction in median monthly headache days from 25 to 13 (p=0.001) and in headache intensity from a median of 8 to 6 on the Numerical Rating Scale (NRS) scale (p<0.001). Of the 27 patients receiving a second GON-B, 33% had a substantial response, 48% a partial response, and 19% no response. Results from subsequent sessions were consistent with these findings. Ten patients with cluster headache underwent GON-B, showing a significant reduction in pain intensity from a median NRS score of 10 to 5 (p=0.008). Two patients with cervicogenic headache showed a partial response to GON-B, with pain intensity decreasing from 8 to 6 and 8 to 7 over 30 monthly episodes. A patient with paroxysmal hemicrania received seven GON-B injections, reducing daily attacks from 30 to 10 and pain intensity from 7 to 6 on the NRS scale. Conclusions: These outcomes affirm GON-B potential in interrupting pain pathways, even at a low dose, in a wide range of headache disorders.","PeriodicalId":39709,"journal":{"name":"Confinia Cephalalgica","volume":"40 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663486","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}
Francesco Casillo, Chiara Abagnale, Gabriele Sebastianelli, Antonio Di Renzo, Vincenzo Parisi, Ettore Cioffi, Mariano Serrao, Cherubino Di Lorenzo
Background: Migraine is a brain disorder characterized by recurring headache attacks, and emotional comorbidities, such as anxiety and depression, may influence the repetition of these attacks. The lack of sensory habituation is a common neurophysiological abnormality in migraine, and research suggests that it is under the influence of serotonin and other monoamines that are also involved in mood disorders. This study aimed to investigate the influence of emotional symptoms on cortical information processing in patients with migraine with aura by correlating cortical activity with self-perceived emotional distress. Methods: Visual evoked potentials from monocular stimulation were recorded in 16 patients with migraine with aura (MA) and 22 healthy volunteers (HV). The visual stimulus consisted of a full-screen black-and-white checkerboard pattern with a reversal rate of 1.55 Hz. 600 consecutive traces were collected and divided into six sequential blocks of 100 sweeps. Before the recording session, both MA patients and HV completed the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI). Pearson's correlation test was used to find correlations between electrophysiological and psychometric variables in HV and MA patients. Results: Compared to HV, MA patients showed a significant difference in the degree of habituation to repeated visual stimulation between the two groups, resulting in a habitation deficit. Psychometric test results showed that trait STAI and BDI values were significantly higher in MA patients. In the MA group, BDI correlated negatively with the amplitude of the first block and positively with the degree of habituation. Conclusions: These results highlight a link between the level of brain responsiveness and depressive symptoms in patients with MA. Further research is required to confirm whether the same correlations exist in patients with other headache disorders.
背景：偏头痛是一种以头痛反复发作为特征的脑部疾病，焦虑和抑郁等情绪并发症可能会影响头痛的反复发作。缺乏感觉习惯是偏头痛常见的神经生理异常现象，研究表明它受到血清素和其他单胺类物质的影响，而这些物质也与情绪障碍有关。本研究旨在通过将大脑皮层活动与自我感觉的情绪困扰相关联，研究情绪症状对先兆性偏头痛患者大脑皮层信息处理的影响。研究方法记录了16名先兆偏头痛患者（MA）和22名健康志愿者（HV）单眼刺激产生的视觉诱发电位。视觉刺激由全屏黑白棋盘图案组成，反转频率为 1.55 Hz。共收集了 600 个连续的轨迹，并将其分为 6 个 100 次扫描的连续块。记录前，MA 患者和 HV 均填写了贝克抑郁量表（BDI）和状态-特质焦虑量表（STAI）。采用皮尔逊相关性检验找出 HV 和 MA 患者的电生理和心理测量变量之间的相关性。结果显示与 HV 相比，MA 患者对重复视觉刺激的习惯化程度在两组之间存在显著差异，从而导致了习惯性障碍。心理测试结果显示，MA 患者的特质 STAI 和 BDI 值明显更高。在 MA 组中，BDI 与第一个区块的振幅呈负相关，而与习惯化程度呈正相关。结论：这些结果突显了大脑反应水平与 MA 患者抑郁症状之间的联系。要确认其他头痛疾病患者是否也存在同样的相关性，还需要进一步的研究。
{"title":"Cortical excitability in patients with migraine with aura and depressive symptoms: a visual evoked potentials study","authors":"Francesco Casillo, Chiara Abagnale, Gabriele Sebastianelli, Antonio Di Renzo, Vincenzo Parisi, Ettore Cioffi, Mariano Serrao, Cherubino Di Lorenzo","doi":"10.4081/cc.2024.15764","DOIUrl":"https://doi.org/10.4081/cc.2024.15764","url":null,"abstract":"Background: Migraine is a brain disorder characterized by recurring headache attacks, and emotional comorbidities, such as anxiety and depression, may influence the repetition of these attacks. The lack of sensory habituation is a common neurophysiological abnormality in migraine, and research suggests that it is under the influence of serotonin and other monoamines that are also involved in mood disorders. This study aimed to investigate the influence of emotional symptoms on cortical information processing in patients with migraine with aura by correlating cortical activity with self-perceived emotional distress. Methods: Visual evoked potentials from monocular stimulation were recorded in 16 patients with migraine with aura (MA) and 22 healthy volunteers (HV). The visual stimulus consisted of a full-screen black-and-white checkerboard pattern with a reversal rate of 1.55 Hz. 600 consecutive traces were collected and divided into six sequential blocks of 100 sweeps. Before the recording session, both MA patients and HV completed the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI). Pearson's correlation test was used to find correlations between electrophysiological and psychometric variables in HV and MA patients. Results: Compared to HV, MA patients showed a significant difference in the degree of habituation to repeated visual stimulation between the two groups, resulting in a habitation deficit. Psychometric test results showed that trait STAI and BDI values were significantly higher in MA patients. In the MA group, BDI correlated negatively with the amplitude of the first block and positively with the degree of habituation. Conclusions: These results highlight a link between the level of brain responsiveness and depressive symptoms in patients with MA. Further research is required to confirm whether the same correlations exist in patients with other headache disorders.","PeriodicalId":39709,"journal":{"name":"Confinia Cephalalgica","volume":"27 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141104843","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. Romozzi, Andrea Burgalassi, Catello Vollono, Maria Albanese, Giulia Vigani, F. De Cesaris, Alberto Chiarugi, Paolo Calabresi, L. Iannone
Background: Clinical studies have shown the efficacy and safety of monoclonal antibodies (mAbs) against calcitonin gene-related peptide (anti- CGRP) in migraine patients with and without aura. Early evidence from post hoc and small subgroup analyses suggests that anti-CGRP mAbs reduce the frequency and intensity of aura. Herein, we prospectively assessed the changes in aura after 12 months of anti-CGRP mAb treatment and performed a literature review.Methods: All outpatients treated with anti-CGRP mAbs for one year in two tertiary Headache Centers and who experienced ≥1 episode of aura/month were enrolled. The study reports data from one month before (baseline) and the last three months (months 10, 11, 12) of treatment.Results: Data from 13 patients with a diagnosis of migraine with and without aura were collected. The mean duration from aura onset was 17.8±7.9 years. At baseline nine patients (69.2%) reported visual aura, and four (30.8%) visual and sensory aura. Mean duration of aura episodes was of 34.2±15.7 minutes. At baseline, the mean number of monthly migraine days (MMDs) was 22.3±7.5, and the mean number of MMDs preceded by aura was 9.15±9.0. At month 12 of treatment, there was a significant reduction of MMDs (6.2±9.0, p=0.002) and MMDs with aura (2.6±2.7, p=0.015). Three patients reported episodes of aura without subsequent headache, a phenomenon that was absent prior to treatment. We identified 14 studies that reported changes in aura during anti-CGRP mAbs treatment.Conclusions: This prospective study shows that anti-CGRP mAbs reduce the number of migraine attacks with aura consistently with the reduction of MMDs. Randomized studies with anti-CGRP mAbs specifically assessing migraine aura are required.
{"title":"Prospective evaluation of aura during anti-calcitonin gene-related peptide monoclonal antibody therapy after 52 weeks of treatment","authors":"M. Romozzi, Andrea Burgalassi, Catello Vollono, Maria Albanese, Giulia Vigani, F. De Cesaris, Alberto Chiarugi, Paolo Calabresi, L. Iannone","doi":"10.4081/cc.2024.15762","DOIUrl":"https://doi.org/10.4081/cc.2024.15762","url":null,"abstract":"Background: Clinical studies have shown the efficacy and safety of monoclonal antibodies (mAbs) against calcitonin gene-related peptide (anti- CGRP) in migraine patients with and without aura. Early evidence from post hoc and small subgroup analyses suggests that anti-CGRP mAbs reduce the frequency and intensity of aura. Herein, we prospectively assessed the changes in aura after 12 months of anti-CGRP mAb treatment and performed a literature review.Methods: All outpatients treated with anti-CGRP mAbs for one year in two tertiary Headache Centers and who experienced ≥1 episode of aura/month were enrolled. The study reports data from one month before (baseline) and the last three months (months 10, 11, 12) of treatment.Results: Data from 13 patients with a diagnosis of migraine with and without aura were collected. The mean duration from aura onset was 17.8±7.9 years. At baseline nine patients (69.2%) reported visual aura, and four (30.8%) visual and sensory aura. Mean duration of aura episodes was of 34.2±15.7 minutes. At baseline, the mean number of monthly migraine days (MMDs) was 22.3±7.5, and the mean number of MMDs preceded by aura was 9.15±9.0. At month 12 of treatment, there was a significant reduction of MMDs (6.2±9.0, p=0.002) and MMDs with aura (2.6±2.7, p=0.015). Three patients reported episodes of aura without subsequent headache, a phenomenon that was absent prior to treatment. We identified 14 studies that reported changes in aura during anti-CGRP mAbs treatment.Conclusions: This prospective study shows that anti-CGRP mAbs reduce the number of migraine attacks with aura consistently with the reduction of MMDs. Randomized studies with anti-CGRP mAbs specifically assessing migraine aura are required.","PeriodicalId":39709,"journal":{"name":"Confinia Cephalalgica","volume":"139 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141001984","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}
Michele Corrado, Elena Mazzotta, Gloria Vaghi, Francescantonio Cammarota, Federico Bighiani, Alessandro Antoniazzi, D. Martinelli, M. Pocora, Luca Martinis, Valentina Grillo, Sara Bottiroli, Armando Perrotta, Giuseppe Cosentino, Grazia Sances, C. Tassorelli, R. De Icco
Introduction: Habituation is a physiological phenomenon, characterized by response reduction to repeated stimulus presentation. In headache disorders, habituation studies have involved different paradigms with several stimulation parameters and sensory modalities, and consistently showed impaired habituation in primary headaches in the interictal phase. The nociceptive blink reflex (nBR) and its related R2 response, modulated by a polysynaptic network in the trigeminocervical complex, is one of the most studied in the field. The lack of nBR habituation normative data hampered the possibility to draw conclusions regarding the functional status of individual patients. The present study aims to define normative values for the nBR habituation process in healthy subjects without a personal diagnosis and family history of migraine, or other headache disorders.Methods: We enrolled 40 healthy subjects (24 females, 32.7±11.6 years) for nBR recording and nBR habituation assessment. To assess the habituation of nBR, 26 consecutive stimuli were administered at three different and randomized stimulus frequencies (0.2, 0.3, 0.5 Hz). After excluding the first response, the remaining 25 area under the curve (AUC) were divided in 5 blocks, and the average values of the AUC was calculated for each block. The percentage reduction in the AUC of the fifth block, compared to the first, represents the habituation index (HI) value. We considered a one-tailed 10th percentile threshold as the lower threshold of normative values for nBR HI.Results: The habituation phenomenon was confirmed for all study frequencies. The absolute AUC of the R2 component across the five blocks of stimulation was higher in female subjects when compared to male for 0.5 Hz (p=0.021) and 0.2 Hz (p=0.007). We found a frequency-dependent habituation pattern, being lower at the 0.2 Hz stimulation when compared to 0.5 Hz (p=0.001), and 0.3 Hz (p=0.008). The average HIs were 73.1±13.6 at 0.5 Hz, 69.2±15.0 at 0.3 Hz, and 61.1±21.4 at 0.2 Hz. HIs were comparable between male and female subjects, without correlations with age, intensity of stimulation, and latency of the R2 component. The 10th percentile of the HIs was 43.5% for 0.5 Hz, 55.8% for 0.3 Hz, and 28.6% for 0.2 Hz.Conclusions: We investigated the nBR habituation in a population of healthy subjects for normative data collection. We described a frequency- dependent degree of habituation, being more pronounced at higher frequencies of stimulation. Moreover, we described gender-related features of response behaviour, which is extremely important in the migraine field. Our study further characterized the physiological habituation phenomenon in healthy controls exposed to a nociceptive stimulation. The definition of a normative habituation value will open novel possibilities in the study of migraine, as well as other headache and pain disorders.
{"title":"Normative values of the nociceptive blink reflex habituation","authors":"Michele Corrado, Elena Mazzotta, Gloria Vaghi, Francescantonio Cammarota, Federico Bighiani, Alessandro Antoniazzi, D. Martinelli, M. Pocora, Luca Martinis, Valentina Grillo, Sara Bottiroli, Armando Perrotta, Giuseppe Cosentino, Grazia Sances, C. Tassorelli, R. De Icco","doi":"10.4081/cc.2024.15730","DOIUrl":"https://doi.org/10.4081/cc.2024.15730","url":null,"abstract":"Introduction: Habituation is a physiological phenomenon, characterized by response reduction to repeated stimulus presentation. In headache disorders, habituation studies have involved different paradigms with several stimulation parameters and sensory modalities, and consistently showed impaired habituation in primary headaches in the interictal phase. The nociceptive blink reflex (nBR) and its related R2 response, modulated by a polysynaptic network in the trigeminocervical complex, is one of the most studied in the field. The lack of nBR habituation normative data hampered the possibility to draw conclusions regarding the functional status of individual patients. The present study aims to define normative values for the nBR habituation process in healthy subjects without a personal diagnosis and family history of migraine, or other headache disorders.Methods: We enrolled 40 healthy subjects (24 females, 32.7±11.6 years) for nBR recording and nBR habituation assessment. To assess the habituation of nBR, 26 consecutive stimuli were administered at three different and randomized stimulus frequencies (0.2, 0.3, 0.5 Hz). After excluding the first response, the remaining 25 area under the curve (AUC) were divided in 5 blocks, and the average values of the AUC was calculated for each block. The percentage reduction in the AUC of the fifth block, compared to the first, represents the habituation index (HI) value. We considered a one-tailed 10th percentile threshold as the lower threshold of normative values for nBR HI.Results: The habituation phenomenon was confirmed for all study frequencies. The absolute AUC of the R2 component across the five blocks of stimulation was higher in female subjects when compared to male for 0.5 Hz (p=0.021) and 0.2 Hz (p=0.007). We found a frequency-dependent habituation pattern, being lower at the 0.2 Hz stimulation when compared to 0.5 Hz (p=0.001), and 0.3 Hz (p=0.008). The average HIs were 73.1±13.6 at 0.5 Hz, 69.2±15.0 at 0.3 Hz, and 61.1±21.4 at 0.2 Hz. HIs were comparable between male and female subjects, without correlations with age, intensity of stimulation, and latency of the R2 component. The 10th percentile of the HIs was 43.5% for 0.5 Hz, 55.8% for 0.3 Hz, and 28.6% for 0.2 Hz.Conclusions: We investigated the nBR habituation in a population of healthy subjects for normative data collection. We described a frequency- dependent degree of habituation, being more pronounced at higher frequencies of stimulation. Moreover, we described gender-related features of response behaviour, which is extremely important in the migraine field. Our study further characterized the physiological habituation phenomenon in healthy controls exposed to a nociceptive stimulation. The definition of a normative habituation value will open novel possibilities in the study of migraine, as well as other headache and pain disorders.","PeriodicalId":39709,"journal":{"name":"Confinia Cephalalgica","volume":"133 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141002131","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}
I. Frattale, L. Papetti, F. Ursitti, G. Sforza, G. Monte, Luigi Mazzone, Massimiliano Valeriani
Background: Migraine is a frequent neurological condition with a high impact on quality life. The diagnosis is clinical in accordance with the International Classification of Headache Disorders version 3 criteria. Early diagnosis is important to initiate timely treatment. A screening tool for adulthood is already available (ID-Migraine), while there is currently no questionnaire that allows for diagnosis in children and adolescents. The aim of the present study is to demonstrate the validity of ID-Migraine to diagnose migraine in pediatric population.Methods: A total of 94 pediatric patients were enrolled and administered ID-Migraine. The mean age was 11.6 years. The study group included patients with a diagnosis of migraine (63%) and primary stabbing headache (37%).Results and conclusions: Specificity and positive predictive values were >80% (92% and 93% respectively); sensitivity and negative predictive values tended towards reliability (71% and 66% respectively), making the ID-Migraine a reliable tool in diagnosing migraine in the pediatric population.
{"title":"ID-Migraine test for pediatric population: preliminary results from the Italian validation","authors":"I. Frattale, L. Papetti, F. Ursitti, G. Sforza, G. Monte, Luigi Mazzone, Massimiliano Valeriani","doi":"10.4081/cc.2024.15761","DOIUrl":"https://doi.org/10.4081/cc.2024.15761","url":null,"abstract":"Background: Migraine is a frequent neurological condition with a high impact on quality life. The diagnosis is clinical in accordance with the International Classification of Headache Disorders version 3 criteria. Early diagnosis is important to initiate timely treatment. A screening tool for adulthood is already available (ID-Migraine), while there is currently no questionnaire that allows for diagnosis in children and adolescents. The aim of the present study is to demonstrate the validity of ID-Migraine to diagnose migraine in pediatric population.Methods: A total of 94 pediatric patients were enrolled and administered ID-Migraine. The mean age was 11.6 years. The study group included patients with a diagnosis of migraine (63%) and primary stabbing headache (37%).Results and conclusions: Specificity and positive predictive values were >80% (92% and 93% respectively); sensitivity and negative predictive values tended towards reliability (71% and 66% respectively), making the ID-Migraine a reliable tool in diagnosing migraine in the pediatric population.","PeriodicalId":39709,"journal":{"name":"Confinia Cephalalgica","volume":"9 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141005175","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}
S. Guerzoni, Flavia Lo Castro, C. Baraldi, Daria Brovia, F. Tascedda, V. Rivi, Luca Pani
Background: Migraine represents one of the most disabling neurological diseases in the world. This burden is primarily due to recurrent pain episodes, alongside cognitive function impairments that patients may experience. This paper aims to explore the effect of three anti-calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies (mAbs) – erenumab, fremanezumab, and galcanezumab – on the cognitive performance of a sample of patients suffering from migraine using the Montreal Cognitive Assessment (MoCA) questionnaire.Methods: A total of 215 patients suffering from migraine who visited the Modena Headache Center were enrolled. The MoCA questionnaire was filled in by the patients at the baseline and subsequent assessments were conducted at 6 and 12 months thereafter. Additionally, patients were requested to complete the 6-item Headache Impact Test, Migraine Disability Assessment Score, and Hospital Anxiety and Depression Scale every three months.Results: The sample was composed of 82% of female participants and 87% of the enrolled patients were diagnosed with chronic migraine. Following one year of treatment, there was a significant enhancement observed in MoCA scores compared to baseline measurements. Moreover, higher consumption of analgesics, elevated body mass index (BMI), and prolonged chronic migraine history exhibited an inverse correlation with MoCA score improvements after 12 months.Conclusions: Erenumab, fremanezumab, and galcanezumab have proven to be effective in relieving the cognitive impairment associated with migraine after 1 year of treatment. These findings underscore the reversibility of cognitive impairment among migraine sufferers, even among those suffering from chronic migraine, as delineated by the majority of the patients under study. This study revealed that prolonged chronic migraine history, higher baseline analgesic intake, and elevated BMI were all predictive of diminished cognitive enhancements following treatment.
{"title":"Anti-CGRP monoclonal antibodies improve cognitive function in patients affected by chronic migraine complicated with medication overuse-headache","authors":"S. Guerzoni, Flavia Lo Castro, C. Baraldi, Daria Brovia, F. Tascedda, V. Rivi, Luca Pani","doi":"10.4081/cc.2024.15760","DOIUrl":"https://doi.org/10.4081/cc.2024.15760","url":null,"abstract":"Background: Migraine represents one of the most disabling neurological diseases in the world. This burden is primarily due to recurrent pain episodes, alongside cognitive function impairments that patients may experience. This paper aims to explore the effect of three anti-calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies (mAbs) – erenumab, fremanezumab, and galcanezumab – on the cognitive performance of a sample of patients suffering from migraine using the Montreal Cognitive Assessment (MoCA) questionnaire.Methods: A total of 215 patients suffering from migraine who visited the Modena Headache Center were enrolled. The MoCA questionnaire was filled in by the patients at the baseline and subsequent assessments were conducted at 6 and 12 months thereafter. Additionally, patients were requested to complete the 6-item Headache Impact Test, Migraine Disability Assessment Score, and Hospital Anxiety and Depression Scale every three months.Results: The sample was composed of 82% of female participants and 87% of the enrolled patients were diagnosed with chronic migraine. Following one year of treatment, there was a significant enhancement observed in MoCA scores compared to baseline measurements. Moreover, higher consumption of analgesics, elevated body mass index (BMI), and prolonged chronic migraine history exhibited an inverse correlation with MoCA score improvements after 12 months.Conclusions: Erenumab, fremanezumab, and galcanezumab have proven to be effective in relieving the cognitive impairment associated with migraine after 1 year of treatment. These findings underscore the reversibility of cognitive impairment among migraine sufferers, even among those suffering from chronic migraine, as delineated by the majority of the patients under study. This study revealed that prolonged chronic migraine history, higher baseline analgesic intake, and elevated BMI were all predictive of diminished cognitive enhancements following treatment.","PeriodicalId":39709,"journal":{"name":"Confinia Cephalalgica","volume":"39 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141002205","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}
In the early 1950s, Federigo Sicuteri, professor of clinical pharmacology, following the indication of his mentor, Enrico Greppi, professor of internal medicine, started a modern Italian investigation and clinical unit exclusively dedicated to headache medicine at the Careggi Hospital of the University of Florence. Soon, other colleagues – mostly but not exclusively neurologists – joined these pioneers and founded in 1976 the Italian Society for the Study of Headaches [...].
{"title":"Confinia Cephalalgica: a new start","authors":"Pierangelo Geppetti","doi":"10.4081/cc.2024.15766","DOIUrl":"https://doi.org/10.4081/cc.2024.15766","url":null,"abstract":"In the early 1950s, Federigo Sicuteri, professor of clinical pharmacology, following the indication of his mentor, Enrico Greppi, professor of internal medicine, started a modern Italian investigation and clinical unit exclusively dedicated to headache medicine at the Careggi Hospital of the University of Florence. Soon, other colleagues – mostly but not exclusively neurologists – joined these pioneers and founded in 1976 the Italian Society for the Study of Headaches [...].","PeriodicalId":39709,"journal":{"name":"Confinia Cephalalgica","volume":"79 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141003173","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}
Pub Date : 2008-01-01DOI: 10.1007/978-88-470-0754-3_10
G. C. Manzoni, P. Torelli
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