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Stephen B Shrewsbury, Maria Jeleva, Kelsey H Satterly, Jason Lickliter, John Hoekman
OBJECTIVE: Investigate the safety and pharmacokinetics (PK) of INP104, intranasal dihydroergotamine mesylate (DHE) administered via a Precision Olfactory Delivery (POD® ) device, (Impel NeuroPharma, Seattle, WA) vs intravenous (IV) DHE and DHE nasal spray (Migranal® ) in healthy adult subjects. METHODS: This was a Phase 1, open-label, randomized, single-dose, 3-period, 3-way crossover study. Subjects received a single dose of A) INP104 1.45 mg (a drug-device combination product composed of DHE and the I123 POD device); B) DHE 45® Injection (IV) 1...
January 19, 2019: Headache
Mario F P Peres, Arão Belitardo Oliveira, Juliane P Mercante, Helder H Kamei, Patricia R Tobo, Todd D Rozen, Morris Levin, Dawn C Buse, Giancarlo Lucchetti
BACKGROUND: Optimism and pessimism are related to several mental health and brain disorders, are significant predictors of physical and psychological health outcomes, and implicated as psychosocial determinants of the pain experience. Despite this promising evidence, limited information is available on optimism and pessimism in headache disorders. OBJECTIVE: To evaluate the influence of optimism and pessimism in meeting criteria for migraine and related disability in a population-based sample...
January 19, 2019: Headache
Kai-Uwe Kern, Myriam Schwickert-Nieswandt, Christian Maihöfner, Charly Gaul
BACKGROUND: Trigeminal neuralgia is difficult to treat and shows upregulation of sodium channels. The expectorant ambroxol acts as a strong local anesthetic, about 40 times stronger than lidocaine. It preferentially inhibits the channel subtype Nav 1.8, expressed especially in nociceptive C-fibers. It seemed reasonable to try ambroxol for the treatment with neuropathic facial pain unresponsive to other standard options. MATERIAL AND METHODS: Medical records of patients suffering from classical trigeminal neuralgia (n = 5) and successful pain reduction following topical ambroxol 20% cream in addition to standard treatment are reported...
January 17, 2019: Headache
Alicia Gonzalez-Martinez, Daniel Romero-Palacián, Julio Dotor García-Soto, Pedro Sánchez, Gemma Reig Roselló, Gustavo Zapata Wainberg
OBJECTIVES: To report a case of reversible cerebral vasoconstriction syndrome (RCVS) possibly precipitated by tocilizumab. BACKGROUND: Immunosuppressant drugs are a rare cause of reversible cerebral vasoconstriction, a syndrome characterized by segmental vasospasm. However, although it is considered a reversible process that resolves within 3 months, the cerebral vasoconstriction over time may lead to severe complications such as strokes. RESULTS: We describe a 53-year-old woman who presented with a reversible vasoconstriction syndrome possibly associated with tocilizumab, an inhibitor of IL-6 receptor used in inflammatory diseases such as rheumatoid arthritis...
January 17, 2019: Headache
Carmen Fourier, Caroline Ran, Anna Steinberg, Christina Sjöstrand, Elisabet Waldenlind, Andrea Carmine Belin
OBJECTIVE: The purpose of this study was to investigate the HCRTR2 gene variants rs3122156, rs2653342, and rs2653349 in a large homogenous Swedish case-control cohort in order to further evaluate the possible contribution of HCRTR2 to cluster headache. BACKGROUND: Cluster headache is a severe neurovascular disorder and the pathophysiology is not yet fully understood. Due to striking circadian and circannual patterns of this disease, the hypothalamus has been a research focus in cluster headache...
January 16, 2019: Headache
Marta Oses, Ivana Zamarbide, Andrea Gómez, Javier Del Val, Isabel Herrera
No abstract text is available yet for this article.
January 11, 2019: Headache
Wei He, Yixin Zhang, Ting Long, Qi Pan, Shanshan Zhang, Jiying Zhou
BACKGROUND: Structural damage or demyelization of the sphenopalatine ganglion may cause sphenopalatine neuralgia (SN). The current International Classification of Headache Disorders, third edition (ICHD-3) regards SN as a phenotype of cluster headache. Whether SN is an independent neuralgia entity has been debated for years. METHODS: This article presents a case series of SN, a review of all published cases, and a pooled data analysis of the identified cases. RESULTS: Seven patients were identified, with a median age at symptom onset of 59 years...
January 11, 2019: Headache
Federico Mainardi, Ferdinando Maggioni, Giorgio Zanchin
INTRODUCTION: Headache attributed to aeroplane travel (AH) is one of the new nosological entries in the International Classification of Headache Disorders (ICHD) 3 beta. MATERIALS AND METHODS: This study retraces the history of headache related to flight, from the initial description to the modern reports, on the basis of original sources. RESULTS: Head pain related to flight has been reported since the beginning of flight era. However, most of those early cases are easily recognized as secondary to an exceptional barotrauma and/or a sinusitis concomitant with the flight...
January 11, 2019: Headache
Stuart M Pearson, Mark J Burish, Robert E Shapiro, Yuanqing Yan, Larry I Schor
OBJECTIVE: To assess the effectiveness and adverse effects of acute cluster headache medications in a large international sample, including recommended treatments such as oxygen, commonly used medications such as opioids, and emerging medications such as intranasal ketamine. Particular focus is paid to a large subset of respondents 65 years of age or older. BACKGROUND: Large international surveys of cluster headache are rare, as are examinations of treatments and side effects in older cluster headache patients...
January 11, 2019: Headache
Tae-Jin Song, Soo-Jin Cho, Won-Joo Kim, Kwang Ik Yang, Chang-Ho Yun, Min Kyung Chu
OBJECTIVE: This study was conducted to investigate sex differences in the prevalence and clinical presentation of migraine and probable migraine in a general population-based sample. BACKGROUND: While there is research on sex differences in clinical characteristics and their impact on migraine headache, only few studies have investigated sex differences in probable migraine in population-based settings. Moreover, compared with Western countries, the prevalence of probable migraine in Asia is relatively high...
January 9, 2019: Headache
Valentina Mancini, Giulio Mastria, Viviana Frantellizzi, Patrizia Troiani, Stefania Zampatti, Stefania Carboni, Emiliano Giardina, Rosa Campopiano, Stefano Gambardella, Federica Turchi, Barbara Petolicchio, Massimiliano Toscano, Mauro Liberatore, Alessandro Viganò, Vittorio Di Piero
Genetic mutations of sporadic hemiplegic migraine (SHM) are mostly unknown. SHM pathophysiology relies on cortical spreading depression (CSD), which might be responsible for ischemic brain infarction. Cystic fibrosis (CF) is caused by a monogenic mutation of the chlorine transmembrane conductance regulator (CFTR), possibly altering brain excitability. We describe the case of a patient with CF, who had a migrainous stroke during an SHM attack. A 32-year-old Caucasian male was diagnosed with CF, with heterozygotic delta F508/unknown CFTR mutation...
January 8, 2019: Headache
Olafur Sveinsson, Malin Säflund, Christina Sjöstrand
No abstract text is available yet for this article.
January 2, 2019: Headache
Dawn C Buse, Jacob D Greisman, Khosrow Baigi, Richard B Lipton
BACKGROUND: Migraine is a common and often debilitating neurological disease. It can be divided into episodic and chronic subforms based on the number of monthly headache days. Because only a subset of individuals with episodic migraine (EM) progress to chronic migraine (CM) over any given time period, understanding the factors that predict the new onset of CM or "migraine progression" may provide insights into the mechanisms, pathophysiology, prevention, and treatment of CM...
December 27, 2018: Headache
(no author information available yet)
OBJECTIVE: To provide healthcare professionals with updated guidance in the use of novel preventive and acute treatments for migraine in adults. BACKGROUND: The principles of preventive and acute pharmacotherapy for patients with migraine have been outlined previously, but the emergence of new technologies and treatments, as well as new formulations of previously established treatments, has created a need for an updated guidance on the preventive and acute treatment of migraine...
December 10, 2018: Headache
Mia Minen, Sarah Jinich, Gladys Vallespir Ellett
BACKGROUND: There are no clear guidelines on how to treat posttraumatic headache (PTH) or post-concussive symptoms (PCS). However, behavioral interventions such as cognitive behavioral therapy, biofeedback, and relaxation are Level-A evidence-based treatments for headache prevention. To understand how to develop and study further mind-body interventions (MBIs) and behavioral therapies for PTH and PCS, we developed the following question using the PICO framework: Are behavioral therapies and MBIs effective for treating PTH and PCS? METHODS: We conducted a systematic search of 3 databases (Medline, PsycINFO, and EMBASE) for behavioral interventions and MBIs with the subject headings and keywords for PTH, concussion, and traumatic brain injury (TBI)...
December 1, 2018: Headache
Mario Fernando Prieto Peres, Juliane Prieto Peres Mercante, Arão Belitardo de Oliveira
BACKGROUND: Primary headaches can be reduced by lifestyle changes, such as stress management and physical activity. However, access to programs focused on behavioral interventions is limited in underserved, poor communities. OBJECTIVES: We performed a randomized open-label clinical trial to test the therapeutic and behavioral effects of aerobic exercise, relaxation, or the combination of both, in individuals with primary headaches of a small, low-income community of the Brazilian Amazon...
November 28, 2018: Headache
Elissa K Ortolani, Robert Safier, Ellen B Mitchell, Catalina Cleves-Bayon
No abstract text is available yet for this article.
November 25, 2018: Headache
Yohannes W Woldeamanuel, Danielle D DeSouza, Bharati M Sanjanwala, Robert P Cowan
OBJECTIVES: The objectives of this cross-sectional pilot study were threefold: to identify regions of cortical thickness that differentiate chronic migraine (CM) from controls, to assess group differences in interregional cortical thickness covariance, and to determine group differences in associations between clinical variables and cortical thickness. BACKGROUND: Cortical thickness alterations in relation to clinical features have not been adequately explored in CM...
November 23, 2018: Headache
Russell Nichols, Erin Doty, Sara Sacco, Dustin Ruff, Eric Pearlman, Sheena K Aurora
OBJECTIVE: To examine the likelihood of response with continued galcanezumab treatment in patients with episodic or chronic migraine without initial clinical improvement. BACKGROUND: A percentage of patients with migraine may require additional time on pharmacotherapy but discontinue treatment prematurely. Additionally, recognizing when continued treatment is unlikely to provide improvement limits unnecessary exposure. METHODS: Post hoc analysis of response after continued galcanezumab treatment was conducted in a subset of patients with episodic (N = 879) and chronic (N = 555) migraine who did not achieve "good" early improvement (episodic, ≥50% reduction in baseline migraine headache days [MHD] and chronic, ≥30% reduction) after 1 month of dosing (NR-1; episodic, n = 450 and chronic, n = 306)...
November 21, 2018: Headache
Daniel M Cushman, Lauren Borowski, Colby Hansen, John Hendrick, Troy Bushman, Masaru Teramoto
OBJECTIVE: To examine the association of commonly prescribed post-concussive medications, namely gabapentin and tricyclic antidepressants (TCAs), with symptom reduction after concussion. BACKGROUND: Concussion is a common diagnosis in modern medicine. Many providers use medication to target the residual symptoms of a concussion, with little evidence supporting their efficacy. DESIGN: Retrospective study with longitudinal analysis using mixed-effects and piecewise regression analyses of 277 patients presenting to an academic sports medicine clinic, all of whom were clinically diagnosed with a concussion...
November 19, 2018: Headache
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