Headache Currents最新文献

{"title":"Clinical Science: Treatment of Medication Overuse Headache and Long-term Outcome","authors":"William B. Young M.D.","doi":"10.1111/j.1743-5013.2004.10112.x","DOIUrl":"10.1111/j.1743-5013.2004.10112.x","url":null,"abstract":"<p> <i>Medication overuse headache is an important and challenging problem for clinicians and researchers. The new International Headache Society classification now gives specific limits for medication use based on the number of days of treatment per month. Medication overuse headache is increasingly recognized in children. Triptan overusers have a more migrainous phenotype than overusers of other medications, as well as a shorter period of induction and a milder and more ultimately successful medication withdrawal course. Treatment may involve weaning the overused medications or abrupt discontinuation using a transitional medication for 1 or 2 weeks. Detoxification may be performed in an inpatient or outpatient setting. Repetitive intravenous valproate, prochlorperazine, or lidocaine may be reasonable alternatives to the traditional treatment of metoclopramide and dihydroergotamine. Biofeedback-assisted relaxation training improves outcomes after detoxification at 3 years. Even aggressive treatment is unsuccessful in a significant number of cases.</i> </p>","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 3","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2004-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10112.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89957443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basic Science: Headache Induced by Acute Medication Overuse","authors":"Volker Limmroth \u0000 M.D., Ph.D.\u0000 ,&nbsp;Berndt Liedert \u0000 Ph.D.","doi":"10.1111/j.1743-5013.2004.10111.x","DOIUrl":"https://doi.org/10.1111/j.1743-5013.2004.10111.x","url":null,"abstract":"","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 3","pages":"60-63"},"PeriodicalIF":0.0,"publicationDate":"2004-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10111.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109175261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral and Central Sensitization: Expert Commentary on Selected Abstracts","authors":"Steven B. Graff-Radford \u0000 D.D.S.","doi":"10.1111/j.1743-5013.2004.10108.x","DOIUrl":"10.1111/j.1743-5013.2004.10108.x","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <p>We have previously shown that injection of the inflammatory irritant and small-fiber excitant mustard oil (MO) into the temporomandibular joint (TMJ) region can reflexively induce a prolonged increase in the activity of both digastric and masseter muscles in rats. It is possible that peripheral excitatory amino acid (EAA) receptors play a role in this effect, because MO-evoked increases in jaw muscle activity are attenuated by preapplication of the noncompetitive NMDA receptor antagonist MK-801 into the TMJ region. In the present study, the EAA receptor agonists glutamate, NMDA, kainate, and AMPA were applied locally to the TMJ region. Jaw muscle responses similar to those evoked by MO application to the TMJ region were achieved with glutamate, NMDA, AMPA, and kainate. Repeated application of glutamate, NMDA, or AMPA at intervals of 30 min evoked responses in the ipsilateral jaw muscles that were of comparable magnitude. Co-application of the NMDA receptor antagonist DL-2-amino-5-phosphonovalerate (0.5 μmol) significantly reduced the magnitude of the glutamate- and NMDA-evoked ipsilateral jaw muscle responses without affecting responses evoked by AMPA. In contrast, co-application of the non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (1 nmol) significantly reduced the magnitude of the glutamate- and AMPA-evoked ipsilateral jaw muscle responses without affecting responses evoked by NMDA. This evidence suggests that both NMDA and non-NMDA EAA receptor types are located within the TMJ region and may contribute to jaw muscle activity that can be reflexively evoked from the TMJ region.</p>\u0000 </div>","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 2","pages":"38-41"},"PeriodicalIF":0.0,"publicationDate":"2004-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10108.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78924990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Implication of Trigeminal Sensitization in Acute and Chronic Migraine: A Review","authors":"Richard B. Lipton M.D.,&nbsp;Marcelo E. Bigal M.D., Ph.D.","doi":"10.1111/j.1743-5013.2004.10107.x","DOIUrl":"10.1111/j.1743-5013.2004.10107.x","url":null,"abstract":"<p> <i>It has been proposed that, early in the course of a migraine attack, sensitization of the first order trigeminal nerve occurs manifesting itself in throbbing pain. In 75% of migraine sufferers, eventually sensitization of the second order trigeminal neuron occurs (central sensitization [CS] manifested by cutaneous allodynia [CA]. Studies show that the efficacy of triptans and other acute treatments is much higher if they are given while pain is mild. Other studies suggest that it is the presence of CS/CA that predicts treatment response. Repeated development of CS has been identified as a candidate risk factor for the development of transformed migraine. If so, avoiding CA (therefore avoiding CS) may provide a strategy for preventing headache progression. In this article, we discuss the therapeutic implications of CS in episodic and transformed migraine.</i> </p>","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 2","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2004-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10107.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86254561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Implications of Trigeminal Sensitization in Acute and Chronic Migraine: Expert Commentary on Selected Abstracts","authors":"W. J. Becker \u0000 M.D.","doi":"10.1111/j.1743-5013.2004.10106.x","DOIUrl":"10.1111/j.1743-5013.2004.10106.x","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <p>OBJECTIVE: To evaluate the efficacy and tolerability of sumatriptan, 50-mg and 100-mg tablets, compared with the placebo for the treatment of migraine at the first sign of pain.</p>\u0000 <p>PATIENTS AND METHODS: Two identical multicenter randomized, double-blind, placebo-controlled, single-attack studies were conducted from May through November 2000 in adults (aged 18–65 years). Patients treated migraine at the first sign of pain, while pain was mild, but not more than 2 hours after onset with oral sumatriptan, 50 or 100 mg, or matching placebo. The primary end point was pain-free relief at 2 hours after treatment with 50 mg of sumatriptan compared with placebo.</p>\u0000 <p>RESULTS: There were 354 patients in study 1 and 337 patients in study 2. Significantly more patients treated with sumatriptan, 50 and 100 mg, were completely free from pain 2 and 4 hours after the treatment versus patients treated with placebo (at 2 hours, 50% and 57% vs. 29%; at 4 hours, 61% and 68% vs. 30%; for both, <i>p</i> &lt; 0.001). Also, significantly more patients treated with sumatriptan, 50 and 100 mg, were migraine-free (no pain or associated symptoms) versus those treated with placebo at 2 and 4 hours after the treatment (at 2 hours, 43% and 49% vs. 24%; at 4 hours, 54% and 63% vs. 28%; for both, <i>p</i> &lt; 0.001). The incidence of overall adverse events was low with the 50- and 100-mg dose of sumatriptan (placebo, 7%; sumatriptan at 50 mg, 14%; sumatriptan at 100 mg, 16%).</p>\u0000 <p>CONCLUSIONS: Treatment of migraine at the first sign of pain with sumatriptan, 50-mg and 100-mg tablets, provides superior pain-free relief at 2 and 4 hours after the treatment compared with the placebo. Results of these studies suggest that sumatriptan at 100 mg may be more efficacious than at 50 mg when used in the early treatment paradigm. Because these studies were not powered to detect statistical differences between active doses, studies to investigate this finding are warranted.</p>\u0000 </div>","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 2","pages":"42-46"},"PeriodicalIF":0.0,"publicationDate":"2004-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10106.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78206221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migraine, Sensitization of Trigeminovascular Neurons, and Triptan Therapy","authors":"Rami Burstein Ph.D.,&nbsp;Itay Goor-Aryeh M.D.,&nbsp;Moshe Jakubowski Ph.D.","doi":"10.1111/j.1743-5013.2004.10105.x","DOIUrl":"10.1111/j.1743-5013.2004.10105.x","url":null,"abstract":"","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 2","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"2004-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10105.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74041763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5-HTIF Receptor Agonist","authors":"Marcelo E. Bigal \u0000 MD, PhD","doi":"10.1111/j.1743-5013.2004.10102C.x","DOIUrl":"10.1111/j.1743-5013.2004.10102C.x","url":null,"abstract":"Selective Seratonin 1F (5-HT(1F)) Receptor Agonist LY334370 for Acute Migraine: A Randomised Controlled Trial \u0000 \u0000BACKGROUND: Triptans (5-HT(1B/1D) receptor agonists) are effective drugs for acute migraine, but the side-effect of coronary vasoconstriction restricts their use in patients who are at risk of coronary artery disease. We have studied the efficacy of LY334370, a selective serotonin 1F (5-HT(1F)) receptor agonist with preclinical efficacy and no vasoconstriction, for migraine relief. \u0000 \u0000 \u0000 \u0000METHODS: We gave LY334370 (20, 60, or 200 mg) or placebo to 99 outpatients with moderate or severe migraine headaches in a double blind, parallel group study. We measured efficacy by sustained response, response at 2 h, pain free at 2 h, and sustained pain free. \u0000 \u0000 \u0000 \u0000RESULTS: The proportions of patients with defined endpoints for placebo and LY334370 20, 60, and 200 mg, respectively, were: sustained response, two of 26 (8%), three of 22 (14%), 11 of 30 (37%), and 11 of 21 (52%) (dose response p < 0.001); response, five of 26 (19%), four of 22 (18%), 15 of 30 (50%), and 15 of 21 (71%) (p < 0.001); pain free, one of 26 (4%), none of 22, eight of 30 (27%), and eight of 21 (38%) (p = 0.001); sustained pain free, one of 26 (4%), none of 22, seven of 30 (23%), and seven of 21 (33%) (p = 0.002); recurrence rates, one of five (20%), none of four, four of 15 (27%), and three of 15 (20%). More patients given LY334370 than placebo reported asthenia, somnolence, and dizziness. \u0000 \u0000 \u0000 \u0000CONCLUSION: Our findings show that LY334370 is effective in treatment of acute migraine through selective trigeminovascular neuronal inhibition.","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2004-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10102C.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77221654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GABAA Receptors","authors":"Marcelo E. Bigal \u0000 MD, PhD","doi":"10.1111/j.1743-5013.2004.10102E.x","DOIUrl":"10.1111/j.1743-5013.2004.10102E.x","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <p>METHODS: GABA (gamma-aminobutyric acid) receptors involved in craniovascular nociceptive pathways were characterised by in vivo microiontophoresis of GABA receptor agonists and antagonists onto neurones in the trigeminocervical complex of the cat. Extracellular recordings were made from neurons in the trigeminocervical complex activated by supramaximal electrical stimulation of superior sagittal sinus, which were subsequently stimulated with L-glutamate.</p>\u0000 <p>RESULTS: Cell firing evoked by microiontophoretic application of L-glutamate (n = 30) was reversibly inhibited by GABA in every cell tested (n = 19), the GABA(A) agonist muscimol (n = 10) in all cells tested, or both where tested, but not by iontophoresis of either sodium or chloride ions at comparable ejection currents. Inhibited cells received wide dynamic range (WDR) or nociceptive specific input from cutaneous receptive fields on the face or forepaws. The inhibition of trigeminal neurons by GABA or muscimol could be antagonized by the GABA(A) antagonist N-methylbicuculline, 1(S), 9(R) in all but two cells tested (n = 16), but not by the GABA(B) antagonist 2-hydroxysaclofen (n = 11). 5. R(-)-baclofen, a GABA(B) agonist, inhibited the firing of three out of seven cells activated by L-glutamate. Where tested, this inhibition could be antagonized by 2-hydroxysaclofen. These baclofen-inhibited cells were characterized as having low threshold mechanoreceptor/WDR input.</p>\u0000 <p>CONCLUSION: GABA thus appears to modulate nociceptive input to the trigeminocervical complex mainly through GABA(A) receptors. GABA(A) receptors may therefore provide a target for the development of new therapeutic agents for primary headache disorders.</p>\u0000 </div>","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2004-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10102E.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81671768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CGRP Receptor Antagonists","authors":"Marcelo E. Bigal \u0000 MD, PhD","doi":"10.1111/j.1743-5013.2004.10102A.x","DOIUrl":"10.1111/j.1743-5013.2004.10102A.x","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <p>BACKGROUND: Calcitonin gene-related peptide (CGRP) may have a causative role in migraine. We therefore hypothesized that a CGRP-receptor antagonist might be effective in the treatment of migraine attacks.</p>\u0000 <p>METHODS: In an international, multicenter, double-blind, randomized clinical trial of BIBN 4096 BS, a highly specific and potent nonpeptide CGRP-receptor antagonist, 126 patients with migraine received one of the following: placebo or 0.25, 0.5, 1, 2.5, 5, or 10 mg of BIBN 4096 BS intravenously over a period of 10 minutes. A group-sequential adaptive treatment-assignment design was used to minimize the number of patients exposed.</p>\u0000 <p>RESULTS: The 2.5-mg dose was selected, with a response rate of 66 percent, as compared with 27 percent for placebo (P = 0.001). The BIBN 4096 BS group as a whole had a response rate of 60 percent. Significant superiority over placebo was also observed with respect to most secondary end points: the pain-free rate at 2 hours; the rate of sustained response over a period of 24 hours; the rate of recurrence of headache; improvement in nausea, photophobia, phonophobia, and functional capacity; and the time to meaningful relief. An effect was apparent after 30 minutes and increased over the next few hours. The overall rate of adverse events was 25 percent after the 2.5-mg dose of the drug and 20 percent for the BIBN 4096 BS group as a whole, as compared with 12 percent for placebo. The most frequent side effect was paresthesia. There were no serious adverse events.</p>\u0000 <p>CONCLUSIONS: The CGRP antagonist BIBN 4096 BS was effective in treating acute attacks of migraine.</p>\u0000 </div>","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2004-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10102A.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86953215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5-HT1F","authors":"F. Michael Cutrer M.D.","doi":"10.1111/j.1743-5013.2004.10101C.x","DOIUrl":"https://doi.org/10.1111/j.1743-5013.2004.10101C.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Possible Antimigraine Mechanisms of Action of the 5HT1F Receptor Agonist LY334370</h3>\u0000 \u0000 \u0000 \u0000 <p>This study investigated whether the selective 5HT1F receptor agonist LY334370 has other possible antimigraine mechanisms in addition to the proposed inhibition of dural plasma extravasation. LY334370 (up to 10(−5) M) had no vasoconstrictor effects on human cerebral arteries in vitro. It had no effect (up to 10 mg kg-1, i.v.) on neurogenic vasodilation of dural blood vessels produced by electrical stimulation of the dura mater in anesthetized rats. Nor had it any effect (at 3 mg kg-1, i.v.) on the hyperalgesia produced by injection of carrageenan into the paw of conscious rats or on nociceptive reflex responses in the spinalized, decerebrate rabbit (up to 3 mg per kg, i.v.), indicating that it has no general analgesic properties. However, it significantly inhibited activation of second-order neurons in the trigeminal nucleus caudalis produced by electrical stimulation of the dura mater in anesthetized rats at 3 mg per kg, i.v. These results provide evidence to suggest that LY334370 has a central mechanism of action in blocking the transmission of nociceptive impulses within the trigeminal nucleus caudalis and that this may represent a mechanism through which it has its antimigraine effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Novel Potent 5-HT(1F) Receptor Agonists: Structure-Activity Studies of a Series of Substituted N-[3-(1-methyl-4-piperidinyl)-1H-pyrrolo[3,2-b]pyridin-5-yl]amides</h3>\u0000 \u0000 \u0000 \u0000 <p>Compound 1a (LY334370), a selective 5-HT(1F) receptor agonist (SSOFRA), inhibited dural inflammation in the neurogenic plasma protein extravasation model of migraine and demonstrated clinical efficacy for the acute treatment of migraine. Although 1a was greater than 100-fold selective over both the 5-HT(1B) and 5-HT(1D) receptors, it exhibited appreciable 5-HT(1A) receptor affinity. Described here is the synthesis and evaluation of a series of pyrrolo[2,3-c]pyridine and pyrrolo[3,2-b]pyridine (2a and 3a) as well as pyrrolo[3,2-d]pyrimidine (4a) analogues of 1a, compounds prepared in an effort to identify SSOFRAs with improved selectivity over other 5-HT(1) receptor subtypes. The pyrrolo[3,2-b]pyridine analogue 3a showed high 5-HT(1F) receptor affinity but offered no improvement in selectivity compared to 1a. However, the C-5 acetamide derivative, 3b, was greater than 100-fold selective over the 5-HT(1A), 5-HT(1B), and 5-HT(1D) receptors. SAR studies of this series determined that alkylamides in particular exhibited high selectivity for the 5-HT(1F) receptor. Replacement at C-5 with other substituents decreased affinity or selectivity. These SAR studies identified SSOFRAs that demonstrated oral activity in the neurogenic plasma protein extravasation model, a m","PeriodicalId":100600,"journal":{"name":"Headache Currents","volume":"1 1","pages":"16-17"},"PeriodicalIF":0.0,"publicationDate":"2004-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1743-5013.2004.10101C.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109165451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}