Cephalalgia最新文献

{"title":"Neurotransmitter-related functional connectivity changes in serotonin and dopamine systems after mindfulness in medication overuse headache.","authors":"Davide Fedeli, Giuseppe Ciullo, Greta Demichelis, Jean Paul Medina Carrion, Maria Grazia Bruzzone, Emilio Ciusani, Alessandra Erbetta, Stefania Ferraro, Marina Grisoli, Erika Guastafierro, Danilo Antonio Montisano, Domenico D'Amico, Alberto Raggi, Anna Nigri, Licia Grazzi","doi":"10.1177/03331024251332561","DOIUrl":"https://doi.org/10.1177/03331024251332561","url":null,"abstract":"<p><p>Background/HypothesisMindfulness practice has gained attention in managing chronic migraine with medication overuse headache (CM-MOH), showing clinical improvements and functional connectivity reorganization. However, the relationship between these effects and the underlying neurotransmitter systems remains unexplored.MethodsThirty-four CM-MOH patients were divided into treatment as usual (TaU, <i>N</i> = 17) and mindfulness-added-to-TaU (TaU + MIND, <i>N</i> = 17) groups. Participants underwent resting-state fMRI scans before treatment and after one year. We adopted the neurotransmitter-related functional connectivity framework to investigate longitudinal functional changes associated with the distribution of serotonin, dopamine, and norepinephrine systems by comparing TaU + MIND with TaU groups.ResultsWhen compared with TaU, TaU + MIND patients longitudinally showed increased serotonin-enriched functional connectivity in the caudate and accumbens nuclei, and increased dopamine-enriched functional connectivity in the right insular cortex.Conclusion/InterpretationThese regions are involved in emotional, cognitive, and sensory modulation of pain and addiction. Our findings suggest the impact of mindfulness practice on serotonin and dopamine systems with potential beneficial effects in chronic pain management.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251332561"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of app- and internet-delivered headache interventions: From ideation to implementation and the future.","authors":"Anker Stubberud, Mattias Linde, Erling Tronvik","doi":"10.1177/03331024251348651","DOIUrl":"https://doi.org/10.1177/03331024251348651","url":null,"abstract":"<p><p>BackgroundThere is an increasing trend in the use of the internet and smartphone applications to deliver headache interventions. However, their efficacies remain unclear. Moreover, developing such interventions can be cumbersome and increasingly challenging when navigating the regulatory landscape of medical devices. The present study aimed to review the literature on internet- and app-based headache interventions and discuss opportunities and challenges in the process of developing such interventions.MethodsThis narrative review was based on a comprehensive literature search of PubMed. Publications investigating internet- and app-delivered interventions for headache disorders were identified, systematically assessed and summarised.ResultsInternet- and app-delivered interventions were mainly applied to deliver behavioural change techniques and relaxation training, coordinate management plans with patients, and promote medication adherence. Eleven randomised controlled trials, including two large-scale studies, did not demonstrate clear superiority of internet-delivered behavioural therapy over other therapies or waitlist control. Internet-delivered relaxation training trials might be more promising; however, they are old and less robust. Most studies investigating app-delivered behavioural therapy and relaxation training are pilot and feasibility trials, making it difficult to conclude their efficacy. Using the Internet and apps to manage care plans and promote medication adherence seems feasible, resulting in positive impacts on individual disease burden, health care and societal costs. However, these applications require further investigation.ConclusionsWe discussed important aspects of the conceptualisation, design and development of internet- and app-delivered interventions for headaches and provided specific recommendations to develop these interventions. Thereafter, we described and discussed the regulatory pathways for software interventions, which, in most cases, are considered medical devices and are subject to stringent regulations. Adhering to these regulations and creating a usable intervention with the evidence of efficacy established through robust clinical trials is time-consuming and requires medical, technological and regulatory knowledge.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251348651"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting excellence in scientific peer review: The Cephalalgia Reviewer Academy.","authors":"Simona Sacco","doi":"10.1177/03331024251346916","DOIUrl":"https://doi.org/10.1177/03331024251346916","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251346916"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity with fibromyalgia predicted poorer outcomes in patients with chronic migraine on flunarizine: Prospective proof-of-concept study.","authors":"Yu-Hsiang Ling, Li-Ling Hope Pan, Shih-Pin Chen, Wei-Ta Chen, Hung-Yu Liu, Shuu-Jiun Wang, Yen-Feng Wang","doi":"10.1177/03331024251353412","DOIUrl":"https://doi.org/10.1177/03331024251353412","url":null,"abstract":"<p><p>AimFibromyalgia (FM) and chronic migraine (CM) are commonly comorbid. Clinical observations suggest patients with chronic migraine comorbid with fibromyalgia (CMFM) seem less responsive to migraine preventive treatment; however, evidence is still lacking. This study examined the responsiveness to migraine preventive treatment in patients with CM and CMFM.MethodsPatients with CM and CMFM were prospectively recruited. None of them received migraine prevention prior to participation. Both groups were administered with flunarizine as migraine prevention and were asked to keep headache diaries. The CMFM group received additional standard treatment for FM concomitantly, predominately pregabalin. Treatment response was defined as ≧50% reduction in monthly headache days (MHDs) at the third month post-treatment compared with baseline.ResultsEighty-four patients with CM (38.3 ± 11.5 years old, 93% female) and 38 with CMFM (40.2 ± 11.3 years old, 87% female) finished the study for final analyses. CMFM had more MHD and higher levels of depression and anxiety at baseline. After treatment, CM demonstrated better treatment outcomes (50% responder rate 52% vs. 32%, <i>p</i> = 0.033). The presence of FM in patients with CM increased the odds of non-converter to EM after controlling for baseline MHD using a logistic regression model (OR: 2.8 [1.1-7.1], <i>p</i> = 0.027). Comorbid FM in patients with CM showed limited improvement despite receiving standard treatments for both conditions.ConclusionThis proof-of-concept research underscores the importance of clinicians recognizing FM in patients with CM since they are prone to poor responses to treatment.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251353412"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortical thickness studies in migraine: Current evidence and future directions.","authors":"Basit Ali Chaudhry, Samaira Younis, Roberta Messina, David García-Azorín, Nazia Karsan, Gianluca Coppola, Rune Häckert Christensen, Mohammad Mahdi Al-Karagholi, Patricia Pozo-Rosich, Faisal Mohammad Amin","doi":"10.1177/03331024251341204","DOIUrl":"https://doi.org/10.1177/03331024251341204","url":null,"abstract":"<p><p>BackgroundStructural imaging offers insight into migraine pathogenesis. Magnetic resonance imaging (MRI) morphometry plays a crucial role in identifying these alterations, yet the clinical significance remains debated. While gray matter volume and cortical curvature are commonly analyzed, cortical thickness offers a more direct measure of cytoarchitectural differences and neuroplastic changes in migraine. Advanced structural MRI techniques, including surface-based morphometry and voxel-based morphometry, have provided insights into cortical thickness alterations in migraine. These methods enable high-resolution assessment of brain morphometry, revealing dynamic changes associated with migraine phases and treatment.MethodsThis narrative review synthesizes findings from cortical thickness studies, focusing on methodological approaches, variations in imaging sequences and study designs, including cross-sectional and longitudinal studies.ResultsStudies using surface-based morphometry (i.e. SBM) and voxel-based morphometry (i.e. VBM) have reported inconsistent findings. Increased thickness is frequently observed in pain-processing regions, such as the somatosensory cortex, insula and anterior cingulate cortex reflecting hyperexcitability or maladaptive neuroplasticity. by contrast, cortical thinning has been noted in regions such as the orbitofrontal cortex, posterior cingulate cortex and visual cortex, suggesting neuronal loss or impaired cortical integrity. Differences between episodic and chronic migraine further highlight progressive structural changes associated with disease burden. Emerging evidence also suggests that preventive treatments, including calcitonin gene-related peptide monoclonal antibodies and botulinum toxin A, may reverse some of these cortical alterations, particularly in treatment responders.ConclusionsCortical thickness analysis provides valuable insights into migraine pathophysiology, offering a potential biomarker for disease progression and treatment response. However, inconsistencies across studies highlight the need for standardized MRI protocols and larger longitudinal investigations to clarify the clinical relevance of cortical thickness changes in migraine.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251341204"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective cohort study of anti-CGRP monoclonal antibody unresponsive migraine individuals treated with atogepant: The RESCUE study.","authors":"Alex Jaimes, Jaime Rodríguez-Vico, Olga Pajares, Ignacio Eguilior Caffarena, Anna Lena Nystrom Hernández, Andrea Gómez, Jesús Porta-Etessam","doi":"10.1177/03331024251346925","DOIUrl":"https://doi.org/10.1177/03331024251346925","url":null,"abstract":"<p><p>BackgroundA subset of individuals with episodic migraine (EM) and chronic migraine (CM) does not respond to anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs), even after switching agents. Although atogepant is effective in EM and CM, its role in individuals unresponsive to anti-CGRP mAbs remains to be elucidated. We hypothesize that atogepant may be a viable preventive option in these cases.MethodsWe conducted a retrospective cohort study in EM and CM individuals who discontinued anti-CGRP mAbs due to lack or loss of efficacy and were subsequently treated with atogepant. The primary endpoint was the ≥50% response rate in monthly headache days (MHDs). Secondary outcomes included ≥30% and ≥75% response rates in MHDs, response rates in monthly moderate-to-severe headache days (MSHDs), and changes in MHDs, MSHDs, acute medication days (AMDs) and Headache Impact Test (HIT-6). Patient Global Impression (PGI) scores and adverse events (AEs) were recorded.ResultsOf 213 screened records, 44 participants met inclusion criteria; 39 (88.6%) were female and 39 (88.6%) had CM. Prior use of anti-CGRP mAbs included erenumab in 11.4% of participants, galcanezumab in 52.3% and fremanezumab in 86.3%. After three months, 18.2% achieved a ≥50% reduction in MHDs; ≥30% and ≥75% response rates were 25.0% and 6.8% respectively. For MSHDs, ≥30%, ≥50% and ≥75% response rates were 47.6%, 33.3% and 19.0%, respectively. Median MHDs decreased from 24.5 (interquartile range (IQR) = 16.0-30.0; range 9.0-31.0) to 21.5 (IQR = 10.0-30.0; range 3.0-31.0; <i>p</i> = 0.011), and median MSHDs from 15.0 (IQR = 10.0-25.5; range 5.0-30.0) to 12.0 (IQR = 5.9-19.0; range 0.0-30.0; <i>p</i> = 0.001). AMDs and HIT-6 scores also showed significant reductions. According to the PGI scale, 59.1% of individuals reported some degree of improvement. AEs occurred in 50.0% of participants, most commonly constipation (31.8%). Five (11.4%) participants discontinued treatment due to side effects.ConclusionsAfter three months of treatment, atogepant led to a clinically meaningful improvement in a subset of participants. It may be a valuable preventive option for individuals unresponsive to anti-CGRP mAbs and warrants further investigation in prospective studies.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251346925"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher socioeconomic status is associated with dispensation of monoclonal antibodies against calcitonin gene-related peptide in migraine: A nested case-control study.","authors":"Therese Wennersten, Jonatan D Lindh, A Ingela M Nilsson Remahl, Marine L Andersson, Mia von Euler, Karin Wirdefeldt, Isabella Ekheden","doi":"10.1177/03331024251348648","DOIUrl":"https://doi.org/10.1177/03331024251348648","url":null,"abstract":"<p><p>BackgroundHigher socioeconomic status (SES) among people with migraine has been associated with an increased use of triptans, but it is undetermined whether high SES is also associated with dispensation of monoclonal antibodies against calcitonin gene-related peptide (CGRPi), a prophylactic treatment against migraine episodes. Our hypothesis was that higher SES is associated with CGRPi dispensation, although the association is expected to be attenuated in a country that generally allows for reimbursement of CGRPi costs.MethodsIn this register-based nested case-control study, the association between SES, categorized into three levels (low, middle and high) and the outcome of a first dispensation of a CGRPi was assessed among people with a migraine diagnosis in Region Stockholm, using univariable and multivariable logistic regression models.ResultsOf 52,996 individuals in the study population, 3.2% (n = 1674) were dispensed CGRPi. Individuals with high or middle SES had an increased probability of being dispensed CGRPi, compared to individuals with low SES (adjusted odds ratio = 1.68; 95% confidence interval = 1.46-1.92 and adjusted odds ratio = 1.41; 95% confidence interval = 1.24-1.61, respectively).ConclusionsHigher SES was associated with dispensation of CGRPi, which suggests unequal access to CGRPi.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251348648"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of calcitonin gene-related peptide monoclonal antibody use in people with migraine: Results of the OVERCOME (US) study.","authors":"Sait Ashina, Gilwan Kim, E Jolanda Muenzel, Dawn C Buse, Anthony J Zagar, Armen Zakharyan, Robert E Shapiro, Robert A Nicholson, Eric M Pearlman, Richard B Lipton","doi":"10.1177/03331024251341243","DOIUrl":"https://doi.org/10.1177/03331024251341243","url":null,"abstract":"<p><p>BackgroundUnderstanding characteristics and reasons associated with using calcitonin gene-related peptide monoclonal antibodies (CGRP mAb) for migraine prevention may help clinicians individualize treatment plans and achieve better patient outcomes.MethodsWe analyzed 2019-2020 cohort data of OVERCOME (US), a population-based survey among adults with migraine. Eligible participants were categorized based on current CGRP mAb usage (\"NEVER\" and \"EVER\" users [\"Continued\", \"Switched\" and \"Discontinued\"]). Machine learning techniques followed by logistic regression were used to examine, among 60 sociodemographic, clinical, migraine-related- and migraine treatment utilization characteristics, those associated with CGRP mAb use status.ResultsOf 39,113 participants, 25.6% had ever used migraine preventive medication(s) and 5.0% used CGRP mAbs (of which 46.1% Continued, 14.7% Switched and 39.3% Discontinued). Top factors associated with higher odds of CGRP mAb EVER vs. NEVER use were currently using recommended acute medication (odds ratio (OR) = 2.43; 95% confidence interval (CI) = 2.09-2.82) and contraindications for triptan use (OR = 2.32; 95% CI = 2.06-2.60). Continuing use vs. switching or discontinuing was most associated with current use of botulinum toxin for migraine (OR = 2.21; 95% CI = 1.42-3.44 and OR = 4.53; 95% CI = 3.14-6.55, respectively).ConclusionsAt the time of survey, CGRP-targeted mAbs remain underutilized for migraine and multiple characteristics are associated with CGRP mAb use patterns.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251341243"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No additional benefit with detoxification strategies: A real world experience in 200 patients with chronic migraine and either simple or complex MOH treated with CGRP monoclonal antibodies.","authors":"Marcello Silvestro, Ilaria Orologio, Pasquale Sozio, Valentina Dortucci, Francesca Trojsi, Mattia Siciliano, Gioacchino Tedeschi, Alessandro Tessitore, Antonio Russo","doi":"10.1177/03331024251329808","DOIUrl":"10.1177/03331024251329808","url":null,"abstract":"<p><p>BackgroundAlthough withdrawal from analgesics with or without detoxification strategy represented a mainstay in medication overuse headache (MOH) management, recent evidence supports that it is no longer beneficial when CGRP-targeting monoclonal antibodies (CGRP-mAbs) are employed. However, MOH could be stratified into simple and complex MOH phenotypes according to different clinical parameters (i.e., amounts and class of analgesics, psychiatric comorbidities, history of relapse after withdrawal, symptoms of central sensitization, and maladaptive anticipatory response to pain experience). Herein, we explored the effectiveness of CGRP-mAbs plus detoxification strategy compared to CGRP- mAbs preventive treatment alone in patients with either simple or complex MOH phenotypes.MethodsThis is a six-month observational study including chronic migraine patients with MOH treated with subcutaneous CGRP-mAbs. Patients were stratified based on both MOH complexity and detoxification strategy to evaluate differences in the changes of monthly headache days, pain intensity and duration, and monthly days with acute medication intake after the first, third and sixth month of preventive treatment with CGRP-mAbs.ResultsTwo hundred patients with migraine and MOH were recruited. A significant reduction of headache attacks frequency, intensity, duration and monthly days with acute medication intake has been observed both in patients sub-classified as complex MOH (58.5%) and in those with simple MOH (41.5%) after the first, third and sixth month of preventive treatment with CGRP-mAbs (p < 0.001). Furthermore, stratifying patients based on the MOH complexity and detoxification strategy, no differences were found in the reduction of monthly headache days as well as in other parameters of disease severity (p > 0.05).ConclusionOur findings might suggest a change in the mind-set of clinicians, still considering the withdrawal with or without detoxification strategy as a \"conditio sine qua non\" in patients with MOH, towards a novel approach where the reduction of analgesics intake represents the natural consequence of CGRP-mAbs effectiveness.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251329808"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Painful nervus intermedius neuropathy attributed to Bell's palsy: The need for independent diagnostic criteria.","authors":"Umberto Pensato, Raffaele Ornello","doi":"10.1177/03331024251340059","DOIUrl":"https://doi.org/10.1177/03331024251340059","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251340059"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}