Cephalalgia最新文献

{"title":"Longitudinal analysis of pain-induced brain activations in post-traumatic headache.","authors":"Dohyun Ku, Lingchao Mao, Simona Nikolova, Gina M Dumkrieger, Katherine B Ross, Matthew Huentelman, Trent Anderson, Frank Porreca, Edita Navratilova, Amaal Starling, Teresa Wu, Jing Li, Catherine D Chong, Todd J Schwedt","doi":"10.1177/03331024251345160","DOIUrl":"https://doi.org/10.1177/03331024251345160","url":null,"abstract":"<p><p>BackgroundHeadache is a common symptom following mild traumatic brain injury (mTBI). Post-traumatic headache (PTH), a secondary headache disorder that develops after mTBI, often persists for months or years. To identify potential recovery mechanisms and prognostic biomarkers, the present study investigated whether longitudinal changes in pain-induced brain activation differ between healthy controls (HC) and PTH participants showing headache improvement and those without improvement.MethodsThirty-three participants who met International Classification of Headache Disorders, 3rd edition, criteria for acute PTH within 59 days post-mTBI and 33 HC participants were included with no significant differences in demographics. All participants underwent functional magnetic resonance imaging scans at baseline, four weeks, and 16 weeks post-enrollment using a thermal stimulation paradigm with noxious and non-painful heat stimuli. 'Painful vs. Non-Painful Heat' contrasts were generated using SPM12. PTH improvement was assessed at three months post-enrollment via electronic headache diaries. Two-sample <i>t</i>-tests compared the brain activation between HC and PTH at baseline. Linear mixed-effects models examined longitudinal changes for HC, PTH improvement and non-improvement groups across visits. Generalized linear models compared these groups within visits.ResultsBaseline analysis revealed several regions with significantly higher activation in acute PTH compared to HC, including bilateral postcentral gyrus, right superior temporal gyrus, right middle temporal gyrus, left inferior parietal gyrus, right superior parietal gyrus, left ventral striatum, left olfactory cortex, left gyrus rectus, and left middle occipital gyrus. Over time, the PTH improvement group demonstrated progressive normalization across all identified brain regions, whereas the non-improvement group showed only partial normalization in left ventral striatum, left olfactory cortex, and left gyrus rectus. Sustained elevated activation in specific regions distinguished PTH participants without headache improvement from those with headache improvement, suggesting potential biomarkers for persistent PTH.ConclusionsOur findings demonstrate significantly altered pain-induced brain activations in participants with acute PTH compared to HC. Longitudinal analysis revealed distinct recovery trajectories: progressive normalization in the improvement group versus persistent alterations in the non-improvement group. These neuroimaging patterns may serve as biomarkers for identifying individuals at risk for persistent PTH, with implications for early intervention and personalized treatment approaches.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251345160"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157200","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":"Raising the bar in migraine prevention: Toward freedom and optimal control.","authors":"Antonio Russo, Uwe Reuter","doi":"10.1177/03331024251331198","DOIUrl":"https://doi.org/10.1177/03331024251331198","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251331198"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092673","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":"Comment on: Setting higher standards for migraine prevention: A position statement of the International Headache Society.","authors":"Alessandra Sorrentino, Cherubino Di Lorenzo","doi":"10.1177/03331024251343217","DOIUrl":"https://doi.org/10.1177/03331024251343217","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251343217"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126718","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":"Serum GFAP and NfL levels in migraine: A registry for migraine (REFORM) study.","authors":"Emil Gozalov, William K Karlsson, Rune H Christensen, Haidar M Al-Khazali, Malene B Hansen, Dorte A Olsen, Helle B Søndergaard, Finn Sellebjerg, Jonna S Madsen, Messoud Ashina, Håkan Ashina","doi":"10.1177/03331024251338178","DOIUrl":"https://doi.org/10.1177/03331024251338178","url":null,"abstract":"<p><p>ObjectiveTo determine whether serum glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) concentrations differ between adults with migraine and healthy controls.MethodsThis single-center, cross-sectional study was conducted from September 2020 to June 2022. Adults diagnosed with migraine and healthy controls were enrolled. Serum GFAP and NfL concentrations were quantified using an ultra-sensitive single-molecule array platform. Analyses were adjusted for potential confounders, including age, sex, body mass index and smoking status.ResultsWe assessed serum samples from 603 participants with migraine and 154 controls. Serum GFAP concentrations were 6.8% higher in the overall migraine group compared to controls (95% confidence interval = 0.4-13.5%; <i>P</i> = 0.036). Conversely, serum NfL concentrations did not differ between participants with migraine and controls (difference: -1.4%; 95% confidence interval = -7.9 to 5.6%; <i>p</i> = 0.68). Neither serum GFAP, nor NfL concentrations varied according to migraine subtype or headache status at the time of blood sampling.ConclusionsOur findings demonstrate a modest yet statistically significant increase in serum GFAP among adults with migraine, independent of migraine subtype, whereas serum NfL levels were comparable to those of controls. Further research is needed to clarify the neurobiological mechanisms underlying elevated serum GFAP in migraine.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251338178"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126744","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":"Effects of substance P on headache induction and arterial dilation in healthy adults.","authors":"Haidar M Al-Khazali, Rune H Christensen, Emil Gozalov, Zahra Hakimzadeh, Anna G Melchior, Rogelio Dominguez-Moreno, Messoud Ashina, Håkan Ashina","doi":"10.1177/03331024251336132","DOIUrl":"10.1177/03331024251336132","url":null,"abstract":"<p><p>ObjectiveTo determine whether intravenous infusion of substance P elicits headache and arterial dilation in healthy adults.MethodsIn a double-blind, placebo-controlled, two-way crossover study, we randomly allocated healthy adults to receive either substance P (1.5 pmol/kg/min) or placebo (isotonic saline) by 20-minute intravenous infusion on separate experiment days. The primary endpoint was the incidence of headache within 12 hours after the infusion. Other endpoints included the area under the curve (AUC) for headache intensity scores over the 12-hour observation period and AUC changes in the superficial temporal artery (STA) diameter from baseline to 120 minutes post-infusion.ResultsTwenty-one participants underwent randomization and completed both experiment days. Headache was reported by 15 (71%) of 21 participants following substance P, compared with two (10%) after placebo (<i>p </i>< 0.001). The AUC for headache intensity scores was significantly higher after substance P infusion than after placebo (<i>p </i>= 0.03). In addition, there was a significant STA diameter increase with substance P, compared with placebo (<i>p </i>= 0.005).ConclusionsAmong healthy adults, substance P infusion elicited headache and arterial dilation. These findings support a role for substance P in headache pathogenesis and encourage further investigation in migraine and other headache disorders. Additional research is also needed to explore new therapeutic strategies targeting substance P or its downstream signaling.Trial Registration:CT identifier: NCT06632080.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251336132"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076346","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":"Amylin and the amylin receptors in migraine: Is there another pathway to target?","authors":"David Moreno-Ajona, Helin Gosalia, Jan Hoffmann, Peter J Goadsby","doi":"10.1177/03331024251340066","DOIUrl":"https://doi.org/10.1177/03331024251340066","url":null,"abstract":"<p><p>Here, we review the available evidence implicating amylin in migraine, its relationship with calcitonin gene-related peptide (CGRP) and its potential utility as a therapeutic target. The pathophysiology of migraine is currently better understood and the role of CGRP is key. Treatments targeting this pathway have been successful and migraine is a complex disorder, with so many molecules being implicated. Amylin, as for CGRP, is part of the calcitonin/CGRP peptide family. Some therapies intended to block the CGRP pathway can also target amylin receptors. Similar to CGRP, amylin can trigger migraine attacks in a provocation study. Amylin plasma levels have been highlighted as a potential migraine biomarker in one study in migraine patients. Moreover, some preclinical studies in rodents have also discussed sex differences. Comprehending the distinct and overlapping mechanisms between amylin and CGRP signalling could develop further our understanding of migraine pathophysiology. In summary, this review reveals, through initial studies, that targeting the amylin pathway may have a potential role as a novel treatment option for those who may not respond to other treatments, or as a better alternative.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251340066"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101430","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":"Intact white matter in adults with migraine: A REFORM MRI study.","authors":"Cédric Gollion, Håkan Ashina, Rune Häckert Christensen, Haidar M Al-Khazali, Daniel Tolnai, Messoud Ashina, Faisal Mohammad Amin","doi":"10.1177/03331024251339423","DOIUrl":"https://doi.org/10.1177/03331024251339423","url":null,"abstract":"<p><p>BackgroundDiffusion tensor imaging (DTI) provides valuable insights into the white matter integrity of people with migraine. The present study compares the microstructural white matter integrity between a large sample of people with migraine and healthy controls, as well as across different migraine subtypes.MethodsThis cross-sectional case-control study included adults with migraine and age- and sex-matched healthy controls. Each participant and control underwent a single brain magnetic resonance imaging session, including DTI, to assess microstructural white matter integrity using tract-based spatial statistics by voxel-wise comparison using a general linear model (GLM). The DTI outcome measures included fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity. Comparisons were made between participants with migraine and controls, as well as among different migraine subtypes (migraine with aura, migraine without aura, episodic migraine and chronic migraine). Additional comparisons were conducted between participants during and outside of migraine attacks, as well as between hemispheres ipsilateral and contralateral to the pain side in those scanned during unilateral migraine attacks.ResultsIn total, 293 participants with migraine and 154 healthy controls provided DTI data eligible for analysis. Among the participants, 181 (61.7%) had chronic migraine, 103 (35.1%) had migraine with aura and 79 (26.9%) were scanned during a migraine attack. No significant differences in white matter integrity were identified between participants with migraine and controls, nor among the different migraine subtypes.ConclusionsOur results suggest that migraine does not result in microstructural alterations within the cerebral white matter. Further research is necessary to explore other potential radiologic biomarkers and pathophysiologic mechanisms underlying migraine.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251339423"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179745","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":"Behavioral, non-pharmacological intervention modalities to alleviate persistent headache attributable to traumatic brain injury: A systematic review of patient pain outcomes in the context of the mutual maintenance model.","authors":"Elizabeth M Sanford, Kristin N Sramek, Donald D McGeary, Paul S Nabity","doi":"10.1177/03331024251341237","DOIUrl":"10.1177/03331024251341237","url":null,"abstract":"<p><p>BackgroundPersistent post-traumatic headache (PPTH) is a disabling sequela of traumatic brain injury (TBI). Many individuals seek behavioral interventions to supplement pharmacological treatment. This systematic review describes behavioral interventions for treatment of PPTH and psychosocial factors related to outcomes in adults.MethodsA systematic search for behavioral interventions for adult patients who suffered headache attributable to mild TBI was conducted across PubMed, CINAHL, Scopus, PsycINFO and Cochrane Library in June 2024. Studies were excluded if they (a) did not evaluate outcomes related to PPTH pain; (b) evaluated pediatric populations; (c) used animal models; (d) evaluated interventions other than behavioral modalities; and (e) TBI was moderate or severe. Risk of bias was assessed for included randomized controlled trials (RCTs) using Cochrane's Risk of Bias II (RoB2).ResultsThe search and evaluation process identified 12 articles evaluating 2293 individuals with PPTH. Study designs included randomized controlled trials (n = 4) and observational studies (n = 8). Behavioral intervention modalities included cognitive behavioral therapy (n = 5), education/counseling (n = 3), exercise (n = 2) and integrated managed care (n = 2). Three included RCTs were assessed to have low risk of bias and one had some concerns of potential bias.ConclusionsCognitive behavioral interventions within interdisciplinary systems of care may be the optimal combination. Mutual maintenance may explain and contextualize the high comorbidity between PPTH and affective distress. Treatment for PPTH in adults with mild TBI should incorporate treatment for psychological distress.Trial RegistrationThis systematic review was registered in Prospero (CRD42024556014).</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251341237"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126714","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":"Effectiveness of transcranial direct current stimulation and monoclonal antibodies acting on the CGRP as a combined treatment for migraine (TACTIC): Results of a randomized controlled trial.","authors":"Raffaele Ornello, Aurora D'Atri, Roberto De Icco, Federico De Santis, Chiara Rosignoli, Agnese Onofri, Gloria Vaghi, Francescantonio Cammarota, Carla Brancaccio, Michele Corrado, Federico Bighiani, Valentina Grillo, Grazia Sances, Domenico Corigliano, Federico Salfi, Cristina Tassorelli, Michele Ferrara, Simona Sacco","doi":"10.1177/03331024251325567","DOIUrl":"10.1177/03331024251325567","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundMigraine pathogenesis involves both central and peripheral mechanisms. Although calcitonin gene-related peptide monoclonal antibodies have shown efficacy over placebo in migraine prevention, a proportion of individuals with migraine may experience a substantial residual burden while on treatment. Transcranial direct current stimulation is a non-invasive neuromodulation technique that can target central migraine mechanisms and may therefore complement calcitonin gene-related peptide monoclonal antibodies. The present study aimed to assess the efficacy of transcranial direct current stimulation as an adjunctive treatment to calcitonin gene-related peptide monoclonal antibodies in migraine prevention and to investigate its neurophysiological effects.MethodsThis is a multicenter, randomized double-blind, sham-controlled, parallel-group trial including subjects with migraine on treatment with calcitonin gene-related peptide monoclonal antibodies for ≥90 days and with ≥8 monthly migraine days in the last 30 days. Subjects were randomized to active or sham transcranial direct current stimulation. The transcranial direct current stimulation protocol consisted of five daily 20-minute sessions of bilateral cathodal stimulation on the occipital area and anodal stimulation on the M1 area. High-density electroencephalographic recordings were performed before the first and after the last transcranial direct current stimulation session. The primary endpoint was the number of headache days during the 28-day follow-up period controlling for the 28-days baseline value. Secondary endpoints included the number of migraine days during the follow-up period, disability measures and electroencephalographic spectral power. The active and sham groups were compared using analysis of covariance. For clinical outcomes with significant differences between groups, we also ran paired &lt;i&gt;t&lt;/i&gt;-tests comparing baseline and follow-up assessment within groups.ResultsThirty participants were randomized (15 to active and 15 to sham group). Headache days during the 28-day follow-up period did not differ significantly between groups (&lt;i&gt;p&lt;/i&gt; = 0.560, η&lt;sub&gt;p&lt;/sub&gt;&lt;sup&gt;2 &lt;/sup&gt;= 0.017). However, participants receiving active transcranial direct current stimulation reported fewer migraine days during follow-up compared to the sham group (&lt;i&gt;p&lt;/i&gt; = 0.008, η&lt;sub&gt;p&lt;/sub&gt;&lt;sup&gt;2 &lt;/sup&gt;= 0.241). Paired &lt;i&gt;t&lt;/i&gt;-tests indicated that the active tDCS group reported a reduction in migraine days during the follow-up period compared to baseline (&lt;i&gt;t&lt;/i&gt; = 2.557, &lt;i&gt;p&lt;/i&gt; = 0.023, Cohen's &lt;i&gt;d&lt;/i&gt; = 0.660), while no difference was found in the sham group. Referring to neurophysiological endpoints, active transcranial direct current stimulation induced a significant decrease in delta power at frontal regions compared to sham.ConclusionsThis randomized-controlled trial suggests that transcranial direct current stimulation is a promising potentially effective treatment that may give a","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251325567"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092598","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":"OnabotulinumtoxinA treatment for chronic migraine in pregnancy: An updated report of real-world headache and pregnancy outcomes over 14 years in Hull.","authors":"Ho Tin Wong, Rafiullah Khan, Alina Buture, Modar Khalil, Fayyaz Ahmed","doi":"10.1177/03331024251327387","DOIUrl":"https://doi.org/10.1177/03331024251327387","url":null,"abstract":"<p><p>BackgroundOnabotulinumtoxinA is widely used for patients with chronic migraine, but its safety and efficacy in pregnancy remain unclear. In 2020, we published a report of 45 subjects who became pregnant on OnabotulinumtoxinA treatment for chronic migraine. Although numbers were small, the results suggested that OnabotulinumtoxinA treatment was effective in pregnancy without evidence of adverse pregnancy outcome. We now have an additional 81 subjects to add to the database.MethodThis is a tertiary centre (Hull) prospective study between 2010-2024. Subjects who became pregnant during treatment with OnabotulinumtoxinA for chronic migraine were recruited. Subjects were provided informed consent whether to continue treatment with OnabotulinumtoxinA. All subjects were followed up 12-weekly with headache and pregnancy outcomes collected.ResultsBetween 2010-2024, 126 subjects became pregnant during OnabotulinumtoxinA treatment for chronic migraine. Of these, 97/126 (77.0%) opted to continue treatment with OnabotulinumtoxinA. All 97/97 (100.0%) subjects who continued OnabotulinumtoxinA treatment remained in migraine remission, compared to only 9/29 (31.0%) who discontinued treatment. 2/97 (2.1%) subjects who continued treatment suffered miscarriages whereas 1/29 (3.4%) subjects who discontinued treatment suffered a miscarriage. No foetal malformations were reported.ConclusionIn our small descriptive study, subjects who continued OnabotulinumtoxinA in pregnancy continued to have migraine remission with no adverse pregnancy outcomes in our cohort.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251327387"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983398","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}