ContinuumPub Date : 2024-04-01DOI: 10.1212/CON.0000000000001418
Richard B Lipton
{"title":"Preventive Treatment of Migraine.","authors":"Richard B Lipton","doi":"10.1212/CON.0000000000001418","DOIUrl":"https://doi.org/10.1212/CON.0000000000001418","url":null,"abstract":"OBJECTIVE\u0000This article describes strategies for the preventive treatment of migraine including the emerging role of calcitonin gene-related peptide (CGRP)-targeted therapies and introduces novel paradigms for the preventive treatment of migraine.\u0000\u0000\u0000LATEST DEVELOPMENTS\u0000Multiple migraine medications targeting CGRP have been introduced since 2018, including injectable monoclonal antibodies (ie, eptinezumab, erenumab, fremanezumab, and galcanezumab) and oral small-molecule CGRP receptor antagonists (ie, ubrogepant, rimegepant, atogepant, and zavegepant). With the exceptions of ubrogepant and zavegepant, which are approved only as acute treatments, all of these agents have demonstrated efficacy in the preventive treatment of migraine; the monoclonal antibodies and atogepant have evidence of effectiveness in adults with either episodic or chronic migraine. The safety and tolerability profiles of CGRP-targeted therapies in migraine are favorable.\u0000\u0000\u0000ESSENTIAL POINTS\u0000The goals of preventive migraine therapy include reducing the frequency, severity, duration, and disability associated with attacks, reducing the need for acute treatment and the risk of medication overuse, enhancing self-efficacy and health-related quality of life, and reducing headache-related distress and interictal burden. Six drugs targeting CGRP (four monoclonal antibodies and two gepants) are now available for the preventive treatment of episodic migraine in adults. The efficacy of CGRP-targeted medications in the acute and preventive treatment of migraine, together with good safety and tolerability, has led to the emergence of new approaches to preventive treatment.","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"65 9","pages":"364-378"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ContinuumPub Date : 2024-04-01DOI: 10.1212/CON.0000000000001398
Matthew Robbins
{"title":"New Daily Persistent Headache.","authors":"Matthew Robbins","doi":"10.1212/CON.0000000000001398","DOIUrl":"https://doi.org/10.1212/CON.0000000000001398","url":null,"abstract":"OBJECTIVE\u0000This article describes the clinical features, etiology, differential diagnosis, management, and prognosis of new daily persistent headache.\u0000\u0000\u0000LATEST DEVELOPMENTS\u0000New daily persistent headache has attracted renewed attention as it may arise in the setting of a COVID-19 infection. Spontaneous intracranial hypotension, particularly from CSF-venous fistulas, remains an important secondary headache disorder to consider before diagnosing new daily persistent headache. Symptomatic treatment for new daily persistent headache may include acute and preventive therapies used for migraine and tension-type headache, such as triptans, oral preventive agents, onabotulinumtoxinA, and agents that target calcitonin gene-related peptide.\u0000\u0000\u0000ESSENTIAL POINTS\u0000New daily persistent headache is a daily headache syndrome that starts acutely and can only be diagnosed after 3 months have elapsed and other secondary and primary headache diagnoses have been excluded. The clinical manifestations largely resemble either chronic migraine or chronic tension-type headache. The underlying cause is unknown, but it is plausible that multiple etiologies exist and that it is not a single disease entity. The prognosis is variable but often poor, and the treatment approach is largely extrapolated from the management of chronic migraine and chronic tension-type headache.","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"30 1","pages":"425-437"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ContinuumPub Date : 2024-04-01DOI: 10.1212/CON.0000000000001416
Rashmi B Halker Singh, Jessica Kiarashi
{"title":"Diversity, Equity, and Inclusion in Headache Care and Research.","authors":"Rashmi B Halker Singh, Jessica Kiarashi","doi":"10.1212/CON.0000000000001416","DOIUrl":"https://doi.org/10.1212/CON.0000000000001416","url":null,"abstract":"ABSTRACT\u0000This article reviews the disparities faced by individuals who experience headache disorders and discusses potential solutions to deliver equitable care. Disparities exist in the diagnosis and treatment of headache disorders with regard to race, ethnicity, sex, gender, sexual orientation, geography, and socioeconomic status. Furthermore, research in the realm of headache disparities is inadequate, and the clinical trial representation of patients from underserved communities is poor. Many barriers exist to optimizing care for underserved communities and this article addresses these barriers and presents ways to combat them.","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"62 ","pages":"498-511"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ContinuumPub Date : 2024-04-01DOI: 10.1212/CON.0000000000001437
Lyell K Jones
{"title":"Headache Neurology's Call to Action.","authors":"Lyell K Jones","doi":"10.1212/CON.0000000000001437","DOIUrl":"https://doi.org/10.1212/CON.0000000000001437","url":null,"abstract":"","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"423 2","pages":"294-295"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ContinuumPub Date : 2024-04-01DOI: 10.1212/CON.0000000000001403
P. Rizzoli
{"title":"Medication-Overuse Headache.","authors":"P. Rizzoli","doi":"10.1212/CON.0000000000001403","DOIUrl":"https://doi.org/10.1212/CON.0000000000001403","url":null,"abstract":"OBJECTIVE\u0000Medication-overuse headache (MOH) has been described for almost 100 years and is characterized as a daily or near-daily headache that usually presents in patients with preexisting primary headache disorders who are overusing one or more acute or symptomatic headache medications. This article reviews the diagnosis and management of patients with MOH.\u0000\u0000\u0000LATEST DEVELOPMENTS\u0000The International Classification of Headache Disorders criteria for MOH have changed over time. The worldwide prevalence appears to be between 1% and 2%. Together, headache disorders, including MOH, are currently ranked as the second leading cause of years lived with disability in the Global Burden of Disease world health survey. Significant neurophysiologic changes are seen in the brains of patients with MOH, including functional alterations in central pain processing and modulating systems and central sensitization. Research supports updates to the principles of management, including weaning off the overused medication, preventive therapy, biobehavioral therapy, and patient education.\u0000\u0000\u0000ESSENTIAL POINTS\u0000MOH is a fairly common and treatable secondary headache disorder that produces significant disability and a substantial reduction in quality of life. The costs related to lost income and disability are substantial. MOH is intimately related to chronic migraine, which continues to be underrecognized and undertreated. Treatment focuses on both the institution of effective preventive migraine therapy and the reduction or removal of the overused medications. Educational efforts directed toward both providers and patients have been shown to be effective in reducing the effect of MOH.","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"46 16","pages":"379-390"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ContinuumPub Date : 2024-04-01DOI: 10.1212/CON.0000000000001409
Peter J. Goadsby
{"title":"Indomethacin-Responsive Headache Disorders.","authors":"Peter J. Goadsby","doi":"10.1212/CON.0000000000001409","DOIUrl":"https://doi.org/10.1212/CON.0000000000001409","url":null,"abstract":"OBJECTIVE\u0000This article describes the clinical features and treatment of the indomethacin-responsive headache disorders paroxysmal hemicrania and hemicrania continua.\u0000\u0000\u0000LATEST DEVELOPMENTS\u0000Both paroxysmal hemicrania and hemicrania continua are treated with indomethacin at the lowest clinically useful dose. It has recently become clear that some patients with either condition may respond to treatment with noninvasive vagus nerve stimulation, which can be both indomethacin sparing and, in some cases, headache controlling. Given the lifelong nature of both paroxysmal hemicrania and hemicrania continua, brain imaging with MRI is recommended when the conditions are identified, specifically including pituitary views.\u0000\u0000\u0000ESSENTIAL POINTS\u0000Paroxysmal hemicrania and hemicrania continua are indomethacin-responsive headache disorders that offer a rewarding and unique opportunity to provide marked clinical improvement when recognized and treated appropriately. These disorders share the final common pathway of the trigeminal-autonomic reflex, with head pain and cranial autonomic features, and are differentiated pathophysiologically by the pattern of brain involvement, which can be seen using functional imaging. They have distinct differential diagnoses to which the clinician needs to remain alert.","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"702 ","pages":"488-497"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ContinuumPub Date : 2024-03-29DOI: 10.1080/10304312.2024.2335518
Rob Cover
{"title":"LGBTQ+ collecting institutions: the culture of strategic management, motivation and professionalization","authors":"Rob Cover","doi":"10.1080/10304312.2024.2335518","DOIUrl":"https://doi.org/10.1080/10304312.2024.2335518","url":null,"abstract":"This paper presents findings from an Australian Research Council Linkage Project investigating LGBTQ+ memory, migration and collecting institution practices. It analyses the ways in which minority ...","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ContinuumPub Date : 2024-03-29DOI: 10.1080/10304312.2024.2336186
David Rhodes, Matt Byrne, Jason Boron
{"title":"Queering primary initial teacher education","authors":"David Rhodes, Matt Byrne, Jason Boron","doi":"10.1080/10304312.2024.2336186","DOIUrl":"https://doi.org/10.1080/10304312.2024.2336186","url":null,"abstract":"This research was designed to raise awareness, access and understanding of lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual/aromantic and others who sit outside of the hete...","PeriodicalId":79211,"journal":{"name":"Continuum","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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