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Article
Clinical Neurology
Gabriel Garate et al.
Summary: This study aimed to analyze the changes in alpha and beta-CGRP levels during CGRP monoclonal antibodies treatment in patients with chronic migraine. Blood samples were collected from patients with chronic migraine and healthy controls, and the levels of alpha and beta-CGRP were measured using ELISA. The results showed that alpha-CGRP levels significantly decreased during mAb treatment and the decrease was correlated with a reduction in migraine days. Beta-CGRP levels did not change during treatment. These findings support the role of alpha-CGRP as a biomarker for chronic migraine.
ANNALS OF NEUROLOGY
(2023)
Article
Clinical Neurology
Simona Nikolova et al.
Summary: This longitudinal study aimed to investigate the association between brain iron accumulation and the response to erenumab treatment for migraine. The results showed that erenumab responders had higher T2* values in the periaqueductal gray and anterior cingulate cortex, indicating less iron accumulation in these regions.
Review
Clinical Neurology
Mi Ji Lee et al.
Summary: This article reviews the use of monoclonal antibodies against calcitonin gene-related peptide (CGRP) or its receptor (anti-CGRP(-R) mAbs) and small-molecule CGRP receptor antagonists (gepants) in specific situations, such as non-responders to prior therapy, combination therapy, switching, and treatment termination. The evidence supports the use of all available anti-CGRP(-R) mAbs in non-responders to prior therapy. There is insufficient evidence to support or reject the efficacy of combining CGRP(-R) mAbs or gepants with oral migraine prophylactic agents or botulinum toxin A. Switching from one CGRP(-R) mAb to another might benefit a fraction of patients. Currently, treatment termination depends on reimbursement policies, and the optimal mode of termination is discussed.
Review
Clinical Neurology
Severin Schramm et al.
Summary: This systematic review summarizes recent findings on the use of functional magnetic resonance imaging (fMRI) in migraine research. fMRI has revealed functional brain changes in migraine and their partial correlation with clinical parameters. However, replication of findings and standardization of reporting are needed to increase the reliability and value of observations.
Review
Clinical Neurology
Mohammad Al-Mahdi Al-Karagholi et al.
Summary: The review aimed to investigate the role of prolactin signaling in the pathophysiology of headache and migraine. Sex-dependent features of migraines suggest the involvement of the hypothalamus-pituitary-gonadal axis. Prolactin signaling has been implicated in sex-related differences in pain perception.
Article
Clinical Neurology
Marta Waliszewska-Prosol et al.
Summary: The Migraine in Poland study is the first nationwide cross-sectional online survey of Polish migraine patients. The study reveals that despite high access to neurologist consultations and accurate diagnosis, there are still diagnostic and therapeutic difficulties for migraine patients in Poland.
JOURNAL OF HEADACHE AND PAIN
(2023)
Article
Clinical Neurology
Keiko Ihara et al.
Summary: This study investigated the clinical characteristics of Japanese migraine patients who responded well to CGRPmAbs based on real-world data. The study found that older age, fewer prior treatment failures, and no history of immune-rheumatologic diseases were associated with a better response to CGRPmAbs.
JOURNAL OF HEADACHE AND PAIN
(2023)
Article
Clinical Neurology
Bianca Raffaelli et al.
Summary: The cessation of CGRP(-receptor) antibodies migraine prophylaxis led to a significant increase in migraine frequency and acute medication intake over time. However, by weeks 13-16, the monthly migraine days were not significantly different from baseline values.
Article
Clinical Neurology
Luigi Francesco Iannone et al.
Summary: This study evaluated the effects of discontinuation and retreatment of anti-CGRP mAbs in resistant chronic migraine patients and found that most patients experienced worsening of symptoms during the 3-month discontinuation period, which was rapidly resolved by retreatment. However, a quarter of patients showed sustained benefit during discontinuation and did not require retreatment.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Fabrizio Vernieri et al.
Summary: This study found that in patients with chronic migraine, unilateral pain, a good response to triptans, and normal weight may be associated with a persistent positive response in the first 3 months of therapy with galcanezumab.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Chiara Zecca et al.
Summary: In this study, treatment with ERE significantly reduced MMDs in migraine patients. Factors such as age at migraine onset, number of failed preventive medications, and migraine burden were found to influence the response to ERE. The study also suggested a potential role for RAMP1 rs7590387 as a genetic predictor of ERE efficacy.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Christopher Kjaer Cullum et al.
Summary: This study assessed the real-world efficacy and safety of erenumab in patients with chronic migraine. The results showed that erenumab was effective and well-tolerated in reducing the frequency of migraine attacks in patients with chronic migraine.
JOURNAL OF HEADACHE AND PAIN
(2022)
Article
Clinical Neurology
Umberto Pensato et al.
Summary: The study found that erenumab significantly reduced migraine frequency and pain medication intake in refractory chronic migraine patients with medication overuse headache. After 3 months, 51% of patients experienced a reduction of at least 50% in monthly headache days, with 20% experiencing a reduction of at least 75%. Allodynia was identified as a negative predictive factor for erenumab response, while 64% of patients clinically converted to episodic migraine without medication overuse.
NEUROLOGICAL SCIENCES
(2022)
Review
Clinical Neurology
Fred Cohen et al.
Summary: Remarkable advancements have been made in the field of migraine research and treatment, particularly with the discovery of CGRP functional blocking monoclonal antibodies (mAbs) as an effective preventive therapy for both chronic and episodic migraine. These mAbs offer advantages such as high affinity and selectivity, long-circulating plasma half-lives, and limited risk for side effects and drug-drug interactions. However, long-term safety and use during pregnancy should be further studied.
Article
Biology
Hauke Basedau et al.
Summary: This study found that treatment with CGRP antibodies had specific effects on brain activation and modulation in migraine patients. Galcanezumab reduced hypothalamic activation in all patients, with a stronger reduction in responders. Comparison between galcanezumab and erenumab showed differences in brain networks activated by the two antibodies. Pre-treatment activity of the spinal trigeminal nucleus and its coupling with the hypothalamus were associated with response to galcanezumab.
Article
Clinical Neurology
Magdalena Nowaczewska et al.
Summary: This study aimed to investigate the relationship between baseline clinical parameters and cerebral blood flow (CBF) with the efficacy of monoclonal antibodies (mAbs). The study found that patients with lower baseline mean blood flow velocity (Vm) in the cerebral arteries had a better response to mAbs treatment. Additionally, unilateral pain localization, higher HIT-6 scores, and absence of family history of migraine were associated with better responsiveness to mAbs.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
Todd J. J. Schwedt et al.
Summary: The study found that reductions in migraine frequency with erenumab treatment are associated with changes in brain functional connectivity and processing of extracranial painful stimuli that differ from non-responders.
JOURNAL OF HEADACHE AND PAIN
(2022)
Article
Clinical Neurology
Alicia Alpuente et al.
Summary: This study aimed to analyze salivary calcitonin gene-related peptide (CGRP) levels in patients with migraine, predict erenumab response based on baseline CGRP levels, and evaluate CGRP changes post-treatment. The results showed that patients with migraine had higher CGRP levels compared to healthy controls, and the presence of depressive symptoms increased salivary CGRP levels. Additionally, baseline salivary CGRP concentration was associated with treatment response to erenumab for patients with episodic migraine.
ANNALS OF NEUROLOGY
(2022)
Review
Clinical Neurology
Janu Thuraiaiyah et al.
Summary: This systematic review investigated the levels of cytokines in migraine patients during and outside attacks. It found that the anti-inflammatory cytokine interleukin 10 was decreased, while transforming growth factor beta 1 was increased in migraine patients compared to controls during non-attack periods. Pro-inflammatory cytokines, tumor necrosis factor alpha and interleukin 6, were increased in migraine patients compared to controls outside attacks. The levels of cytokines during attacks varied. The review suggests an involvement of cytokines in the inflammatory mechanisms of migraine.
Review
Clinical Neurology
Betel Tesfay et al.
Summary: The purpose of this study was to provide an overview of clinical studies on CGRP measurements in body fluids of migraine patients and to discuss the validity of CGRP measurement as a clinical biomarker of migraine. Several studies have reported increased CGRP levels in various body fluids of migraine patients, suggesting that CGRP may be a feasible biomarker. However, inconsistencies and methodological challenges in measuring CGRP levels exist. CGRP measurements may have potential as biomarkers for predicting response to migraine therapy.
CURRENT OPINION IN NEUROLOGY
(2022)
Review
Clinical Neurology
Roberta Messina et al.
Summary: This review examines the use of fMRI to study the mechanisms of migraine. It finds that migraine attacks are associated with hypothalamic hyperexcitability and disruptions in the pain and central trigeminovascular pathways. The visual cortex also becomes hyperexcitable during the aura phase. Additionally, disruptions in the pontine, thalamic, sensorimotor, and visual networks are observed during the headache phase, while hypothalamic activity and connectivity normalize. The visual cortex remains hyperexcitable during the postdromal phase, and asymptomatic migraine patients also show functional alterations in pain and visual processing brain areas.
CURRENT OPINION IN NEUROLOGY
(2022)
Review
Clinical Neurology
Hakan Ashina et al.
Summary: Provoked and spontaneous migraine attacks have similar neurobiological characteristics, with the exception of the source of migraine-inducing substances. However, provoked attacks cannot be used to study the events preceding the release of migraine-inducing signaling molecules during spontaneous attacks.
JOURNAL OF HEADACHE AND PAIN
(2022)
Article
Clinical Neurology
Priscilla Monterrey et al.
Summary: The study aimed to investigate the proportion and characteristics of patients with migraine in Central American and Caribbean countries, as well as the impact of migraine on their daily activities, professional and social lives. The results showed that a high proportion of patients experienced long duration and high severity of migraine attacks, which directly affected their work/social life.
Article
Clinical Neurology
Simone de Vries Lentsch et al.
Summary: This study evaluated the serum levels of Calcitonin Gene-Related Peptide (CGRP)-like immunoreactivity (CGRP-LI) in migraine patients before and after starting treatment with erenumab, and examined their association with clinical treatment response. The results showed that lower levels of serum CGRP-LI 2-4 weeks after starting treatment with erenumab were associated with a higher reduction in migraine days after three months of treatment. This suggests that changes in CGRP levels shortly after starting erenumab are important for its clinical effect.
JOURNAL OF HEADACHE AND PAIN
(2022)
Correction
Clinical Neurology
Ali H. Mokdad
Article
Clinical Neurology
Ilaria Frattale et al.
Summary: The study found that 80.2% of triptan users were triptan responders, while 63.7% were erenumab responders. The response to triptans was associated with the response to erenumab in the study, with a significant odds ratio for erenumab response in triptan users compared to non-users. Starting erenumab also improved triptan response in both erenumab responders and non-responders, suggesting potential benefits for migraine treatment.
JOURNAL OF HEADACHE AND PAIN
(2021)
Article
Clinical Neurology
Bottiroli Sara et al.
Summary: This study evaluated the psychological predictors of treatment outcome with the anti-CGRP monoclonal antibody erenumab in patients with chronic migraine. It found that anxious-fearful personality, current stressors, and anxiety were negative predictors of treatment outcome. Erenumab confirmed its effectiveness in patients with difficult-to-treat migraine.
JOURNAL OF HEADACHE AND PAIN
(2021)
Review
Clinical Neurology
Sait Ashina et al.
Summary: Individuals with migraine exhibit structural and functional changes in the brain, including white matter abnormalities, silent infarct-like lesions, and volumetric changes. Neuroimaging studies have helped characterize these changes, but limitations such as small sample sizes and poorly defined control groups exist.
Article
Clinical Neurology
Andreas R. Gantenbein et al.
Summary: The study analyzed the effects of discontinuation of anti-calcitonin gene-related peptide antibodies treatment on migraine patients after 12 months of treatment, finding that migraine frequency increased in most patients after treatment interruption, necessitating re-prophylaxis. Therefore, limiting treatment to benefiting patients and periodically confirming the need for prophylaxis is recommended.
Review
Medicine, General & Internal
Messoud Ashina et al.
Summary: The paper discusses the progress made in the search for biomarkers of migraine within genetics, provocation modeling, biochemistry, and neuroimaging research. Challenges and future directions for each biomarker modality are outlined, as well as advances in combining and integrating data from multiple biomarker modalities. These efforts contribute to developing precision medicine for future patients with migraine.
Article
Clinical Neurology
Hashmat Ghanizada et al.
Summary: The study confirms that IV infusion of adrenomedullin may trigger migraine attacks, leading to increased headache intensity and changes in physiological indicators such as heart rate and flushing.
Article
Clinical Neurology
Marcello Silvestro et al.
Summary: Patients with refractory migraine who do not respond to CGRP-mAbs treatment show higher baseline frequency of migraine attacks, medication overuse, and pain catastrophizing. Olanzapine treatment was effective in reducing headache days/month in 67% of patients who did not respond to CGRP-mAbs, supporting the hypothesis of dopaminergic pathway involvement in migraine refractoriness.
ACTA NEUROLOGICA SCANDINAVICA
(2021)
Article
Clinical Neurology
Piero Barbanti et al.
Summary: In a real-world setting, erenumab showed long-term effectiveness, safety, and tolerability in patients with high-frequency episodic migraine or chronic migraine with multiple prior preventive treatment failures. Positive predictors of responsiveness included allodynia in high-frequency episodic migraine, male sex, and baseline migraine frequency in chronic migraine, while negative predictors included psychiatric comorbidities and prior treatment failures in chronic migraine patients.
Article
Clinical Neurology
A. B. Gago-Veiga et al.
Summary: The study found differences in the choice of preventive treatment for migraine patients between neurologists from different countries. The main differences were in the use of antidepressants, antiepileptic drugs, beta-blockers and antihypertensive drugs, OnabotulinumtoxinA, with variations persisting even in patients without comorbidities.
JOURNAL OF HEADACHE AND PAIN
(2021)
Review
Clinical Neurology
Oguzhan Kursun et al.
Summary: Neuroinflammatory pathways, especially those involving inflammasome proteins, show promise as potential treatment targets and even biomarkers in migraine. The activation of inflammasomes can stimulate trigeminal neurons and contribute to the generation of migraine pain, making them an important focus in migraine research. The NLRP3 inflammasome, in particular, is well-studied and has been implicated in various inflammatory pain conditions, including migraine.
JOURNAL OF HEADACHE AND PAIN
(2021)
Article
Clinical Neurology
Byung-Kun Kim et al.
Summary: The study found that Korean patients with migraine face significant unmet needs in terms of diagnosis, understanding of the disease, and disease management. Patients took an average of 10.1 years to be diagnosed, with a lack of understanding about migraine and high levels of disability and poor quality of life reported. Satisfaction with previous doctor-patient relationships and medications was generally low among respondents.
JOURNAL OF HEADACHE AND PAIN
(2021)
Review
Clinical Neurology
Diana N. Krause et al.
Summary: Reproductive hormones influence migraine in women but the basis of these effects is unknown. In this Review, the authors discuss what is known about sex hormones and their receptors in migraine-related areas of the CNS and the trigeminovascular pathway and propose a simple model to explain how hormones influence menstrual migraine.
NATURE REVIEWS NEUROLOGY
(2021)
Article
Behavioral Sciences
Carlo Baraldi et al.
Summary: This study aimed to identify clinical predictors of good response in patients with chronic migraine and medication overuse-headache treated with erenumab. After 1 year, significant improvements were observed in headache days, analgesic consumption, headache impact tests, and migraine disability assessment questionnaire scores compared to baseline. Patients with longer medication overuse-headache duration, higher analgesic intake, and more previous failed preventive treatments may receive less benefit with erenumab.
BRAIN AND BEHAVIOR
(2021)
Article
Medicine, General & Internal
Lanfranco Pellesi et al.
Summary: The study found that a 2-hour infusion of VIP caused migraine attacks in 71% of patients, mimicking their spontaneous attacks. Additionally, the area under the curve of headache intensity scores and the superficial temporal artery diameter were significantly greater after VIP compared with placebo infusion.
Article
Clinical Neurology
Hashmat Ghanizada et al.
Summary: The IV infusion of adrenomedullin was found to increase the incidence and intensity of migraine attacks, as well as significant adverse effects on heart rate and flushing. The study suggests that adrenomedullin may be a potential therapeutic target for migraine treatment.
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Clinical Neurology
Simona Sacco et al.
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(2020)
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Messoud Ashina
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Casper Emil Christensen et al.
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Anders Eklund et al.
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Public, Environmental & Occupational Health
Asbjorn Hrobjartsson et al.
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
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Paul Durham et al.
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Psychology, Clinical
Gordon J. G. Asmundson et al.
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