Headache最新文献

{"title":"Navigating the patient journey in migraine prevention: An American Migraine Foundation position paper.","authors":"Lawrence C Newman, Christine Lay, Richard B Lipton, Jessica Ailani, Kathleen B Digre, Arthur Caplan, Nim Singh, Heather Phillips, Rachel Koh, Royce Warrick, David W Dodick","doi":"10.1111/head.15062","DOIUrl":"https://doi.org/10.1111/head.15062","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to understand the factors limiting access to medications for the preventive treatment of migraine and to improve access to evidence-based preventive care.</p><p><strong>Background: </strong>For decades, the effective use of medication for the preventive treatment of migraine was limited by slow onset, slow and complex dose titration schedules, modest benefits, drug interactions, frequent side effects, and very low long-term adherence. The calcitonin gene-related peptide (CGRP) targeted preventive medications mitigate some of these limitations and demonstrated substantial therapeutic benefits in a significant proportion of adults with migraine. The American Headache Society considers these medications among the first-line options for migraine prevention, although access to them remains limited. The American Migraine Foundation hosted a single-day, multidisciplinary expert panel discussion to identify barriers to optimal preventive care and developed recommendations to address them.</p><p><strong>Methods: </strong>Participants identified and prioritized barriers and used a modified nominal group technique to achieve consensus on them. A series of moderated discussions in plenary and breakout sessions was used to create possible solutions. Modified nominal group technique was also employed to achieve consensus on the priorities among these barriers and to achieve whole-group consensus on the recommendations. Ethical issues that inform access were discussed.</p><p><strong>Results: </strong>Participants included eight neurologists and board-certified headache specialists, six representatives of reimbursement decision-makers, six employees of life sciences companies, four patient advocates with lived experience with migraine, and a medical ethicist. Among those who have consulted healthcare professionals and received a diagnosis of migraine, we identified four main barriers to accessing preventive treatment: restrictive prior authorization requirements, the perceived lack of real-world evidence and treatment guidelines, the need for clinician education, and the need for patient education. Consensus recommendations for eliminating barriers centered on using new evidence to evaluate policies that restrict the selection of first-line therapies, initiating/improving collaboration among stakeholders, sharing of data and best practices, and increased training. Participants agreed to explore novel definitions of the value of preventive treatment and to establish the Migraine Prevention Network to facilitate ongoing cooperation and collective action. However, due to financial limitations, staffing changes, and time constraints, post-meeting discussions led to a shift from establishing a broad Migraine Prevention Network to forming smaller task forces focused on the top-priority barriers (real-world evidence and The Patient Playbook) identified through collaborative voting among American Headache Society, American","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225302","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":"Can atogepant be a preventive treatment for cluster headache?-Insights from a case series.","authors":"Catarina Serrão, Filipa Dourado Sotero, Linda Azevedo Kaupilla, Isabel Pavão Martins","doi":"10.1111/head.15066","DOIUrl":"https://doi.org/10.1111/head.15066","url":null,"abstract":"<p><p>Cluster headache (CH) is a disabling primary headache disorder with limited therapeutic options. Calcitonin gene-related peptide (CGRP) is known to be involved in CH pathophysiology; however, except for galcanezumab (300 mg) in episodic CH, anti-CGRP monoclonal antibodies did not reduce CH attacks in randomized clinical trials. Atogepant is an oral, small-molecule, CGRP receptor antagonist, which is approved for the preventive treatment of migraine. Here, we describe four case reports of CH (two episodic CH and two chronic CH), unresponsive to previous prophylactic treatments, who responded to daily atogepant (60 mg). Chronic CH cases were refractory to subcutaneous galcanezumab. In one case, a reduction to atogepant (30 mg daily) resulted in recurrence of headache attacks, which subsided on reintroduction of the initial dose. No serious adverse effects were reported. Despite the limited number of cases and the open retrospective design, our case series suggests atogepant as a possible prophylactic treatment for CH. Further research on CGRP signaling in CH and the implementation of well-designed clinical trials are necessary.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225325","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":"Migraine in the workplace: Work productivity impact in a large US-based healthcare system using a cross-sectional employee survey.","authors":"Olivia Begasse de Dhaem, Allison Verhaak, Meghan Fajardo, Brian Grosberg","doi":"10.1111/head.15053","DOIUrl":"10.1111/head.15053","url":null,"abstract":"<p><strong>Objective: </strong>(1) To estimate the impact of migraine on work productivity among employees at a large healthcare system in the United States. (2) To assess the knowledge and perception of migraine among employees and to evaluate the number of employees interested in receiving migraine care to help plan a future workplace migraine education and management program.</p><p><strong>Background: </strong>Despite advances in treatment, migraine is underdiagnosed and undertreated and remains a leading cause of disability in the world. Workplace migraine education and/or management programs have been shown to improve migraine-related productivity. However, there has not yet been a published organization-wide workplace migraine education and management program in the United States.</p><p><strong>Methods: </strong>This is a cross-sectional, online survey of employees at a large healthcare system in the Northeast region of the United States that was open from November 1, 2024, to January 3, 2025. Survey questions queried employment status (one question), knowledge and perceptions of migraine (two questions), headache and migraine screen (four questions), productivity impact (two questions), and potential interest in receiving care for headaches (one question).</p><p><strong>Results: </strong>Out of 33,761 employees, 20,000 were reached via internal communication, 6583 (32.9%) agreed to participate, and 5771 (28.9%) completed the survey. The majority of employees who chose to complete the survey (5337/5771; 92.5%) endorsed having headaches; of these, 59.6% (3183/5337) screened positive on the ID Migraine screen. The participants who screened positive for migraine reported 0.66 missed workdays and 3.77 days with productivity reduced by at least 50% due to migraine in the past 3 months, leading to an estimated lost productive time (LPT) of 10.12 days annually per employee with migraine. Participants reported associating the word \"migraine\" most closely with headache or pain (4182/5754; 72.7%). Only about half of participants answered the knowledge question correctly (2819/5751; 49.0%). Of the 5771 survey participants, 992 (17.2%) were interested in receiving headache care.</p><p><strong>Conclusion: </strong>Migraine significantly impacts workplace productivity at a large healthcare system, particularly presenteeism. Migraine tends to be perceived as a headache and about half of the participants did not answer the knowledge question correctly. This survey study supports a need for a workplace migraine education and management program for healthcare workers.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1634-1640"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023118","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":"Insomnia symptoms amongst those with acute post-traumatic headache attributed to mild traumatic brain injury.","authors":"Ben J Braunecker, Dani Smith, Christopher A Dodoo, Todd J Schwedt, Catherine D Chong","doi":"10.1111/head.14971","DOIUrl":"10.1111/head.14971","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Previous publications have described the presence and severity of insomnia amongst those with persistent post-traumatic headache (PPTH), but there has been a paucity of studies investigating insomnia during the acute phase of post-traumatic headache (APTH). The primary study objective was to investigate insomnia symptoms and their severity in individuals with APTH due to mild traumatic brain injury (mTBI), and the secondary objective was to assess how psychological factors, sensory hypersensitivities, headache burden, and cognitive performance might associate with insomnia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this clinic-based, cross-sectional study, 82 individuals with APTH due to mTBI and 82 healthy controls (HC) were included. Participants completed the Insomnia Severity Index (ISI), Trail Making Test (TMT A and B), 12-item Allodynia Symptom Checklist (ASC-12), State-Trait Anxiety Inventory, Photosensitivity Assessment Questionnaire (PAQ), Beck Depression Inventory (BDI), Hyperacusis Questionnaire (HQ), Rey Auditory Verbal Learning Test (RAVLT), and a detailed headache characteristics questionnaire within 59 days of their mTBI to assess insomnia severity, psychological features, sensory hypersensitivities, headache symptoms, and cognitive performance. The questionnaire and test results were compared between APTH and HC groups. Within the APTH group, ISI scores were correlated with the other assessments to determine underlying clinical relationships.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants with APTH, evaluated an average of 27.2 days after their mTBI, had significantly higher ISI scores (median [interquartile range, IQR] score 12 [6-17]) compared to HC (0 [1.3-6], p &lt; 0.001). Twenty-four (29%) individuals with APTH had ISI scores categorized as moderate clinical insomnia compared to two (2%) in the HC group. Additionally, seven (9%) in the APTH group and none of the HC had ISI scores indicative of severe clinical insomnia. Those with APTH significantly differed from the HC on the BDI (median [IQR] score APTH: 9 [5-16.8] vs. HC: 2 [0-4]; p &lt; 0.001), state anxiety (median [IQR] score APTH: 36.5 [26-45] vs. HC: 23 [20-27.5]; p &lt; 0.001), trait anxiety (median [IQR] score APTH: 38 [27.3-46.8] vs. HC: 26 [23-30]; p &lt; 0.001), photosensitivity (median [IQR] PAQ score APTH: 2 [1-4] vs. HC: 0 [0-1]; p &lt; 0.001), allodynia (median [IQR] ASC-12 score APTH: 2 [0-5.8] vs. HC: 0 [0-0], p &lt; 0.001), hyperacusis (median [IQR] HQ score APTH: 15.5 [7-23] vs. HC: 4 [2.3-7], p &lt; 0.001), and RAVLT-delayed recall (median [IQR] score APTH: -0.8 [-1.5 to 0] vs. HC: -0.1 [-0.9 to 0.7], p = 0.019). For participants with APTH, the ISI was most significantly associated with the BDI (standardized regression coefficient (RC) [95% confidence interval, CI] 0.68 [0.52-0.84], p &lt; 0.001), followed by state anxiety (RC [95% CI] 0.60 [0.42-0.78], p &lt; 0.001), trait anxiety (RC [95% CI] 0.56 [0.37-0.74], p &lt; 0.001), headache severity (RC [95% CI] 0.4","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1565-1572"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal associations between genetically predicted placental weight and migraine.","authors":"Chung-Chih Liao, Chun-I Lee, Yi-Chun Huang, Ke-Ru Liao, Jung-Miao Li","doi":"10.1111/head.14977","DOIUrl":"10.1111/head.14977","url":null,"abstract":"<p><strong>Background: </strong>Placental weight (PW) is a crucial factor in fetal development, influencing various health outcomes throughout life. This study investigates whether there is a causal relationship between PW and the risk of developing migraine.</p><p><strong>Methods: </strong>Genetic variants associated with PW were obtained from the Early Growth Genetics Consortium, including fetal, maternal, and paternal genomes. Migraine data were derived from a 2022 genome-wide association study meta-analysis by the International Headache Genetics Consortium. Significant single nucleotide polymorphisms (SNPs) associated with PW were selected and analyzed to assess causality.</p><p><strong>Results: </strong>Out of 11 PW phenotypes, six PW phenotypes with at least two SNPs each were included for Mendelian randomization analysis. The analysis revealed that PW (fetal effect, conditional on maternal and paternal genotype) was significantly associated with a reduced risk of migraine (odds ratio 0.81, 95% confidence interval 0.71-0.93; p = 0.003, false discovery rate adjusted p = 0.018). Sensitivity analyses confirmed the robustness of the findings, showing no evidence of heterogeneity or pleiotropy.</p><p><strong>Conclusion: </strong>Our findings suggest a potential causal relationship between fetal genetically predicted increased PW and a reduced risk of migraine in the offspring. Further research into the mechanisms underlying this association and its implications for migraine prevention is warranted.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1584-1592"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266124","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":"Sex influences the progression of cephalic mechanical and light hypersensitivities in a mouse model of chronic migraine.","authors":"Marie Raquin, Yara Mrad, Mohamed A Zkim, Radhouane Dallel, Isabelle Ranchon-Cole, Cristina Alba-Delgado","doi":"10.1111/head.15015","DOIUrl":"10.1111/head.15015","url":null,"abstract":"<p><strong>Objectives/background: </strong>Our aim was to compare the temporal dynamics of light and cephalic mechanical sensitivities in male and female mice as they relate to migraine chronicization. Cutaneous and light hypersensitivities are among the most common features of migraine, with greater severity observed in females. In 3% of patients, episodic migraine progresses to a chronic form, and sensory hypersensitivity becomes persistent. The pathophysiology underlying this transformation is complex and not fully understood. Moreover, studies comparing the evolution of sensory hypersensitivity between sexes are scarce.</p><p><strong>Methods: </strong>Systemic administration of isosorbide dinitrate (ISDN, 10 mg/kg) was used to induce migraine-like behaviors in C57BL/6 mice. Cephalic sensitivity was assessed using periorbital von Frey testing. Light sensitivity was evaluated using the elevated plus maze and light/dark box paradigms. The effectiveness of current migraine treatments, sumatriptan (1 mg/kg) and propranolol (20 mg/kg), was also evaluated.</p><p><strong>Results: </strong>A single ISDN injection induced transient cephalic mechanical hypersensitivity in both males and females, with no sex differences observed. Acute treatment with sumatriptan effectively blocked this hypersensitivity, showing similar efficacy in both sexes. Notably, light hypersensitivity was induced exclusively in acute ISDN-treated females, developing earlier, and persisting longer than cephalic mechanical hypersensitivity. Repeated ISDN administration resulted in persistent and dose-dependent sensory hypersensitivity in both sexes. Interestingly, the chronicization patterns were sex-specific; ISDN-treated females developed persistent light and cephalic mechanical hypersensitivities simultaneously, whereas ISDN-treated males showed delayed light aversion. Prophylactic treatment with propranolol prevented the chronicity of cephalic mechanical hypersensitivity in both sexes, and partially attenuated acute ISDN-induced mechanical and light hypersensitivities.</p><p><strong>Conclusion: </strong>The progression from acute to chronic ISDN-induced cephalic mechanical and light hypersensitivities has sex-specific characteristics that mimic the clinical features of migraine. These findings support the involvement of distinct underlying mechanisms and highlight the need for tailored treatment strategies to optimize migraine management in both male and female populations.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1603-1616"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707283","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":"Disagreement with categorization of clinical trials included in Treadwell et al. systematic review and meta-analysis.","authors":"Rebecca Erwin Wells, David Seminowicz, Nathaniel O'Connell, Elizabeth W Loder","doi":"10.1111/head.15000","DOIUrl":"10.1111/head.15000","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1503-1504"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of different exercise types on migraine frequency in individuals with migraine: A pilot study.","authors":"Yunus Emre Meydanal, Seçkin Şenışık, Hadiye Şirin","doi":"10.1111/head.14951","DOIUrl":"10.1111/head.14951","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the effects of different types and combinations of exercise on migraine attacks and accompanying comorbidities.</p><p><strong>Background: </strong>Combining aerobic and resistance exercises may yield more significant improvements in patients with migraine.</p><p><strong>Methods: </strong>This parallel-group randomized controlled study included 24 participants, who were then divided equally into three groups: an aerobic exercise group, a combined exercise group (aerobic and resistance exercises), and a control group. It was conducted at Ege University Hospital between September 2022 and March 2024. Following a 1-month baseline headache diary period, both intervention groups participated in the same aerobic exercises 3 days a week for 12 weeks. The combined exercise group performed five resistance exercises targeting the neck, upper back, and shoulder muscles alongside the aerobic exercises 3 days a week for 12 weeks. Measurements were taken at baseline, after the 3-month intervention period, and after a 2-month follow-up period. The primary outcome was the number of migraine headache days per month. Secondary outcomes included anxiety and depression levels, aerobic capacity, physical activity status, and migraine-related quality of life.</p><p><strong>Results: </strong>The number of migraine days per month significantly decreased in both the aerobic and combined exercise groups during the post-intervention period, while no significant change was observed in the control group (p < 0.001 for aerobic and combined exercise groups, p = 0.166 for control group). Migraine headache frequency showed a statistically significant decrease in the combined exercise group compared to the aerobic exercise group (p = 0.027). Additionally, both exercise groups showed significant improvements in aerobic capacity (p < 0.001 for both) and physical activity levels (p < 0.001 and p = 0.001, respectively) post-intervention, which were not observed in the control group (p = 0.747 for aerobic capacity, p = 0.05 for physical activity levels). Although no significant effect on depression scores was observed in either exercise group, anxiety scores significantly decreased in the combined exercise group from pre- to post-intervention (p = 0.037). Significant improvements in migraine-related quality of life were observed in both intervention groups (p = 0.018 and p = 0.001, respectively), with no significant difference (p = 0.934). Neither significant change was observed in depression and anxiety scores nor migraine-related quality of life in the control group (p = 0.593, p = 0.438 and 0.081 respectively).</p><p><strong>Conclusions: </strong>Aerobic and combined exercise groups showed a reduction in monthly migraine headache frequency without any side effects, with the reduction being statistically more significant in the combined exercise group.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1593-1602"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics and safety of eptinezumab in children and adolescents with migraine.","authors":"Andrew D Hershey, Johan Areberg, Line Pickering Boserup, Annika Lindsten, Monika Rosen","doi":"10.1111/head.14959","DOIUrl":"10.1111/head.14959","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective was to characterize the pharmacokinetics (PK) and safety of eptinezumab in children and adolescents with migraine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Migraine in children and adolescents is a prevalent and potentially debilitating disease, and few preventive therapies are approved for use in these populations. Eptinezumab, a calcitonin gene-related peptide monoclonal antibody approved for migraine prevention in adults, has demonstrated efficacy at doses of 100 mg or 300 mg administered intravenously every 12 weeks. Defining the appropriate dosing of eptinezumab in children and adolescents is required to accurately examine the safety and efficacy of its use as a preventive migraine therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this open-label PK clinical trial conducted between August 2020 and October 2022, children and adolescents with migraine (aged 6-17 years) received weight-adjusted intravenous eptinezumab infusions. The doses were designed to match the exposure from a 300 mg dose in adults. The trial included a 28-day screening period, a 20-week main trial period, and an optional 44-week multiple-dose extension period. Participants were dosed on Day 1 and had follow-up visits at Weeks 4, 8, 12, and 20. The extension period included three additional eptinezumab infusions every 12 weeks. Primary PK endpoints included area under the curve (from zero to infinity; AUC&lt;sub&gt;0-inf&lt;/sub&gt;) of eptinezumab and maximum concentration (C&lt;sub&gt;max&lt;/sub&gt;). The effect of eptinezumab on migraine-related disability was explored using the Pediatric Migraine Disability Assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 28 participants (12 children [aged 6-11 years] and 16 adolescents [aged 12-17 years]) were enrolled in the trial, with 23 continuing into the extension period. A single intravenous administration of eptinezumab at 150 mg or 300 mg resulted in similar mean plasma concentration-time curves (mean AUC&lt;sub&gt;0-inf&lt;/sub&gt;: 92,890 h·μg/mL [150 mg], 95,550 h·μg/mL [300 mg]; mean C&lt;sub&gt;max&lt;/sub&gt;: 131.8 μg/mL [150 mg], 141.2 μg/mL [300 mg]). The PK profile of eptinezumab after multiple intravenous administrations in the extension period was also similar. No serious adverse events (AEs) or severe treatment-emergent AEs (TEAEs) were observed. The most common TEAE was orthostatic hypotension, reported in three adolescents (11% of total population). Other TEAEs occurred as single incidences. Improvement in migraine-associated disability was seen in both children and adolescents after a single intravenous administration of eptinezumab (median [range] score changes from baseline to Week 12 were -22 [-70, -6] in children and -17.0 [-117, 42] in adolescents) and was maintained during the extension period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The PK profile in children and adolescents was consistent across different dose levels and weight groups. These results support the use of weight-based eptinezumab dosing in child","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1573-1583"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term evolution of white and gray matter structural properties in migraine.","authors":"Álvaro Planchuelo-Gómez, Carmen Martín-Martín, Ángel L Guerrero, David García-Azorín, Rodrigo de Luis-García, Santiago Aja-Fernández","doi":"10.1111/head.14949","DOIUrl":"10.1111/head.14949","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To elucidate the specific brain changes linked to clinical diagnoses and distinct temporal progression in migraine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gray (GM) and white matter (WM) differences were previously identified in chronic migraine (CM) compared to episodic migraine (EM). Regarding GM, patients with CM showed increased cortical thickness in the inferior temporal gyrus, and reduced surface area in the precuneus cortex, superior frontal and temporal gyri, and supramarginal gyrus. In the WM, widespread reduced axial and mean diffusivity have been observed in patients with CM in tracts such as the middle cerebellar peduncle, the internal capsule, the corticospinal tract, and the sagittal stratum. However, no longitudinal studies with a long follow-up have been conducted to comprehend how those differences evolve over an extended period, in relation to the clinical evolution of the disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A longitudinal study with a cohort design was conducted. Brain T1- and diffusion-weighted magnetic resonance imaging data were acquired in patients with migraine at two different timepoints, the first between May 2015 and July 2018, and the second between November 2021 and February 2022. Three WM descriptors and four GM morphometry parameters were extracted. Next, longitudinal changes were analyzed using generalized linear mixed models, after considering three different clinical groups: patients with a stable diagnosis (CM or EM) at both timepoints (24 CM, 31 EM), and 24 patients with CM who improved to EM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Different patterns of structural longitudinal changes were found depending on the clinical evolution. Regarding GM, patients with stable EM showed a longitudinal cortical thickness increase in the parietal and temporal cortex (annual relative change between 0.38% and 0.52% in five regions, adjusted p between 0.013 and 0.017), and the postcentral gyrus (annual relative change of 0.37%, adjusted p = 0.014). Patients with stable CM and EM showed a longitudinal cortical thickness decrease in the posterior cingulate gyrus (annual relative change of 0.51%, adjusted p = 0.027, and 0.34%, adjusted-p = 0.019, respectively), and patients who improved from CM to EM showed no changes (corrected p &gt; 0.05). Moreover, regarding WM, the patients with stable EM showed a longitudinal increase in fractional anisotropy in the cerebral peduncle (annual relative change of 0.24%, adjusted p = 0.014).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Differences in clinical evolution are linked to distinct patterns of structural changes, suggesting a heterogeneous impact of disease evolution on brain structure. Patients with CM who improved to EM showed no significant GM differences while those with longitudinally stable diagnoses showed cortical thickness maladaptation in pain processing-related regions and adaptation in other regions associated with migraine. Patients who improved from CM to EM ","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1526-1540"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}