OnabotulinumtoxinA in elderly patients with chronic migraine: insights from a real-life European multicenter study - Journal of Neurology
Source : https://link.springer.com/article/10.1007/s00415-022-11457-5
Introduction Although migraine prevalence decreases with aging, some older patients still suffer from chronic migraine (CM). This study aimed to investigate the outcome of OnabotulinumtoxinA (OBT-A) as preventative therapy in...
Conclusions: In a population of elderly CM patients with a long history of migraine OBT-A provided a significant benefit, over the first three treatment cycles, as good as in non-old patients.
The contribution of the left precuneus to emotion memory in migraine without aura patients
Source : https://www.frontiersin.org/articles/10.3389/fnins.2022.905942/full
BackgroundThe impact of migraine without aura (MWoA) on cognitive function remains controversial, especially given the sparse literature on emotional memory.MethodsTwenty seven MWoA patients and 25 healthy controls (HCs) were enrolled...
Conclusions: Our study demonstrated the tendency for the influence of migraine on emotional memory and revealed the left precuneus as a critical contributor to recollection performance, providing novel insights for understanding emotional memory and its neural mechanisms in MWoA patients.
Serum Calcitonin Gene-Related Peptide Is Elevated in... : Journal of Neuro-Ophthalmology
pathy [RPON]). As migraine is associated with elevated serum calcitonin gene-related peptide (CGRP) levels, we studied serum CGRP levels among patients with OM/RPON to determine whether they are elevated during...
Conclusions: Elevated serum CGRP levels during the ictal phase of OM/RPON favor migraine as the underlying cause of episodic headache with ophthalmoplegia.
Calcitonin Gene-Related Peptide (CGRP) and Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) in Migraine Pathogenesis - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/36297301/
2022 Sep 27;15(10):1189. doi: 10.3390/ph15101189. 1 Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, 2600 Copenhagen, Denmark. 2 Department of Neurorehabilitation/Traumatic Brain Injury, Rigshospitalet, 2100 Copenhagen, Denmark. Free PMC...
Conclusions: Human studies into the pathophysiological underpinnings of CGRP and PACAP in migraine are manifold and here we review the works investigating these neuropeptides in patients suffering from migraine in order to elucidate the background for developing new treatment options for this vastly disabling disorder.
Blood Pressure in Migraine Patients Treated With Monoclonal Anti-CGRP (receptor) Antibodies: A Prospective Follow-up Study
Source : https://n.neurology.org/content/early/2022/10/04/WNL.0000000000201008
Background and Objectives: Anti-CGRP (receptor) antibodies are approved as preventive treatment for migraine. Recent concerns have been raised after a retrospective analysis of post-marketing case reports of elevated BP associated...
Discussion: The mean systolic and diastolic BP increased after anti-CGRP (receptor) antibodies were started. The majority of patients remained within the normal blood pressure limits, but some patients required antihypertensive treatment. Physicians should be aware that people with migraine may be at risk to develop hypertension when treated with anti-CGRP (receptor) antibodies and this should be added to (inter)national treatment guidelines.
• Source: Journal of Neurology, Neurosurgery, & Psychiatry
• Discussion: “Orthoptic measurements can be used to diagnose MG by quantifying EOM ]extraocular muscle] weakness and fatiguability. Drift during persistent gaze on a Hess chart is specific for MG and could be used for diagnostic purposes. The Hess chart examination is widely available, inexpensive and fast. Moreover, orthoptic measurements may be a clinically relevant outcome measure for clinical trials.”
• Diagnosing ocular MG is difficult due to the paucity of serum antibodies. In the current study, researchers assessed EOM weakness via orthoptic measures such as the adapted Hess chart examination.
• Dutch researchers performed a prospective study in patients with 20 patients with MG (i.e., antibody positive MG) and 14 seronegative MG patients. They assessed orthoptic measures in 19 healthy vs. 18 control participants with Graves orbitopathy, chronic progressive external ophthalmoplegia, or oculopharyngeal muscular dystrophy.
• Increasing dosages from 70 mg to 140 mg did not impact BP levels.
• “Our data suggest that there might be a different effect for renumber than for fremanezumab. Our results seem to demonstrate a larger and more consistent effect on the BP in patients treated with adenoma than in patients treated with fremanezumab,” the authors wrote. “We cannot for certain conclude whether there are indeed differences between these 2 drugs or what the reason for these differences would be. One reason could be that erenumab might have a larger inhibiting effect on the CGRP pathway than fremanezumab, although this seems unlikely given the similar clinical efficacy of both drugs.”
• Limitations of the current study include it being underpowered and the presence of white-coat hypertension.