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Migraine treatment

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https://www.readbyqxmd.com/read/28653227/anti-cgrp-monoclonal-antibodies-the-next-era-of-migraine-prevention
#1
REVIEW
Amy R Tso, Peter J Goadsby
Migraine is a very disabling disorder with severe impact on patients' lives and substantive costs to society in terms of healthcare costs and lost productivity. Prevention is a key component of migraine therapy, and while numerous preventive options exist, each is burdened by either troublesome side effects or insufficient efficacy. All migraine preventives currently in clinical use were licensed for other purposes and, by chance, have efficacy against migraine. As our understanding of migraine has evolved, calcitonin gene-related peptide (CGRP) has moved to the forefront as a neuropeptide central to migraine pathophysiology...
August 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28649860/do-racial-ethnic-disparities-exist-in-recommended-migraine-treatments-in-us-ambulatory-care
#2
Larry Charleston Iv, James Francis Burke
Background Racial disparities in migraine have been reported in the US. Migraine in African Americans (AA) is more frequent, more severe, more likely to become chronic and associated with more depression and lower quality of life compared to non-Hispanic Whites (NHW). It is possible that racial differences in prescribing practices contribute to these differences, but little is known about the quality of migraine prescribing patterns in the US or whether racial differences exist. Objective To determine if racial differences in quality of migraine medical prescription care exist...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28647791/premonitory-symptoms-of-migraine-in-childhood-and-adolescence
#3
REVIEW
N Karsan, P Prabhakar, P J Goadsby
PURPOSE OF REVIEW: Premonitory symptoms in migraine; symptoms occurring before the onset of migraine pain or aura, are an increasingly recognised area of interest within headache research. It has been recently documented in the literature that these symptoms also occur in children and adolescents, with a comparable phenotype to adults. This review discusses the wide presentation of premonitory symptoms in migraine in children and adolescents, and the importance of understanding how these early symptoms are mediated in order to ensure that targeted abortive therapies are developed in the future...
July 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28647288/gap-junctions-pannexins-and-pain
#4
REVIEW
David C Spray, Menachem Hanani
Enhanced expression and function of gap junctions and pannexin (Panx) channels has been associated with both peripheral and central mechanisms of pain sensitization. At the level of the sensory ganglia, evidence includes augmented gap junction and pannexin1 expression in glial cells and neurons in inflammatory and neuropathic pain models and increased synchrony and enhanced cross-excitation among sensory neurons by gap junction-mediated coupling. In spinal cord and in suprapinal areas, evidence is largely limited to increased expression of relevant proteins, although in several rodent pain models, hypersensitivity is reduced by treatment with gap junction/Panx1 channel blocking compounds...
June 21, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#5
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g. premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28645744/reversible-hemispheric-hypoperfusion-in-two-cases-of-smart-syndrome
#6
Karmen Wai, Anna Balabanski, Nicholas Chia, Timothy Kleinig
Stroke-like migraine attacks after radiation therapy (SMART) syndrome manifests as prolonged episodes of cortical dysfunction, years after cranial irradiation. We present two cases demonstrating reversible hemispheric hypoperfusion. Case 1 presented with left hemispheric symptoms following previous similar episodes. CT perfusion (CTP) demonstrated reversible hemispheric hypoperfusion; subsequent investigations were consistent with SMART syndrome. Case 2 presented following the third episode of a hemispheric syndrome with near-identical CTP abnormalities...
June 20, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28645559/multicenter-prevalence-of-opioid-medication-use-as-abortive-therapy-in-the-emergency-department-treatment-of-migraine-headaches
#7
Neil Young, Daniel Silverman, Heather Bradford, Jeffrey Finkelstein
Despite a range of therapeutic options for treating acute migraine headaches, the use of opioids is still reported to be common practice. This study describes treatment practices in regards to migraines in the ED. It characterizes the prevalence of opioid orders during visits in three different settings, an academic medical center, a non-academic urban ED, and a community ED. Fourteen months of consecutive migraine visits were identified. All medications ordered were separated into first-line and rescue medications...
June 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28645128/-headache-news
#8
Hans-Christoph Diener, Charly Gaul, Dagny Holle-Lee, Lazaros Lazaridis, Steffen Nägel, Mark Obermann
A review of the latest and most relevant information on different disorders of head and facial pain is presented. News from epidemiologic studies regarding the relationship between migraine and patent foramen ovale, the cardiovascular risk in migraine, and migraine behavior during menopause, and the development of white matter lesions or migraine genetics are presented. Regarding pathophysiology there are very recent insights regarding the role of the hypothalamus during prodromal phase and the interplay of brain-stem and hypothalamus during the attack...
June 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28644160/calcitonin-gene-related-peptide-targeted-therapies-for-migraine-and-cluster-headache-a-review
#9
Nathaniel M Schuster, Alan M Rapoport
Calcitonin gene-related peptide (CGRP) is a signaling neuropeptide released from activated trigeminal sensory afferents in headache and facial pain disorders. There are a handful of CGRP-targeted therapies currently in phase 3 studies for migraine acute treatment or prevention. Currently, 4 monoclonal antibodies targeting either the CGRP ligand or receptor are being studied for migraine prevention: ALD403 (eptinezumab), AMG 334 (erenumab), LY2951742 (galcanezumab), and TEV-48125 (fremanezumab). Meanwhile, 1 small-molecule CGRP receptor antagonist (ubrogepant, MK-1602) is currently in phase 3 studies for the acute treatment of migraine...
June 21, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28640657/retinal-findings-on-oct-in-systemic-conditions
#10
Preeti Patil Chhablani, Vikas Ambiya, Akshay G Nair, Sailaja Bondalapati, Jay Chhablani
PURPOSE: Imaging technology has advanced by leaps and bounds in the recent past and has resulted in a much greater understanding of ocular diseases. The aim of this review article is to summarize optical coherence tomography (OCT) findings of various systemic conditions. METHOD: A systematic literature search of the Medline/PubMed database was performed. English articles up to April 2015 were included. Terms used for search included: Alzheimer's Disease; Multiple Sclerosis; Parkinson's Disease; Behçet's Disease; Schizophrenia; Migraine; Obstructive Sleep Apnea Syndrome; Neurofibromatosis; Sickle Cell Disease; Renal diseases; Lupus Retinopathy; Valsalva Retinopathy; Whiplash Retinopathy; Shaken-Baby Syndrome; Choroidal metastases; Intracranial Hypertension; Drug toxicity; Deferoxamine; Sildenafil; Tamoxifen; Hydroxychloroquine; Chloroquine; Ethambutol; Lead; Sickle Cell Disease; and Thalassemia along with OCT...
June 22, 2017: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/28638026/-analysis-of-the-efficacy-of-reflexology-in-the-complex-treatment-of-chronic-migraine
#11
M I Safonov, M V Naprienko
AIM: To evaluate the effect of different reflexology techniques on main clinical indices of patients with chronic migraine, the number of analgesics used and dynamics of chronic migraine comorbid disorders. MATERIAL AND METHODS: The study included 84 patients (60 women (71.5%) and 24 men (28.5%)), aged from 18 to 63 years, with a diagnosis of chronic migraine. Patients were randomized in 4 groups - Su Jok (n=22), acupuncture (n=22), electroacupuncture (n=20), control (n=20)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28627714/migraine-subclassification-via-a-data-driven-automated-approach-using-multimodality-factor-mixture-modeling-of-brain-structure-measurements
#12
Todd J Schwedt, Bing Si, Jing Li, Teresa Wu, Catherine D Chong
BACKGROUND: The current subclassification of migraine is according to headache frequency and aura status. The variability in migraine symptoms, disease course, and response to treatment suggest the presence of additional heterogeneity or subclasses within migraine. OBJECTIVE: The study objective was to subclassify migraine via a data-driven approach, identifying latent factors by jointly exploiting multiple sets of brain structural features obtained via magnetic resonance imaging (MRI)...
June 19, 2017: Headache
https://www.readbyqxmd.com/read/28625856/nitroglycerin-increases-serotonin-transporter-expression-in-rat-spinal-cord-but-anandamide-modulated-this-effect
#13
Gábor Nagy-Grócz, Zsuzsanna Bohár, Annamária Fejes-Szabó, Klaudia Flóra Laborc, Eleonóra Spekker, Lilla Tar, László Vécsei, Árpád Párdutz
Migraine is one of the most prevalent neurological diseases, which affects 16% of the total population. The exact pathomechanism of this disorder is still not well understood, but it seems that serotonin and its transporter have a crucial role in the pathogenesis. One of the animal models of migraine is the systemic administration of nitroglycerin (NTG), a nitric oxide (NO) donor. NO can initiate a central sensitization process in the trigeminal system, which is also present in migraineurs. Recent studies showed that the endocannabinoid system has a modulatory role on the trigeminal activation and sensitization...
June 15, 2017: Journal of Chemical Neuroanatomy
https://www.readbyqxmd.com/read/28616617/comparison-of-granisetron-and-metoclopramide-in-the-treatment-of-pain-and-emesis-in-migraine-patients-a-randomized-controlled-trial-study
#14
Hassan Amiri, Niloufar Ghodrati, Mehrnaz Nikuyeh, Samad Shams-Vahdati, Mehran Jalilzadeh-Binazar
OBJECTIVES: One of the irritating features of migraine is emesis that can compromise taking oral medications. We designed this study to compare the effectiveness of granisetron and metoclopramide in reducing pain and treating emesis in migraine patients. METHODS: We included a total of 148 patients with migraine headache presenting to two referral hospitals in a prospective, double-blinded randomized controlled trial. We compared the effect of granisetron (2 mg intravenous) with metoclopramide (10 mg intravenous)...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28616038/electroacupuncture-at-fengchi-gb20-inhibits-calcitonin-gene-related-peptide-expression-in-the-trigeminovascular-system-of-a-rat-model-of-migraine
#15
Luo-Peng Zhao, Lu Liu, Pei Pei, Zheng-Yang Qu, Yu-Pu Zhu, Lin-Peng Wang
Most migraine patients suffer from cutaneous allodynia; however, the underlying mechanisms are unclear. Calcitonin gene-related peptide (CGRP) plays an important role in the pathophysiology of migraine, and it is therefore, a potential therapeutic target for treating the pain. In the present study, a rat model of conscious migraine, induced by repeated electrical stimulation of the superior sagittal sinus, was established and treated with electroacupuncture at Fengchi (GB20) (depth of 2-3 mm, frequency of 2/15 Hz, intensity of 0...
May 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28615422/prognostic-factors-for-chronic-headache-a-systematic-review
#16
REVIEW
Katrin Probyn, Hannah Bowers, Fiona Caldwell, Dipesh Mistry, Martin Underwood, Manjit Matharu, Tamar Pincus
OBJECTIVE: To identify predictors of prognosis and trial outcomes in prospective studies of people with chronic headache. METHODS: This was a systematic review of published literature in peer-reviewed journals. We included (1) randomized controlled trials (RCTs) of interventions for chronic headache that reported subgroup analyses and (2) prospective cohort studies, published in English, since 1980. Participants included adults with chronic headache (including chronic headache, chronic migraine, and chronic tension-type headache with or without medication overuse headache)...
June 14, 2017: Neurology
https://www.readbyqxmd.com/read/28611661/discovery-and-development-of-calcium-channel-blockers
#17
REVIEW
Théophile Godfraind
In the mid 1960s, experimental work on molecules under screening as coronary dilators allowed the discovery of the mechanism of calcium entry blockade by drugs later named calcium channel blockers. This paper summarizes scientific research on these small molecules interacting directly with L-type voltage-operated calcium channels. It also reports on experimental approaches translated into understanding of their therapeutic actions. The importance of calcium in muscle contraction was discovered by Sidney Ringer who reported this fact in 1883...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28611163/angle-closure-as-a-cause-for-intermittent-headache-in-a-child
#18
Nuno Pinto Ferreira, Joana Medeiros Pinto, Filomena Pinto, Luis Abegão Pinto
Angle closure is usually associated with older patients, as it typically manifests in middle to later life, being associated with an age-related increased lens volume. However, angle closure can occur in any age group if there is an anatomical predisposition that promotes pupillary block or an anterior pulling of the iris. During an acute angle closure, patients generally experience ocular pain, headache, nausea, vomiting and conjunctival hyperaemia. These attacks can be misinterpreted as migraine, particularly if subacute or chronic and the demographic characteristics of the patient do not suggest a primary angle closure event...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28611097/epidemiology-endovascular-treatment-and-prognosis-of-cerebral-venous-thrombosis-us-center-study-of-152-patients
#19
Kristin Salottolo, Jeffrey Wagner, Donald F Frei, David Loy, Richard J Bellon, Kathryn McCarthy, Judd Jensen, Christopher Fanale, David Bar-Or
BACKGROUND: Cerebral venous thrombosis is a rare cause of stroke that poses diagnostic, therapeutic, and prognostic challenges. Mainstay treatment is systemic anticoagulation, but endovascular treatment is increasingly advocated. Our objectives were to describe the epidemiology, treatment, and prognosis of 152 patients with cerebral venous thrombosis. METHODS AND RESULTS: This was a retrospective study of consecutive cerebral venous thrombosis cases from 2006 to 2013 at a comprehensive stroke center through hospital discharge...
June 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28608601/brain-structural-properties-predict-psychologically-mediated-hypoalgesia-in-an-8-week-sham-acupuncture-treatment-for-migraine
#20
Jixin Liu, Junya Mu, Qianqian Liu, Wanghuan Dun, Ming Zhang, Jie Tian
Neuroimaging studies described brain structural changes that comprise the mechanisms underlying individual differences in migraine development and maintenance. However, whether such interindividual variability in migraine was observed in a pretreatment scan is a predisposition for subsequent hypoalgesia to placebo treatment that remains largely unclear. Using T1-weighted imaging, we investigated this issue in 50 healthy controls (HC) and 196 patients with migraine without aura (MO). An 8-week double-blinded, randomized, placebo-controlled acupuncture was used, and we only focused on the data from the sham acupuncture group...
June 13, 2017: Human Brain Mapping
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