Pub Date : 2021-01-01DOI: 10.1177/25158163211015654
B. Plato, J. Andrews, M. Rettiganti, A. Tockhorn-Heidenreich, J. Bardos, R. Wenzel, Dulanji K. Kuruppu, A. Ambrosini
Objective: The efficacy of galcanezumab was evaluated in patients with episodic cluster headache and history of preventive treatment failure. Methods: In the randomized, 8-week, double-blind study (CGAL), patients with episodic cluster headache received once-monthly subcutaneous injections of galcanezumab 300 mg or placebo. Patients who completed CGAL and enrolled in an open-label study were queried for preventive treatment history. In a subset of patients with a known history of failure of verapamil or any other prior preventive treatment, a post hoc analysis of least square mean change from baseline in weekly cluster headache attack frequency across Weeks 1 to 3 was assessed. Results: Fifteen patients provided data for known history of prior preventive treatment failure (6 placebo, 9 galcanezumab), of whom 11 failed verapamil. The mean reduction in the weekly frequency of cluster headache attacks was greater with galcanezumab compared to placebo among patients with prior preventive treatment failure (8.2 versus 2.4); mean difference 5.8 (95% confidence interval [CI] 2.0, 13.6) and among patients with verapamil failure (10.1 versus 1.6); mean difference 8.5 (95% CI 0.4, 16.7). Conclusion: In this exploratory analysis of patients with a known history of prior preventive treatment failures, treatment with galcanezumab resulted in greater mean reductions in weekly cluster headache attacks compared with placebo. ClinicalTrials.gov: NCT02397473 (I5Q-MC-CGAL) NCT02797951 (I5Q-MC-CGAR)
目的:评价galcanezumab治疗阵发性丛集性头痛和有预防治疗失败史患者的疗效。方法:在为期8周的随机双盲研究(CGAL)中，发作性丛集性头痛患者接受每月一次的galcanezumab 300 mg皮下注射或安慰剂。完成CGAL并参加开放标签研究的患者被询问预防性治疗史。在一组已知维拉帕米或任何其他预防性治疗失败史的患者中，对第1周至第3周每周丛集性头痛发作频率从基线的最小二乘平均变化进行事后分析。结果:15例患者提供了已知预防性治疗失败史的资料(安慰剂6例，加卡单抗9例)，其中维拉帕米失败11例。在先前预防性治疗失败的患者中，与安慰剂相比，galcanezumab组每周丛集性头痛发作频率的平均降低幅度更大(8.2 vs 2.4);维拉帕米失效患者的平均差异为5.8(95%可信区间[CI] 2.0, 13.6)(10.1对1.6);平均差异8.5 (95% CI 0.4, 16.7)。结论:在这项对有已知预防性治疗失败史的患者的探索性分析中，与安慰剂相比，galcanezumab治疗导致每周丛集性头痛发作的平均减少量更大。临床试验网站:NCT02397473 (I5Q-MC-CGAL) NCT02797951 (I5Q-MC-CGAR)
{"title":"Efficacy of galcanezumab in patients with episodic cluster headaches and a history of preventive treatment failure","authors":"B. Plato, J. Andrews, M. Rettiganti, A. Tockhorn-Heidenreich, J. Bardos, R. Wenzel, Dulanji K. Kuruppu, A. Ambrosini","doi":"10.1177/25158163211015654","DOIUrl":"https://doi.org/10.1177/25158163211015654","url":null,"abstract":"Objective: The efficacy of galcanezumab was evaluated in patients with episodic cluster headache and history of preventive treatment failure. Methods: In the randomized, 8-week, double-blind study (CGAL), patients with episodic cluster headache received once-monthly subcutaneous injections of galcanezumab 300 mg or placebo. Patients who completed CGAL and enrolled in an open-label study were queried for preventive treatment history. In a subset of patients with a known history of failure of verapamil or any other prior preventive treatment, a post hoc analysis of least square mean change from baseline in weekly cluster headache attack frequency across Weeks 1 to 3 was assessed. Results: Fifteen patients provided data for known history of prior preventive treatment failure (6 placebo, 9 galcanezumab), of whom 11 failed verapamil. The mean reduction in the weekly frequency of cluster headache attacks was greater with galcanezumab compared to placebo among patients with prior preventive treatment failure (8.2 versus 2.4); mean difference 5.8 (95% confidence interval [CI] 2.0, 13.6) and among patients with verapamil failure (10.1 versus 1.6); mean difference 8.5 (95% CI 0.4, 16.7). Conclusion: In this exploratory analysis of patients with a known history of prior preventive treatment failures, treatment with galcanezumab resulted in greater mean reductions in weekly cluster headache attacks compared with placebo. ClinicalTrials.gov: NCT02397473 (I5Q-MC-CGAL) NCT02797951 (I5Q-MC-CGAR)","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/25158163211015654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46417470","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 : 2021-01-01DOI: 10.1177/25158163211029909
H. Pohl, A. Gantenbein, P. Sandor, J. Schoenen, C. Andrée
Background: Cluster headache cannot be cured, and not all attacks can be aborted or prevented. Nevertheless, therapeutic guidelines focus solely on the attacks and ignore reverberations of the disorder on patients’ lives. However, it is likely that not only pain reduces patients’ quality of life (QoL). Objective: To investigate whether the interictal burden independently influence the QoL of subjects suffering from cluster headache. Methods: In this cross-sectional study, we asked patients with a self-reported cluster headache diagnosis to answer a modified EUROLIGHT questionnaire that included the EURO-HIS QoL scale. We built a generalised linear model and included the QoL as the dependent variable. Independent variables comprised both the ictal and the interictal burden. Results: The data of 625 participants entered the analysis. Several aspects of the interictal burden independently reduced the QoL. Among them were fear of pain, self-concealment, and private life difficulties due to the disorder. Conclusion: Both the ictal and the interictal burden of cluster headache independently reduce patients’ QoL. We advocate adopting a more holistic approach to cluster headache management extending the focus towards the afflicted person and their QoL, which would generate novel therapeutic goals and strategies, complementary to treating and preventing cluster headache attacks.
{"title":"The impact of the disease burden on the quality of life of cluster headache patients","authors":"H. Pohl, A. Gantenbein, P. Sandor, J. Schoenen, C. Andrée","doi":"10.1177/25158163211029909","DOIUrl":"https://doi.org/10.1177/25158163211029909","url":null,"abstract":"Background: Cluster headache cannot be cured, and not all attacks can be aborted or prevented. Nevertheless, therapeutic guidelines focus solely on the attacks and ignore reverberations of the disorder on patients’ lives. However, it is likely that not only pain reduces patients’ quality of life (QoL). Objective: To investigate whether the interictal burden independently influence the QoL of subjects suffering from cluster headache. Methods: In this cross-sectional study, we asked patients with a self-reported cluster headache diagnosis to answer a modified EUROLIGHT questionnaire that included the EURO-HIS QoL scale. We built a generalised linear model and included the QoL as the dependent variable. Independent variables comprised both the ictal and the interictal burden. Results: The data of 625 participants entered the analysis. Several aspects of the interictal burden independently reduced the QoL. Among them were fear of pain, self-concealment, and private life difficulties due to the disorder. Conclusion: Both the ictal and the interictal burden of cluster headache independently reduce patients’ QoL. We advocate adopting a more holistic approach to cluster headache management extending the focus towards the afflicted person and their QoL, which would generate novel therapeutic goals and strategies, complementary to treating and preventing cluster headache attacks.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/25158163211029909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42842005","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 : 2021-01-01DOI: 10.1177/25158163211039800
Vanesa Nagel, L. Bonamico, M. Goicochea
Background: The International Headache Society defines Occipital neuralgia as an unilateral or bilateral paroxysmal, shooting or stabbing pain in the posterior part of the scalp, in the distribution(s) of the greater, lesser and/or third occipital nerves. The most common pain trigger in this area result from chronically contracted muscles. Different aetiologies of headache with occipital neuralgia phenotype have been described. Case: We report four cases in which pain with occipital neuralgia phenotype was the initial symptom of a clivus chordoma; a para-pharyngeal carcinoma; a vertebral dissection; and a brachial plexitis due to zoster. Conclusion: A detailed anamnesis and physical examination should be performed in these patients. If during follow up atypical finding appears, we recommend head and neck gadolinium-enhanced MRI and biochemistry to exclude secondary causes.
{"title":"Headache with occipital neuralgia phenotype: Report of four cases","authors":"Vanesa Nagel, L. Bonamico, M. Goicochea","doi":"10.1177/25158163211039800","DOIUrl":"https://doi.org/10.1177/25158163211039800","url":null,"abstract":"Background: The International Headache Society defines Occipital neuralgia as an unilateral or bilateral paroxysmal, shooting or stabbing pain in the posterior part of the scalp, in the distribution(s) of the greater, lesser and/or third occipital nerves. The most common pain trigger in this area result from chronically contracted muscles. Different aetiologies of headache with occipital neuralgia phenotype have been described. Case: We report four cases in which pain with occipital neuralgia phenotype was the initial symptom of a clivus chordoma; a para-pharyngeal carcinoma; a vertebral dissection; and a brachial plexitis due to zoster. Conclusion: A detailed anamnesis and physical examination should be performed in these patients. If during follow up atypical finding appears, we recommend head and neck gadolinium-enhanced MRI and biochemistry to exclude secondary causes.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46969896","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 : 2020-12-29DOI: 10.1177/2515816320985800
{"title":"Corrigendum to “How advocacy affects Twitter migraine conversations: A pilot cross-sectional survey of Northeast American ‘migraine’ landscape on Twitter from May to June 2020”","authors":"","doi":"10.1177/2515816320985800","DOIUrl":"https://doi.org/10.1177/2515816320985800","url":null,"abstract":"","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320985800","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45317703","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 : 2020-12-08DOI: 10.1177/2515816320980995
Conor Fearon, K. Moloney, A. Chalissery, D. Ferguson, J. Redmond
Background: Headaches represent a significant proportion of referrals to any neurology consult service, of which many are migrainous. Regular use of opioids can lead to medication overuse headache in these patients and in some cases, dependence. The epidemic of opioid abuse represents a serious public health concern, with long term use of opioids associated with risk of misuse, abuse, addiction and even overdose. Methods: We audited headache referrals to the neurology consult service in an acute tertiary hospital over three 6-month periods between 2012 and 2019. Appropriateness of referrals with respect to NICE guidelines and initial treatments strategies were assessed. Results: The majority of headache disorders seen were migrainous and we found an alarming and repeated trend of early opioid prescribing in the initial acute setting (up to 56%). Conclusions: Further education of healthcare professionals and patients is urgently required to prevent this group becoming victims of the growing global opioid epidemic.
{"title":"The opioid epidemic and headache: Experience of a general neurology consult service","authors":"Conor Fearon, K. Moloney, A. Chalissery, D. Ferguson, J. Redmond","doi":"10.1177/2515816320980995","DOIUrl":"https://doi.org/10.1177/2515816320980995","url":null,"abstract":"Background: Headaches represent a significant proportion of referrals to any neurology consult service, of which many are migrainous. Regular use of opioids can lead to medication overuse headache in these patients and in some cases, dependence. The epidemic of opioid abuse represents a serious public health concern, with long term use of opioids associated with risk of misuse, abuse, addiction and even overdose. Methods: We audited headache referrals to the neurology consult service in an acute tertiary hospital over three 6-month periods between 2012 and 2019. Appropriateness of referrals with respect to NICE guidelines and initial treatments strategies were assessed. Results: The majority of headache disorders seen were migrainous and we found an alarming and repeated trend of early opioid prescribing in the initial acute setting (up to 56%). Conclusions: Further education of healthcare professionals and patients is urgently required to prevent this group becoming victims of the growing global opioid epidemic.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320980995","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47048019","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 : 2020-11-09DOI: 10.1177/2515816320972085
Pengfei Zhang, Santosh P Bhaskarabhatla
Background: Twitter is a leading microblogging platform, with over 126 million daily active users as of 2019, which allows for large-scale analysis of tweets related to migraine. June 2020 encompassed the National Migraine and Headache Awareness Month in the United States and the American Headache Society’s virtual annual conference, which offer opportunities for us to study online migraine advocacy. Objective: We aim to study the content of individual tweets about migraine, as well as study patterns of other topics that were discussed in those tweets. In addition, we aim to study the sources of information that people reference within their tweets. Thirdly, we want to study how online awareness and advocacy movements shape these conversations about migraine. Methods: We designed a Twitter robot that records all unique public tweets containing the word “migraine” from May 8th, 2020 to June 23rd, 2020, within a 400 km radius of New Brunswick, New Jersey, United States. We built two network analysis models, one for the months of May 2020 and June 2020. The model for the month of May served as a control group for the model for the month of June, the Migraine Awareness Month. Our network model was developed with the following rule: if two hashtag topics co-exist in a single tweet, they are considered nodes connected by an edge in our network model. We then determine the top 30 most important hashtags in the month of May and June through applications of degree, between-ness, and closeness centrality. We also generated highly connected subgraphs (HCS) to categorize clusters of conversations within each of our models. Finally, we tally the websites referenced by these tweets during each month and categorized these websites according to the HCS subgroups. Results: Migraine advocacy related tweets are more popular in June when compared to May as judged by degree and closeness centrality measurements. They remained unchanged when judged by between-ness centralities. The HCS algorithm categorizes the hashtags into a large single dominant conversation in both months. In each of the months, advocacy related hashtags are apart of each of the dominant conversation. There are more hashtag topics as well as more unique websites referenced in the dominant conversation in June than in May. In addition, there are many smaller subgroups of migraine-related hashtags, and in each of these subgroups, there are a maximum of two websites referenced. Conclusion: We find a network analysis approach to be fruitful in the area of migraine social media research. Migraine advocacy tweets on Twitter not only rise in popularity during migraine awareness month but also may potentially bring in more diverse sources of online references into the Twitter migraine conversation. The smaller subgroups we identified suggest that there are marginalized conversations referencing a limited number of websites, creating a possibility of an “echo chamber” phenomenon. These subgroups provide an
{"title":"How advocacy affects Twitter migraine conversations: A pilot cross-sectional survey of Northeast American “migraine” landscape on Twitter from May to June 2020","authors":"Pengfei Zhang, Santosh P Bhaskarabhatla","doi":"10.1177/2515816320972085","DOIUrl":"https://doi.org/10.1177/2515816320972085","url":null,"abstract":"Background: Twitter is a leading microblogging platform, with over 126 million daily active users as of 2019, which allows for large-scale analysis of tweets related to migraine. June 2020 encompassed the National Migraine and Headache Awareness Month in the United States and the American Headache Society’s virtual annual conference, which offer opportunities for us to study online migraine advocacy. Objective: We aim to study the content of individual tweets about migraine, as well as study patterns of other topics that were discussed in those tweets. In addition, we aim to study the sources of information that people reference within their tweets. Thirdly, we want to study how online awareness and advocacy movements shape these conversations about migraine. Methods: We designed a Twitter robot that records all unique public tweets containing the word “migraine” from May 8th, 2020 to June 23rd, 2020, within a 400 km radius of New Brunswick, New Jersey, United States. We built two network analysis models, one for the months of May 2020 and June 2020. The model for the month of May served as a control group for the model for the month of June, the Migraine Awareness Month. Our network model was developed with the following rule: if two hashtag topics co-exist in a single tweet, they are considered nodes connected by an edge in our network model. We then determine the top 30 most important hashtags in the month of May and June through applications of degree, between-ness, and closeness centrality. We also generated highly connected subgraphs (HCS) to categorize clusters of conversations within each of our models. Finally, we tally the websites referenced by these tweets during each month and categorized these websites according to the HCS subgroups. Results: Migraine advocacy related tweets are more popular in June when compared to May as judged by degree and closeness centrality measurements. They remained unchanged when judged by between-ness centralities. The HCS algorithm categorizes the hashtags into a large single dominant conversation in both months. In each of the months, advocacy related hashtags are apart of each of the dominant conversation. There are more hashtag topics as well as more unique websites referenced in the dominant conversation in June than in May. In addition, there are many smaller subgroups of migraine-related hashtags, and in each of these subgroups, there are a maximum of two websites referenced. Conclusion: We find a network analysis approach to be fruitful in the area of migraine social media research. Migraine advocacy tweets on Twitter not only rise in popularity during migraine awareness month but also may potentially bring in more diverse sources of online references into the Twitter migraine conversation. The smaller subgroups we identified suggest that there are marginalized conversations referencing a limited number of websites, creating a possibility of an “echo chamber” phenomenon. These subgroups provide an","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320972085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45873193","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 : 2020-10-27DOI: 10.1177/2515816320964401
D. Chowdhury, A. Mundra
Objective: The aim of this study is to critically analyze the evidence of the efficacy and safety of greater occipital nerve (GON) block for the preventive treatment of chronic migraine (CM). Background: A rigorous scientific assessment of efficacy and safety of the GON block for preventive treatment in CM is not available. This critical review was undertaken for this purpose. Methods: References for this review were identified by searches of articles published in the English language in PubMed between 1969 and April 15, 2020 using “greater occipital nerve block,” “chronic migraine,” “migraine,” “headache,” and “treatment” as keywords. Results: Out of potential 532 articles, 9 open-label and 4 placebo-controlled trials that studied the role of GON block for prevention of CM were identified and reviewed. Open-label trials reported a reduction of headache severity and frequency in 35–68% of patients. The beneficial effect of a single block lasted up to 4 weeks. Randomized controlled trials (RCTs) used varied methodology and techniques of GON block and the outcomes were reported at different time points. A single RCT showed a beneficial effect of the GON block at 1 week. However, the GON block was found to be safe and well tolerated. Conclusion: Long-term efficacy of GON block in CM shall need further well-designed RCTs using standardized methodology. This study, in addition, reviewed the limitations and uncertainties regarding the technique and methods of use of GON block in CM.
{"title":"Role of greater occipital nerve block for preventive treatment of chronic migraine: A critical review","authors":"D. Chowdhury, A. Mundra","doi":"10.1177/2515816320964401","DOIUrl":"https://doi.org/10.1177/2515816320964401","url":null,"abstract":"Objective: The aim of this study is to critically analyze the evidence of the efficacy and safety of greater occipital nerve (GON) block for the preventive treatment of chronic migraine (CM). Background: A rigorous scientific assessment of efficacy and safety of the GON block for preventive treatment in CM is not available. This critical review was undertaken for this purpose. Methods: References for this review were identified by searches of articles published in the English language in PubMed between 1969 and April 15, 2020 using “greater occipital nerve block,” “chronic migraine,” “migraine,” “headache,” and “treatment” as keywords. Results: Out of potential 532 articles, 9 open-label and 4 placebo-controlled trials that studied the role of GON block for prevention of CM were identified and reviewed. Open-label trials reported a reduction of headache severity and frequency in 35–68% of patients. The beneficial effect of a single block lasted up to 4 weeks. Randomized controlled trials (RCTs) used varied methodology and techniques of GON block and the outcomes were reported at different time points. A single RCT showed a beneficial effect of the GON block at 1 week. However, the GON block was found to be safe and well tolerated. Conclusion: Long-term efficacy of GON block in CM shall need further well-designed RCTs using standardized methodology. This study, in addition, reviewed the limitations and uncertainties regarding the technique and methods of use of GON block in CM.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320964401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41411936","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 : 2020-10-16DOI: 10.1177/2515816320964405
Marco Lisicki, M. Carpinella, G. Coppola, Tatiana Castro Zamparella, Emiliano Ruiz-Romagnoli, M. Manise, A. M. de Noordhout, J. Schoenen, Diego Conci Magris
Introduction: Visual manifestations are the most prominent non-painful features of migraine. During the last decades, visual area V3a has gathered attention of headache scientists because of its apparent implication on aura initiation, photophobia and cortical hyper-responsiveness related to visual motion perception. In this hypothesis-generating study, we performed an in silico analysis of gene expression in left V3a and the cerebral gyrus that harbours it (left superior occipital gyrus (lSOG)) searching for transcriptomic patterns that could be linked with migraine’s pathophysiology. Materials and methods: Neurotransmitter receptor gene expression levels in left V3a were extracted from validated brain mRNA expression models using a probabilistic volumetric mask of this region. The primary visual cortex and other sensory cortices (auditory, olfactory and somatosensory) were used as comparators. Genome-wide transcriptomic differences between the gyrus harbouring left V3a (lSOG) and the rest of the cerebral cortex were assessed using the Allen Brain Institute Human RNA micro array atlas/database. Results: Adrenergic receptor β1, dopaminergic receptor D3 and serotoninergic receptors 1B, 1F and 2A, which have been previously implicated in migraine’s pathophysiology and/or treatment, showed significantly higher expression levels on left V3a. Transcriptomic differences between the lSOG harbouring V3a and the rest of the cortex comprise genes whose products are involved in neuronal excitability (SLC17A6, KCNS1, KCNG1 and GABRQ), activation of multiple signal transduction pathways (MET) and cell metabolism (SPHKAP via its interaction with cAMP-dependent protein kinase). Conclusions: Focal gene expression analysis of V3a suggests some clues about its implication in migraine. Further studies are warranted.
{"title":"In silico analysis of gene expression in V3a and the superior occipital gyrus: Relevance for migraine","authors":"Marco Lisicki, M. Carpinella, G. Coppola, Tatiana Castro Zamparella, Emiliano Ruiz-Romagnoli, M. Manise, A. M. de Noordhout, J. Schoenen, Diego Conci Magris","doi":"10.1177/2515816320964405","DOIUrl":"https://doi.org/10.1177/2515816320964405","url":null,"abstract":"Introduction: Visual manifestations are the most prominent non-painful features of migraine. During the last decades, visual area V3a has gathered attention of headache scientists because of its apparent implication on aura initiation, photophobia and cortical hyper-responsiveness related to visual motion perception. In this hypothesis-generating study, we performed an in silico analysis of gene expression in left V3a and the cerebral gyrus that harbours it (left superior occipital gyrus (lSOG)) searching for transcriptomic patterns that could be linked with migraine’s pathophysiology. Materials and methods: Neurotransmitter receptor gene expression levels in left V3a were extracted from validated brain mRNA expression models using a probabilistic volumetric mask of this region. The primary visual cortex and other sensory cortices (auditory, olfactory and somatosensory) were used as comparators. Genome-wide transcriptomic differences between the gyrus harbouring left V3a (lSOG) and the rest of the cerebral cortex were assessed using the Allen Brain Institute Human RNA micro array atlas/database. Results: Adrenergic receptor β1, dopaminergic receptor D3 and serotoninergic receptors 1B, 1F and 2A, which have been previously implicated in migraine’s pathophysiology and/or treatment, showed significantly higher expression levels on left V3a. Transcriptomic differences between the lSOG harbouring V3a and the rest of the cortex comprise genes whose products are involved in neuronal excitability (SLC17A6, KCNS1, KCNG1 and GABRQ), activation of multiple signal transduction pathways (MET) and cell metabolism (SPHKAP via its interaction with cAMP-dependent protein kinase). Conclusions: Focal gene expression analysis of V3a suggests some clues about its implication in migraine. Further studies are warranted.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320964405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47432296","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 : 2020-10-13DOI: 10.1177/2515816320966965
A. Goulart, Bianca de Almeida-Pititto, P. Lotufo, I. Santos, Sandra R. G. Ferreira, I. Benseñor
Background: Relationships of adipokines (ADP) with migraine are not well-established. We examined the relationship of adiponectin and leptin with migraine by aura symptoms. Methods: In a baseline cross-sectional data of Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), associations of ADP levels and migraine were assessed in a sample of 257 nondiabetic subjects, free from cardiovascular disease. Associations of ADP tertiles (dependent variable) and migraine status were tested using logistic regression models. Categories of migraine were created as follows: no headache (reference), migraine with aura (MA), and migraine without aura (MO) in all sample and by sex. Odds ratio (OR) with respective 95% confidence interval (CI) adjusted for age, sex, body mass index, and metabolic syndrome. Results: Among participants (46 years ± SD: 4.8), 47.5% were women and 36.2% had migraine (16.7% MA). Median values of leptin (ng/mL) increased gradually across subgroup: no headache: 9.5 (interquartile range (IQR): 5.5–15.7) versus MO: 17.0 (IQR: 10.9–34.2) versus MA: 20.9 (IQR: 11.7–29.3), overall p value <0.0001, but not for adiponectin levels. After full adjustment, the third of leptin was positively associated with MA (OR 2.89 (1.00–8.4)) and the second of adiponectin was associated with MO (OR 2.76; 95% CI: 1.09–6.96, p = 0.03). Positive associations with MA, second (OR 3.81; 95% CI: 1.07–13.59; p = 0.04) and third tertile of leptin (6.54; 95% CI: 1.74–24.57, p = 0.005), were also observed in women, but not in men. Conclusions: Positive associations between ADP and migraine, particularly between MA and leptin levels in women, raise the possibility of adipocytokines and play a role in migraine pathophysiology.
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