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Al-Beltagi M, Saeed NK, Bediwy AS, Elbeltagi R. Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders. World J Clin Pediatr 2025; 14:103323. [DOI: 10.5409/wjcp.v14.i2.103323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 12/14/2024] [Accepted: 01/02/2025] [Indexed: 03/18/2025] Open
Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.
AIM To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.
METHODS A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.
RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.
CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Paediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Nermin K Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Governmental Hospitals, Manama 26671, Bahrain
- Medical Microbiology Section, Department of Pathology, The Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel S Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
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de Oliveira I, de Fontes BR, de Ataíde Mariz H, Duarte ALBP, Sampaio Rocha-Filho PA. Headache in patients with systemic lupus erythematosus: A matched case-control study. Headache 2025; 65:568-577. [PMID: 40022497 DOI: 10.1111/head.14919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Revised: 11/20/2024] [Accepted: 11/24/2024] [Indexed: 03/03/2025]
Abstract
OBJECTIVES To compare the prevalence and characteristics of headaches between patients with systemic lupus erythematosus (SLE) and people without the disease and to assess whether there was a relationship between headaches and disease activity. BACKGROUND Headache is a common symptom in patients with SLE; however, the effect of SLE on headaches is not fully known. METHODS This was a case-control study. Individuals with and without SLE matched by age and sex were compared. All participants were assessed by a neurologist. A semi-structured questionnaire, the six-item Headache Impact Test (HIT-6) and the Hospital Anxiety and Depression Scale were used. Disease activity was measured by a rheumatologist using the Physician Global Assessment (PGA) and quantified using the modified Systemic Lupus Erythematosus Disease Activity Index 2000 scale (modified SLEDAI-2K). Data were collected between November 2021 and January 2023. RESULTS A total of 228 individuals were included, 114 in each group. The SLE group presented with more moderate/severe headache attacks than the controls (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.21-4.95; p = 0.013). When comparing patients with active SLE and those without disease activity, there was no difference in the prevalence (OR 1.48, 95% CI 0.38-5.74), type (migraine: OR 1.69, 95% CI 0.71-3.99; tension-type headache: OR 0.64, 95% CI 0.25-1.68), frequency (4; 2-15 vs. 3; 1-12 days/month; p = 0.250), intensity (moderate/severe intensity: OR 0.59, 95% CI 0.19-1.82), or impact of headache (HIT-6: 61; 50-65 vs. 56; 45-63; p = 0.278). The magnitude of SLE activity (modified SLEDAI-2K) demonstrated no statistically significant association with the impact (standardized beta coefficient: 0.02, 95% CI -0.05 to 0.09; p = 0.792) or monthly frequency of headache (standardized beta coefficient: 0.09, 95% CI -0.08 to 0.26; p = 0.275). CONCLUSIONS Headache is a common symptom in SLE, although the prevalence was similar to that of the controls without the disease. While patients with SLE had more intense headache attacks than the controls without SLE, there was no association between headache and SLE activity.
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Affiliation(s)
- Igor de Oliveira
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Recife, Brazil
| | - Bruno Rodrigo de Fontes
- Programa de Pós-Graduação Em Inovação Terapêutica, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Henrique de Ataíde Mariz
- Division of Rheumatology, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | | | - Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
- Headache Clinic, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil
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Legesse SM, Addila AE, Jena BH, Jikamo B, Abdissa ZD, Hailemarim T. Irregular meal and migraine headache: a scoping review. BMC Nutr 2025; 11:60. [PMID: 40140884 PMCID: PMC11938733 DOI: 10.1186/s40795-025-01048-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Accepted: 03/19/2025] [Indexed: 03/28/2025] Open
Abstract
INTRODUCTION Migraines are a type of headache, with certain types being more severe than others. The aim of this scoping review is to map the association between migraine headache and irregular meals, including skipping meals or missed diets and fasting. METHODS The six-stages methodological framework of Arksey & O'Malley for scoping reviews was used. A protocol was registered on OSF on November 17, 2024 ( https://doi.org/10.17605/OSF.IO/Z8C7M ) as OSF preregistration for Generalized Systematic Review Registration. Searches were made from the Cochrane Library, Research for Life, PQD Evidence, Global Index Medicus, Scopus, and MEDLINE databases. To make comprehensive searches, Google Scholar, Google, and grey literature sources, including databases of relevant organizations, were searched. Only studies published in English without a date limit were considered. Screening and data extraction were conducted by two groups of reviewers independently. RESULT Thirty-six studies were included in this review. It includes systematic reviews, randomized placebo-control trials, cohort studies, literature reviews, chart reviews, case control studies, case studies, and cross-sectional studies. Some studies found no clear link between meal omission and migraines, with mixed evidence on the role of dietary factors as triggers. But the majority of studies suggest that fasting and skipping meals, especially breakfast, can trigger migraines by reducing brain glucose levels and causing hypoglycemia, a known trigger. The timing of meals is crucial, as missed meals can provoke different types of migraines, including retinal and abdominal migraines. Moreover, irregular meal patterns, particularly in those with chronic migraines, are strong predictors of attacks. Consistent and balanced meals help to prevent migraines and manage symptoms. CONCLUSION While few studies show mixed evidence, the majority indicate that fasting or skipping meals can trigger migraines. Regular, balanced meals benefit preventing and managing migraines, as irregular meal patterns are predictors of migraine attacks. Moreover, some studies have low to moderate methodological quality, often lacking rigorous control groups and randomization. Thus, it is recommended to draw conclusions from interventional research having longitudinal research with better sample sizes.
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Affiliation(s)
- Samson Mideksa Legesse
- Nutrition, Environmental Health, and Non-communicable Disease Research Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia.
| | - Alemu Earsido Addila
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Belayneh Hamdela Jena
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Birhanu Jikamo
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Zewditu Denu Abdissa
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfahun Hailemarim
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Health Informatics, College of Health Sciences, Hawassa, Ethiopia
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López-Medina DC, Arboleda-Ramírez A, Ríos-Díaz S, Zambrano-Cruz R, Arboleda-Jaramillo A, Betancur-Henao C, Henao-Pérez M. Cognition, mental health, and quality of life in patients with chronic and episodic migraine during the interictal period. BMC Neurol 2025; 25:108. [PMID: 40087647 PMCID: PMC11907823 DOI: 10.1186/s12883-025-04122-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Accepted: 03/05/2025] [Indexed: 03/17/2025] Open
Abstract
INTRODUCTION Migraine is a highly prevalent and disabling condition, not only due to its painful symptoms but also because of its significant impact on mental health and cognitive functioning, leading to a considerable deterioration in quality of life. This study aimed to evaluate the cognitive profile, mental health, and quality of life in patients with chronic and episodic migraine during the interictal period, and to explore their relationship with sociodemographic and clinical variables. METHOD This observational, descriptive, cross-sectional analytical study included 60 patients diagnosed with chronic or episodic migraine, who were enrolled in a health program for headache patients between 2010 and 2016. Cognitive function, anxiety and/or depression symptoms, and quality of life during the interictal period were assessed. Descriptive analyses were conducted, and associations were evaluated by configuring primary (type of migraine) and alternative events (cognitive impairment, depression and/or anxiety, and poor quality of life). RESULTS The mean age of the participants was 45 years (SD ± 8), with 83.3% being women and 93.3% belonging to middle and low socioeconomic strata. Of the 60 patients, 83.3% (50) were diagnosed with chronic migraine, while the remaining had episodic migraine. The use of one or more cognition-altering medications was observed in 90% of patients with chronic migraine and 60% of those with episodic migraine (p = 0.02). Anxiety was more prevalent in patients with episodic migraine, whereas depression was more common among those with chronic migraine. Female gender, middle socioeconomic status, and longer disease duration were significantly associated with chronic migraine. Among the 57 patients who completed the Mini-Mental State Examination, 38.6% had cognitive impairment, which decreased with longer migraine duration and better social interaction. Memory and selective attention were the most affected cognitive domains in both groups. No significant associations were found for the other variables after adjusting for confounders. CONCLUSIONS Chronic migraine significantly impacts mental health, cognition, and quality of life, with depression and cognitive impairments being prevalent. Social interaction and longer disease duration may protect against cognitive decline, highlighting the need for multidisciplinary, personalized interventions addressing neurological and psychosocial challenges.
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Affiliation(s)
| | | | - Sara Ríos-Díaz
- Fundación Instituto Neurológico de Colombia, Medellín, Colombia
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Chaudhary S, Khanduri S, Mata S, Rao BCS, Singh Anand K, Kishore Kumar R, Sudha Kumari KG, Mahajan B, Kumar Rana R, Singhal R, Mata S, Makhija R, Bharti, Srikanth N, Dhiman KS, Rabinarayan Acharya. Randomized double blind placebo controlled multicentric clinical trial of Ayush M-3 in the management of migraine- A study protocol. J Ayurveda Integr Med 2025; 16:101054. [PMID: 40056811 PMCID: PMC11930692 DOI: 10.1016/j.jaim.2024.101054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/28/2024] [Accepted: 08/20/2024] [Indexed: 03/10/2025] Open
Abstract
BACKGROUND Migraine is acknowledged as an intricate and incapacitating neurological malady, profoundly exerting a potent influence on the health-related quality of life of patients causing disability, and augmented burden on families, and entire communities. Notwithstanding the strides made in the field of headache disorder management, there remains a cohort of migraine-afflicted patients who do not encounter satisfactory alleviation. This emphasizes the need for alternative systems in addressing the issue and there is a growing interest in exploring Indian system of medicine to address migraine symptoms. OBJECTIVE Due to the dearth of prospective, high-quality randomized controlled trials, this protocol aims to conduct a scientific study of the polyherbal formulation 'Ayush M3' to assess its safety and efficacy in patients suffering with migraine. MATERIALS AND METHODS A prospective, randomized, double blind, parallel-group, placebo controlled, multi - centric, two-arm, exploratory study has been designed to enrol a total of 360 patients at three sites. Migraine patients with or without aura diagnosed as per International Headache Society-ICHD-III below Grade III of MIDAS will be randomized in a 1:1 ratio and administered the trial drug, Ayush M - 3 or placebo for twice a day after food for 16 weeks. OUTCOME MEASURES The primary outcomes measures for the study will be changes in the character of disease in terms of frequency, intensity of headache as per VAS (0-10) and duration of episode of headache. Secondary outcome measure will be changes in MIDAS, MSQ2.1, changes in associated symptoms of migraine, change in the use of analgesics/symptom alleviating medication & Change in the required dose/withdrawal of Anti-hypertensive drugs if any. Assessment will be conducted on an interval of 28 days till 16 weeks and an intervention free follow up at the end of week 20.
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Affiliation(s)
- Shweta Chaudhary
- Ayush Wellness Centre, Rashtrapati Bhawan As Ayurveda Physician, Central Ayurveda Research Institute (CARI), New Delhi, India.
| | - Shruti Khanduri
- Central Council for Research in Ayurvedic Sciences (CCRAS) Headquarters, New Delhi, India
| | | | - B C S Rao
- CCRAS, Headquarters, New Delhi, India
| | | | - R Kishore Kumar
- Department of Integrative Medicine, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, India
| | - K G Sudha Kumari
- Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital (ATC-RML), New Delhi, India
| | | | | | - Richa Singhal
- CCRAS, Ministry of Ayush, ICMR- National Institute of Malaria Research, New Delhi, India
| | - Shweta Mata
- Central Ayurveda Research Institute (CARI), New Delhi, India
| | - Renu Makhija
- Central Ayurveda Research Institute (CARI), New Delhi, India
| | - Bharti
- Central Ayurveda Research Institute (CARI), New Delhi, India
| | - N Srikanth
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, India
| | - K S Dhiman
- Shri Krishna Ayush University, Kurukshetra, Haryana, India
| | - Rabinarayan Acharya
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, India
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Satapathy P, Chauhan S, Gaidhane S, Bishoyi AK, Priya GP, Jayabalan K, Mishra S, Sharma S, Bushi G, Shabil M, Syed R, Kundra K, Dev N, Ansar S, Sah S, Zahiruddin QS, Samal SK, Jena D, Goh KW. Trends in migraine and tension-type headaches in South Asia: findings from the Global Burden of Disease Study 2021 (1990-2021). Front Neurol 2025; 16:1514712. [PMID: 40109844 PMCID: PMC11921782 DOI: 10.3389/fneur.2025.1514712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Accepted: 01/13/2025] [Indexed: 03/22/2025] Open
Abstract
Background Headache disorders, including migraines and tension-type headaches (TTH), are major contributors to global disability. In South Asia, where these conditions are often underdiagnosed, their burden has grown substantially. This study evaluates trends in headache disorders across eight South Asian countries from 1990 to 2021, using data from the Global Burden of Disease (GBD) Study 2021. Methods Data from the GBD study were analysed to evaluate incidence, prevalence, and years lived with disability (YLDs) for headache disorders and their subtypes. Trends were assessed using absolute numbers and age-standardized rates, with demographic patterns by age and gender examined to identify vulnerable populations. Joinpoint regression analysis was employed to detect significant temporal shifts. Results From 1990 to 2021, headache disorders in South Asia rose from 114.2 million to 206.8 million in incidence, and from 367.4 million to 698.5 million in prevalence, with YLDs nearly doubling from 6.0 million to 11.6 million. Migraines accounted for 294.4 million cases, while TTH contributed 495.4 million cases, with YLDs increasing by 92.88 and 99.35%, respectively. Afghanistan saw the highest relative growth, while India contributed the largest absolute burden. Women and middle-aged adults were disproportionately affected, with the highest prevalence observed in females aged 30-34 years. The Maldives showed dramatic increases in TTH-related YLDs, highlighting disparities in smaller nations. Conclusion The rising burden of headache disorders in South Asia highlights the need for region-specific strategies targeting high-burden subtypes, countries, and vulnerable populations to mitigate their disabling impacts.
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Affiliation(s)
- Prakasini Satapathy
- Centre of Research Impact and Outcome, Chitkara University, Rajpura, India
- Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia
| | - Shubham Chauhan
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Ashok Kumar Bishoyi
- Marwadi University Research Center, Department of Microbiology, Marwadi University, Rajkot, India
| | - G Padma Priya
- Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, India
| | - Karthikeyan Jayabalan
- Department of Chemistry, Sathyabama Institute of Science and Technology, Chennai, India
| | - Swati Mishra
- Department of Pharmacology, IMS and SUM Hospital, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, India
| | - Shilpa Sharma
- Department of Pharmacy, Chandigarh Pharmacy College, Chandigarh Group of Colleges-Jhanjeri, Mohali, India
| | - Ganesh Bushi
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
- Research and Enterprise, University of Cyberjaya, Persiaran Bestari, Cyber, Cyberjaya, Malaysia
| | - Muhammed Shabil
- University Center for Research and Development, Chandigarh University, Mohali, India
- Department of Medical Laboratories Techniques, AL-Mustaqbal University, Hillah, Iraq
| | - Rukshar Syed
- IES Institute of Pharmacy, IES University, Bhopal, India
| | - Kamal Kundra
- New Delhi Institute of Management, New Delhi, India
| | - Navneet Dev
- Department of Dermatology, Graphic Era Deemed to be University, Dehradun, India
| | - Sabah Ansar
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sanjit Sah
- Department of Paediatrics, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pimpri-Chinchwad, India
- Department of Public Health Dentistry, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pimpri-Chinchwad, India
- Department of Medicine, Korea University, Seoul, Republic of Korea
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), Global Consortium of Public Health and Research, Division of Evidence Synthesis, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shailesh Kumar Samal
- Unit of Immunology and Chronic Disease, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Diptismita Jena
- Noida Institute of Engineering and Technology (Pharmacy Institute), Greater Noida, India
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia
- Faculty of Mathematics and Natural Sciences, Universitas Negeri Padang, Padang, Indonesia
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Lee SH, Jo JH, Park JW. Temporomandibular disorders patients with migraine symptoms have increased disease burden due to psychological conditions. J Oral Facial Pain Headache 2025; 39:70-80. [PMID: 40129424 PMCID: PMC11933985 DOI: 10.22514/jofph.2025.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Accepted: 09/26/2024] [Indexed: 03/26/2025]
Abstract
BACKGROUND Various studies have demonstrated a close link between headaches and temporomandibular disorders (TMD). However, the results are often limited to certain clinical aspects and are based on a cross-sectional study design. This study aimed to examine the clinical characteristics of patients with both TMD and migraine symptoms and to assess the long-term treatment outcomes compared to TMD patients without migraine. METHODS Sixty-four TMD patients were evaluated using the Diagnostic Criteria for TMD protocol and validated questionnaires, including Generalized Anxiety Disorder-7, Patient Health Questionnaire (PHQ)-9, PHQ-15, the Graded Chronic Pain Scale, and the Symptom Checklist-90-Revision (SCL-90-R). Patients were divided into two groups based on the presence of migraine symptoms requiring medication. The study compared psychological and clinical profiles, as well as long-term treatment outcomes. RESULTS The migraine group exhibited greater psychological distress, as indicated by higher scores in the SCL-90-R subscales for somatization (p = 0.035), obsessive-compulsive behavior (p = 0.015), interpersonal sensitivity (p = 0.002), depression (p = 0.035), anxiety (p = 0.042), hostility (p = 0.004), paranoid ideation (p = 0.016), and psychoticism (p = 0.044). Additionally, they scored higher on the PHQ-9 (p = 0.023) and PHQ-15 (p = 0.016). Pain levels were higher in the migraine group at 3 months post-treatment (p = 0.023) but the difference with the non-migraine group disappeared 6 months post-treatment. Younger age (odds ratio (OR) = 0.844, p = 0.001), female (OR = 0.001, p = 0.011), and more positive sites on masticatory muscle palpation (OR = 2.580, p = 0.011) were associated with a higher likelihood of experiencing migraine. Mental illness history (β = -0.465, p = 0.002), tongue ridging (β = -0.683, p < 0.001), and Oral Behavior Checklist scores (β = 0.483, p = 0.002) were associated with TMD pain intensity in the migraine group. CONCLUSIONS TMD patients using sumatriptan for migraine symptoms had higher levels of disability and psychological distress, leading to an increased disease burden. Although the migraine group had worse short-term TMD treatment outcomes, these differences resolved after six months of treatment.
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Affiliation(s)
- Soo Haeng Lee
- Department of Oral Medicine, Seoul
National University Dental Hospital,
03080 Seoul, Republic of Korea
- Department of Oral Medicine and Oral
Diagnosis, Seoul National University
School of Dentistry, 03080 Seoul,
Republic of Korea
| | - Jung Hwan Jo
- Department of Oral Medicine, Seoul
National University Dental Hospital,
03080 Seoul, Republic of Korea
- Department of Oral Medicine and Oral
Diagnosis, Seoul National University
School of Dentistry, 03080 Seoul,
Republic of Korea
- Dental Research Institute, Seoul
National University, 03080 Seoul,
Republic of Korea
| | - Ji Woon Park
- Department of Oral Medicine, Seoul
National University Dental Hospital,
03080 Seoul, Republic of Korea
- Department of Oral Medicine and Oral
Diagnosis, Seoul National University
School of Dentistry, 03080 Seoul,
Republic of Korea
- Dental Research Institute, Seoul
National University, 03080 Seoul,
Republic of Korea
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Talemi FE, Hussen BM, Keshmir F, Movafagh A, Sarabi P, Rahmanian M, Sayad A, Ghafouri-Fard S. Up-regulation of MAPK14-related lncRNAs in the circulation of migraineurs. Sci Rep 2025; 15:7250. [PMID: 40021777 PMCID: PMC11871286 DOI: 10.1038/s41598-025-91943-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Accepted: 02/24/2025] [Indexed: 03/03/2025] Open
Abstract
Mitogen-activated protein kinase 14 (MAPK14) has a fundamental role in the development of different inflammatory and neurodegenerative disorders. However, its roles in the pathoetiology of migraine are not clear. The current case-control study focused on expression analysis of MAPK14 and related long non-coding RNAs (lncRNAs) in the circulation of migraineurs compared with healthy controls. Data showed remarkable elevation of expression levels of MAPK14, HLA Complex Group 11 (HCG11), zinc ribbon domain-containing 1-antisense 1 (ZNRD1-AS1), RAD51 antisense RNA 1 (RAD51-AS1) and long noncoding RNA-activated by DNA damage (NORAD) in both groups of migraineurs (with aura and without aura) compared with controls. The accuracy of expression levels of MAPK14, HCG11, ZNRD1-AS1, RAD51-AS1 and NORAD for differentiating migraineurs from controls was 85.71%, 81.56%, 85.11%, 77.8% and 94.33%, respectively. Thus, MAPK14 and its related lncRNAs are putative markers for migraine and might participate in the pathogenesis of this neurologic condition.
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Affiliation(s)
- Fatemeh Ensafi Talemi
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bashdar Mahmud Hussen
- Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region, Iraq
- Department of Biomedical Sciences, College of Science, Cihan University-Erbil, Erbil, Kurdistan Region, Iraq
| | - Fatemeh Keshmir
- Phytochemistry Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abolfazl Movafagh
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Sarabi
- Phytochemistry Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rahmanian
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezou Sayad
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Mackenzie E, Cheng R, Zhang P. GPT meets PubMed: a novel approach to literature review using a large language model to crowdsource migraine medication reviews. BMC Neurol 2025; 25:69. [PMID: 39972406 PMCID: PMC11837380 DOI: 10.1186/s12883-025-04071-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 02/05/2025] [Indexed: 02/21/2025] Open
Abstract
OBJECTIVE To evaluate the potential of two large language models (LLMs), GPT-4 (OpenAI) and PaLM2 (Google), in automating migraine literature analysis by conducting sentiment analysis of migraine medications in clinical trial abstracts. BACKGROUND Migraine affects over one billion individuals worldwide, significantly impacting their quality of life. A vast amount of scientific literature on novel migraine therapeutics continues to emerge, but an efficient method by which to perform ongoing analysis and integration of this information poses a challenge. METHODS "Sentiment analysis" is a data science technique used to ascertain whether a text has positive, negative, or neutral emotional tone. Migraine medication names were extracted from lists of licensed biological products from the FDA, and relevant abstracts were identified using the MeSH term "migraine disorders" on PubMed and filtered for clinical trials. Standardized prompts were provided to the APIs of both GPT-4 and PaLM2 to request an article sentiment as to the efficacy of each medication found in the abstract text. The resulting sentiment outputs were classified using both a binary and a distribution-based model to determine the efficacy of a given medication. RESULTS In both the binary and distribution-based models, the most favorable migraine medications identified by GPT-4 and PaLM2 aligned with evidence-based guidelines for migraine treatment. CONCLUSIONS LLMs have potential as complementary tools in migraine literature analysis. Despite some inconsistencies in output and methodological limitations, the results highlight the utility of LLMs in enhancing the efficiency of literature review through sentiment analysis.
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Affiliation(s)
- Elyse Mackenzie
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Jersey, USA
| | - Roger Cheng
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Jersey, USA
| | - Pengfei Zhang
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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10
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Thorsteinson VH, Haczkewicz KM, Gallant NL. Gender-based discrimination and its influence on mental health symptoms among people living with and without migraine: A case-control study. J Health Psychol 2025:13591053251317069. [PMID: 39972608 DOI: 10.1177/13591053251317069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2025] Open
Abstract
Women are more likely than men to experience migraine and to endorse worse symptoms. Migraine is associated with anxiety, depressive and posttraumatic stress disorders. Women who experience migraine are also more likely to report a history of discriminatory experiences. This study investigated migraine characteristics, mental health outcomes and gender-based discrimination among women using a case-control study with a migraine and non-migraine sample. Two hundred ninety-two women completed an online survey with measures of migraine characteristics (as applicable), mental health symptoms, and gender-based discrimination. Women living with migraine experienced worse mental health symptoms and more gender-based discrimination than the non-migraine group. Migraine frequency and lifetime day-to-day discrimination significantly predicted anxiety, depression, and trauma symptoms, while anticipated discrimination significantly predicted trauma symptoms; lifetime day-to-day discrimination significantly predicted migraine-related reduction in productivity; and gender-based discrimination significantly predicted migraine-related social absences. These findings may be used to improve management of migraine among women.
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Ge R, Xu X, Chen Y, You S, Xu J, Dai H, Huang W, Sun H, Cao Y, Chang J. The quality and reliability of online video resources concerning patient education for migraine treatment in China Mainland: an electronic media-based study. BMC Public Health 2025; 25:656. [PMID: 39966862 PMCID: PMC11834577 DOI: 10.1186/s12889-025-21861-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 02/07/2025] [Indexed: 02/20/2025] Open
Abstract
BACKGROUND Migraine is an extremely prevalent and disabling primary neurological disease worldwide. Although multiple forms of patient education for migraine management have been employed in the past decades, the quality and reliability of headache-related online videos targeting migraine patients remained unclear, particularly those in China. Therefore, in this study, our research team aimed to explore the overall quality and credibility of online videos concerning patient education on migraine treatment in China Mainland. METHODS A total of 182 online videos concerning migraine treatment were retrieved from four most popular Chinese language online video platforms, including Douyin, BiliBili, Haokan Video, and Xigua Video. Our research team collected the producer identity and basic information of these videos, and then used two major score instruments, i.e., the Global Quality Score (GQS) scale and the DISCERN questionnaire, to evaluate the quality and reliability of its content. Subsequently, overall descriptive analysis and detailed comparison among specific video platforms and producers were performed. Finally, using the Spearman correlation coefficient, we also explored the potential correlation between video general information and video quality and reliability. RESULTS The overall quality and reliability of the migraine-related information provided by online videos were poor, yet those uploaded to Douyin were relatively more satisfactory. Among all study videos, 10 encouraged patients to keep a headache diary, 12 warned about the risk of medication overuse, and 32 emphasized the preventive treatment of chronic migraine. However, the treatment recommendations proposed by video creators were highly heterogenous, with the most frequently mentioned pharmacological, non-pharmacological, and traditional Chinese medicine measures being Triptans (n = 57, 31.3%), massage (n = 40, 22.0%), and acupuncture (n = 31, 17.0%), respectively. We also observed slight positive correlations between video quality and the numbers of likes and comments received. CONCLUSIONS The results of our research revealed that the quality and reliability of Chinese language online videos focused on patient education for migraine treatment were inadequate, suggesting that viewers should treat these contents with caution. However, the prospects for video-based patient education remain promising. Implementing appropriate strategies, such as strengthening regulations on health-related videos and instituting a review process conducted by medical professionals, may elevate the overall quality and trustworthiness of medical information shared through online video platforms.
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Affiliation(s)
- Rongguang Ge
- Department of Neurology and Clinical Research Centre of Neurological Disease, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Xiuman Xu
- Department of Neurology and Clinical Research Centre of Neurological Disease, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Yunhao Chen
- Department of Occupational and Environmental Health, School of Public Health, Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Shoujiang You
- Department of Neurology and Clinical Research Centre of Neurological Disease, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jiaping Xu
- Department of Neurology and Clinical Research Centre of Neurological Disease, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Haoyi Dai
- Department of Neurology and Clinical Research Centre of Neurological Disease, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Wenqi Huang
- Department of Occupational and Environmental Health, School of Public Health, Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Hongpeng Sun
- Department of Occupational and Environmental Health, School of Public Health, Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Yongjun Cao
- Department of Neurology and Clinical Research Centre of Neurological Disease, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China.
| | - Jie Chang
- Department of Occupational and Environmental Health, School of Public Health, Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China.
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, Suzhou Medical College of Soochow University, Suzhou, China.
- MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China.
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12
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Abdalla K, Alawneh KZ, Al-Bdour M, Abu-Salih AQ. Migraine and MRI: uncovering potential associations. Head Face Med 2025; 21:6. [PMID: 39955604 PMCID: PMC11830205 DOI: 10.1186/s13005-024-00478-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Accepted: 12/30/2024] [Indexed: 02/17/2025] Open
Abstract
OBJECTIVE This study aims to investigate the association between patients with migraine headaches and brain magnetic resonance imaging (MRI) findings. BACKGROUND Migraine is a frequently encountered primary headache disorder with a disproportionate female predominance. Diagnosis is usually based on the patient's clinical history with neuroimaging reserved for severe or atypical presentations to exclude other pathologies. Migraine patients often experience a profound impact on their quality of life. METHODS A retrospective study was conducted at King Abdullah University Hospital, Jordan, involving patients with a clinical diagnosis of migraine who had undergone MRI brain imaging between January 2021 to March 2023. Descriptive data were documented, with two independent neuro-radiologists interpreting MRI findings. RESULTS Our study included 670 migraine patients (510 females; mean age, 40.3 years). White matter hyperintensity lesions were found in 309 patients (46.1%), significantly affecting older age groups with a mean age of 46.8 years (p > 0.001). Additionally, gender played a role, with a higher prevalence of these lesions in female migraine patients, accounting for 79.6% (p = 0.05). Multiple logistic regression analysis proved age to be an independent risk factor for the presence of white matter hyperintensity lesions (OR: 1.0688, 95% CI: 1.0546-1.0831, p > 0.001). CONCLUSION White matter hyperintensity lesions were seen in the MRI imaging of a subset of migraine patients. Patients with these lesions tend to be older and of female gender. However, the clinical significance of these findings remains unclear.
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Affiliation(s)
- Khalid Abdalla
- Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
| | - Khaled Z Alawneh
- Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Al-Bdour
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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13
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Çöme O, Limnili G, Güldal AD. The impact of alternate nostril breathing on the severity and frequency of migraine attacks: a randomized control trial. Prim Health Care Res Dev 2025; 26:e12. [PMID: 39950247 PMCID: PMC11836872 DOI: 10.1017/s1463423625000064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 11/21/2024] [Accepted: 12/19/2024] [Indexed: 02/21/2025] Open
Abstract
BACKGROUND Migraine is a prevalent and debilitating neurological disorder that significantly affects quality of life. While pharmacological treatments exist, they can have limitations such as side effects, contraindications, and incomplete relief, prompting interest in non-pharmacological approaches for better symptom management. OBJECTIVE This study aimed to assess the effectiveness of alternate nostril breathing (ANB) as a non-pharmacological intervention to reduce the frequency and severity of migraine attacks and associated disability in adult patients. METHODS A single-center, open-label, two-arm, parallel-group randomized controlled trial was conducted at six Family Health Centers (FHCs) of Dokuz Eylul University, Izmir, Turkey. A total of 86 migraine patients aged 18-50 years, diagnosed with migraine based on ICD-10 criteria, were randomized into control (n = 43) and intervention (n = 43) groups. The intervention group practiced ANB three times daily for three months, while the control group continued their usual care. The primary outcomes were changes in migraine frequency and severity. Secondary outcomes included changes in migraine-related disability, both outcomes measured using the Migraine Disability Assessment Scale (MIDAS). RESULTS The intervention group showed a significant reduction in migraine attack frequency (P = 0.002) and MIDAS scores (P = 0.003) compared to the control group. Both groups experienced a reduction in attack severity (P = 0.001), though no significant difference was observed between the groups (P = 0.074). Within-group comparisons showed significant improvements in attack frequency, severity, and MIDAS scores in the intervention group (P = 0.001 for all). CONCLUSION ANB significantly reduced migraine frequency and disability, making it a promising non-invasive and accessible treatment option for migraine management. Further research with longer follow-up periods is needed to explore its long-term effects and broader applicability.
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Affiliation(s)
- Oğulcan Çöme
- Department of Family Medicine, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Gizim Limnili
- Department of Family Medicine, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Azize Dilek Güldal
- Department of Family Medicine, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
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Esteves-Mesquita V, Fernández-Cardero Á, Sarriá B, Martín-Cabrejas I. An Assessment of the Dietary Habits of Individuals with Migraine Living in Spain: An Exploratory Observational Cross-Sectional Pilot Study. Nutrients 2025; 17:686. [PMID: 40005014 PMCID: PMC11857930 DOI: 10.3390/nu17040686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Revised: 02/10/2025] [Accepted: 02/12/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND/OBJECTIVES Eating habits have been proposed as a potential therapeutic approach for migraines; nevertheless, scientific evidence to support firm recommendations is lacking. Specifically, dietary habits in migraineurs living in Spain have not been investigated. Therefore, this study aimed to evaluate their dietary patterns and examine how these habits vary based on the frequency of migraine attacks or the degree of migraine-related disability. METHODS An exploratory, observational, cross-sectional pilot study was conducted on 260 individuals (18-64 years old) diagnosed with migraine in Spain. Data on diet, lifestyle, and migraine characteristics were collected with an online questionnaire consisting of a food frequency questionnaire and enquires about perceptions about diet, lifestyle, and different aspects related to migraines. Statistical differences were analyzed with the Kruskal-Wallis test, followed by Dunn's post-hoc test, using JASP. RESULTS The consumption of plant-based foods was below the AESAN recommendations. No differences were observed in terms of food servings consumption across different migraine attack frequencies or levels of migraine-related disability. Both the chronic migraine group and the severe disability group showed differences in the consumption of some foods considered as migraine triggers (such as chocolate, cured cheese, cured meats, and alcoholic beverages). Moreover, people who suffered from infrequent migraine consumed significantly more caffeine than those who had chronic migraine. CONCLUSION It remains unclear whether avoiding dietary migraine triggers is driven by the biological effects of certain food compounds or influenced by dietary perceptions and unfounded beliefs. Thus, further research on the role of diet in migraine management is necessary.
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Affiliation(s)
- Vanessa Esteves-Mesquita
- School of Medicine, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain;
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), C/Jose Antonio Novais 6, 28040 Madrid, Spain
| | - Álvaro Fernández-Cardero
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), C/Jose Antonio Novais 6, 28040 Madrid, Spain
- Department of Nutrition and Food Science I, School of Pharmacy, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain; (Á.F.-C.)
| | - Beatriz Sarriá
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), C/Jose Antonio Novais 6, 28040 Madrid, Spain
- Department of Nutrition and Food Science I, School of Pharmacy, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain; (Á.F.-C.)
| | - Izaskun Martín-Cabrejas
- Department Food Technology, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain;
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Sic A, Bogicevic M, Brezic N, Nemr C, Knezevic NN. Chronic Stress and Headaches: The Role of the HPA Axis and Autonomic Nervous System. Biomedicines 2025; 13:463. [PMID: 40002876 PMCID: PMC11852498 DOI: 10.3390/biomedicines13020463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2024] [Revised: 01/27/2025] [Accepted: 02/11/2025] [Indexed: 02/27/2025] Open
Abstract
Chronic stress significantly influences the pathogenesis of headache disorders, affecting millions worldwide. This review explores the intricate relationship between stress and headaches, focusing on the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Persistent stress could lead to neuroinflammation, increased pain sensitivity, and vascular changes that could contribute to headache development and progression. The bidirectional nature of this relationship creates a vicious cycle, with recurrent headaches becoming a source of additional stress. Dysregulation of the HPA axis and ANS imbalance could amplify susceptibility to headaches, intensifying their frequency and severity. While pharmacological interventions remain common, non-pharmacological approaches targeting stress reduction, such as cognitive-behavioral therapy, biofeedback, and relaxation techniques, offer promising avenues for comprehensive headache management. By addressing the underlying stress-related mechanisms, these approaches provide a sustainable strategy to reduce headache frequency and improve patients' quality of life.
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Affiliation(s)
- Aleksandar Sic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (A.S.); (M.B.); (N.B.); (C.N.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Bogicevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (A.S.); (M.B.); (N.B.); (C.N.)
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA
| | - Nebojsa Brezic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (A.S.); (M.B.); (N.B.); (C.N.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Clara Nemr
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (A.S.); (M.B.); (N.B.); (C.N.)
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (A.S.); (M.B.); (N.B.); (C.N.)
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
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Kourlaba G, Vikelis M, Karapanayiotides T, Solakidi A, Trafalis D, Lioliou K, Andriopoulos P, Panagiotou A, Mitsikostas DD. Unmet needs in the management of migraine in Greece from the perspective of medical experts: a Delphi consensus. Front Neurol 2025; 16:1556808. [PMID: 40040919 PMCID: PMC11878100 DOI: 10.3389/fneur.2025.1556808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Accepted: 01/31/2025] [Indexed: 03/06/2025] Open
Abstract
Introduction Migraine is a chronic, debilitating neurological disorder affecting billions worldwide. While not life-threatening, migraine patients experience significant unmet needs in diagnosis and management. Addressing these challenges could result in improvement of patient outcomes and reduction of the socioeconomic burden migraine imposes on individuals, healthcare system and the society. Objective This survey aimed to capture in Greece the perspective of medical experts (neurologists) specializing in migraine management regarding the socioeconomic burden of migraine and the unmet needs in diagnosis and treatment. Methods An online Delphi-based survey was conducted with 13 neurologists, experts in migraine. The survey consisted of 55 statements derived from literature research, regarding the burden of disease, diagnosis, treatment and unmet needs. Participants' level of agreement for each statement was measured through a 5-point Likert scale ("Strongly Agree," "Agree," "Neither Agree nor Disagree," "Disagree" and "Strongly Disagree"). Three rounds of voting were conducted to achieve consensus. The consensus threshold was set at 70% of responses, focusing on "Strongly Agree"/ "Agree" or "Disagree"/ "Strongly Disagree." Results Most experts agreed on statements emphasizing on financial and social impact of the disease and its epidemiology. However, consensus was not reached on statements concerning patient preferences for treatment administration, treatment adherence, opioid use, and frequency of visits to neurologists. Consensus was reached on the need for better healthcare professional training and the development of effective, safe treatments. Conclusion This survey highlighted the challenges of prompt diagnosis and effective management of migraine. Addressing these needs requires patient-centered approaches, enhanced healthcare-provider training, tailored therapeutic interventions, and advanced communication platforms.
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Affiliation(s)
- Georgia Kourlaba
- Department of Nursing, Faculty of Health Sciences, University of the Peloponnese, Tripoli, Greece
| | | | - Theodoros Karapanayiotides
- 2nd Department of Neurology, Faculty of Health Sciences, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Katerina Lioliou
- Department of Nursing, Faculty of Health Sciences, University of the Peloponnese, Tripoli, Greece
| | - Panagiotis Andriopoulos
- Department of Nursing, Faculty of Health Sciences, University of the Peloponnese, Tripoli, Greece
| | - Aspasia Panagiotou
- Department of Nursing, Faculty of Health Sciences, University of the Peloponnese, Tripoli, Greece
| | - Dimos-Dimitrios Mitsikostas
- 1st Neurology Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Martini N, Hawa T, Almouallem MM, Hanna M, Almasri IA, Hamzeh G. Investigating risk factors for migraine in Syrian women: a cross-sectional case-control study. Sci Rep 2025; 15:4148. [PMID: 39900976 PMCID: PMC11791034 DOI: 10.1038/s41598-025-87487-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Accepted: 01/20/2025] [Indexed: 02/05/2025] Open
Abstract
This study aimed to investigate the relationship between potential risk factors and migraine among Syrian women through a cross-sectional case-control design. A total of 989 women were enrolled, including 519 migraine patients and 470 non-migraine controls. Data collection involved a comprehensive questionnaire covering demographic information, clinical features, and medical history. Statistical analysis was performed using descriptive statistics and Chi-Square tests. The findings revealed that migraineurs were more likely to smoke, have a higher BMI, have a family history of migraines (particularly in first-degree relatives), have a surgical history, and have undergone a cesarean delivery. No significant associations were found between migraine and allergies, anemia, contraceptive use, or menstrual cycle regularity. These results support existing literature on smoking, BMI, and family history as established risk factors for migraine, while also highlighting the novel associations between migraine and surgical history and delivery type. The study emphasizes the importance of addressing modifiable lifestyle factors and understanding familial predispositions in managing migraine in Syrian women. Further research in this region is crucial for a better understanding of the disease and effective management strategies.
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Affiliation(s)
- Nafiza Martini
- Faculty of Medicine, Damascus University, Damascus, Syria
- Medical Research Department, Stemosis for Scientific Research, Damascus, Syria
| | - Tamam Hawa
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Mohamad Moamen Almouallem
- Faculty of Medicine, Damascus University, Damascus, Syria
- Medical Research Department, Stemosis for Scientific Research, Damascus, Syria
| | - Majd Hanna
- Faculty of Medicine, Damascus University, Damascus, Syria.
- Medical Research Department, Stemosis for Scientific Research, Damascus, Syria.
| | - Imad-Addin Almasri
- Medical Research Department, Stemosis for Scientific Research, Damascus, Syria
- Applied Statistics Department, Damascus University, Damascus, Syria
| | - Ghassan Hamzeh
- Faculty of Medicine, Damascus University, Damascus, Syria
- Medical Research Department, Stemosis for Scientific Research, Damascus, Syria
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Xu R, Zhang R, Dong L, Xu X, Fan X, Zhou J. An analysis of the burden of migraine and tension-type headache across the global, China, the United States, India and Japan. FRONTIERS IN PAIN RESEARCH 2025; 6:1539344. [PMID: 39963513 PMCID: PMC11830714 DOI: 10.3389/fpain.2025.1539344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Accepted: 01/15/2025] [Indexed: 02/20/2025] Open
Abstract
Background Recurrent headaches in headache disorders adversely impact quality of life and job. Migraines and tension-type headache TTH) are the most common primary headaches and a prominent cause of disability globally. However, few research compare headache illness burden in China, India, the United States (US), and Japan. Methods Global and Chinese, the US, Indian, and Japanese migraine and TTH incidence, prevalence, and disability-adjusted life years were taken from the GBD database for 1990-2021. The data is studied utilizing decomposition analysis, health inequality research, joinpoint regression model, and Bayesian Average Annual Percentage Change (BAPC) model. Results The study found that migraine mostly affects women aged 15-49, while TTH are evenly distributed across gender and age. The worldwide average annual percentage change (AAPC) in disease-adjusted life years (DALYs) for migraine and TTH from 1990 to 2021 was 0.0357, a statistically significant trend (p < 0.001), as determined using joinpoint analysis. China exhibited the quickest rise in migraine and TTH incidence and prevalence, as well as the age-standardized rate (ASR) of DALYs, of the four nations analyzed. The US had the highest value of these indicators. Forecasting models reveal that without policy action, migraine prevalence will grow but TTH prevalence would stay unchanged. Decomposition research showed that population expansion is the major cause of migraines and TTH, which will be slightly alleviated by population aging. Health disparities across economic growth areas lessened between 1990 and 2021, according to the report. Conclusion Globally and in China, migraine and TTH incidence and burden have increased since 1990. Migraines are becoming more common in young and middle-aged women, so headache treatment professionals should invest more in patient education to raise awareness and improve self-management to reduce disease burden and medical costs.
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Affiliation(s)
- Rongjiang Xu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruonan Zhang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liang Dong
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaonuo Xu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoping Fan
- Phase I Clinical Research Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiying Zhou
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Alsaadi T, Al Madani A, Alhatou M, Nada M, Albilali A, Al-Qassabi A, Mohamed H, Mohamed H, El Masry R, Saifuddin GA, AlRukn SA. Prevalence, Treatment, and Unmet Needs of Migraine in the Middle East: A Systematic Review. Pain Ther 2025; 14:145-183. [PMID: 39738973 PMCID: PMC11751246 DOI: 10.1007/s40122-024-00686-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 11/20/2024] [Indexed: 01/02/2025] Open
Abstract
INTRODUCTION Migraine is a debilitating neurological disorder characterized by recurrent throbbing, moderate-to-severe headaches that disrupt daily chores, leisure, and social activities of patients, impacting their overall quality of life (QoL). Despite the high disease burden, there is a scarcity of data on migraines within the Middle East (ME) region. Thus, a systematic literature review (SLR) was conducted to examine epidemiological data, treatment patterns, QoL, and unmet needs regarding migraines in the ME region. METHODS Electronic searches were carried out using the MEDLINE® and Embase® databases via the OvidSP® platform for articles published prior to April 2024. The inclusion and exclusion criteria for the selection of studies were based on the Patients, Intervention, Comparator, Outcomes, and Study design framework, which identified 42 studies. RESULTS The prevalence of migraines reported from the region ranged between 2.6 and 32%, and the average age of patients with migraines reported in these studies ranged from 27 to 37.5 years. The data indicated a gender disparity in migraine prevalence, with women exhibiting a 2- to 2.5-fold higher prevalence. Common comorbidities reported were depression, anxiety, and irritable bowel disease. Migraines significantly impact patients' physical and emotional well-being, leading to disabilities and loss of productivity. The most common triggers of migraines were sleep disorders, dietary habits, and stress. The current treatment landscape for acute migraines encompasses anti-inflammatory agents, analgesics, triptans, ditans, calcitonin-gene-related peptides, and antiemetics. However, migraines in the region are often underestimated, underreported, and undertreated. Several unmet needs persist in the region, including delayed referral along with delayed diagnosis, misdiagnosis, poor treatment adherence, limited accessibility to treatments, and a lack of awareness among health care providers and patients. CONCLUSIONS The SLR highlights knowledge gaps in clinical aspects and the treatment of migraines and enables clinicians to make informed decisions to ensure optimal patient outcomes in diverse clinical settings.
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Affiliation(s)
- Taoufik Alsaadi
- Chair of the Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, United Arab Emirates.
| | | | | | - Mona Nada
- Department of Neurology, Cairo University, Giza, Egypt
| | - Abdulrazaq Albilali
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Al-Qassabi
- Neurology Unit, Department of Medicine, College of Medicine & Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | | | | | | | | | - Suhail Abdullah AlRukn
- Consultant Neurology, Head of Stroke Program, Rashid Hospital, Dubai Medical College, Dubai, United Arab Emirates
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Tischler-Strasser V, Burdiladze I, Cabral G, Ekizoglu E, Grodzka O, Pardo K, Sochan P, Zaunandra L, MaassenVanDenBrink A, Lampl C. Effects of proton pump inhibitor (PPI) use on migraine - a critical review. J Headache Pain 2025; 26:20. [PMID: 39885408 PMCID: PMC11783727 DOI: 10.1186/s10194-025-01954-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Accepted: 01/13/2025] [Indexed: 02/01/2025] Open
Abstract
BACKGROUND Proton pump inhibitor (PPI) drugs are widely used and are among the most significant achievements of modern pharmacology. Their primary purpose is treating and preventing gastric acid-related disorders. Migraine and PPI intake are prevalent, and many people are affected by both. In the last few years, a potential link between PPI intake and the development of headaches-especially migraine-has come to increased attention. In this review, we critically examine the scientific data concerning the co-occurrence of these two entities. FINDINGS There seems to be a possible link between the use of PPIs and the occurrence of headache, especially migraine, suggesting a pathophysiological connection on several levels. Moreover, PPI use is only partially without side effects, even if these may not occur immediately. Whether the relation is causative or merely co-existential is currently not yet clear. The influence of genetics, environment, gut microbiome, medication intake and evolution of headache is multidirectional. CONCLUSION A relation between the prevalence of migraine and the use of PPIs on a population and personal level seems likely. Although PPIs have many advantages, they should be prescribed with caution, especially in patients who suffer from headaches and migraine. In this narrative review, we aim to critically evaluate existing data and offer a potential approach to accurately identify any connections and interactions, leading to a better understanding of how these conditions may influence each other.
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Affiliation(s)
- Viktoria Tischler-Strasser
- Department of Neurology, Koventhospital Barmherzige Brüder, Linz, Austria
- Headache Medical Center Linz, Seilerstätte 2, Linz, Austria
| | - Irma Burdiladze
- Department of Neurology, Tbilisi Central Hospital, Tbilisi, Georgia
| | - Goncalo Cabral
- Neurology Department, Hospital de Egas Moniz, Rua da Junqueira, Lisbon, Portugal
| | - Esme Ekizoglu
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Olga Grodzka
- Department of Neurology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Keshet Pardo
- Department of Neurology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Patryk Sochan
- Department of Neurology, Faculty of Medicine and Dentistry, Medical University, Bielanski Hospital, Warsaw, Poland
| | - Laura Zaunandra
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antoinette MaassenVanDenBrink
- Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Christian Lampl
- Department of Neurology, Koventhospital Barmherzige Brüder, Linz, Austria.
- Headache Medical Center Linz, Seilerstätte 2, Linz, Austria.
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21
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Ranjan S, Paikaray A, Mishra A, Sethi A, Dhurua D, Panda AK. Association of ESR1 Polymorphisms with Susceptibility to Migraine: A Meta-Analysis and Trial Sequential Analysis. Curr Pain Headache Rep 2025; 29:41. [PMID: 39878792 DOI: 10.1007/s11916-024-01338-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2024] [Indexed: 01/31/2025]
Abstract
BACKGROUND Migraine is a highly prevalent and incapacitating neurological disorder mostly characterised by recurring attacks of moderate to severe throbbing and pulsating pain on one side of the head. The role of estrogen in migraine has been well documented. Although genetic variations in the ESR1 gene have been associated with an increased risk of developing migraine, the findings are inconsistent. We performed a meta-analysis of previously published articles considering four important single nucleotide polymorphisms in the ESR1 gene (rs1801132, rs2228480, rs2234693, and rs9340799) to explore their possible association with the development of migraine and its clinical phenotypes. MATERIALS AND METHODS We thoroughly searched literature databases, including PubMed, Science Direct, and Scopus until March 14, 2024, to identify the relevant reports. We utilized GPower software v.3 to assess the power of each report included in the meta-analysis and Comprehensive Meta-analysis v4 for all meta-analysis-related analyses. We employed funnel plots and Egger's regression test to identify publication biases within each genetic comparison model. We used Cochrane Q statistics, probability value, and I2 to assess heterogeneity. RESULTS After applying predefined criteria, a meta-analysis was conducted with 11 relevant studies comprising 3835 cases of migraine and 3655 healthy individuals. The analysis indicated a strong correlation between ESR1 polymorphisms (rs2228480 and rs9340799) and the likelihood of developing migraine. Furthermore, the subgroup analysis showed that rs2228480 is associated with susceptibility to migraine in both Caucasians and Asians. Additionally, rs2234693 variants were found to be linked with the development of migraine with aura. However, the trial sequential analysis suggested that more case-control studies are necessary to establish the definitive role of ESR1 variants in migraine. CONCLUSIONS ESR1 variants (rs2228480, rs2234693, and rs9340799) are associated with an increased risk of migraine and related phenotypes. However, further studies are needed to establish a definitive conclusion.
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Affiliation(s)
- Shovit Ranjan
- University Department of Zoology, Kolhan University, Chaibasa, 833201, Jharkhand, India
| | - Akshita Paikaray
- University Department of Zoology, Kolhan University, Chaibasa, 833201, Jharkhand, India
- ImmGen EvSys Lab, BT-113 Department of Biotechnology, Berhampur University, Bhanja Bihar Berhampur, Berhampur, 760007, Odisha, India
- Centre of Excellence on ''Bioprospecting of Ethnopharmaceuticals of Southern Odish'' (CoE- BESO), Berhampur University, Bhanja Bihar, Berhampur, 760007, Odisha, India
| | - Ankur Mishra
- University Department of Zoology, Kolhan University, Chaibasa, 833201, Jharkhand, India
- ImmGen EvSys Lab, BT-113 Department of Biotechnology, Berhampur University, Bhanja Bihar Berhampur, Berhampur, 760007, Odisha, India
- Centre of Excellence on ''Bioprospecting of Ethnopharmaceuticals of Southern Odish'' (CoE- BESO), Berhampur University, Bhanja Bihar, Berhampur, 760007, Odisha, India
| | - Aman Sethi
- University Department of Zoology, Kolhan University, Chaibasa, 833201, Jharkhand, India
- ImmGen EvSys Lab, BT-113 Department of Biotechnology, Berhampur University, Bhanja Bihar Berhampur, Berhampur, 760007, Odisha, India
- Centre of Excellence on ''Bioprospecting of Ethnopharmaceuticals of Southern Odish'' (CoE- BESO), Berhampur University, Bhanja Bihar, Berhampur, 760007, Odisha, India
| | - Dibenwita Dhurua
- University Department of Zoology, Kolhan University, Chaibasa, 833201, Jharkhand, India
- ImmGen EvSys Lab, BT-113 Department of Biotechnology, Berhampur University, Bhanja Bihar Berhampur, Berhampur, 760007, Odisha, India
- Centre of Excellence on ''Bioprospecting of Ethnopharmaceuticals of Southern Odish'' (CoE- BESO), Berhampur University, Bhanja Bihar, Berhampur, 760007, Odisha, India
| | - Aditya K Panda
- ImmGen EvSys Lab, BT-113 Department of Biotechnology, Berhampur University, Bhanja Bihar Berhampur, Berhampur, 760007, Odisha, India.
- Centre of Excellence on ''Bioprospecting of Ethnopharmaceuticals of Southern Odish'' (CoE- BESO), Berhampur University, Bhanja Bihar, Berhampur, 760007, Odisha, India.
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Wang YP, Wei HX, Hu YY, Zhang C, Niu YM. Causal Association Between Obstructive Sleep Apnea and Migraine: A Bidirectional Mendelian Randomization Study. Nat Sci Sleep 2025; 17:183-194. [PMID: 39881850 PMCID: PMC11776924 DOI: 10.2147/nss.s492630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 01/17/2025] [Indexed: 01/31/2025] Open
Abstract
Objective Patients with obstructive sleep apnea (OSA) frequently suffer from migraine, however the causal relationship between OSA and migraine is unknown. Investigating the causation will assist in understanding the etiology of OSA and migraine. Methods Bidirectional two-sample Mendelian randomization (MR) and multivariable MR (MVMR) approaches were carried out to investigate the causal link between OSA and migraine. The public genome-wide association study (GWAS) data for OSA, migraine, and subtypes were obtained from the IUE open GWAS project and the FinnGen consortium. To investigate the causal links between OSA and migraine, inverse variance weighted (IVW) analysis was used in conjunction with four additional statistical approaches. Furthermore, sensitivity studies were performed using heterogeneity and pleiotropy tests to assess the estimation's robustness. Results In general, our findings suggested that the OSA is causally associated with migraine with aura (MA, IVW: OR = 1.147; 95% CI = 1.016-1.295; P = 0.026), which was confirmed with the MVMR analysis further (OR = 1.184, 95% CI = 1.028-1.364, P = 0.020). In addition, increased risk of migraine and migraine without aura on OSA occurrence were identified in the reverse analysis, but these results were subsequently negated with MVMR analysis. Conclusion According to the current findings, there was a preliminary causal effect of OSA on MA among European descendants. Clinical Relevance These findings suggest a potential causal effect of OSA on migraine and provide new insights to prevent and manage the two disorders.
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Affiliation(s)
- Yu-Pei Wang
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People’s Republic of China
| | - Hui-Xia Wei
- Department of Anesthesiology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, People’s Republic of China
| | - Yuan-Yuan Hu
- Department of Stomatology, Gongli Hospital of Shanghai Pudong New Area, Shanghai, People’s Republic of China
| | - Chao Zhang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People’s Republic of China
| | - Yu-Ming Niu
- Department of Stomatology, Gongli Hospital of Shanghai Pudong New Area, Shanghai, People’s Republic of China
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People’s Republic of China
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei Provincial Clinical Research Center for Umbilical Cord Blood Hematopoietic Stem Cells, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People’s Republic of China
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23
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Huang B, Chen W, Peng C, Wang Y, Shen X, Zhang Q, Yang L, Wu J. Global trends in migraine and anxiety over the past 10 years: a bibliometric analysis. Front Neurol 2025; 15:1448990. [PMID: 39917435 PMCID: PMC11799673 DOI: 10.3389/fneur.2024.1448990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 12/26/2024] [Indexed: 02/09/2025] Open
Abstract
Background Recent studies have shown that migraine significantly increases the incidence of anxiety and is positively correlated with the severity and frequency of migraine. The relationship between migraine and anxiety has attracted extensive attention. This study focused on the association between migraine and anxiety, aiming to predict potential future research trends. Methods A bibliometric analysis was conducted using publications from the Core Collection of Web of Science. We utilized CiteSpace.5.8.R3 and VOSviewer 1.6.17 to evaluate the value of articles over the past 10 years. Results The number of publications has increased significantly over the past 10 years. The cooperative network analysis shows that the United States is the most collaborative country. Additionally, Harvard University is the institution and Richard B. Lipton the individual with the highest number of studies on migraine. The analysis of keyword outbreaks indicates that the strong citation burst words are closely related to sex differences, activation, allodynia, and preventive treatment, which represent emerging new research areas and potential hotspots for future research. Conclusion An overall upward trend in the research of migraine and anxiety was observed. Sex differences, functional magnetic resonance imaging (fMRI), activation, allodynia, and preventive treatment are predicted to be hotspots in the future.
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Affiliation(s)
- Biao Huang
- Department of Acupuncture, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Weining Chen
- Graduate School, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Chunmei Peng
- Department of Asset Management, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yu Wang
- Graduate School, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xiuli Shen
- Department of Gastroenterology, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Qi Zhang
- Medical Department, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Liu Yang
- Graduate School, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jun Wu
- Department of Asset Management, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Abo-Elghiet F, Elosaily H, Hussein DK, El-Shiekh RA, A’aqoulah A, Yousef EM, Selim HMRM, El-Dessouki AM. Bridging Gaps in Migraine Management: A Comprehensive Review of Conventional Treatments, Natural Supplements, Complementary Therapies, and Lifestyle Modifications. Pharmaceuticals (Basel) 2025; 18:139. [PMID: 40005953 PMCID: PMC11858087 DOI: 10.3390/ph18020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 01/01/2025] [Accepted: 01/14/2025] [Indexed: 02/27/2025] Open
Abstract
Background: Migraine, a complex neurological condition, poses significant challenges for both sufferers and healthcare providers. While prescription medications play a vital role in managing migraine attacks, the quest for natural, non-pharmacological alternatives has garnered increasing interest. This review explores the efficacy and safety of natural supplements as treatments for migraine relief, comparing them with conventional prescription medications. Methods: The review delves into herbal supplements, clinical studies on natural remedies, aromatherapy, dietary influences, and lifestyle modifications in the context of migraine management in several databases. Results: The findings shed light on the potential of natural supplements as complementary or alternative approaches to traditional migraine therapies, offering insights into a holistic and personalized treatment paradigm for migraine sufferers. Conclusions: Natural supplements have gained attention as potential treatments for migraine relief, often perceived as safer alternatives to conventional medications.
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Affiliation(s)
- Fatma Abo-Elghiet
- Department of Pharmacognosy and Medicinal Plants, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo 11754, Egypt;
| | - Heba Elosaily
- Biochemistry Department, Faculty of Pharmacy, Ahram Canadian University, 4th Industrial Region, 6th of October City 12585, Egypt;
| | - Doha K. Hussein
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt;
| | - Riham A. El-Shiekh
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt;
| | - Ashraf A’aqoulah
- Department of Public Health, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Einas M. Yousef
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia;
| | - Heba Mohammed Refat M. Selim
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, P.O. Box 71666, Riyadh 11597, Saudi Arabia;
| | - Ahmed M. El-Dessouki
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ahram Canadian University, 6th of October City 12566, Egypt;
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Coppola G, Brown JD, Mercadante AR, Drakeley S, Sternbach N, Jenkins A, Blakeman KH, Gendolla A. The epidemiology and unmet need of migraine in five european countries: results from the national health and wellness survey. BMC Public Health 2025; 25:254. [PMID: 39838307 PMCID: PMC11753071 DOI: 10.1186/s12889-024-21244-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 12/30/2024] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND Despite the high global prevalence, burden, and direct and indicated costs, migraines are often under-diagnosed and undertreated. Understanding the prevalence of migraine and unmet needs is crucial for improving diagnosis and treatment across Europe (EU) countries; however, real-world studies are limited. METHODS This retrospective cross-sectional survey utilized weighted patient-reported data from the 2020 National Health and Wellness Survey (NHWS) in five EU (5EU) countries (France, Germany, United Kingdom [UK], Italy, and Spain). The survey included adults aged ≥ 18 years who self-reported experiencing migraines in the past 12 months and had a physician's diagnosis. The survey assessed migraine prevalence by age and sex. Other measures included migraine characteristics, disability assessment, migraine frequency (monthly migraine days [MMDs] and monthly headache days [MHDs], menstrually-related migraine, treatment patterns, and provider characteristics. RESULTS The study included 7,311 respondents with diagnosed migraines, representing an estimated 30.5 million adults with a weighted prevalence of 11.5% in the 5EU. Spain had the highest prevalence (14.0%), followed by Italy, France, UK, and Germany. Migraine prevalence was highest in the age group of 30-39 years, and females had nearly twice the prevalence compared to males. About 56% of respondents reported disability due to migraines, with highest percentage reported in Germany (66.0%). About 46% of female respondents reported experiencing menstrually-related migraines. One-fourth of the study respondents reported > 4 MMDs and 56.2% reported > 4 MHD. Current treatment patterns revealed that 79.7% of respondents were receiving some form of migraine treatment, with non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, and triptans being the most commonly reported prescription medications. Primary care physicians (PCPs) were the most common providers diagnosing migraines, followed by neurologists. CONCLUSIONS In the 5EU, one-fourth of diagnosed respondents reported > 4 MMDs, and 56.2% reported > 4 MHDs. Nearly half of females experienced menstrually-related migraines. Although most patients reported taking medication for migraine, severe disability and medication overuse were observed. PCPs were the main treatment providers, highlighting the need for improved expertise and referrals to specialists. Further research is required for a better understanding of the disparities between migraine frequency and treatment approaches.
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Affiliation(s)
- Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | | | | | | | | | - Aaron Jenkins
- Pfizer Ltd, Walton Oaks, Dorking Road, Tadworth, KT20 7NS, Surrey, UK.
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Al-Saadi R, Mohammed Jawad ZJ, Khalaf OH, Muhsain SNF. Histopathological effects of repeated 14-day administration of rizatriptan benzoate in a nitroglycerin-induced migraine rabbits model. Open Vet J 2025; 15:179-186. [PMID: 40092178 PMCID: PMC11910268 DOI: 10.5455/ovj.2024.v15.i1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 12/24/2024] [Indexed: 03/19/2025] Open
Abstract
Background Migraine is one of multiple attack neurological conditions that causes moderate to severe headaches with no defined pathophysiology and few animal models. Aim Establishing an animal model that reproduces migraine-like action is important in medical research to identify the mechanism underlying this disorder. Additionally, it facilitates the availability and reliability of new models that may act as human surrogate models. Method Rabbits were divided into four groups. Negative group, migraine group, rizatriptan-nitroglycerin group, and rizatriptan group. The frequency of head scratching and the histopathological changes in the brain, liver, kidney, and heart for groups were evaluated in all groups. Results The behavioral characteristic of head scratching was significantly increased in the NTG group (50.4 ± 3.8) compared with the control group (9.2 ± 1.3) after 30 min of the experiment. Moreover, animals treated with rizatriptan benzoate (Riza) 10 mg/kg/orally for 14 days followed by NTG injection showed a significant decrease in the head scratch action (16.8 ± 2.3 and 17.6 ± 3.3) than the animals of NTG group (50.4 ± 3.8 and 43.6 ± 2.3) after 30 min and 60 min, respectively. Furthermore, animals treated with Riza alone showed no statistical differences in the head scratches (7.8 ± 1.3, 9.2 ± 0.8, 10.6 ± 1.1 and 9.6 ± 1.3, respectively) during the 120 min of the experiment, compared with the control group. Histopathological alterations in the brain of rabbits that received NTG showed severe diffuse dilated and engorged blood vessels. These changes were also recorded in the liver and kidney of this group. This marked vasodilation of blood vessels and central and portal veins confirms the successful induction of migraine in the rabbit model. In contrast, animals treated with Riza for 14 days demonstrated substantially less vascular dilation following NTG injection. No significant pathological lesions were observed in animals treated with Riza. Conclusion The current study successfully established a rabbit model of migraine using a single dose of NTG to induce migraine-like behavior. Moreover, pre-treatment with rizatriptan benzoate for fourteen days significantly reduced the symptoms of migraine and histopathological changes in different organs.
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Affiliation(s)
- Raghad Al-Saadi
- Department of Pathology & Poultry Diseases, College of Veterinary Medicine, University of Baghdad, Baghdad City, Iraq
| | - Zainab Jamal Mohammed Jawad
- Department of Pathology & Poultry Diseases, College of Veterinary Medicine, University of Baghdad, Baghdad City, Iraq
| | - Omar Hussein Khalaf
- Department of Pathology & Poultry Diseases, College of Veterinary Medicine, University of Baghdad, Baghdad City, Iraq
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La Touche R, García-Pastor T, Reina-Varona Á, Paris-Alemany A, Grande-Alonso M. General physical impairments in migraine patients beyond cervical function. Sci Rep 2024; 14:30916. [PMID: 39730625 DOI: 10.1038/s41598-024-81841-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 11/29/2024] [Indexed: 12/29/2024] Open
Abstract
Previous research has focused on the possibility of cervical dysfunction in migraine patients, similar to what is observed in patients with tension-type headaches. However, there is no evidence concerning the physical function of other body regions, even though lower levels of physical activity have been reported among migraine patients. The aim of this study was to compare cervical and extra-cervical range of motion, muscular strength, and endurance, as well as overall levels of physical activity, between patients with chronic migraine (CM) and asymptomatic participants. The secondary objective included the analysis of associations between CM-related disability and various physical and psychological variables. A total of 90 participants were included in this cross-sectional study: 30 asymptomatic participants (AG) and 60 patients with CM. Cervical and lumbar range of motion, strength and endurance, as well as handgrip strength were measured. Headache-related disability, kinesiophobia, pain behaviors, physical activity level and headache frequency were assessed through a self-report. Lower values were found in CM vs AG for cervical and lumbar ranges of motion (p < 0.05; effect sizes ranging from 0.57 to 1.44). Also, for neck extension strength (p = 0.013; d = - 0.66), lumbar strength (p < 0.001; d = - 1.91) and handgrip strength (p < 0.001; d = - 0.98), neck endurance (p < 0.001; d = - 1.81) and lumbar endurance (p < 0.001; d = - 2.11). Significant differences were found for physical activity levels (p = 0.01; d = - 0.85) and kinesiophobia (p < 0.001; d = - 0.93) between CM and AG. Headache-related disability was strongly associated with headache frequency, activity avoidance, and rest, which together explained 41% of the variance. The main findings of this study suggest that patients with CM have a generalized fitness deficit and not specifically cervical dysfunction. These findings support the hypothesis that migraine patients have not only neck-related issues but also general body conditions.
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Affiliation(s)
- Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios (CSEU) La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios (CSEU) La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain
| | - Teresa García-Pastor
- Facultad HM de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
| | - Álvaro Reina-Varona
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios (CSEU) La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios (CSEU) La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Alba Paris-Alemany
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios (CSEU) La Salle, Universidad Autónoma de Madrid, Madrid, Spain.
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain.
- Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, s/n, Ciudad Universitaria, 28040, Madrid, Spain.
| | - Mónica Grande-Alonso
- Departamento de Cirugía, Ciencias Médicas y Sociales, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Spain
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Rubio AC, Arciniegas JA, Bolanos-Lopez JE, Gonzalez FJ, Gomez D, Mesa A, Bello C, Garcia M, Perez LE, Reyes JM. Epidemiological, clinical characterization and treatment patterns of migraine patients in a Colombian cohort from 2018 to 2022. J Headache Pain 2024; 25:226. [PMID: 39719604 DOI: 10.1186/s10194-024-01918-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 11/18/2024] [Indexed: 12/26/2024] Open
Abstract
BACKGROUND To describe the epidemiology and clinical characteristics of migraine and the status of treatment in Colombia. Additionally, the use of health resources by patients was measured. METHODS This was a non-interventional, retrospective, descriptive study conducted in one Colombian Health Management Organization (HMO) from 2018 to 2022 with a follow-up period of 5 years. Migraine patients were identified using the International Code Disease 10th version G43, and the diagnosis was confirmed by a neurologist. The first recorded migraine diagnosis was defined as the index date. Medical records, claim databases and other electronic databases from the HMO were used to determine the clinical characteristics, treatments, and health care services. RESULTS A total of 89,227 patients were included in the study. The mean follow-up period was 3.7 years (standard deviation 1.2). Most of them were women (84.9%). Many patients were first seen by a general practitioner (82.6%), and only 8.9% were first seen by a neurologist. The prevalence of migraine during follow-up was between 1.69 and 2.42 patients in 100 HMO affiliates in 2020, the year with the highest prevalence (2.42 [95% CI 2.41-2.44]), and the incidence ranged from 0.032 to 1.72 per 100 patient-year at risk of developing migraine. Hypertension (21.3%), arrythmia (4.1%) and structural heart disease (3.4%) were the most common cardiovascular diseases. The annual mean number of outpatient consultations in 2018 was 1.43 consultations per patient, which decreased to 0.68 in 2022. The most frequent treatments for acute events were nonsteroidal anti-inflammatory drugs (NSAIDs) (range 37-42%) in monotherapy, combinations of analgesics (range 14-35%), and corticosteroids (range 10-15%). Triptans were used in 4% of patients in the first medication record, reaching a maximum of 16% of patients. Among preventive treatments, beta-blockers (24-49%) and antiepileptics (29-41%) were the most common. CONCLUSION The prevalence of migraine in Colombia according to health electronic databases was lower than that reported in previous studies conducted in the country. The treatment patterns for acute and preventive treatment of migraine follow the recommendations of different guidelines. Cardiovascular disease is relevant for the management of migraine.
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Affiliation(s)
| | | | | | | | - D Gomez
- Suramericana IPS, Medellin, Colombia
| | - A Mesa
- Pfizer SAS, Bogota, Colombia
| | - C Bello
- Suramericana IPS, Medellin, Colombia
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Crowe HM, Sampson L, Purdue-Smithe AC, Rexrode KM, Koenen KC, Rich-Edwards JW. Bidirectional analysis of the association between migraine and post-traumatic stress disorder in Nurses' Health Study II. Epidemiol Psychiatr Sci 2024; 33:e76. [PMID: 39658814 DOI: 10.1017/s2045796024000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2024] Open
Abstract
AIMS Migraine and post-traumatic stress disorder (PTSD) are both twice as common in women as men. Cross-sectional studies have shown associations between migraine and several psychiatric conditions, including PTSD. PTSD is disproportionally common among patients in headache clinics, and individuals with migraine and PTSD report greater disability from migraines and more frequent medication use. To further clarify the nature of the relationship between PTSD and migraine, we conducted bidirectional analyses of the association between (1) migraine and incident PTSD and (2) PTSD and incident migraine. METHODS We used longitudinal data from 1989-2020 among the 33,327 Nurses' Health Study II respondents to the 2018 stress questionnaire. We used log-binomial models to estimate the relative risk of developing PTSD among women with migraine and the relative risk of developing migraine among individuals with PTSD, trauma-exposed individuals without PTSD, and individuals unexposed to trauma, adjusting for race, education, marital status, high blood pressure, high cholesterol, alcohol intake, smoking, and body mass index. RESULTS Overall, 48% of respondents reported ever experiencing migraine, 82% reported experiencing trauma and 9% met the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for PTSD. Of those reporting migraine and trauma, 67% reported trauma before migraine onset, 2% reported trauma and migraine onset in the same year and 31% reported trauma after migraine onset. We found that migraine was associated with incident PTSD (adjusted relative risk [RR]: 1.26, 95% confidence interval [CI]: 1.14-1.39). PTSD, but not trauma without PTSD, was associated with incident migraine (adjusted RR: 1.20, 95% CI: 1.14-1.27). Findings were consistently stronger in both directions among those experiencing migraine with aura. CONCLUSIONS Our study provides further evidence that migraine and PTSD are strongly comorbid and found associations of similar magnitude between migraine and incident PTSD and PTSD and incident migraine.
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Affiliation(s)
- H M Crowe
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - L Sampson
- Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook, NY, USA
| | - A C Purdue-Smithe
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - K M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - K C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Bhardwaj R, Malatesta JA, Madonia J, Anderson MS, Morris B, Matschke KT, Croop R, Bertz R, Liu J. Deconvoluting zavegepant drug-drug interactions: A phase I study to evaluate the effects of rifampin and itraconazole on zavegepant pharmacokinetics. Clin Transl Sci 2024; 17:e70048. [PMID: 39602316 PMCID: PMC11601169 DOI: 10.1111/cts.70048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 08/30/2024] [Accepted: 10/03/2024] [Indexed: 11/29/2024] Open
Abstract
Zavegepant is a calcitonin gene-related peptide receptor antagonist for acute migraine treatment. This Phase I, open-label, fixed-sequence study evaluated the effects of itraconazole (a strong cytochrome P450 3A4 [CYP3A4] and P-glycoprotein [P-gp] inhibitor) on the pharmacokinetics of intranasal/oral zavegepant and the effects of rifampin (a strong inducer of CYP3A4 and P-gp; and an inhibitor of organic anion transporting polypeptide 1B3 [OATP1B3]) on oral zavegepant in healthy participants. In the intranasal/oral zavegepant-itraconazole cohort, participants received a single 10-mg dose of zavegepant nasal spray on Day 1, followed by oral zavegepant (50 mg) on Day 3. Itraconazole 200 mg once daily was administered from Days 4 to 12. On Day 7 zavegepant nasal spray and on Day 11 oral zavegepant were coadministered with itraconazole. In the oral zavegepant-rifampin cohort, participants received oral zavegepant (100 mg) on Day 1, rifampin 600 mg once daily on Days 2-10, and rifampin with zavegepant on Day 11. No significant change in zavegepant exposure was observed following coadministration of itraconazole with zavegepant nasal spray. For oral zavegepant coadministered with itraconazole, the area under the curve from 0 to infinity (AUC0-inf) and the maximum observed concentration (Cmax) of oral zavegepant increased by 59% and 77%, respectively. For oral zavegepant coadministered with rifampin, the AUC0-inf and Cmax of oral zavegepant increased by approximately 2.3- and 2.2-fold, respectively. These results suggest that OATP1B3 and intestinal P-gp are the more prominent pathways, as opposed to CYP3A4, for a zavegepant drug-drug interaction. Coadministration of OATP1B3 inhibitors with zavegepant nasal spray should be avoided.
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Affiliation(s)
| | | | | | | | - Beth Morris
- Biohaven Pharmaceuticals Inc.New HavenConnecticutUSA
| | | | - Robert Croop
- Biohaven Pharmaceuticals Inc.New HavenConnecticutUSA
| | - Richard Bertz
- Biohaven Pharmaceuticals Inc.New HavenConnecticutUSA
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Lipton RB, Ailani J, Blumenfeld AM. What Is Combination Treatment in Migraine? Moving Toward a Uniform Definition of a Familiar Principle. Neurol Ther 2024; 13:1535-1540. [PMID: 39404951 PMCID: PMC11541989 DOI: 10.1007/s40120-024-00669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 09/27/2024] [Indexed: 11/07/2024] Open
Affiliation(s)
- Richard B Lipton
- Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 3c12c, Bronx, NY, 10461, USA.
| | - Jessica Ailani
- MedStar Georgetown University Hospital, Washington, DC, USA
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Cokyaman T, Ozcan Erdem U. Use of ICHD-3rd diagnostic criteria in determining the prevalence of migraine in childhood; school-based cross-sectional questionnaire study. Neurol Res 2024; 46:1130-1136. [PMID: 39291713 DOI: 10.1080/01616412.2024.2403860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 09/08/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVE This study aimed to determine the relationship between migraine prevalence and its diagnostic features in school children. METHODS This study was conducted on children aged 10-18 year who were randomly selected from 22 middle and 26 high schools. Questionnaires were prepared in Turkish with demographic (9 items) and headache characteristics (ICHD-3rd-based headache screening questionnaire, 11 items). RESULTS A total of 1450 surveys were properly filled out. Female/male ratio was 798/652 (55%÷45%) and the mean age was 14.4 years ± 2.1. 96.4% of the population in this study. According to the criteria of headache attack number (≥4 attacks), character (pulsatile) and duration (≥1 h), the prevalence of migraine in the studied population was 23.1%. CONCLUSION Population-based studies are important because they provide information on diagnosing migraine, which is a public health priority in childhood, and contribute to creating the world migraine atlas. Although additional diagnostic clues are needed to determine the prevalence of migraine in childhood, we still widely use headache screening questionnaires based on ICHD-3rd.
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Affiliation(s)
- Turgay Cokyaman
- Department of Pediatrics, Division of Pediatric Neurology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Ulgen Ozcan Erdem
- Department of Pediatrics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Mohammad Alabdali M, Rafique N, AlDossary DA, Alalloush RS, AlHemli HA, Zeerak M, Latif R, Ibrahim Al-Asoom L, Abdulrahman AlSunni A, Mohammed Salem A, Alshurem M, Aljaafari D, Obaid S, Alabdulhadi A. Direct Comparison of Treatment Outcome Between the Botulinum Toxin and Calcitonin Gene-Related Peptide Monoclonal Antibody in Migraine Patients. J Clin Med Res 2024; 16:527-535. [PMID: 39635334 PMCID: PMC11614408 DOI: 10.14740/jocmr6054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 11/13/2024] [Indexed: 12/07/2024] Open
Abstract
Background Migraine is a genetic disorder characterized by recurrent episodes of headache that are throbbing in nature. The objective of this study was to directly compare the efficacy and safety of anti-calcitonin gene-related peptide (anti-CGRP) and botulinum neurotoxin (BoNT) for the preventive treatment of chronic migraine. Methods This quasi-experimental comparative study was conducted on 80 "chronic migraine patients" at King Fahad University Hospital, Dammam, KSA. Chronic migraineurs were divided into two groups (40 patients/group) and were treated with the standard doses of BoNT (group I) and anti-CGRP (group II). All the patients filled out the migraine pain scale, migraine disability assessment score, headache impact test (HIT-6), and adverse drug event questionnaire before the start and at the end of 9 months of treatment. Results Most of the patients were females (76.3% vs. 23.8%) and were suffering from migraine for more than 24 months (66%). The mean age of the participants was 39.07 ± 10.01 years. Both BoNT and anti-CGRP groups showed a statistically significant decrease in mean HIT-6 and pain scores after 9 months of intervention. A direct comparison between the two treatment groups showed that the anti-CGRP drug caused a higher decrease in HIT-6 and pain scores as compared to the botulinum drug, but the difference was not statistically significant (P = 0.075 and 0.07, respectively). The most common adverse effect was "headache", reported by 45% and 40% of patients, followed by "pain at the site of injection" reported by 27.5% and 32.5% of BoNT and anti-CGRP groups, respectively. The two groups did not differ significantly in the frequency of adverse effects such as nausea, vomiting, visual problems, etc., except "joint stiffness". A significantly higher number of anti-CGRP patients experienced joint stiffness as compared to the BoNT group (17.5% vs. 0%, P = 0.006). Conclusion A direct comparison between the two treatments indicated that neither of the two interventions is statistically superior to the other in terms of efficacy and both are equally effective in the management of migraine. However, BoNT can be preferred over anti-CGRP because of its cost-effectiveness.
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Affiliation(s)
- Majed Mohammad Alabdali
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nazish Rafique
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Deena A. AlDossary
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rahaf S. Alalloush
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Haya A. AlHemli
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Zeerak
- Karlsruhe University of applied sciences, Karlsruhe, Germany
| | - Rabia Latif
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lubna Ibrahim Al-Asoom
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Abdulrahman AlSunni
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ayad Mohammed Salem
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Alshurem
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dana Aljaafari
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Aseel Alabdulhadi
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Gendolla A, Brown JD, Mercadante AR, Drakeley S, Sternbach N, Jenkins A, Hygge Blakeman K, Coppola G. The incremental burden and healthcare resource utilization among people with migraine in Europe: Insights from the 2020 European National Health and Wellness Survey. Cephalalgia 2024; 44:3331024241276415. [PMID: 39633516 DOI: 10.1177/03331024241276415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2024]
Abstract
BACKGROUND Despite the high prevalence of migraine in Europe, there is limited research on the burden among people with migraine. METHODS This cross-sectional survey used patient-reported data from the 2020 European National Health and Wellness Survey in France, Germany, Italy, Spain, and the United Kingdom. The study assessed the sociodemographic characteristics, health-related quality of life, depression, work productivity and activity impairment, and healthcare resource utilization among matched samples of people with diagnosed migraine (n = 3985) and compared to a matched cohort without migraine (n = 7970). The study also analyzed the burden across migraine subgroups stratified by the number of migraine headache days. RESULTS Lower health-related quality of life, higher depression, increased work productivity and activity impairment, and higher healthcare resource utilization were reported among people with migraine and ≥1 migraine headache days compared to matched people without migraine (all p < 0.001). Additionally, the incremental burden was also observed across migraine subgroups (1-3, 4-7, 8-14, and ≥15 migraine headache days) irrespective of the use of prescription medication compared to the matched controls without migraine. CONCLUSION Migraine sufferers with ≥1 migraine headache days experienced worse productivity, lower quality of life, depression, and increased healthcare resource utilization than those without migraine, emphasizing the need for effective management strategies.
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Affiliation(s)
| | | | | | | | | | | | | | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy
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Alzahrani S, Mulla MZ, Mulla AZ, Almegbil IT, Alblaihi SK, Alkhani OM, Alzaben FF. Knowledge and Perceptions of Migraine Management and Trigger Factors Among Medical Students in Riyadh, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e75666. [PMID: 39803060 PMCID: PMC11725309 DOI: 10.7759/cureus.75666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2024] [Indexed: 01/16/2025] Open
Abstract
INTRODUCTION Migraines pose a significant risk to the health of individuals who suffer from them. Consequently, healthcare specialists must have sufficient knowledge and awareness to recognize and treat migraines. This study aimed to assess medical students' knowledge and perception of migraine-triggering factors and management methods. METHODS This cross-sectional study was conducted at multiple medical school universities in Riyadh, Saudi Arabia. An online survey approach was employed. RESULTS In total, 233 participants (77% response rate) filled out the survey. Male students were predominantly represented (81%), and most students were in their fifth year (32.2%) or first year (27%) of medical school. Most participants (60.5%) considered that the prevalent age at presentation of migraines was between 17 and 30 years. Knowledge of treatment modalities compared with the year of study was significantly reported to be medication (53.4%), rest (41%), and alternative therapies, such as acupuncture (4.4%), for managing migraines (p ≤ 0.001). The most commonly recognized triggering factors were light (90.6%), stress (86.7%), and inadequate sleep (85.4%). Statistically significant recognized risk and trigger factors among students with different years of medical school training were female gender (p ≤ 0.001), certain odors (p = 0.018), and hormonal changes (p = 0.043). CONCLUSION This study demonstrated the knowledge and perceptions of medical students with different training levels regarding identifying migraine triggers and the required treatments. Although the findings indicated that students demonstrated a general knowledge and recognition of migraine triggers and treatments, an in-depth study on managing individual triggering factors is necessary.
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Affiliation(s)
- Samer Alzahrani
- Department of Family Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Moyser Z Mulla
- Department of Family Medicine, Primary Health Care Corporation, Riyadh, SAU
| | - Adnan Z Mulla
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Ibrahim T Almegbil
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Sultan K Alblaihi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Osama M Alkhani
- Department of Research, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Fawaz F Alzaben
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
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Seng E, Lampl C, Viktrup L, Lenderking WR, Karn H, Hoyt M, Kim G, Ruff D, Ossipov MH, Vincent M. Patients' Experiences During the Long Journey Before Initiating Migraine Prevention with a Calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibody (mAb). Pain Ther 2024; 13:1589-1615. [PMID: 39298053 PMCID: PMC11543966 DOI: 10.1007/s40122-024-00652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/20/2024] [Indexed: 09/21/2024] Open
Abstract
INTRODUCTION Migraine is under-diagnosed and under-treated. Many people with migraine do not seek medical care, and those who do may initially receive a different diagnosis and/or be dissatisfied with provided care on their journey before treatment with a CGRP-mAb (calcitonin-gene-related-peptide monoclonal antibody). METHODS This is a cross-sectional, self-reported, online survey of subjects in Lilly's Emgality® Patient Support Program in 2022. Questionnaires collected insights into subjects' prior experiences with migraine and interactions with healthcare professionals before receiving CGRP-mAbs. RESULTS Of the 250 participants with episodic and 250 with chronic migraine, 90% were female and white with a mean age of 26.2 years (± 11.9) at diagnosis and 40.6 (± 12.0) years at survey enrollment. Many participants (71%) suspected they had migraine before diagnosis, with 31% reluctant to seek help. Of these, approximately one-third were unaware of treatment, did not think that a physician could do anything more for migraine, would not take them seriously, or were reluctant due to a previous unhelpful experience. Participants mainly received information from friends/family (47%) or the internet (28%). Participants initially sought treatment due to an increase in migraine frequency (77%), attacks interfering with work or school (75%), or increased pain intensity (74%). Subjects saw a mean of 4.1 (± 4.3) healthcare providers before migraine diagnosis, and 20% of participants previously received a different diagnosis. Participants reported migraine causes included stress/anxiety/depression (42%), hormonal changes (30%), nutrition (20%), and weather (16%). Acute treatment of migraine included prescription (82%) and over-the-counter (50%) medications, changes in nutrition (62%), adjusting fluid intake (56%), and relaxation techniques (55%). Preventive medications included anticonvulsants (61%), antidepressants (44%), blood pressure-lowering medications (43%), and botulinum toxin A injections (17%). Most discontinuations were due to lack of efficacy or side effects. CONCLUSION People with migraine describe reluctance in seeking health care, and misunderstandings seem common especially in the beginning of their migraine journey. Graphical abstract available for this article.
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Affiliation(s)
- Elizabeth Seng
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Christian Lampl
- Department of Neurology, Konventhospital Barmherzige Brüder Linz, Linz, Austria
| | - Lars Viktrup
- Eli Lilly and Company, Indianapolis, IN, USA.
- Lilly Neuroscience, Lilly Corporate Center, DC 1745, 75/4, Indianapolis, IN, 46285, USA.
| | | | - Hayley Karn
- Evidera, 500 Totten Pond Road, Wilmington, NC, 28401, USA
| | | | - Gilwan Kim
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Dustin Ruff
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Maurice Vincent
- Eli Lilly and Company, Indianapolis, IN, USA
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21044-020, RJ, Brazil
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Posadzki P, Klimek AT, Ernst E. Spinal manipulations for migraine: an updated systematic review and meta-analysis of randomized clinical trials. Syst Rev 2024; 13:296. [PMID: 39614402 PMCID: PMC11606176 DOI: 10.1186/s13643-024-02719-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 11/21/2024] [Indexed: 12/01/2024] Open
Abstract
OBJECTIVE This update of a systematic review evaluates the effectiveness of spinal manipulations as a treatment for migraine headaches. BACKGROUND Spinal manipulation therapy (SMT) is sometimes used to treat migraine headaches; however, the biological plausibility and safety of SMT have repeatedly been questioned. METHODS Amed, Embase, MEDLINE, CINAHL, Mantis, Index to Chiropractic Literature, and Cochrane Central were searched from inception to September 2023. Randomized clinical trials (RCTs) investigating spinal manipulations (performed by various healthcare professionals including physiotherapists, osteopaths, and chiropractors) for treating migraine headaches in human subjects were considered. Other types of manipulative therapy, i.e., cranial, visceral, and soft tissue were excluded. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. RESULTS Three more RCTs were published since our first review; amounting to a total of 6 studies with 645 migraineurs meeting the inclusion criteria. Meta-analysis of six trials showed that, compared with various controls (placebo, drug therapy, usual care), SMT (with or without usual care) has no effect on migraine intensity/severity measured with a range of instruments (standardized mean difference [SMD] - 0.22, 95% confidence intervals [CI] - 0.65 to 0.21, very low certainty evidence), migraine duration (SMD - 0.10; 95% CI - 0.33 to 0.12, 4 trials, low certainty evidence), or emotional quality of life (SMD - 14.47; 95% CI - 31.59 to 2.66, 2 trials, low certainty evidence) at post-intervention. A meta-analysis of two trials showed that compared with various controls, SMT (with or without usual care) increased the risk of AEs (risk ratio [RR] 2.06; 95% CI 1.24 to 3.41, numbers needed to harm = 6; very low certainty evidence). The main reasons for downgrading the evidence were study limitations (studies judged to be at an unclear or high risk of bias), inconsistency (for pain intensity/severity), imprecision (small sizes and wide confidence intervals around effect estimates) and indirectness (methodological and clinical heterogeneity of populations, interventions, and comparators). CONCLUSIONS The effectiveness of SMT for the treatment of migraines remains unproven. Future, larger, more rigorous, and independently conducted studies might reduce the existing uncertainties.
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Affiliation(s)
- Pawel Posadzki
- Faculty of Rehabilitation, University of Physical Education in Kraków, Kraków, Poland.
- Kleijnen Systematic Reviews Ltd, York, UK.
| | - Andrzej T Klimek
- Faculty of Rehabilitation, University of Physical Education in Kraków, Kraków, Poland
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Ataya J, Bannoud N, Daboul R, Hasan YH, Hanifa H, Watfa M, Alnabi NAA, Salama R, Mackieh R. The multifaceted effects of migraine on Syrian society: insights from a multicenter cross-sectional study. BMC Neurol 2024; 24:425. [PMID: 39482573 PMCID: PMC11529229 DOI: 10.1186/s12883-024-03931-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 10/22/2024] [Indexed: 11/03/2024] Open
Abstract
BACKGROUND Migraine is the most common primary headache. It's alone responsible for 1.3% of disability in the world. Migraine both worsen quality of life of individuals and place a significant burden on the society. Despite this, there exists a knowledge gap regarding its repercussions on the Syrian population. METHODS This cross-sectional study enrolled 679 migraine-diagnosed patients from all over Syria through electronic questionnaires disseminated on official social media platforms. Depending on demographic characteristics, physical and mental debility assessed using the Chalder scale, the Migraine Specific Quality of Life Questionnaire (MSQ) and the Generalized Anxiety Disorder 2-item (GAD_2) scale. RESULTS Our study included 679 participants (mean age: 29.49 years; BMI: 24.55). The sample was predominantly female (74.7%) and mostly single (52%). Females reported higher fatigue (mean = 21.48) than males (mean = 19.22; p < .001). However, Males had better Migraine-Specific Quality of Life (MSQ) scores (mean = 49.90) compared to females (mean = 42.27; p < .001). Females scored higher on anxiety (GAD-2: mean = 2.99 vs. mean = 2.35; p < .001). Moreover, urban residents had higher scores on the Role Preventive (RF-P) subscale of the MSQ than rural residents (mean = 49.93 vs. mean = 44.82; p = .014). Higher fatigue and anxiety levels were associated with lower quality of life scores. CONCLUSIONS This study aimed to elucidate the multifaceted impact of migraines on daily life, considering diverse demographic variables to enhance diagnostic accuracy, treatment efficacy, and disease management strategies.
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Affiliation(s)
- Jamal Ataya
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Nour Bannoud
- Faculty of Medicine, Damascus University, Damascus, Syria.
| | - Rawan Daboul
- Faculty of Medicine, Al_Baath University, Homs, Syria
| | | | - Hamdah Hanifa
- Faculty of Medicine, University of Kalamoon, Al-Nabk, Syria
| | - Masa Watfa
- Department of Hematology and Blood Transfusion, Tishreen University Hospital, Latakia, Syria
| | | | - Raghad Salama
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Rustum Mackieh
- Department of Orthopedic Pediatric Surgery, University Children's Hospital, Damascus University, Damascus, Syria
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Al-Quliti KW, Alraddadi AN, Alnoaman AW, Alahmadi MA, Khawaji ZY, Alquliti WK, Aljohani SA. Knowledge, attitudes, and practices of migraine management among primary health care physicians in Al-Madinah Al-Munawarah. J Med Life 2024; 17:1012-1019. [PMID: 39781310 PMCID: PMC11705470 DOI: 10.25122/jml-2024-0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 11/10/2024] [Indexed: 01/12/2025] Open
Abstract
Migraine is a burdensome primary headache disorder with a global prevalence ranging from 15-18%. Our study aimed to assess the knowledge among primary healthcare physicians regarding migraine and evaluate whether their management practices align with current advances. This descriptive cross-sectional study included 212 primary healthcare physicians working in Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia. Data were collected using a self-administered, validated questionnaire distributed at clinics, with participant consent, to ensure privacy. A total of 212 responses were collected, the majority were from men (53.8%) and participants less than 30 years old (43.9%). Most participants held a Bachelor of Medicine, Bachelor of Surgery (MBBS) qualification (general practitioners), accounting for 56.1% of the sample. The results revealed that 83.5% had a high level of knowledge about the diagnostic criteria for migraine. Factors associated with a higher level of knowledge were female gender and age group less than 30 years. However, most participants (62.3%) were not familiar with the new acute and preventive migraine treatments. The findings of this study indicate good knowledge, attitude, and practicing habits among our participants. However, there were clear deficiencies in understanding the latest advancements in migraine treatment. We recommend implementing continuous education programs regarding the advances in migraine treatment among primary care physicians in Al-Madinah Al-Munawarah.
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Affiliation(s)
- Khalid Wasel Al-Quliti
- Department of Medicine, College of Medicine, Taibah University, Madinah, Kingdom of Saudi Arabia
| | | | | | | | - Zakaria Yahya Khawaji
- College of Medicine and Surgery, Taibah University, Madinah, Kingdom of Saudi Arabia
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Olawade DB, Teke J, Adeleye KK, Egbon E, Weerasinghe K, Ovsepian SV, Boussios S. AI-Guided Cancer Therapy for Patients with Coexisting Migraines. Cancers (Basel) 2024; 16:3690. [PMID: 39518129 PMCID: PMC11544931 DOI: 10.3390/cancers16213690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 10/26/2024] [Accepted: 10/28/2024] [Indexed: 11/16/2024] Open
Abstract
Background: Cancer remains a leading cause of death worldwide. Progress in its effective treatment has been hampered by challenges in personalized therapy, particularly in patients with comorbid conditions. The integration of artificial intelligence (AI) into patient profiling offers a promising approach to enhancing individualized anticancer therapy. Objective: This narrative review explores the role of AI in refining anticancer therapy through personalized profiling, with a specific focus on cancer patients with comorbid migraine. Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Google Scholar. Studies were selected based on their relevance to AI applications in oncology and migraine management, with a focus on personalized medicine and predictive modeling. Key themes were synthesized to provide an overview of recent developments, challenges, and emerging directions. Results: AI technologies, such as machine learning (ML), deep learning (DL), and natural language processing (NLP), have become instrumental in the discovery of genetic and molecular biomarkers of cancer and migraine. These technologies also enable predictive analytics for assessing the impact of migraine on cancer therapy in comorbid cases, predicting outcomes and provide clinical decision support systems (CDSS) for real-time treatment adjustments. Conclusions: AI holds significant potential to improve the precision and effectiveness of the management and therapy of cancer patients with comorbid migraine. Nevertheless, challenges remain over data integration, clinical validation, and ethical consideration, which must be addressed to appreciate the full potential for the approach outlined herein.
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Affiliation(s)
- David B. Olawade
- Department of Allied and Public Health, School of Health, Sport and Bioscience, University of East London, London E16 2RD, UK;
- Department of Research and Innovation, Medway NHS Foundation Trust, Gillingham ME7 5NY, Kent, UK; (J.T.); (K.W.)
- Department of Public Health, York St John University, London E14 2BA, UK
| | - Jennifer Teke
- Department of Research and Innovation, Medway NHS Foundation Trust, Gillingham ME7 5NY, Kent, UK; (J.T.); (K.W.)
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury CT1 1QU, Kent, UK
| | - Khadijat K. Adeleye
- Elaine Marieb College of Nursing, University of Massachusetts, Amherst, MA 01003, USA;
| | - Eghosasere Egbon
- Department of Tissue Engineering and Regenerative Medicine, Faculty of Life Science Engineering, FH Technikum, 1200 Vienna, Austria;
| | - Kusal Weerasinghe
- Department of Research and Innovation, Medway NHS Foundation Trust, Gillingham ME7 5NY, Kent, UK; (J.T.); (K.W.)
| | - Saak V. Ovsepian
- Faculty of Engineering and Science, University of Greenwich London, Chatham Maritime ME4 4TB, Kent, UK;
- Faculty of Medicine, Tbilisi State University, Tbilisi 0177, Georgia
| | - Stergios Boussios
- Department of Research and Innovation, Medway NHS Foundation Trust, Gillingham ME7 5NY, Kent, UK; (J.T.); (K.W.)
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury CT1 1QU, Kent, UK
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King’s College London, Strand, London WC2R 2LS, UK
- Kent Medway Medical School, University of Kent, Canterbury CT2 7LX, Kent, UK
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, Kent, UK
- AELIA Organization, 9th Km Thessaloniki–Thermi, 57001 Thessaloniki, Greece
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Tsirelis D, Tsekouras A, Stamati P, Liampas I, Zoupa E, Dastamani M, Tsouris Z, Papadimitriou A, Dardiotis E, Siokas V. The impact of genetic factors on the response to migraine therapy. Rev Neurosci 2024; 35:789-812. [PMID: 38856190 DOI: 10.1515/revneuro-2024-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/17/2024] [Indexed: 06/11/2024]
Abstract
Migraine is a multidimensional disease affecting a large portion of the human population presenting with a variety of symptoms. In the era of personalized medicine, successful migraine treatment presents a challenge, as several studies have shown the impact of a patient's genetic profile on therapy response. However, with the emergence of contemporary treatment options, there is promise for improved outcomes. A literature search was conducted in PubMed and Scopus, in order to obtain studies investigating the impact of genetic factors on migraine therapy outcome. Overall, 23 studies were included in the current review, exhibiting diversity in the treatments used and the genetic variants investigated. Divergent genes were assessed for each category of migraine treatment. Several genetic factors were identified to contribute to the heterogeneous response to treatment. SNPs related to pharmacodynamic receptors, pharmacogenetics and migraine susceptibility loci were the most investigated variants, revealing some interesting significant results. To date, various associations have been recorded correlating the impact of genetic factors on migraine treatment responses. More extensive research needs to take place with the aim of shedding light on the labyrinthine effects of genetic variations on migraine treatment, and, consequently, these findings can promptly affect migraine treatment and improve migraine patients' life quality in the vision of precise medicine.
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Affiliation(s)
- Daniil Tsirelis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Alexandros Tsekouras
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Polyxeni Stamati
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Elli Zoupa
- Larisa Day Care Center of People with Alzheimer's Disease, Association for Regional Development and Mental Health (EPAPSY), 15124 Marousi, Greece
| | - Metaxia Dastamani
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | | | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece
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Nebrisi EE, Ruwayya ZSA, Alzayori DI, Alzayori RI, Chandran SB, Elshafei M. Efficacy and Tolerability of Erenumab and Topiramate for Prevention of Chronic Migraine: A Retrospective Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1684. [PMID: 39459471 PMCID: PMC11509775 DOI: 10.3390/medicina60101684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 10/07/2024] [Accepted: 10/09/2024] [Indexed: 10/28/2024]
Abstract
Background and Objectives: Migraine is a chronic neurological disorder affecting approximately 14% of the global population. Beyond physical pain, migraines significantly impact individuals' quality of life, influencing education, employment, and income levels. Topiramate, a second-generation antiepileptic medication, has demonstrated notable efficacy in reducing the occurrence of chronic migraine. Over the past three decades, extensive research has implicated the neuropeptide calcitonin gene-related peptide (CGRP) in migraine pathogenesis. Erenumab, the first FDA-approved CGRP inhibitor, received approval in 2018. This study aims to compare the clinical efficacy of Erenumab and Topiramate for migraine prevention. Materials and Methods: We conducted a retrospective cohort study of adults with episodic or chronic migraine over a 12-month period, comparing Erenumab (n = 52) and Topiramate (n = 56). Outcomes assessed included changes in the Migraine Disability Assessment (MIDAS) scores from baseline over the last three months of treatment and the proportion of patients achieving a ≥50% reduction in MIDAS scores by the end of the study. Results: The Erenumab group showed significant improvement, with nearly 79% of patients achieving a 50% reduction in their MIDAS score, with a mean reduction of 3.76. Notably, only two patients (3.8.5) discontinued treatment due to adverse events. In contrast, the Topiramate group had over 15% of patients achieve a 50% reduction in MIDAS scores, with a mean reduction of 5.89, and a had discontinuation rate of 14.2% due to adverse events. Conclusions: Both Topiramate and Erenumab are effective for migraine prevention. However, Topiramate has lower tolerability and more side effects, while Erenumab offers better tolerability and safety at a higher cost. Treatment decisions should be individualized based on patient needs, efficacy, safety, and cost considerations.
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Affiliation(s)
- Eslam El Nebrisi
- Department of Biomedical Sciences, Dubai Medical College for Girls, Dubai 20170, United Arab Emirates
| | - Zainaba Suaad Ahmed Ruwayya
- Department of Internal Medicine, Dubai Medical College for Girls, Dubai 20170, United Arab Emirates; (Z.S.A.R.); (D.I.A.); (R.I.A.)
| | - Dalya Ibrahim Alzayori
- Department of Internal Medicine, Dubai Medical College for Girls, Dubai 20170, United Arab Emirates; (Z.S.A.R.); (D.I.A.); (R.I.A.)
| | - Ranya Ibrahim Alzayori
- Department of Internal Medicine, Dubai Medical College for Girls, Dubai 20170, United Arab Emirates; (Z.S.A.R.); (D.I.A.); (R.I.A.)
| | - Shyam Babu Chandran
- Department of Neurology, Zulekha Hospital, Dubai P.O. Box 48577, United Arab Emirates;
| | - Mohamed Elshafei
- Department of Neurology, Zulekha Hospital, Dubai P.O. Box 48577, United Arab Emirates;
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Dwivedi AR, Jaiswal S, Kukkar D, Kumar R, Singh TG, Singh MP, Gaidhane AM, Lakhanpal S, Prasad KN, Kumar B. A decade of pyridine-containing heterocycles in US FDA approved drugs: a medicinal chemistry-based analysis. RSC Med Chem 2024; 16:d4md00632a. [PMID: 39493227 PMCID: PMC11528346 DOI: 10.1039/d4md00632a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Accepted: 10/10/2024] [Indexed: 11/05/2024] Open
Abstract
Heterocyclic scaffolds, particularly, pyridine-containing azaheterocycles, constitute a major part of the drugs approved in the past decade. In the present review, we explored the pyridine ring part of US FDA-approved small molecules (2014-2023). The analysis of the approved drugs bearing a pyridine ring revealed that a total of 54 drugs were approved. Among them, the significant number comprised the anticancer category (18 drugs, 33%), followed by drugs affecting the CNS system (11 drugs, 20%), which include drugs to treat migraines, Parkinsonism disorders, chemotherapeutic-induced nausea, insomnia, and ADHD or as CNS-acting analgesics or sedatives. Next, six drugs (11%) were also approved to treat rare conditions, followed by five drugs that affect the hematopoietic system. The analysis also revealed that drug approval was granted for antibiotics, antivirals, and antifungals, including drugs for the treatment of tropical and sub-tropical diseases. Primary drug targets explored were kinases, and the major metabolizing enzyme was CYP3A4. Further analysis of formulation types revealed that 50% of the approved drugs were tablets, followed by 17% capsules and 15% injections. Elemental analysis showed that most approved drugs contained sulfur, while fluorine was noted in 32 compounds. Therefore, the present review is a concerted effort to cover drugs bearing pyridine rings approved in the last decade and provide thorough discussion and commentary on their pharmacokinetics and pharmacodynamics aspects. Furthermore, in-depth structural and elemental analyses were explored, thus providing comprehensive guidance for medicinal chemists and scientists working in allied science domains.
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Affiliation(s)
| | - Shivani Jaiswal
- Institute of Pharmaceutical Research, GLA University Mathura, 17, Km Stone, National Highway #2, Delhi-Mathura Road India
| | - Deepak Kukkar
- University Centre for Research and Development, Chandigarh University Gharuan 140413 Punjab India
| | - Roshan Kumar
- Graphic Era (Deemed to be University) Clement Town Dehradun 248002 India
- Department Of Microbiology, Central University of Punjab VPO-Ghudda Punjab-151401 India
| | - Thakur Gurjeet Singh
- Centre for Research Impact & Outcome, Chitkara College of Pharmacy, Chitkara University Rajpura 140401 Punjab India
| | - Mahendra Pratap Singh
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University Chennai India
| | - Abhay M Gaidhane
- Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education Wardha India
| | - Sorabh Lakhanpal
- Division of Research and Development, Lovely Professional University Phagwara-144411 India
| | | | - Bhupinder Kumar
- Department of Pharmaceutical Sciences, Chauras Campus, HNB Garhwal University (A Central University) Srinagar Uttarakhand 246174 India
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Tam ACT, Naik H, Trenaman L, Lynd L, Zhang W. Health-related quality of life among women and men living with migraine: a Canada-wide cross-sectional study. J Headache Pain 2024; 25:170. [PMID: 39379822 PMCID: PMC11462961 DOI: 10.1186/s10194-024-01882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 09/30/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND Migraine is a prevalent neurologic disorder that affects women more than men. Examining health-related quality of life (HRQoL) by gender can aid decision makers in prioritizing future treatment and prevention programs. We aimed to quantify HRQoL by different levels of migraine disability and by gender. METHODS As part of a Canada-wide cross-sectional study, we administered an online survey to employed adults who self-reported a diagnosis of migraine. Migraine disability level was assessed using the Migraine Disability Assessment questionnaire (MIDAS). MIDAS scores were used to categorize respondents as having little to no, mild, moderate, or severe level of migraine-related disability. Physical and mental component summary scores (PCS and MCS) and health utilities were derived from responses to the Veterans Rand 12 Item Health Survey. PCS, MCS, and health utilities were summarized by migraine-related disability levels and gender. Covariate-adjusted linear regressions were used to examine the association between migraine disability level and health utility by gender. RESULTS A total of 441 participants completed the survey. The sample was predominantly women (60.1%), White race (75.5%), and had a mean age of 37 years. Mean health utility, PCS, and MCS scores were 0.61 (0.22), 45.0 (7.7), and 43.4 (11.0), respectively. All three scores decreased with increased migraine disability level. Gender differences on HRQoL within each migraine disability level were not statistically significant, except in the little to no disability level where women had lower mean MCS scores and health utility relative to men [mean (SD) MCS: women 44.0 (11.3); men 55.1 (8.1), p < 0.001; health utility: women 0.66 (0.18); men 0.81 (0.18), p < 0.001]. Linear regressions showed women with severe migraine-related disability had reduced health utility compared to women with little to no disability [adjusted difference: -0.16 (95%CI -0.24,-0.09)]. Associations among men increased in magnitude with migraine disability level [adjusted differences: mild - 0.16 (95%CI -0.24,-0.09); moderate - 0.18 (95%CI -0.26,-0.10); severe - 0.28 (95%CI -0.37,-0.20)]. CONCLUSIONS Findings contribute to the literature on the association between migraine disability level and HRQoL by examining trends by gender. Model results emphasize the importance of future treatments reducing severe disability due to migraine among both women and men.
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Affiliation(s)
- Alexander C T Tam
- Centre for Advancing Health Outcomes, Providence Research, Vancouver, BC, Canada
| | - Hiten Naik
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Faculty of Pharmaceutical Sciences, The University of British Columbia, 2405 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada
| | - Logan Trenaman
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Larry Lynd
- Centre for Advancing Health Outcomes, Providence Research, Vancouver, BC, Canada
- Faculty of Pharmaceutical Sciences, The University of British Columbia, 2405 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada
| | - Wei Zhang
- Centre for Advancing Health Outcomes, Providence Research, Vancouver, BC, Canada.
- Faculty of Pharmaceutical Sciences, The University of British Columbia, 2405 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada.
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Alrahbeni T, Mahal A, Alkhouri A, Alotaibi HF, Rajagopal V, Behera A, AL-Mugheed K, Khatib MN, Gaidhane S, Zahiruddin QS, Shabil M, Bushi G, Rustagi S, Kukreti N, Satapathy P, Mohapatra RK, Dziedzic A, Padhi BK. Surgical interventions for intractable migraine: a systematic review and meta-analysis. Int J Surg 2024; 110:6306-6313. [PMID: 38626410 PMCID: PMC11486983 DOI: 10.1097/js9.0000000000001480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 03/30/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Migraine affects ~14-15% of the global population, contributing to nearly 5% of the world's health burden. When drug treatments prove ineffective for intractable migraines, highly specific surgical interventions emerge as potential solutions. The authors aimed to analyze surgical approaches for these refractory or intractable migraines through a systematic review and meta-analysis. METHODS The authors conducted a literature search across databases such as PubMed, Scopus, Web of Science, and Embase, focusing on studies related to migraines and surgical outcomes. The authors considered clinical trials or observational studies that included any surgical intervention for refractory or intractable migraines, emphasizing key outcomes such as reductions in migraine intensity, Migraine Disability Assessment scores (MIDAS), and 50% Migraine Headache Index (MHI) reduction rates. Statistical analyses were performed using R version 4.3. RESULTS Eleven studies were included in the systematic review. A meta-analysis of four studies involving overall 95 patients showed a significant reduction in mean migraine intensity scores using ONS (-2.27, 95% CI: -3.92 to -0.63, P =0.021). Three studies with 85 patients showed an average MIDAS score reduction of -52.3, though this was not statistically significant (95% CI: -136.85 to 32.19, P =0.116). Two additional studies corroborated these reductions in MIDAS scores. Nerve decompression surgery showed a substantial decrease in the average migraine intensity (from 8.31 down to 4.06). Median MIDAS score dropped from 57 to 20. Two studies indicated a success rate of 40 and 82%, respectively, in achieving a 50% reduction in the migraine MHI through nerve decompression. Findings from two studies suggest that septorhinoplasty and sinus surgery effectively decrease migraine intensity scores. CONCLUSION The existing evidence emphasizes the potential advantages of surgical interventions as a promising approach to managing intractable or refractory migraines. However, robust and comprehensive research is crucial to refine and solidify the efficacy of these surgical methods, aiming for widespread benefits for patients, considering cost-effectiveness factors.
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Affiliation(s)
| | - Ahmed Mahal
- Department of Medical Biochemical Analysis, College of Health Technology, Cihan University-Erbil, Erbil, Kurdistan Region, Iraq
| | - Anas Alkhouri
- College of Pharmacy, Cihan University-Erbil, Erbil, Kurdistan Region, Iraq
| | - Hadil F. Alotaibi
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah Bint Abdul Rahman University, Riyadh Saudi Arabia
| | - Vineet Rajagopal
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Behera
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Khalid AL-Mugheed
- Adult Health Nursing and Critical Care. Riyadh Elm University, Saudi Arabia
| | - Mahalaqua N. Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi S. Zahiruddin
- Global Health Academy, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher education and Research, Wardha. India
| | - Muhammed Shabil
- EvidenceSynthesis Lab, Kolkata, India
- Global Center for Evidence Synthesis, Chandigarh, India
| | - Ganesh Bushi
- EvidenceSynthesis Lab, Kolkata, India
- Global Center for Evidence Synthesis, Chandigarh, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, Iraq
| | - Ranjan K. Mohapatra
- Department of Chemistry, Government College of Engineering, Keonjhar, Odisha, India
| | - Arkadiusz Dziedzic
- Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland
| | - Bijaya K. Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Triller P, Blessing VN, Overeem LH, Fitzek MP, Hong JB, Lange KS, Reuter U, Raffaelli B. Efficacy of eptinezumab in non-responders to subcutaneous monoclonal antibodies against CGRP and the CGRP receptor: A retrospective cohort study. Cephalalgia 2024; 44:3331024241288875. [PMID: 39469839 DOI: 10.1177/03331024241288875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2024]
Abstract
BACKGROUND Migraine patients unresponsive to calcitonin gene-related peptide (CGRP)(-receptor, -R) monoclonal antibodies (mAbs) may benefit from switching between CGRP(-R) mAbs. However, some patients do not tolerate or respond to any subcutaneous mAbs. This study evaluates the efficacy of the intravenous CGRP mAb eptinezumab in these therapy-refractory patients. METHODS In this retrospective cohort study, patients with migraine who previously failed erenumab and at least one CGRP mAb (fremanezumab and/or galcanezumab) received eptinezumab 100 mg, followed by a second dose of 100 mg or 300 mg after 12 weeks. Monthly headache days, monthly migraine days, acute medication days, and migraine pain intensity were recorded from standardized headache diaries during the four weeks before the first infusion (baseline), and during weeks 9-12 and 21-24 of treatment. Patient-reported outcomes were analyzed at baseline, weeks 12, and 24. RESULTS From January 2023 to February 2024, 41 patients received eptinezumab 100 mg. Of these, 38 (93%) received a second infusion after 12 weeks, with 29 (71%) increasing the dose to 300 mg. The percentage of patients with a ≥30% reduction rate in monthly migraine days was 23.1% at week 12 and 29.7% at week 24. Monthly migraine days decreased from 16.3 ± 8.0 at baseline to 15.4 ± 8.1 days during weeks 9-12 and 14.4 ± 8.0 days during weeks 21-24 (p = 0.07). During weeks 21-24, 38.5% reported a clinically meaningful reduction in HIT-6 scores and 52.4% in MIDAS scores. No adverse events were reported. CONCLUSIONS Eptinezumab may be an effective and well-tolerated option for some treatment-refractory migraine patients unresponsive to subcutaneous CGRP-(R) mAbs.
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Affiliation(s)
- Paul Triller
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Virginia N Blessing
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lucas H Overeem
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mira P Fitzek
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ja Bin Hong
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Kristin S Lange
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health at Charité (BIH), Berlin, Germany
| | - Uwe Reuter
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Universitätsmedizin Greifswald, Greifswald, Germany
| | - Bianca Raffaelli
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health at Charité (BIH), Berlin, Germany
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47
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Li Z, Zhang X, Kong S, Fu CC, Lv TQ, Xiao B. Association between composite dietary antioxidant index and migraine in American young women: insights from NHANES 1999-2004 cross-sectional data. Front Neurol 2024; 15:1399916. [PMID: 39318876 PMCID: PMC11420992 DOI: 10.3389/fneur.2024.1399916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 08/13/2024] [Indexed: 09/26/2024] Open
Abstract
Background Excessive oxidative stress is one of the key pathophysiological mechanisms underlying migraine, and increasing antioxidant intake has proven to be an effective strategy for the prevention and improvement of migraine symptoms. To explore the relationship between the composite dietary antioxidant index (CDAI) and the occurrence of migraine attacks. Methods Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2004 were utilized. Logistic regression, stratified analysis, and restricted cubic spline (RCS) models were employed to investigate the association between CDAI and migraine attacks. Results A total of 8,137 adults aged ≥20 were enrolled, comprising 1,610 patients with migraine and 6,527 non-migraine individuals. After adjusting for all covariates, CDAI was negatively correlated with migraine. In the overall participants, compared with the CDAI Q1 (-5.83 to -2.14) group, the adjusted odds ratio (OR) for migraine in Q3 (-0.59 to 1.53) and Q4 (1.53-44.63) groups were 0.71 [95% confidence interval (95% CI): 0.54-0.92, p = 0.011] and 0.64 (95% CI: 0.47-0.87, p = 0.005), respectively. After stratifying by age and gender, the protective effect was more pronounced in females aged 20-50, with adjusted OR for Q3 (-0.59 to 1.53) and Q4 (1.53-44.63) groups of 0.60 (95% CI: 0.40-0.90, p = 0.013) and 0.48 (95% CI: 0.30-0.78, p = 0.003), respectively. The RCS curve indicated a nonlinear relationship between CDAI and migraine in females aged 20-50, with a threshold of 0.006. Conclusion CDAI is negatively correlated with migraine attacks, and a higher CDAI may be an effective protective factor in preventing migraine attacks, especially in women aged 20-50.
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Affiliation(s)
- Zeyan Li
- Department of Plastic Surgery, BOE Hospital, Chengdu, China
| | - Xinyu Zhang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Simin Kong
- Department of Plastic Surgery, BOE Hospital, Chengdu, China
| | - Chuan-Chuan Fu
- Department of Plastic Surgery, BOE Hospital, Chengdu, China
| | - Tian-Qi Lv
- Department of Plastic Surgery, BOE Hospital, Chengdu, China
| | - Bin Xiao
- Department of Plastic Surgery, BOE Hospital, Chengdu, China
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Oakley PA, Haas JW, Woodham TJ, Fortner MO, Harrison DE. Resolution of Chronic Migraine Headaches and Improvement in Cervical Spine Kyphosis Following Chiropractic BioPhysics® (CBP®) Treatment: A Case Report With a Seven-Month Follow-Up. Cureus 2024; 16:e69935. [PMID: 39329038 PMCID: PMC11427026 DOI: 10.7759/cureus.69935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2024] [Indexed: 09/28/2024] Open
Abstract
We present a chronic migraine (CM) patient demonstrating significant improvement in subjective and objective reported outcome measures with deeper cervical lordosis parameters and reduced forward head posture on radiographs. A 29-year-old male suffered from CM reporting significant pain and disability with aural, sensory, and motor disturbances during the migraine headaches. Aura with visual disturbances, abnormal facial and extremity sensation, sporadic motor weakness, and other signs of CM were found in the patient's history since age 10. The patient reported previous physical therapy, manual chiropractic, and over-the-counter medications. Migraine-specific prescriptions without long-term reduction in pain and disability were reported. The pain and suffering had been reported to be worsening, and he sought Chiropractic BioPhysics® (CBP®) spine and postural rehabilitation protocols. These protocols were used to increase cervical lordosis, reduce coronal imbalances, increase mobility, and create better posture. These protocols include specific prescriptions based on radiography for postural exercises, postural mirror image® (MI®)traction, and specific spinal manipulative therapy (SMT) focused on posture. All outcome measures improved with the resolution of all initial symptoms of CM. There was a 16° improvement in cervical lordosis, a 30% decrease in headache disability, and additional improvements. These improvements were maintained at a seven-month follow-up during which the patient received infrequent maintenance treatments. This successful treatment of a patient with CM with long-term follow-up adds to evidence that CBP® spinal structural rehabilitation may prove effective and serve as a possible tool for clinicians, physicians, and therapists to treat CM.
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Affiliation(s)
- Paul A Oakley
- Kinesiology and Health Science, York University, Toronto, CAN
- Chiropractic, Innovative Spine and Wellness, Newmarket, CAN
| | - Jason W Haas
- Research, CBP (Chiropractic Biophysics) Non-profit, Inc., Windsor, USA
| | - Thomas J Woodham
- Chiropractic Biophysics, Western Plains Chiropractic, Gillette, USA
| | - Miles O Fortner
- Chiropractic Biophysics, Western Plains Chiropractic, Gillette, USA
| | - Deed E Harrison
- Physical Medicine and Rehabilitation, CBP (Chiropractic Biophysics) Non-profit, Inc., Eagle, USA
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Li Y, Cheng J, Cao Y, Chen K, Liu K, Zhang X, Wu X, Wang Z, Liu X. Increased effective connectivity from the hypothalamus to the left superior frontal gyrus and its association with visual analogue scale in persons with migraines. Quant Imaging Med Surg 2024; 14:6285-6293. [PMID: 39281172 PMCID: PMC11400693 DOI: 10.21037/qims-24-588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 07/05/2024] [Indexed: 09/18/2024]
Abstract
Background In recent years, several functional imaging studies have shown that the hypothalamus is closely associated with migraine and have suggested that the hypothalamus may be a potential site of migraine generation. Studying the characteristics of the functional network of the hypothalamus in persons with migraines may help to understand the neural mechanisms of migraine. We thus used resting-state functional magnetic resonance imaging (rsfMRI) and Granger causal analysis to investigate the effective connectivity (EC) of the hypothalamus in persons with migraines. Methods The study included 17 healthy volunteers and 39 persons with migraines. The EC calculation was based on rsfMRI data from a 3-T magnetic resonance imaging scanner. The brain networks of the hypothalamus were compared using a general linear model to determine if there were any differences between the two groups. We used Pearson correlation analysis to examine the correlation between EC values in abnormal brain regions and clinical variables. Results Compared with healthy controls, those with migraines showed decreased EC from the hypothalamus to the left fusiform and increased EC from the hypothalamus to the medial frontal gyrus/orbital part, right lingual gyrus, left superior frontal gyrus, and right middle frontal gyrus (P<0.05). Meanwhile, persons with migraines also showed decreased EC from the left middle frontal gyrus and right medial frontal gyrus/orbital part to the hypothalamus (P<0.05). EC from the hypothalamus to the left superior frontal gyrus correlated significantly and positively with the visual analogue scale in those with migraines (r=-0.3820; P=0.0164). Conclusions Disturbances in the EC between the hypothalamus and the prefrontal gyrus and visual cortex may play a key role in the neuropathological features of persons with migraines. The current study adds to our understanding of the complexity of migraine mechanisms.
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Affiliation(s)
- Yan Li
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jinming Cheng
- Department of Neurology, the Hebei General Hospital, Shijiazhuang, China
| | - Yungang Cao
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Keyang Chen
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Kun Liu
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xi Zhang
- Department of Neurology, Xingtai People's Hospital, Xingtai, China
| | - Xiaoyuan Wu
- Department of Neurology, the Hebei General Hospital, Shijiazhuang, China
| | - Zhihong Wang
- Department of Neurology, the Second Affiliated Hospital, Hebei Medical University, Shijiazhuang, China
| | - Xiaozheng Liu
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
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Varga E, Ghanem AS, Faludi E, Nguyen CM, Kovács N, Nagy AC. Medical comorbidities and other factors associated with migraine among individuals with diabetes mellitus in Hungary: a cross-sectional study using European Health Interview Surveys 2009-2019. Front Endocrinol (Lausanne) 2024; 15:1379127. [PMID: 39247924 PMCID: PMC11377266 DOI: 10.3389/fendo.2024.1379127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/07/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction Migraine, a debilitating neurological disorder characterized by recurrent headaches, affects over 1.1 billion individuals globally. Diabetes mellitus (DM), a chronic metabolic condition marked by high blood sugar levels, affects 463 million individuals according to the International Diabetes Federation. Our study aimed to evaluate the association between migraine and DM and to identify several demographic, socioeconomic, and lifestyle factors, as well as medical and psychiatric comorbidities, associated with migraine among individuals with DM. Methods This cross-sectional study is based on data from the European Health Interview Surveys conducted in 2009, 2014, and 2019 in Hungary. Pearson's chi-squared tests and multiple logistic regression models were used to assess associations. Statistical significance was set at p<0.05. Results In multiple regression analyses, we found no significant association between DM and migraine after adjusting for socioeconomic status, various health conditions, and lifestyle factors (OR=0.84, 95% CI: 0.66-1.06). However, adults with DM who had comorbid conditions including stroke (OR=2.08, 95% CI: 1.06-4.08), low back pain (OR=3.52, 95% CI: 2.13-5.84), and depression (OR=4.91, 95% CI: 2.84-8.47) were significantly more likely to suffer from migraine. Discussion Our study found no significant difference in the prevalence of migraine among adults with and without diabetes mellitus. However, several comorbidities were found to be significantly associated with migraine occurrence in those with DM. Thus, the study's results highlight the need for proper management of diabetes, especially in terms of comorbidities, to mitigate migraine risk factors and improve patient outcomes.
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Affiliation(s)
- Eszter Varga
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Amr Sayed Ghanem
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Eszter Faludi
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Chau Minh Nguyen
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
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