Cephalalgia最新文献

{"title":"Substance P and the trigeminovascular system: From preclinical mechanisms to human headache induction.","authors":"Berkay Alpay, Rune Häckert Christensen, Haidar M Al-Khazali, Messoud Ashina, Håkan Ashina","doi":"10.1177/03331024251355944","DOIUrl":"https://doi.org/10.1177/03331024251355944","url":null,"abstract":"<p><p>Substance P, a neuropeptide associated with pain and inflammation, has been implicated in migraine pathophysiology through its action within the trigeminovascular system. This narrative review summarizes current evidence on the synthesis, release, receptor binding and downstream effects of substance P. It integrates preclinical and clinical findings to reassess its therapeutic relevance. Substance P is released from primary afferent neurons and acts on neurokinin-1 receptors, which are widely expressed in both peripheral tissues and central pain-processing regions. In the meninges, substance P contributes to vasodilation, plasma protein extravasation, mast cell degranulation and immune cell recruitment, all of which facilitate neurogenic inflammation and possibly lower the activation threshold of meningeal nociceptors. In the central nervous system, substance P promotes excitatory neurotransmission, potentiates glutaminergic activity and attenuates inhibitory GABAergic signaling, cumulatively amplifying pain transmission. Preclinical studies consistently demonstrate that neurokinin-1 receptors antagonists inhibit substance P-induced responses, such as neurogenic inflammation and neuronal activation, supporting their therapeutic potential. However, randomized controlled trials with neurokinin-1 receptors antagonists were not superior to placebo in treating migraine. A re-appraisal of these trials reveal that the disappointing results might be due to methodologic shortcomings, including underpowered samples and suboptimal efficacy endpoints. A recent randomized, double-blind, placebo-controlled, two-way crossover study showed that intravenous infusion of substance P is potent inducer of headache and arterial dilation in healthy adults. These findings align with the established biological functions of substance P and warrant renewed therapeutic interest. Advances in translational research, particularly those emphasizing direct measurement of meningeal nociceptor activity and refined clinical trial design, might overcome past limitations and clarify the role of substance P in migraine. The dismissal of substance P signaling as a therapeutic target might thus have been premature. Renewed efforts might uncover novel therapeutic strategies, offering hope for patients with migraine who remain unresponsive to existing treatment.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251355944"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759297","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":"Proposal of a migraine with associated myofascial pain phenotype: Bridging corpalgia, fibromyalgia and chronic migraine.","authors":"Marcelo M Valença","doi":"10.1177/03331024251360223","DOIUrl":"https://doi.org/10.1177/03331024251360223","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251360223"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774768","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":"Real world effectiveness of anti-CGRP monoclonal antibodies over three consecutive one-year treatment cycles: An intention-to-treat analysis.","authors":"Gloria Vaghi, Michele Corrado, Maria Magdalena Pocora, Federico Bighiani, Francescantonio Cammarota, Alessandro Antoniazzi, Luca Costantino, Daniele Martinelli, Marta Allena, Natascia Ghiotto, Elena Guaschino, Sara Bottiroli, Luigi Francesco Iannone, Francesco De Cesaris, Danilo Antonio Montisano, Licia Grazzi, Grazia Sances, Cristina Montomoli, Cristina Tassorelli, Roberto De Icco","doi":"10.1177/03331024251353421","DOIUrl":"https://doi.org/10.1177/03331024251353421","url":null,"abstract":"<p><p>BackgroundThe present prospective, real-world study aims to assess anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) effectiveness across three consecutive one-year treatment cycles by means of a conservative intention-to-treat (ITT) analysis.MethodsWe enrolled 179 subjects (75.4% females, 51.3 years 95% confidence interval [49.2-53.4] years), 87.2% with chronic migraine and medication overuse) who started mAbs between 2018 and 2020. We recorded clinical data supported by a prospectively filled headache diary up to three one-year treatment cycles. The ITT analysis was performed with a multivariate linear mixed model considering the entire population.ResultsWe observed a marked and consistent reduction in monthly migraine days (MMDs) across the three one-year cycles of treatment: -12.7 )[-11.4 - -14.1] at end of the first year of treatment (C1), -12.4 [-11.0 - -13.8] at the end of the second year (C2) and -12.9 [-11.4 - -14.3] at the end of the third year (C3). Baseline and residual MMDs progressively decreased across the three cycles (<i>p</i> <i>=</i> 0.008): from 21.1 [19.8-22.4] to 9.6 [8.3-11.0] in C1, from 19.0 [17.4-20.5] to 9.6 [8.1-11.1] in C2, and from 15.9 [14.3-17.5] to 8.5 [6.9-10.1] in C3. At the end of C3, the 50% response rate was 38.5% (69/179)<i>.</i>ConclusionsIn our cohort, mAbs induced a meaningful and sustained reduction in MMDs across three consecutive one-year cycles of treatment. The ITT analysis revealed a remaining high burden of disease. While confirming mAbs effectiveness in migraine prevention, these findings underscore the need for more treatment approaches and for exploring other non-CGRP dependent pathways.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251353421"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793534","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":"Exploring medication-overuse and medication-overuse headache in cluster headache.","authors":"Nunu Lund, Marie-Louise Kulas Søborg, Louise Ninett Carlsen, Rigmor Højland Jensen, Anja Sofie Petersen","doi":"10.1177/03331024251364241","DOIUrl":"https://doi.org/10.1177/03331024251364241","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundIt is not well established to what extent medication-overuse occurs in cluster headache (CH), if medication-overuse headache exists in CH and whether the existing criteria for medication-overuse headache are a suitable diagnostic tool in CH. We aimed to examine the prevalence of medication-overuse and probable medication-overuse headache in a well characterized cohort of people with CH and describe associated factors and clinical impact.MethodsParticipants diagnosed with CH according to International Classification of Headache Disorders, 3rd edition (ICHD-3) beta and ICHD-3 were invited to participate in a semi-structured interview investigating medication-overuse and probable medication-overuse headache according to ICHD-3. To add nuance to the debate, we also included a more conservative definition, applying the ICHD-3 criteria for the medication-overuse but specified the headache phenotype to a daily bilateral headache.ResultsIn total, 21% of 433 participants with CH had a medication-overuse according to ICHD-3. Of these, 16% fulfilled the criteria for probable medication-overuse headache according to the ICHD-3, and 12% if excluding isolated triptan overuse. The overused analgesics constituted simple analgesics (52.2%), triptans (37.3%), opioids (29.9%) and combination therapies (20.9%). Associated factors were having chronic CH (odds ratio = 11.4, &lt;i&gt;p&lt;/i&gt; &lt; 0.00001) and comorbid migraine (odds ratio = 2.35, &lt;i&gt;p&lt;/i&gt; &lt; 0.05). Participants with probable medication-overuse headache had longer attack duration (30.0 vs. 20.0 minutes, &lt;i&gt;p&lt;/i&gt; &lt; 0.01) and less effect of acute and preventive medication than those without (20.0 vs. 55.9%, &lt;i&gt;p&lt;/i&gt; &lt; 0.05 and 13.3 vs. 37.3%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01, respectively). If applying the conservative definition with a daily bilateral headache along with a medication-overuse, the prevalence was reduced to 4%.ConclusionsProbable medication-overuse headache was present in every sixth participant with CH in this large cross-sectional cohort study. Interestingly, only a smaller proportion was the result of isolated triptan overuse. In CH, where patients often suffer from daily attacks and may suffer from a daily bilateral inter-ictal pain, our very conservative definition noted a prevalence of 4%. While the existing ICHD-3 criteria for medication-overuse headache may not be directly applicable in CH, the applicability and validity of the very conservative definition warrant further investigation. Still, as in other cross-sectional populations with medication-overuse, we noted an association that acute and preventive treatments were less effective in participants with probable medication-overuse headache compared to those without. Altogether, future prospective studies are necessary to establish the exact extent and presentation of medication-overuse headache in CH and determine whether it is an aggravating factor for the disease. We do not recommend discontinuing triptans if suspecting MOH due to ethical","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251364241"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945017","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 and tolerability of atogepant as preventive treatment in resistant individuals with chronic migraine: Six-month real-world evidence.","authors":"Antonio Russo, Marcello Silvestro, Ian Finkelstein, Dineo Seabi, Adam Ahlden, Anne Hege Aamodt, Edoardo Caronna, Patricia Pozo-Rosich, Erling Tronvik, Christina Sundal","doi":"10.1177/03331024251370608","DOIUrl":"https://doi.org/10.1177/03331024251370608","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundThe discovery of calcitonin gene-related peptide (CGRP) as a key player in migraine pathophysiology has revolutionized the approach to preventive treatment. Atogepant, an oral small-molecule CGRP receptor antagonist, has shown promising efficacy in randomized controlled trials (RCTs) for both episodic and chronic migraine. However, real-world evidence, particularly in individuals with chronic migraine and multiple preventive treatment failures, remains limited. This study is aimed to evaluate the effectiveness, safety, and tolerability of daily atogepant 60 mg in a homogeneous cohort of resistant individuals with chronic migraine over a 24-week period to extend the short-term observation assessed in previous real-world studies.MethodsIn the present real-world, prospective, monocentric study, a total of 100 participants (93% female; mean ± SD, age 43 ± 11 years) with chronic migraine with at least three previous treatment failures without medication overuse headache were consecutively recruited and received atogepant 60 mg daily for six months. All participants had failed a median of six previous preventive treatments, including CGRP-monoclonal antibodies (mAbs) (68%) and onabotulinumtoxin-A (BoNT-A) (14%). Primary outcomes included change in monthly migraine days (MMDs) and greater than 50% responder rate at 12 and 24 weeks. Secondary outcomes included changes in monthly headache days (MHDs), acute medication intake (MAMI), headache impact (Headache Impact Test (HIT-6)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)) and patient satisfaction (Patient's Global Impression of Change (PGIC)), change in MMDs, demographic and clinical features associated with greater than 50% responder rate, as well as effectiveness in individuals with previous CGRP-mAbs failure. Treatment-emergent adverse events (TEAEs) were also recorded.ResultsAt weeks 12 and 24, MMDs were reduced by 5.6 and 7.1 days from baseline, respectively (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), while 45% and 53% of participants achieved a ≥ 50% reduction in MMDs. Significant improvements were also seen in MHDs (-8.1 days), MAMI (-5.1 days) and HIT-6 scores (-6.2 points). Conversion from chronic to episodic migraine occurred in 60% of participants. PGIC results showed that 69% of participants reported feeling \"much\" or \"very much\" better. Logistic regression identified higher socioeconomic status (odds ratio = 2.87) as a positive predictor and previous CGRP-mAb failure (odds ratio = 0.38) as a negative predictor of treatment response. Nevertheless, among individuals with more than one CGRP-mAb failure, 47% achieved a ≥50% reduction in MMDs. TEAEs were reported by 53% of participants, with constipation (28%) and fatigue (16%) being the most common.ConclusionsAtogepant 60 mg daily demonstrated meaningful clinical benefit and good tolerability in real-world individuals with treatment-resistant chronic migraine over a 24-week period. These findings extend data from RCTs and real-","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251370608"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945025","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":"Characteristics of visual snow syndrome in Japan and its association with migraine.","authors":"Yukihisa Suzuki, Motohiro Kiyosawa","doi":"10.1177/03331024251360337","DOIUrl":"10.1177/03331024251360337","url":null,"abstract":"<p><p>ObjectiveVisual snow syndrome (VSS) is closely linked to migraine and involves variable visual disturbances. The present study aimed to investigate the associations between VSS and migraine, as well as VSS and anisometropia.MethodsWe studied 148 patients with VSS (54 males and 94 females, mean age 30.0 years) and 157 control participants. The mean and difference between left and right spherical equivalent refractive values, as well as the presence of migraines, were compared in patients with VSS and healthy controls. Multivariable logistic regression analyses were performed to assess the association between migraine and symptoms (palinopsia, entoptic phenomena, nyctalopia, photophobia, hyperesthesia and tinnitus) in patients with VSS.ResultsPatients with VSS exhibited a greater difference in left and right spherical equivalent refractive values and a higher prevalence of migraine compared to controls. Logistic regression analyses revealed a significant association between migraines and palinopsia. During the follow-up period, we observed spontaneous improvement in symptoms in 10 patients.ConclusionVSS is closely associated with migraine, and anisometropia was more frequent in VSS. The high prevalence of VSS in young individuals may reflect the age-related decline in migraine prevalence.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251360337"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728287","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":"Cranial autonomic symptoms as a protective mechanism in patients with chronic migraine: A cross-sectional study.","authors":"Maria Dolores Villar-Martinez, Peter J Goadsby","doi":"10.1177/03331024251359564","DOIUrl":"https://doi.org/10.1177/03331024251359564","url":null,"abstract":"<p><p>AimTo identify clinical predictors of cranial autonomic symptoms (CAS) in chronic migraine (CM) and explore the role of cranial parasympathetic outflow.MethodsWe conducted a cross-sectional study using audit data from first consultation letters of 333 patients diagnosed with CM at King's College Hospital London (January 2015 to September 2019). All met the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria for CM. Predictors included sex, aura, age, pain quality and headache laterality. A generalized linear regression model with a Poisson distribution was used to analyze CAS count predictors.ResultsOf 333 cases, 85.2% were female and 54% reported aura. CAS were present in 75.1%, with 19.8% experiencing unilateral symptoms. CAS count was positively skewed (mode = 0; median = 2). Female sex (<i>β</i> = 0.244; <i>p</i> = 0.036), aura (β = 0.328; <i>p</i> < 0.001) and unilateral CAS (<i>β</i> = 0.317; <i>p</i> < 0.001) were significant positive predictors. Pain quality and age were not significant.ConclusionsFemale sex and aura are linked to increased CAS in CM. Enhanced trigeminal-autonomic reflex activation may represent a protective cerebrovascular mechanism. CAS may contribute to maintaining perfusion or modifying nociceptive input during attacks. Targeted therapies modulating this pathway could benefit females with aura and frequent CAS.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251359564"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648648","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":"Effect of sumatriptan on ATP-sensitive potassium channel opening in migraine: A randomised controlled trial.","authors":"Zixuan Alice Zhuang, Mohammad Al-Mahdi Al-Karagholi, Håkan Ashina, Thien Phu Do, Messoud Ashina","doi":"10.1177/03331024251341464","DOIUrl":"10.1177/03331024251341464","url":null,"abstract":"<p><p>ObjectiveTo investigate whether early administration of sumatriptan prevents migraine induced by ATP-sensitive potassium (K_ATP) channel opener levcromakalim.MethodsThis single-centre, randomised, double-blind, placebo-controlled, two-way crossover study included adults with migraine without aura. Participants received a 20-minute intravenous infusion of levcromakalim on two separate occasions, followed immediately by a 10-minute intravenous infusion of either sumatriptan or placebo (isotonic saline) in a balanced allocation. The primary endpoint was the difference in the incidence of levcromakalim-induced migraine aftersumatriptan versus placebo over 12 hours. A secondary endpoint was the area under the curve (AUC) for headache intensity scores between experimental days.ResultsTwenty of 24 participants completed the study. The incidence of migraine induced by levcromakalim was 75% following sumatriptan and 85% following placebo (<i>p</i> = 0.69). The AUC for headache intensity scores showed no difference between sumatriptan and placebo days (<i>p</i> = 0.12). Post-hoc analyses correcting for intensity at 40 minutes post-levcromakalim revealed a significantly lower AUC for headache intensity following sumatriptan compared with placebo (<i>p</i> = 0.002).ConclusionsEarly sumatriptan treatment does not prevent migraine induced by K_ATP channel opening, suggesting that K_ATP-induced migraine occurs downstream of sumatriptan's site of action. However, sumatriptan reduces headache intensity, warranting further exploration of its modulatory effects.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251341464"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583225","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":"Sensitizing effect of antimigraine drug sumatriptan on capsaicin-sensitive lung vagal neurons via 5-HT_1B/1D receptors and PKA: Relevance to adverse chest effects.","authors":"Nai-Ju Chan, Yueh-Yin Chen, Chun-Chun Hsu, You Shuei Lin","doi":"10.1177/03331024251355949","DOIUrl":"https://doi.org/10.1177/03331024251355949","url":null,"abstract":"<p><p>BackgroundThe antimigraine drug sumatriptan causes adverse chest effects, namely dyspnea and chest tightness, through unclear mechanisms. Dyspnea is an unpleasant sensation evoked by peripheral sensory signals transmitted to the central nervous system. Capsaicin-sensitive lung vagal (CSLV) afferents are nociceptive-like fibers that provide sensory input from the airways and lungs, mediating airway defense reflexes and evoking unpleasant respiratory sensations. The present study was carried out to investigate the role of CSLV afferents in mediating these adverse chest effects.MethodsExperiments were performed using male Brown-Norway rats. In an <i>in vivo</i> study, we investigated the effect of sumatriptan on CSLV-fiber activities and fiber-mediated airway reflexes using single fiber recordings and breathing pattern monitoring in anesthetized rats. In an <i>in vitro</i> study, the effect of sumatriptan on neuronal sensitivity was evaluated using Ca²⁺ imaging in rat primary cultured CSLV neurons.ResultsOur results showed that intravenous infusion of sumatriptan increased the excitability of CSLV afferents to chemical and mechanical stimuli in anesthetized rats; this sensitizing effect occurred 3-20 minutes after termination of the sumatriptan infusion and reversed by 80 minutes later. In isolated CSLV neurons, sumatriptan-induced enhancement of Ca²⁺ transients evoked by capsaicin was blocked by pretreatment with a 5-hydroxytryptamine 1B and 1D (5-HT_1B/1D) receptor antagonist and a protein kinase A inhibitor, whereas an antagonist of the transient receptor potential ankyrin 1 failed to do so. Additionally, in anesthetized, spontaneously breathing rats, a sumatriptan infusion potentiated changes in CSLV afferent-mediated breathing patterns, suggesting that enhanced sensory signals were transmitted to the central nervous system. Similarly, this potentiating effect was also abolished by a 5-HT_1B/1D receptor antagonist. Furthermore, immunofluorescence staining confirmed that 5-HT_1B/1D receptors were expressed in isolated CSLV neurons.ConclusionsWe concluded that sumatriptan sensitizes CSLV afferents through a direct action on 5-HT_1B/1D receptors expressing in nerve endings followed by protein kinase A activation in rats. These findings suggest that sensitization of CSLV afferents may contribute to the chest discomfort experienced by some migraineurs following sumatriptan administration.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251355949"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559355","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":"Grey-matter network topology in migraine with aura.","authors":"David M Niddam, Kuan-Lin Lai, Yi-Ting Hsiao, Yen-Feng Wang, Shuu-Jiun Wang","doi":"10.1177/03331024251353146","DOIUrl":"https://doi.org/10.1177/03331024251353146","url":null,"abstract":"<p><p>BackgroundInter-regional covariation in grey-matter (GM) structure may provide insights into disease mechanisms. Given that migraine with aura (MA) has been linked to occipital GM alterations, it is plausible that altered occipital GM covariance may also exist in MA.MethodsStructural magnetic resonance images were obtained from 50 MA patients, 50 migraine patients without aura (MO) and 50 healthy controls (HC). Mean GM densities were extracted according to the Automated Anatomical Labeling atlas and regional and global network metrics were compared among the three groups. The local measures primarily focused on occipital regions. We further examined whether voxel-wise covariance of the significant regions was associated with clinical parameters.ResultsIncreased nodal degree was observed in the right lingual gyrus in MA when compared with HC (p < 0.001, p(_FDR) = 0.018) and MO (p = 0.005, p(_FDR) = 0.059), though the latter did not pass correction. In MA, the right lingual gyrus was identified as a hub region and its covariance with the right posterior insula and the left ventral postcentral gyrus was negatively correlated with migraine duration. Global network measures did not differ among the groups.ConclusionMA was associated with localized changes in the GM-network of the visual system, which may interact with pain-related brain regions depending on the duration of the disorder.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251353146"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539185","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}