Cephalalgia最新文献

{"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}

{"title":"Philosophical aspects of migraine: Headache treatment is a human-to-human service.","authors":"Mark J Emmenegger, Andreas R Gantenbein","doi":"10.1177/03331024251343225","DOIUrl":"https://doi.org/10.1177/03331024251343225","url":null,"abstract":"<p><p>Migraine is a complex neurobiological disorder that extends beyond physical symptoms to encompass profound mental, emotional and existential dimensions. Despite its prevalence, the philosophical aspects of migraine remain underexplored in scientific research. This review examines migraine through a philosophical lens, addressing questions of pain, suffering, consciousness and communication. It highlights the different perspectives of neuroscientists, clinicians and patients: the former seeks to understand migraine as a neurological dysfunction, while the latter experiences it as an intensely personal and subjective affliction, and the clinicians try to build a bridge. Bridging these perspectives requires a multidisciplinary approach, integrating neuroscience, philosophy and patient narratives. Philosophical reflections posed by Nietzsche (How should we confront suffering?), Sartre (existence precedes essence) and Camus (How can we accept the absurdity of life and still continue to embrace life fully?) provide a framework to understand the subjective experience of pain and its meaning in human existence. By considering migraine both as a subjective and objective phenomenon, this work advocates for a holistic, patient-centered approach to treatment. It argues that addressing migraine's multifaceted nature, including its physical, emotional, cultural and existential dimensions, can lead to more meaningful and effective therapeutic strategies. This interdisciplinary exploration aims to inspire clinicians to embrace a more comprehensive and empathetic framework for migraine care, a human-to-human service.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251343225"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126720","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":"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":"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":4.6,"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}