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The aim of this cross-sectional study was to investigate the cortical metabolite concentrations in patients suffering from migraine with aura (MWA). We hypothesized that occipital γ-aminobutyric acid (GABA) levels are lower in MWA patients.
Learn More >Current theories associated with the cause of tension type headache are mostly focused on muscle tissues. No study has investigated the presence of role of nerve tissues in this population.
Learn More >Levcromakalim opens ATP-sensitive potassium channels (K channel) and induces head pain in healthy volunteers and migraine headache in migraine patients, but no pain in other parts of the body. K channels are expressed in C- and Aδ-fibers, and these channels might directly activate nociceptors and thereby evoke pain in humans.
Learn More >PACAP and other neuropeptides link chronic migraine and opioid-induced hyperalgesia in mouse models.
Chronic use of opioids can produce opioid-induced hyperalgesia (OIH), and when used to treat migraine, these drugs can result in increased pain and headache chronicity. We hypothesized that overlapping mechanisms between OIH and chronic migraine occur through neuropeptide dysregulation. Using label-free, non-biased liquid chromatography-mass spectrometry to identify and measure changes in more than 1500 neuropeptides under these two conditions, we observed only 16 neuropeptides that were altered between the two conditions. The known pro-migraine molecule, calcitonin-gene related peptide, was among seven peptides associated with chronic migraine, with several pain-processing neuropeptides among the nine other peptides affected in OIH. Furthermore, composite peptide complements Pituitary adenylate cyclase-activating polypeptide (PACAP), Vasoactive intestinal peptide (VIP) and Secretogranin (SCG) showed significant changes in both chronic migraine and OIH. In a follow-up pharmacological study, we confirmed the role of PACAP in models of these two disorders, validating the effectiveness of our peptidomic approach, and identifying PACAP as a mechanistic link between chronic migraine and OIH. Data are available via ProteomeXchange with identifier PXD013362.
Learn More >Nummular headache is a primary headache characterised by superficial, coin-shaped pain. Superficial sensory fibre dysfunction might be involved in its pathophysiology. Considering the mechanism of action of onabotulinumtoxinA, it could be a reasonable option in treatment of nummular headache. The aim of the study was to evaluate the efficacy and tolerability of onabotulinumtoxinA in a series of nummular headache patients.
Learn More >Calcitonin gene-related peptide (CGRP) is a neuronal transmitter present in intracranial sensory nerves, where it is involved in migraine pathophysiology as well as other biological functions. Recently, the fully human monoclonal antibody erenumab (AMG 334), which targets the canonical calcitonin gene-related peptide receptor, showed significant prophylactic efficacy and favourable safety in phase II and III clinical trials for episodic and chronic migraine and is now approved for migraine prevention in several countries.
Learn More >Current Evidence on Potential Uses of MicroRNA Biomarkers for Migraine: From Diagnosis to Treatment.
Migraine is a disabling and recurrent neurological disorder characterized by headache attacks that are often accompanied by sensory and motor disturbances. The value and importance of reliable biomarkers in migraine have been long recognized and a diverse range of biomarkers from biological samples to electrophysiological patterns and brain imaging has been proposed. There is still no consensus on specific biomarker(s) for migraine. Ideally, not a single but a battery of biomarkers would provide a multidisciplinary way to understand and treat migraine better. Translational research has witnessed an escalating number of studies on microRNAs (miRNAs) during the last decade. Identification of the first miRNA occurred in 1993, and currently more than 2000 human miRNAs have been recognized. miRNAs are a group of endogenous small non-coding molecules that play a key role in post-transcriptional gene processes and hence are involved in health and disease. miRNAs have already been found to be involved in the onset and progression of several human disorders including chronic pain conditions; however, there have been far fewer studies in migraine and other headaches. Current evidence does suggest that miRNAs play a role in migraine and its relief and hence these molecules are proposed as potential migraine biomarkers. This review updates the current evidence for the role of miRNAs in migraine; including their potential as biomarkers, with a role in understanding of its pathogenesis, the population at risk, diagnosis, patient stratification, chronification risk factors, response to treatments, and miRNA-based therapeutic options. Limitations exist and further research is required to completely unwrap the potential of miRNAs in migraine research and practice.
Learn More >Migraine headache is an episodic phenomenon, and patients with episodic migraine have ictal (headache), peri-ictal (premonitory, aura, and postdrome), and interictal (asymptomatic) phases. We aimed to find the functional characteristics of migraine brain regardless of headache phase using dynamic functional connectivity analysis. We prospectively recruited 50 patients with migraine and 50 age- and sex-matched controls. All subjects underwent a resting-state functional MRI. Significant networks were defined in a data-driven fashion from the interictal (>48 hours apart from headache phases) patients and matched controls (interictal dataset) and tested to ictal or peri-ictal patients and controls (ictal/peri-ictal dataset). Both static and dynamic analyses were used for the between-group comparison. A false discovery rate correction was performed. As a result, the static analysis did not reveal a network which was significant in both interictal and ictal/peri-ictal datasets. Dynamic analysis revealed significant between-group differences in seven brain networks in the interictal dataset, among which a frontoparietal network (controls > patients, p=0.0467), two brainstem networks (patients > controls, p=0.0467 and <0.001), and a cerebellar network (controls > patients, p=0.0408 and <0.001 in two states) remained significant in the ictal/peri-ictal dataset. Using these networks, migraine was classified with a sensitivity of 0.70 and specificity of 0.76 in the ictal/peri-ictal dataset. In conclusion, the dynamic connectivity analysis revealed more functional networks related to migraine than the conventional static analysis, suggesting a substantial temporal fluctuation in functional characteristics. Our data also revealed migraine-related networks which show significant difference regardless of headache phases between patients and controls.
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