The Journal of Headache and Pain最新文献

{"title":"Comment regarding: what is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta‑analysis of clinical trials.","authors":"Junhee Han,&nbsp;Soo-Jin Cho","doi":"10.1186/s10194-022-01522-9","DOIUrl":"https://doi.org/10.1186/s10194-022-01522-9","url":null,"abstract":"<p><p>In Woldeamanuel and Oliveira (2022)'s article about the efficacy of exercise in the treatment of migraine, the ranking of the efficacy of strength training (mean difference, - 3.55), aerobic exercise (mean difference, - 2.18 to - 3.13), topiramate (mean difference, - 0.98), and amitriptyline (mean difference, 3.82) using network meta-analysis can mislead readers. First, the inclusion criteria were reported at a monthly frequency of migraine and the end of the intervention, but some article did not meet the inclusion criteria or had data inconsistency. Second, there was an inconsistency in the placebos used in the included studies, which can be problematic in network meta-analysis. Third, all three articles on strength training were rated as high-risk or exhibited some risk of bias. Finally, the effectiveness of this statistical method is questionable for assessing physical activities because strength training, aerobic exercise, and preventive medications can be simultaneously recommended for possible synergistic effects in the prevention of migraine.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"144"},"PeriodicalIF":7.4,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40499365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced pain facilitation rather than impaired pain inhibition in burning mouth syndrome female patients.","authors":"Christelle Gremeau-Richard,&nbsp;Paul Pionchon,&nbsp;Aurélien Mulliez,&nbsp;Christian Dualé,&nbsp;Radhouane Dallel","doi":"10.1186/s10194-022-01516-7","DOIUrl":"https://doi.org/10.1186/s10194-022-01516-7","url":null,"abstract":"<p><strong>Background: </strong>Deficient endogenous pain modulation has been implicated in the development and exacerbation of chronic orofacial pain. To date, relatively little is known regarding the function of the endogenous pain modulation in patients with burning mouth syndrome (BMS). This case-control study investigated endogenous pain modulation in women with BMS.</p><p><strong>Methods: </strong>Conditioned pain modulation (CPM) was assessed upon temporal summation (TSP) of thermal pain. Forty female subjects, 20 BMS patients and 20 age-matched control subjects, were included in a 2 session-protocol. Mechanical and thermal pain thresholds were measured on the forearm and hand. TSP was obtained using repetitive laser-evoked thermal stimuli applied on the non-dominant hand, at an intensity yielding to moderate pain. During TSP, CPM was produced by immersing the contralateral foot in a water bath at painful cold (8 °C) temperature. In control conditions, the foot was immersed in a water bath at not painful (30 °C) temperature.</p><p><strong>Results: </strong>BMS was not associated with any impairment in thermal as well as mechanical extracephalic pain thresholds. TSP and CPM efficacy were similar in BMS patients and control subjects. However, BMS patients exhibited enhanced extracephalic heat hyperalgesia.</p><p><strong>Conclusion: </strong>This study reveals that there is no impairment of endogenous pain inhibition mechanisms in BMS patients, but rather an increase in pain facilitation.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"143"},"PeriodicalIF":7.4,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premonitory symptoms in migraine: a systematic review and meta-analysis of observational studies reporting prevalence or relative frequency.","authors":"Anna K Eigenbrodt,&nbsp;Rune Häckert Christensen,&nbsp;Håkan Ashina,&nbsp;Afrim Iljazi,&nbsp;Casper Emil Christensen,&nbsp;Timothy J Steiner,&nbsp;Richard B Lipton,&nbsp;Messoud Ashina","doi":"10.1186/s10194-022-01510-z","DOIUrl":"https://doi.org/10.1186/s10194-022-01510-z","url":null,"abstract":"<p><strong>Background: </strong>Observational studies on the prevalence of premonitory symptoms in people with migraine, preceding the headache pain (or aura) phase, have shown conflicting results. We conducted a systematic review and meta-analysis to estimate the prevalence, and relative frequency among clinic populations, of premonitory symptoms in people with migraine, overall and of the multifarious individual symptoms, and to review the methodologies used to assess them.</p><p><strong>Methods: </strong>We searched PubMed and Embase for studies published from database inception until 31^st of May 2022. Two investigators independently screened titles, abstracts, and full texts. We retrieved observational studies that reported the prevalence/relative frequency of one or more premonitory symptoms in people with migraine. Two investigators independently extracted data and assessed risk of bias. Results were pooled using random-effects meta-analysis. Our main outcomes were the percentage of people with migraine who experienced at least one premonitory symptom and the percentages who experienced different individual premonitory symptoms. To describe our outcomes, we used the terms prevalence for data from population-based samples and relative frequency for data from clinic-based samples. We also descriptively and critically assessed the methodologies used to assess these symptoms.</p><p><strong>Results: </strong>The pooled estimated prevalence in population-based studies of at least one premonitory symptom was 29% (95% CI: 8-63; I² 99%) and the corresponding pooled estimated relative frequency in clinic-based studies was 66% (95% CI: 45-82; I² 99%). The data from clinic-based studies only supported meta-analysis of 11 of 96 individual symptoms, with relative frequency estimates ranging from 11 to 49%. Risk of bias was determined as high in 20 studies, moderate in seven, and low in two.</p><p><strong>Conclusions: </strong>The substantial between-study heterogeneity demands cautious interpretation of our estimates. Studies showed wide methodological variations, and many lacked rigor. Overall, the evidence was insufficient to support reliable prevalence estimation or characterization of premonitory symptoms. More data are needed, of better quality, to confirm the existence of a distinctive premonitory phase of migraine, and its features. Methodological guidelines based on expert consensus are a prerequisite.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"140"},"PeriodicalIF":7.4,"publicationDate":"2022-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9655795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year effectiveness of erenumab in resistant chronic migraine: a prospective real-world analysis.","authors":"Anna P Andreou,&nbsp;Matteo Fuccaro,&nbsp;Bethany Hill,&nbsp;Madeleine Murphy,&nbsp;Valeria Caponnetto,&nbsp;Rachael Kilner,&nbsp;Giorgio Lambru","doi":"10.1186/s10194-022-01507-8","DOIUrl":"https://doi.org/10.1186/s10194-022-01507-8","url":null,"abstract":"<p><strong>Background: </strong>Controlled and real-world evidence have demonstrated the efficacy of calcitonin gene related peptide (CGRP) monoclonal antibodies (MABs) in migraine. However, data on the over-one-year sustained effectiveness of CGRP MABs in resistant chronic migraine (CM) is sparse.  METHODS: This is a two-year real-world prospective analysis of an ongoing single centre audit conducted in patients with resistant CM. Patients received monthly erenumab for six months before assessing its effectiveness. Responders were considered those who achieved at least 30% reduction in monthly migraine days (MMD) by month 6, compared to baseline. Secondary outcomes were also analysed, including changes of the Headache Impact Test version 6 (HIT-6).</p><p><strong>Results: </strong>One hundred sixty-four patients [135 (82.3%) females; mean age 46 SD 14) years] were included in the audit and 160 patients analysed. Patients had failed a mean of 8.4 preventive treatments at baseline. At month 6, 76 patients (48%) were 30% responders to erenumab, 50 patients (31%) were 50% responders and 25 (15%) were 75% responders. The mean reduction in MMD at month 6 was 7.5 days compared to baseline (P < 0.001). At month 12 and month 18, 61 patients (38%) and 52 patients (33%) remained 30% responders respectively. At month 24, 36 patients (23%) remained 30% responders, 25 patients (16%) and 13 patients (8%) were respectively 50% and 75% responders. Compared to 95% of patients at baseline, at months 6, 12 and 24, 46%, 29% and 16% of responders respectively had severe disability. At least one adverse event at month 6, 12, 18 and 24 was reported by 49%, 19%, 11% and 3% of patients. By month 6, 13% of patients discontinued the treatment because of side effects, often constipation.</p><p><strong>Conclusions: </strong>Long-term sustained effectiveness of erenumab was reported only by a minority of resistant CM patients. Although more research in resistant migraine is needed, Erenumab can provide long-term meaningful reduction in migraine load and migraine-related disability in some patients.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"139"},"PeriodicalIF":7.4,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40666417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of response to anti-CGRP monoclonal antibodies: a 24-week, multicenter, prospective study on 864 migraine patients.","authors":"Piero Barbanti,&nbsp;Gabriella Egeo,&nbsp;Cinzia Aurilia,&nbsp;Claudia Altamura,&nbsp;Florindo d'Onofrio,&nbsp;Cinzia Finocchi,&nbsp;Maria Albanese,&nbsp;Marco Aguggia,&nbsp;Renata Rao,&nbsp;Maurizio Zucco,&nbsp;Fabio Frediani,&nbsp;Massimo Filippi,&nbsp;Roberta Messina,&nbsp;Sabina Cevoli,&nbsp;Antonio Carnevale,&nbsp;Giulia Fiorentini,&nbsp;Stefano Messina,&nbsp;Francesco Bono,&nbsp;Paola Torelli,&nbsp;Stefania Proietti,&nbsp;Stefano Bonassi,&nbsp;Fabrizio Vernieri","doi":"10.1186/s10194-022-01498-6","DOIUrl":"https://doi.org/10.1186/s10194-022-01498-6","url":null,"abstract":"<p><strong>Background and objectives: </strong>The identification of predictors of response to antiCGRP mAbs could favor tailored therapies and personalized treatment plans. This study is aimed at investigating predictors of ≥ 50%, ≥ 75% and 100% response at 24 weeks in patients with high-frequency episodic (HFEM: 8-14 days/month) or chronic migraine (CM).</p><p><strong>Methods: </strong>This is a large, multicenter, cohort, real-life study. We considered all consecutive adult patients affected by HFEM or CM who were prescribed antiCGRP mAbs for ≥ 24 weeks in 20 headache centers. Patients were interviewed face-to-face using a shared semi-structured questionnaire carefully exploring socio-demographic and clinical characteristics. Patients received subcutaneous erenumab (70 mg or140 mg, monthly), galcanezumab (120 mg monthly, following a 240 mg loading dose), or fremanezumab (225 mg, monthly or 675 mg, quarterly) according to drug market availability, physician's choice, or patient's preference. The primary endpoint of the study was the assessment of ≥ 50% response predictors at 24 weeks. Secondary endpoints included ≥ 75% and 100% response predictors at 24 weeks.</p><p><strong>Results: </strong>Eight hundred sixty-four migraine patients had been treated with antiCGRP mAbs for ≥ 24 weeks (erenumab: 639 pts; galcanezumab: 173 pts; fremanezumab: 55 pts). The ≥50% response (primary endpoint) in HFEM was positively associated with unilateral pain (UP) + unilateral cranial autonomic symptoms (UAs) (OR:4.23, 95%CI:1.57-11.4; p = 0.004), while in CM was positively associated with UAs (OR:1.49, 95%CI:1.05-2.11; p = 0.026), UP + UAs (OR:1.90, 95%CI:1.15-3.16; p = 0.012), UP + allodynia (OR:1.71, 95%CI:1.04-2.83; p = 0.034), and negatively associated with obesity (OR:0.21, 95%CI:0.07-0.64; p = 0.006). The 75% response (secondary endpoint) was positively associated with UP + UAs in HFEM (OR:3.44, 95%CI:1.42-8.31; p = 0.006) and with UP + UAs (OR:1.78, 95%CI:1.14-2.80; p = 0.012) and UP + allodynia (OR:1.92, 95%CI:1.22-3.06; p = 0.005) in CM. No predictor of 100% response emerged in patients with HFEM or CM.</p><p><strong>Conclusions: </strong>A critical evaluation of headache characteristics indicating peripheral or central sensitization may help in predicting responsiveness to antiCGRP mAbs in HFEM and CM. A more precise pain profiling may represent a steppingstone for a mechanism-based approach and personalized treatment of migraine with compounds targeting specific molecular mechanisms.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"138"},"PeriodicalIF":7.4,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40658942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CGRP-induced migraine-like headache in persistent post-traumatic headache attributed to mild traumatic brain injury.","authors":"Håkan Ashina,&nbsp;Afrim Iljazi,&nbsp;Haidar M Al-Khazali,&nbsp;Thien Phu Do,&nbsp;Anna K Eigenbrodt,&nbsp;Eigil L Larsen,&nbsp;Amalie M Andersen,&nbsp;Kevin J Hansen,&nbsp;Karoline B Bräuner,&nbsp;Basit Ali Chaudhry,&nbsp;Casper E Christensen,&nbsp;Faisal Mohammad Amin,&nbsp;Henrik W Schytz","doi":"10.1186/s10194-022-01499-5","DOIUrl":"https://doi.org/10.1186/s10194-022-01499-5","url":null,"abstract":"<p><strong>Objective: </strong>To ascertain whether intravenous infusion of calcitonin gene-related peptide (CGRP) can induce migraine-like headache in people with persistent post-traumatic headache attributed to mild traumatic brain injury (TBI) and no pre-existing migraine.</p><p><strong>Methods: </strong>A non-randomized, single-arm, open-label study at a single site in Denmark. Eligible participants were aged 18 to 65 years and had a known history of persistent post-traumatic headache attributed to mild TBI for ≥ 12 months. All participants received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min. A headache diary was used to collect outcome data until 12 h after the start of CGRP infusion. The primary end point was the incidence of migraine-like headache during 12-hour observational period.</p><p><strong>Results: </strong>A total of 60 participants completed the study protocol and provided data for the analysis of the primary end point. The median age was 32.5 (IQR, 25.5-43.0) years; 43 participants (72%) were female. Following CGRP infusion, 43 (72%) of 60 participants developed migraine-like headache during the 12-hour observational period. The median time to peak headache intensity was 40 min (IQR, 20-60), and the median peak headache intensity was 6 (IQR, 5-8) on the 11-point numeric rating scale.</p><p><strong>Conclusion: </strong>Intravenous infusion of CGRP is a potent inducer of migraine-like headache in people with persistent post-traumatic headache attributed to mild TBI. This observation underscores the importance of CGRP in the genesis of migraine-like headache that is often experienced by individuals who are afflicted by persistent post-traumatic headache. Further research is warranted to ascertain whether other signaling molecules also contribute to the disease mechanisms underlying post-traumatic headache.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"135"},"PeriodicalIF":7.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40396476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure.","authors":"Simona Sacco,&nbsp;Christian Lampl,&nbsp;Faisal Mohammad Amin,&nbsp;Mark Braschinsky,&nbsp;Christina Deligianni,&nbsp;Derya Uludüz,&nbsp;Jan Versijpt,&nbsp;Anne Ducros,&nbsp;Raquel Gil-Gouveia,&nbsp;Zaza Katsarava,&nbsp;Paolo Martelletti,&nbsp;Raffaele Ornello,&nbsp;Bianca Raffaelli,&nbsp;Deirdre M Boucherie,&nbsp;Patricia Pozo-Rosich,&nbsp;Margarita Sanchez-Del-Rio,&nbsp;Alexandra Sinclair,&nbsp;Antoinette Maassen van den Brink,&nbsp;Uwe Reuter","doi":"10.1186/s10194-022-01502-z","DOIUrl":"https://doi.org/10.1186/s10194-022-01502-z","url":null,"abstract":"<p><strong>Background: </strong>Triptans are migraine-specific acute treatments. A well-accepted definition of triptan failure is needed in clinical practice and for research. The primary aim of the present Consensus was to provide a definition of triptan failure. To develop this definition, we deemed necessary to develop as first a consensus definition of effective treatment of an acute migraine attack and of triptan-responder.</p><p><strong>Main body: </strong>The Consensus process included a preliminary literature review, a Delphi round and a subsequent open discussion. According to the Consensus Panel, effective treatment of a migraine attack is to be defined on patient well-being featured by a) improvement of headache, b) relief of non-pain symptoms and c) absence of adverse events. An attack is considered effectively treated if patient's well-being, as defined above, is restored within 2 hours and for at least 24 hours. An individual with migraine is considered as triptan-responder when the given triptan leads to effective acute attack treatment in at least three out of four migraine attacks. On the other hand, an individual with migraine is considered triptan non-responder in the presence of failure of a single triptan (not matching the definition of triptan-responder). The Consensus Panel defined an individual with migraine as triptan-resistant in the presence of failure of at least 2 triptans; triptan refractory, in the presence of failure to at least 3 triptans, including subcutaneous formulation; triptan ineligibile in the presence of an acknowledged contraindication to triptan use, as specified in the summary of product characteristics.</p><p><strong>Conclusions: </strong>The novel definitions can be useful in clinical practice for the assessment of acute attack treatments patients with migraine. They may be helpful in identifying people not responding to triptans and in need for novel acute migraine treatments. The definitions will also be of help in standardizing research on migraine acute care.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"133"},"PeriodicalIF":7.4,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9555163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33503502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world experience with 240 mg of galcanezumab for the preventive treatment of cluster headache.","authors":"Heejung Mo,&nbsp;Byung-Kun Kim,&nbsp;Heui-Soo Moon,&nbsp;Soo-Jin Cho","doi":"10.1186/s10194-022-01505-w","DOIUrl":"https://doi.org/10.1186/s10194-022-01505-w","url":null,"abstract":"<p><strong>Background: </strong>Galcanezumab of 300 mg monthly is the FDA approved preventive medication for cluster headache (CH) during the cluster period. Compared to the 120 mg galcanezumab syringe for the treatment of migraines, the 100 mg syringe for CH has globally not been as widely available. The aim of our study was to investigate the preventive efficacy and tolerability of two 120 mg galcanezumab doses for episodic CH in clinical practices.</p><p><strong>Methods: </strong>We evaluated patients with CH who received at least 1 dose of 240 mg (2 prefilled syringe of 120 mg) of galcanezumab in the 3 university hospitals from February 2020 to September 2021. In the patients with episodic CH, the efficacy and safety data of galcanezumab were analyzed regarding to the presence of the conventional preventive therapy at the timing of therapy of galcanezumab. The data of other subtypes of CH were separately described.</p><p><strong>Results: </strong>In 47 patients with episodic CH, galcanezumab was started median 18 days after the onset of current bout (range 1-62 days) and 4 patients (10.8%) received second dose of galcanezumab. The median time to the first occurrence of 100% reduction from baseline in CH attacks per week after galcanezumab therapy was 17 days (25% to 75% quartile range: 5.0 ~ 29.5) in all patients with episodic CH, 15.5 days (3.8 ~ 22.1) in 36 patients with galcanezumab therapy add-on conventional preventive therapy, 21.0 days (12.0 ~ 31.5) in 11 patients started galcanezumab as initial preventive therapy. Among 33 patients with headache diary, the proportion of patients with 50% or more reduction in weekly CH attacks at week 3 from baseline were 78.8%. There was no significant difference in the proportion of patients with a reduction of at least 50% in weekly frequency of CH attacks at week 3 between 24 patients received galcanezumab therapy add-on conventional preventive therapy and 9 patient who received initial galcanezumab therapy. (83.3%, vs 66.7%, p = 0.36). There were no significant differences in proportion of \"very much better or \"much better\" between 36 patients received galcanezumab therapy add-on conventional preventive therapy and 11 patient who received initial GT (86.1%, vs 63.6%, p = 0.18).</p><p><strong>Conclusion: </strong>One 240 mg dose of galcanezumab with/without conventional therapy for the prevention of CH is considered effective and safe in clinical practices, as seen in the clinical trial of galcanezumab.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"132"},"PeriodicalIF":7.4,"publicationDate":"2022-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9547445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33493604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral blood flow alterations in migraine patients with and without aura: An arterial spin labeling study.","authors":"Tong Fu,&nbsp;Lindong Liu,&nbsp;Xiaobin Huang,&nbsp;Di Zhang,&nbsp;Yujia Gao,&nbsp;Xindao Yin,&nbsp;Hai Lin,&nbsp;Yongming Dai,&nbsp;Xinying Wu","doi":"10.1186/s10194-022-01501-0","DOIUrl":"https://doi.org/10.1186/s10194-022-01501-0","url":null,"abstract":"<p><strong>Background: </strong>Migraine aura is a transient, fully reversible visual, sensory, or other central nervous system symptom that classically precedes migraine headache. This study aimed to investigate cerebral blood flow (CBF) alterations of migraine with aura patients (MwA) and without aura patients (MwoA) during inter-ictal periods, using arterial spin labeling (ASL).</p><p><strong>Methods: </strong>We evaluated 88 migraine patients (32 MwA) and 44 healthy control subjects (HC) who underwent a three-dimensional pseudo-continuous ASL MRI scanning. Voxel-based comparison of normalized CBF was conducted between MwA and MwoA. The relationship between CBF variation and clinical scale assessment was further analyzed. The mean CBF values in brain regions showed significant differences were calculated and considered as imaging features. Based on these features, different machine learning-based models were established to differentiate MwA and MwoA under five-fold cross validation. The predictive ability of the optimal model was further tested in an independent sample of 30 migraine patients (10 MwA).</p><p><strong>Results: </strong>In comparison to MwoA and HC, MwA exhibited higher CBF levels in the bilateral superior frontal gyrus, bilateral postcentral gyrus and cerebellum, and lower CBF levels in the bilateral middle frontal gyrus, thalamus and medioventral occipital cortex (all p values < 0.05). These variations were also significantly correlated with multiple clinical rating scales about headache severity, quality of life and emotion. On basis of these CBF features, the accuracies and areas under curve of the final model in the training and testing samples were 84.3% and 0.872, 83.3% and 0.860 in discriminating patients with and without aura, respectively.</p><p><strong>Conclusion: </strong>In this study, CBF abnormalities of MwA were identified in multiple brain regions, which might help better understand migraine-stroke connection mechanisms and may guide patient-specific decision-making.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"131"},"PeriodicalIF":7.4,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33487516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting-state magnetoencephalographic oscillatory connectivity to identify patients with chronic migraine using machine learning.","authors":"Fu-Jung Hsiao,&nbsp;Wei-Ta Chen,&nbsp;Li-Ling Hope Pan,&nbsp;Hung-Yu Liu,&nbsp;Yen-Feng Wang,&nbsp;Shih-Pin Chen,&nbsp;Kuan-Lin Lai,&nbsp;Gianluca Coppola,&nbsp;Shuu-Jiun Wang","doi":"10.1186/s10194-022-01500-1","DOIUrl":"https://doi.org/10.1186/s10194-022-01500-1","url":null,"abstract":"<p><p>To identify and validate the neural signatures of resting-state oscillatory connectivity for chronic migraine (CM), we used machine learning techniques to classify patients with CM from healthy controls (HC) and patients with other pain disorders. The cross-sectional study obtained resting-state magnetoencephalographic data from 240 participants (70 HC, 100 CM, 35 episodic migraine [EM], and 35 fibromyalgia [FM]). Source-based oscillatory connectivity of relevant cortical regions was calculated to determine intrinsic connectivity at 1-40 Hz. A classification model that employed a support vector machine was developed using the magnetoencephalographic data to assess the reliability and generalizability of CM identification. In the findings, the discriminative features that differentiate CM from HC were principally observed from the functional interactions between salience, sensorimotor, and part of the default mode networks. The classification model with these features exhibited excellent performance in distinguishing patients with CM from HC (accuracy ≥ 86.8%, area under the curve (AUC) ≥ 0.9) and from those with EM (accuracy: 94.5%, AUC: 0.96). The model also achieved high performance (accuracy: 89.1%, AUC: 0.91) in classifying CM from other pain disorders (FM in this study). These resting-state magnetoencephalographic electrophysiological features yield oscillatory connectivity to identify patients with CM from those with a different type of migraine and pain disorder, with adequate reliability and generalizability.</p>","PeriodicalId":501630,"journal":{"name":"The Journal of Headache and Pain","volume":" ","pages":"130"},"PeriodicalIF":7.4,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}