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A stated preference survey to explore patient preferences for novel preventive migraine treatments - PubMed

In this DCE assessing CGRP inhibitors attributes, the main driver of patient choice was treatment effectiveness, specifically reduced migraine severity, and consistent treatment effectiveness. Further, patients exhibited an overall preference ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/36047857/


Conclusion: In this DCE assessing CGRP inhibitors attributes, the main driver of patient choice was treatment effectiveness, specifically reduced migraine severity, and consistent treatment effectiveness. Further, patients exhibited an overall preference for an oral tablet every other day over injectables. Patients' experience with previous...

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Risk factors of vestibular migraine-related brain white matter lesions - Acta Neurologica Belgica

Objective and purpose Migraine is related to white matter lesions (WMLs), and attack frequency and duration in migraine patients are thought to increase WMLs. However, the relationship between vestibular migraine ..... see more

Source : https://link.springer.com/article/10.1007/s13760-022-02076-y


Conclusion: These results substantiate that vertigo frequency is an independent risk factor for WMLs in VM. A high frequency of vertigo episodes is more likely to be associated with WMLs than a low frequency. These results suggest a possible approach to the prevention of WMLs in VM patients.

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Real-World Patient Experience of CGRP-Targeting Therapy for Migraine: a Narrative Review - Current Pain and Headache Reports

Purpose of Review To summarize available calcitonin gene-related peptide (CGRP)-targeting therapies for migraine and discuss their use in real-world populations. Background CGRP has long been a topic of interest in ..... see more

Source : https://link.springer.com/article/10.1007/s11916-022-01077-z


Recent findings and summary: Overall, studies reporting real-world patient experiences of CGRP-targeting therapies suggested meaningful effectiveness for migraine treatment with response rates comparable to the numbers reported in clinical trials. Furthermore, studies suggested benefit in patients with multiple prior unsuccessful treatment...

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Non-aura visual disturbance with high visual aura rating scale scores has stronger association with migraine chronification than typical aura - PubMed

1 Keelung Hospital of the Ministry of Health and Welfare, Keelung, Taiwan. 2 Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. 3 School ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/36068697/


Conclusion: Presence of non-aura transient visual disturbance may suggest a higher migraine-related disability and is linked to higher risk of chronic migraine than typical migraine aura in migraine patients. Further studies are needed to elucidate the potential mechanism.

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Huma Sheikh Commented on a Post
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How can we improve migraine diagnosis?

As few as half of all patients reporting migraine-like symptoms have been formally diagnosed with migraine headaches. Underdiagnosis and treatment may be due to atypical presentation with lack of the best-known symptoms of migraine. Migraines can also mimic other neurological, ocular, or even gastrointestinal conditions. Many patients with migraines are misdiagnosed with sinusitis or tension-type headaches, or suspected of having glaucoma, meningitis, epilepsy, a stroke, brain aneurysm, or a malignancy in the brain.  

In making your diagnosis, how do you differentiate between migraine and those neurological conditions that share similar symptoms?  How do you think more migraine patients can receive a correct diagnosis? 

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Preventive migraine treatment in mitochondrial diseases: a case report of erenumab efficacy and literature review - PubMed

Migraine is a common condition in mitochondrial diseases, with a higher prevalence than in the general population. Although several clinical studies support the hypothesis that mitochondrial dysfunction plays a central ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/36097203/


Conclusion/Relevance: Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) or against its receptor are innovative and specific therapies for migraine prophylaxis. This class of drugs is particularly suitable for subjects, such as those suffering from genetically determined mitochondrial dysfunction, in which pharmacological...

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Preventive treatment can reverse cognitive impairment in chronic migraine - The Journal of Headache and Pain

Objective To study the impact of chronic migraine (CM) on the cognition and quality of life (QoL) of patients in the interictal period, and to analyse the degree of reversibility ..... see more

Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01486-w


Conclusions: This study confirms poor cognitive performance that is not explained by migraine pain itself, as it occurs in the interictal period, irrespective of the patient’s emotional status. Our findings show that these effects are reversible in some cases with preventive treatment of CM, reaffirming the important impact of this condition...

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Does MIDAS reduction at 3 months predict the outcome of erenumab treatment? A real-world, open-label trial - The Journal of Headache and Pain

Background In Italy, monoclonal antibodies targeting the CGRP pathway are subsidized for the preventive treatment of high frequency and chronic migraine (CM) in patients with a MIgraine Disability ASsessment (MIDAS) ..... see more

Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01480-2


Conclusion: MIDASRes only partly reflects the 12-month outcome of erenumab treatment in CM, as it excludes more than one third of responders. A criterion based on the alternative consideration of ≥ 50% reduction in MIDAS score or MMDs in the first three months of treatment represents a more precise and inclusive option.

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Safety and efficacy of erenumab in patients with trigeminal neuralgia in Denmark: a double-blind, randomised, placebo-controlled, proof-of-concept study

Trigeminal neuralgia is a severe facial pain disorder that is difficult to treat. Erenumab, a monoclonal antibody against the calcitonin gene-related peptide (CGRP) receptor, has proven efficacy in migraine. Erenumab ..... see more

Source : https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00294-0/fulltext


Interpretation: Erenumab did not reduce pain intensity compared with placebo in patients with trigeminal neuralgia and CGRP probably does not have an important role in paroxysmal pain. Well tolerated, effective treatments in trigeminal neuralgia are still needed.

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A systematic review of economic evaluations of pharmacological treatments for adults with chronic migraine - The Journal of Headache and Pain

Background and aims Chronic migraine is a common neurovascular brain disorder with substantial economic costs. We performed a systematic review to identify economic evaluations of pharmacological treatments for adults with ..... see more

Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01492-y


Conclusions: Evidence to support the cost-effectiveness of pharmacological treatments of chronic migraine in the adult population using Botox and Erenumab were identified. Our findings suggest that both Botox and Erenumab, are cost-effective compared to placebo; although Erenumab had more incremental economic benefits compared to Botox.

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Serum CGRP in migraine patients using erenumab as preventive treatment - The Journal of Headache and Pain

Aim Serum levels of Calcitonin Gene-Related Peptide (CGRP)-like immunoreactivity (CGRP-LI) in migraine patients before and after starting treatment with erenumab were measured to evaluate the association with clinical treatment response. ..... see more

Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01483-z


Conclusion: Lower serum CGRP-LI 2–4 weeks after starting treatment with erenumab was associated with a higher reduction in migraine days after three months of treatment. Although the underlying mechanisms remain to be determined, this suggests that changes in CGRP levels, shortly after starting erenumab, are important for its clinical effect.

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TRIGEMINAL NEURALGIA FACIAL PAIN SYMPTOMS AND TREATMENTS - Virtual Headache Specialist

You are eating your lunch, biting into that delicious apple, when suddenly you have a severe electrical zapping shock across part of your face. You jerk your head back because ..... see more

Source : https://virtualheadachespecialist.com/trigeminal-neuralgia-facial-pain-symptoms-and-treatments/

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NECK PAIN AND HEADACHE. THE TRIGEMINOCERVICAL NUCLEUS CONNECTION BETWEEN MIGRAINE, HEADACHE AND NECK PAIN. - Virtual Headache Specialist

Can headache cause neck pain? Can neck pain cause headache? Do you have neck pain with a headache? What are neck pain headache causes? These are likely familiar questions if ..... see more

Source : https://virtualheadachespecialist.com/neck-pain-and-headache-migraine-headache-and-neck-pain/

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Role of Calcitonin Gene-Related Peptide on the Gastrointestinal Symptoms of Migraine-Clinical Considerations: A Narrative Review

Calcitonin gene-related peptide (CGRP) is involved in several of the pathophysiological processes underpinning migraine attacks. Therapies that target CGRP or its receptor have shown efficacy as preventive or acute treatments ..... see more

Source : https://n.neurology.org/content/early/2022/09/20/WNL.0000000000201332


Conclusion/Relevance: In this review, we summarize the epidemiological evidence for associations between migraine and gastrointestinal disorders, consider the possible physiological role of CGRP in these associations, and review the clinical occurrence of gastrointestinal events in patients with migraine receiving CGRP-based therapies and...

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Role of endothelin in the pathophysiology of migraine: A new view on an old player

There is cumulating evidence that endothelin-1 (ET-1) may play a role in migraine, however controversial findings still impede a conclusion to be drawn. Herein we tested the hypothesis that endothelin ..... see more

Source : https://www.sciencedirect.com/science/article/abs/pii/S0143417922000610?via=ihub


Conclusion: Selective blockade of ETB receptors in the TG fully prevented the development of periorbital mechanical allodynia and photic sensitivity induced by CGRP, but ETA receptor blockade caused only a slight reduction of periorbital mechanical allodynia without affecting photic sensitivity. ETB receptor-operated mechanisms in the TG may...

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Bidirectional Association Between Fibromyalgia and Migraine Among Probands and Unaffected Non-Twin Siblings: A Nationwide Population-Based Study - PubMed

doi: 10.1111/papr.13160. Online ahead of print. 1 Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 2 Department of Psychiatry, Taipei Veterans General Hospital, Taipei, ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/36054795/


Conclusion: The bidirectional association between fibromyalgia and migraine among probands and unaffected siblings suggests a familial coaggregation of these two conditions. Additional studies are required to investigate the genetic and environmental etiologies for this coaggregation.

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  • from Doctor Unite September 12, 2022
    Interesting study that explored the bidirectional relationship between fibromyalgia and migraine among probands with either of the two disorders and their unaffected siblings
  • September 09, 2022
    Treating fibromyalgia can be very difficult
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Level of therapeutic innovation from the registration studies of the new drugs for the prophylaxis of migraine - PubMed

The new monoclonal antibodies of the class of CGRP targeting therapies have been authorized with efficacy data only against placebo. They do not offer additional clinical benefits compared to available ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/36054749/


Discussion: The new monoclonal antibodies of the class of CGRP targeting therapies have been authorized with efficacy data only against placebo. They do not offer additional clinical benefits compared to available therapies for the prevention of migraine attacks, with the exception of a lower frequency of administration and a more rapid effect....

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Salivary CGRP and Erenumab Treatment Response: Towards Precision Medicine in Migraine - PubMed

Patients with migraine not only have higher CGRP levels compared with HCs, but also the presence of depressive symptoms seems to increase salivary CGRP levels and we have evidence, for ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/36054144/


Interpretation: Patients with migraine not only have higher CGRP levels compared with HCs, but also the presence of depressive symptoms seems to increase salivary CGRP levels and we have evidence, for the first time, that baseline salivary CGRP concentration is associated with treatment response to erenumab.

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Investigation on how dynamic effective connectivity patterns encode the fluctuating pain intensity in chronic migraine

Chronic migraine is characterised by persistent headaches for >15 days per month; the intensity of the pain is fluctuating over time. Here, we explored the dynamic interplay of connectivity patterns ..... see more

Source : https://www.sciencedirect.com/science/article/pii/S2452073X22000174?via=ihub


Conclusion/Relevance: The results reflect the multi-facetted clinical picture of the disease. Across all sessions, each patient with chronic migraine exhibited a distinct pattern of pain intensity-related cortical connectivity. The diversity of the individual findings are accompanied by inconsistent relations between the connectivity...

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Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: a clinical service evaluation - The Journal of Headache and Pain

Background Calcitonin gene-related peptide (CGRP) inhibitors have been developed as options for treatment of chronic and episodic migraine. We present our experience of the use of erenumab in a tertiary ..... see more

Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01456-2


Conclusion: Erenumab was an effective treatment for chronic migraine in this treatment resistant population over 3 months of follow up. Presence of daily headache predicted poorer response but there was still a significant positive response rate in this group.

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