Migraine/Headache

The complex mechanisms underlying migraine are not entirely understood. It has been suggested that descending endogenous pain modulation is an important contributing factor, although research is controversial. A frequently used method to quantify the inhibitory pain modulation system is offset analgesia (OA), defined as a disproportionally large decrease in pain perception in response to a small decrease of painful stimulation. The aim of this study is to evaluate the OA response in patients with migraine and healthy controls, measured at the forehead (trigeminal, V1) and forearm (extra-trigeminal). Patients with episodic migraine during the headache free interval (n=26) and age and sex matched headache-free controls (n=26) were included in this cross-sectional study. All participants underwent an individualized OA paradigm consisting of three-stimulus offset trials and three constant temperature trials examined at both, a trigeminal and an extra-trigeminal test site. Items from the quantitative sensory testing protocol were additionally included. In contrast to the extra-trigeminal area, a reduced offset analgesia response was shown in the trigeminal area in patients with migraine compared to healthy controls (p<0.01, MD: 13.7, 95%CI: 3.8; 23.6). Statistically significant differences between the trigeminal area and the extra-trigeminal area were neither observed in healthy controls nor in patients with migraine (p>0.05). Mechanical detection, mechanical pain threshold, warm detection and heat pain threshold showed no significant differences between groups or test sites (p>0.05). In summary, patients with episodic migraine in the headache free interval exhibited somatotopically specific differences in endogenous pain modulation.

Migraine and vasovagal syncope are comorbid conditions that may share part of their pathophysiology through autonomic control of the systemic circulation. Nitroglycerin can trigger both syncope and migraine attacks, suggesting enhanced systemic sensitivity in migraine. We aimed to determine the cardiovascular responses to nitroglycerin in migraine.

To describe the clinical presentation and early clinical course of a sample of deployed U.S. military service members following concussion, underscoring the impact of pre-existing migraine and other co-occurring conditions. It is important to obtain a comprehensive clinical history to identify evidence of underlying migraine and other health conditions which may contribute to an individual's presenting symptoms influencing early management and outcomes following concussion. Early outcome measures assessed include headache treatment response and fitness for return to duty.

The diagnostic criteria of episodic and chronic cluster headache (cCH) were recently modified, yet pathophysiological differences between the two are still unclear. The aim of this cross-sectional study is to identify and characterize other differences between episodic and cCH.

A method for assessing dynamic muscle hyperalgesia (dynamic pressure algometry) has been developed and applied in tension-type and migraine headaches.

Observational studies have implicated migraine as a risk factor for coronary artery disease (CAD) and atrial fibrillation (AF), however it is unclear whether migraine is causal in this relationship. We investigated potential causality between genetically instrumented liability to migraine and cardiovascular disease outcomes using two-sample Mendelian randomization.