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Hosokawa K, Usami K, Tatsuoka Y, Danno D, Takeshima T, Tatsuoka Y, Takahashi R, Ikeda A. Novel and reappraised wide-band EEG findings in migraineurs: Its correlation with several clinical variables. Clin Neurophysiol 2024; 166:166-175. [PMID: 39178551 DOI: 10.1016/j.clinph.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 07/05/2024] [Accepted: 07/24/2024] [Indexed: 08/26/2024]
Abstract
OBJECTIVE Cortical spreading depolarization is one possible pathogenesis of migraine, of which slow neurophysiological change is barely recorded in conventional EEG settings. Using wide-band EEG conditions, we reappraised the features of EEG in migraineurs, including subdelta-band EEG changes. METHODS This retrospective study included 144 patients with migraine. We delineated EEG of focal delta slow (FDS) (1-4 Hz) by time constant (TC) 0.3 s and focal subdelta slow (FSDS) (< 1 Hz) by TC 2 s. Relationships between clinical variables and EEG findings were evaluated. RESULTS Of 144 patients, 39 had aura and 105 did not. FSDS and FDS were observed in 38 and 58 patients, respectively. No EEG was recorded during the aura. In multivariate analysis with the phase of migraine, family history, age, and percentage of sleep during EEG recording, the phase of migraine was related to the occurrence of FSDS (postdrome vs interictal, prodrome, and headache respectively (OR = 49.00 [95% CI = 3.89-616.66], 46.28 [2.99-715.78], 32.79 [2.23-481.96], p = 0.0026, 0.0061, 0.011). FDS was clinically unremarkable for differential evaluation. CONCLUSIONS Wide-band EEG abnormality in migraineurs, i.e., FSDS, can be affected by migraine phase. SIGNIFICANCE Wide-band EEG finding could be a biomarker related to clinical variables in migraines.
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Affiliation(s)
- Kyoko Hosokawa
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan
| | - Kiyohide Usami
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan; Department of Clinical Laboratory, Kyoto University Hospital, Japan
| | - Yuu Tatsuoka
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan
| | - Daisuke Danno
- Department of Neurology, Headache Center, Social Medical Corporation Kotobukikai Tominaga Hospital, Japan
| | - Takao Takeshima
- Department of Neurology, Headache Center, Social Medical Corporation Kotobukikai Tominaga Hospital, Japan
| | | | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan.
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2
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Fang M, Wang M. The imaging findings of migraine with visual aura in a CADASIL patient. Neurol Sci 2024; 45:4087-4090. [PMID: 38634957 DOI: 10.1007/s10072-024-07524-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 04/19/2024]
Abstract
Head MRI images of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients during migraine attacks are rare.
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Affiliation(s)
- Ming Fang
- Department of Neurology, The Third Hospital of Nanchang, Nanchang, China
| | - Mingyue Wang
- Department of Neurology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
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3
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Denney DE, Lee AA, Landy SH, Smitherman TA. Headache-related disability as a function of migraine aura: A daily diary study. Headache 2024. [PMID: 39087912 DOI: 10.1111/head.14796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE To examine the unique role of migraine aura in predicting day-to-day levels of headache-related disability. BACKGROUND Migraine symptoms and psychological variables contribute to headache-related disability. Migraine aura may be associated with more severe symptom profiles and increased risk of psychiatric comorbidities, but the impact of aura on daily functioning is unknown. The present study sought to evaluate the role of migraine aura in predicting same-day and subsequent-day migraine-related disability while accounting for demographic, headache, and psychological variables. METHODS This was an observational prospective cohort study among 554 adults with migraine. For each participant, data on migraine symptoms and psychological variables were collected daily for 90 days using the N-1 Headache™ digital app (N = 11,156 total migraine days). Analyses assessed whether the presence of aura predicted daily ratings of migraine-related disability independently of other headache and psychological variables. Given the number of predictors examined, statistical significance was set at p < 0.01. RESULTS The mean (standard deviation, range) patient-level Migraine Disability Assessment questionnaire score across days of the migraine episode was 1.18 (1.03, 0-3). Aura was significantly associated with higher disability ratings on all days of the migraine episode (odds ratio [OR] 1.40, 99% confidence interval [CI] 1.13-1.74; p < 0.001). This relationship remained unchanged after adjusting for patient-level variables (OR 1.40, 99% CI 1.13-1.73; p < 0.001) and day-level psychological variables (OR 1.39, 99% CI 1.12-1.73; p < 0.001) but was fully negated after controlling for day-level headache variables (OR 1.19, 99% CI 0.95-1.49; p = 0.039). Aura on the first day of the episode was associated with increased odds of allodynia (OR 1.87, 99% CI 1.22-2.86; p < 0.001), phonophobia (OR 1.62, 99% CI 1.17-2.25; p < 0.001), photophobia (OR 1.89, 99% CI 1.37-2.59; p < 0.001), and nausea/vomiting (OR 1.54, 99% CI 1.17-2.02; p < 0.001) on all days of the episode, but not episode duration (p = 0.171), peak severity (p = 0.098), or any examined psychological variables (sleep duration [p = 0.733], sleep quality [p = 0.186], stress [p = 0.110], anxiety [p = 0.102], or sadness [p = 0.743]). CONCLUSION The presence of aura is predictive of increased headache-related disability during migraine episodes, but this effect is attributable to associated non-pain symptoms of migraine.
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Affiliation(s)
- Delora E Denney
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
| | - Stephen H Landy
- Department of Neurology, University of Tennessee College of Medicine, Memphis, Tennessee, USA
- Tupelo Headache Clinic, Tupelo, Mississippi, USA
| | - Todd A Smitherman
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
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4
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Uzay B, Donmez-Demir B, Ozcan SY, Kocak EE, Yemisci M, Ozdemir YG, Dalkara T, Karatas H. The effect of P2X7 antagonism on subcortical spread of optogenetically-triggered cortical spreading depression and neuroinflammation. J Headache Pain 2024; 25:120. [PMID: 39044141 PMCID: PMC11267761 DOI: 10.1186/s10194-024-01807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 06/06/2024] [Indexed: 07/25/2024] Open
Abstract
Migraine is a neurological disorder characterized by episodes of severe headache. Cortical spreading depression (CSD), the electrophysiological equivalent of migraine aura, results in opening of pannexin 1 megachannels that release ATP and triggers parenchymal neuroinflammatory signaling cascade in the cortex. Migraine symptoms suggesting subcortical dysfunction bring subcortical spread of CSD under the light. Here, we investigated the role of purinergic P2X7 receptors on the subcortical spread of CSD and its consequent neuroinflammation using a potent and selective P2X7R antagonist, JNJ-47965567. P2X7R antagonism had no effect on the CSD threshold and characteristics but increased the latency to hypothalamic voltage deflection following CSD suggesting that ATP acts as a mediator in the subcortical spread. P2X7R antagonism also prevented cortical and subcortical neuronal activation following CSD, revealed by bilateral decrease in c-fos positive neuron count, and halted CSD-induced neuroinflammation revealed by decreased neuronal HMGB1 release and decreased nuclear translocation of NF-kappa B-p65 in astrocytes. In conclusion, our data suggest that P2X7R plays a role in CSD-induced neuroinflammation, subcortical spread of CSD and CSD-induced neuronal activation hence can be a potential target.
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Affiliation(s)
- Burak Uzay
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Buket Donmez-Demir
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye
| | - Sinem Yilmaz Ozcan
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye
| | - Emine Eren Kocak
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye
- Department of Psychiatry, Hacettepe University, Ankara, Türkiye
| | - Muge Yemisci
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye
- Department of Neurology, Hacettepe University, Ankara, Türkiye
| | - Yasemin Gursoy Ozdemir
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye
- School of Medicine, Koc University, Istanbul, Türkiye
| | - Turgay Dalkara
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye
- Department of Neurology, Hacettepe University, Ankara, Türkiye
| | - Hulya Karatas
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, Ankara, 06100, Türkiye.
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Nagata E, Takao M, Toriumi H, Suzuki M, Fujii N, Kohara S, Tsuda A, Nakayama T, Kadokura A, Hadano M. Hypersensitivity of Intrinsically Photosensitive Retinal Ganglion Cells in Migraine Induces Cortical Spreading Depression. Int J Mol Sci 2024; 25:7980. [PMID: 39063222 PMCID: PMC11276861 DOI: 10.3390/ijms25147980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/13/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Migraine is a complex disorder characterized by episodes of moderate-to-severe, often unilateral headaches and generally accompanied by nausea, vomiting, and increased sensitivity to light (photophobia), sound (phonophobia), and smell (hyperosmia). Photophobia is considered the most bothersome symptom of migraine attacks. Although the underlying mechanism remains unclear, the intrinsically photosensitive retinal ganglion cells (ipRGCs) are considered to be involved in photophobia associated with migraine. In this study, we investigated the association between the sensitivity of ipRGCs and migraines and cortical spreading depression (CSD), which may trigger migraine attacks. The pupillary responses closely associated with the function of ipRGCs in patients with migraine who were irradiated with lights were evaluated. Blue (486 nm) light irradiation elicited a response from ipRGCs; however, red light (560 nm) had no such effect. Melanopsin, a photosensitive protein, phototransduces in ipRGCs following blue light stimulation. Hypersensitivity of ipRGCs was observed in patients with migraine. CSD was more easily induced with blue light than with incandescent light using a mouse CSD model. Moreover, CSD was suppressed, even in the presence of blue light, after injecting opsinamide, a melanopsin inhibitor. The hypersensitivity of ipRGCs in patients with migraine may induce CSD, resulting in migraine attacks.
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Affiliation(s)
- Eiichiro Nagata
- Department of Neurology, Tokai University School of Medicine, Isehara 259-1193, Japan; (N.F.); (S.K.); (T.N.); (A.K.); (M.H.)
| | - Motoharu Takao
- Department of Human and Information Science, Tokai University, Hiratsuka 259-1292, Japan;
| | - Haruki Toriumi
- Department of Acupuncture and Moxibustion, Shonan Keiiku Hospital, Fujisawa 252-0816, Japan; (H.T.); (M.S.)
| | - Mari Suzuki
- Department of Acupuncture and Moxibustion, Shonan Keiiku Hospital, Fujisawa 252-0816, Japan; (H.T.); (M.S.)
| | - Natsuko Fujii
- Department of Neurology, Tokai University School of Medicine, Isehara 259-1193, Japan; (N.F.); (S.K.); (T.N.); (A.K.); (M.H.)
| | - Saori Kohara
- Department of Neurology, Tokai University School of Medicine, Isehara 259-1193, Japan; (N.F.); (S.K.); (T.N.); (A.K.); (M.H.)
| | - Akio Tsuda
- Bioresearch Center Co., Ltd., Tokyo 101-0032, Japan;
| | - Taira Nakayama
- Department of Neurology, Tokai University School of Medicine, Isehara 259-1193, Japan; (N.F.); (S.K.); (T.N.); (A.K.); (M.H.)
| | - Ayana Kadokura
- Department of Neurology, Tokai University School of Medicine, Isehara 259-1193, Japan; (N.F.); (S.K.); (T.N.); (A.K.); (M.H.)
| | - Manaka Hadano
- Department of Neurology, Tokai University School of Medicine, Isehara 259-1193, Japan; (N.F.); (S.K.); (T.N.); (A.K.); (M.H.)
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Veréb D, Szabó N, Kincses B, Szücs-Bencze L, Faragó P, Csomós M, Antal S, Kocsis K, Tuka B, Kincses ZT. Imbalanced temporal states of cortical blood-oxygen-level-dependent signal variability during rest in episodic migraine. J Headache Pain 2024; 25:114. [PMID: 39014299 PMCID: PMC11251240 DOI: 10.1186/s10194-024-01824-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Migraine has been associated with functional brain changes including altered connectivity and activity both during and between headache attacks. Recent studies established that the variability of the blood-oxygen-level-dependent (BOLD) signal is an important attribute of brain activity, which has so far been understudied in migraine. In this study, we investigate how time-varying measures of BOLD variability change interictally in episodic migraine patients. METHODS Two independent resting state functional MRI datasets acquired on 3T (discovery cohort) and 1.5T MRI scanners (replication cohort) including 99 episodic migraine patients (n3T = 42, n1.5T=57) and 78 healthy controls (n3T = 46, n1.5T=32) were analyzed in this cross-sectional study. A framework using time-varying measures of BOLD variability was applied to derive BOLD variability states. Descriptors of BOLD variability states such as dwell time and fractional occupancy were calculated, then compared between migraine patients and healthy controls using Mann-Whitney U-tests. Spearman's rank correlation was calculated to test associations with clinical parameters. RESULTS Resting-state activity was characterized by states of high and low BOLD signal variability. Migraine patients in the discovery cohort spent more time in the low variability state (mean dwell time: p = 0.014, median dwell time: p = 0.022, maximum dwell time: p = 0.013, fractional occupancy: p = 0.013) and less time in the high variability state (mean dwell time: p = 0.021, median dwell time: p = 0.021, maximum dwell time: p = 0.025, fractional occupancy: p = 0.013). Higher uptime of the low variability state was associated with greater disability as measured by MIDAS scores (maximum dwell time: R = 0.45, p = 0.007; fractional occupancy: R = 0.36, p = 0.035). Similar results were observed in the replication cohort. CONCLUSION Episodic migraine patients spend more time in a state of low BOLD variability during rest in headache-free periods, which is associated with greater disability. BOLD variability states show potential as a replicable functional imaging marker in episodic migraine.
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Affiliation(s)
- Dániel Veréb
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Semmelweis u. 6, Szeged, 6725, Hungary.
| | - Nikoletta Szabó
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Medicine Essen, Essen, Germany
- Department of Neurology, Center for Translational Neuro- and Behavioural Sciences, University Medicine Essen, Essen, Germany
| | - Laura Szücs-Bencze
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary
| | - Péter Faragó
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary
| | - Máté Csomós
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Semmelweis u. 6, Szeged, 6725, Hungary
| | - Szabolcs Antal
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Semmelweis u. 6, Szeged, 6725, Hungary
| | - Krisztián Kocsis
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Semmelweis u. 6, Szeged, 6725, Hungary
| | - Bernadett Tuka
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Semmelweis u. 6, Szeged, 6725, Hungary
| | - Zsigmond Tamás Kincses
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Semmelweis u. 6, Szeged, 6725, Hungary
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7
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Li Z, Mei Y, Wang W, Wang L, Wu S, Zhang K, Qiu D, Xiong Z, Li X, Yuan Z, Zhang P, Zhang M, Tong Q, Zhang Z, Wang Y. White matter and cortical gray matter microstructural abnormalities in new daily persistent headache: a NODDI study. J Headache Pain 2024; 25:110. [PMID: 38977951 PMCID: PMC11232337 DOI: 10.1186/s10194-024-01815-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 06/18/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND New daily persistent headache (NDPH) is a rare primary headache with unclear pathogenesis. Neuroimaging studies of NDPH are limited, and controversy still exists. Diffusion tensor imaging (DTI) is commonly used to study the white matter. However, lacking specificity, the potential pathological mechanisms of white matter microstructural changes remain poorly understood. In addition, the intricacy of gray matter structures impedes the application of the DTI model. Here, we applied an advanced diffusion model of neurite orientation dispersion and density imaging (NODDI) to study the white matter and cortical gray matter microstructure in patients with NDPH. METHODS This study assessed brain microstructure, including 27 patients with NDPH, and matched 28 healthy controls (HCs) by NODDI. The differences between the two groups were assessed by tract-based spatial statistics (TBSS) and surface-based analysis (SBA), focusing on the NODDI metrics (neurite density index (NDI), orientation dispersion index (ODI), and isotropic volume fraction (ISOVF)). Furthermore, we performed Pearson's correlation analysis between the NODDI indicators and clinical characteristics. RESULTS Compared to HCs, patients with NDPH had a reduction of density and complexity in several fiber tracts. For robust results, the fiber tracts were defined as comprising more than 100 voxels, including bilateral inferior fronto-occipital fasciculus (IFOF), left superior longitudinal fasciculus (SLF) and inferior longitudinal fasciculus (ILF), as well as right corticospinal tract (CST). Moreover, the reduction of neurite density was uncovered in the left superior and middle frontal cortex, left precentral cortex, and right lateral orbitofrontal cortex and insula. There was no correlation between the NODDI metrics of these brain regions and clinical variables or scales of relevance after the Bonferroni correction. CONCLUSIONS Our research indicated that neurite loss was detected in both white matter and cortical gray matter of patients with NDPH.
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Affiliation(s)
- Zhilei Li
- Department of Neurology, The Second Hospital of Lanzhou University, Cuiying Gate, No. 82 Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Yanliang Mei
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Lei Wang
- Department of Neurology, The Second Hospital of Lanzhou University, Cuiying Gate, No. 82 Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Shouyi Wu
- Department of Neurology, The Second Hospital of Lanzhou University, Cuiying Gate, No. 82 Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Kaibo Zhang
- Department of Neurology, The Second Hospital of Lanzhou University, Cuiying Gate, No. 82 Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Dong Qiu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Zhonghua Xiong
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xiaoshuang Li
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Mantian Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Qiuling Tong
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhenchang Zhang
- Department of Neurology, The Second Hospital of Lanzhou University, Cuiying Gate, No. 82 Linxia Road, Chengguan District, Lanzhou, 730000, China.
| | - Yonggang Wang
- Department of Neurology, The Second Hospital of Lanzhou University, Cuiying Gate, No. 82 Linxia Road, Chengguan District, Lanzhou, 730000, China.
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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Wei S, Du T, Zhang L, Li X, Wang Z, Ning Y, Tang Y, Wu X, Han J. A comprehensive exploration of astrocytes in migraine: a bibliometric and visual analysis. Eur J Med Res 2024; 29:321. [PMID: 38858735 PMCID: PMC11163711 DOI: 10.1186/s40001-024-01919-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Migraine, as a prevalent neurologic disorder, involves intricate and yet incompletely elucidated pathophysiological mechanisms. A plethora of research findings underscores the pivotal role played by astrocytes in the progression of migraines. In order to elucidate the current advances and directions in research pertaining to astrocytes in migraines, we conducted bibliometric analysis of relevant literature and visualized the results. Subsequently, we expound upon these findings to contribute to the evolving understanding of the role of astrocytes in migraine pathophysiology. METHODS On November 21, 2023, we conducted a search on Web of Science (WOS), restricting the document type to articles or reviews and language to English. Following a meticulous selection process involving three researchers, we identified the literature to be included in our analysis. Subsequently, we employed Microsoft Office Excel programs, R, VOSviewer, Scimago Graphica, and CiteSpace software to conduct visualization analysis of basic information and trends regarding journals, countries/regions, and influential authors, institutions, keywords, and papers. RESULTS As of November 21, 2023, relevant literature has been published in 71 journals across 27 countries/regions. This corpus comprises contributions from 576 authors affiliated with 220 institutions, encompassing 865 keywords and referencing 6065 scholarly articles. CEPHALALGIA stands out as the most influential journal in this field, while authors PIETROBON D and DALKARA T have significant impact. The United States is highly influential, with CNR and UNIV PADUA emerging as highly influential institutions. The predominant category is Neurosciences. CONCLUSIONS Future investigators may continue to focus on migraines with aura, familial hemiplegic migraine (FHM), and the crucial calcitonin gene-related peptide (CGRP) system. Employing advanced observational techniques, such as imaging, researchers should pay attention to cellular and tissue structures, such as microglia and the trigeminal ganglion, as well as mechanisms involving inflammation and central sensitization. Moreover, animal models are paramount in obtaining high-quality evidence.
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Affiliation(s)
- Shijie Wei
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tianqi Du
- Center of Human Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Lili Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuhao Li
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhe Wang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yike Ning
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yu Tang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xinyu Wu
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jing Han
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
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9
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Wei S, Du T, Zhang L, Li X, Wang Z, Ning Y, Tang Y, Wu X, Han J. A comprehensive exploration of astrocytes in migraine: a bibliometric and visual analysis. Eur J Med Res 2024; 29:321. [PMID: 38858735 DOI: 10.1186/s40001-024-01919-zif:] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/03/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Migraine, as a prevalent neurologic disorder, involves intricate and yet incompletely elucidated pathophysiological mechanisms. A plethora of research findings underscores the pivotal role played by astrocytes in the progression of migraines. In order to elucidate the current advances and directions in research pertaining to astrocytes in migraines, we conducted bibliometric analysis of relevant literature and visualized the results. Subsequently, we expound upon these findings to contribute to the evolving understanding of the role of astrocytes in migraine pathophysiology. METHODS On November 21, 2023, we conducted a search on Web of Science (WOS), restricting the document type to articles or reviews and language to English. Following a meticulous selection process involving three researchers, we identified the literature to be included in our analysis. Subsequently, we employed Microsoft Office Excel programs, R, VOSviewer, Scimago Graphica, and CiteSpace software to conduct visualization analysis of basic information and trends regarding journals, countries/regions, and influential authors, institutions, keywords, and papers. RESULTS As of November 21, 2023, relevant literature has been published in 71 journals across 27 countries/regions. This corpus comprises contributions from 576 authors affiliated with 220 institutions, encompassing 865 keywords and referencing 6065 scholarly articles. CEPHALALGIA stands out as the most influential journal in this field, while authors PIETROBON D and DALKARA T have significant impact. The United States is highly influential, with CNR and UNIV PADUA emerging as highly influential institutions. The predominant category is Neurosciences. CONCLUSIONS Future investigators may continue to focus on migraines with aura, familial hemiplegic migraine (FHM), and the crucial calcitonin gene-related peptide (CGRP) system. Employing advanced observational techniques, such as imaging, researchers should pay attention to cellular and tissue structures, such as microglia and the trigeminal ganglion, as well as mechanisms involving inflammation and central sensitization. Moreover, animal models are paramount in obtaining high-quality evidence.
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Affiliation(s)
- Shijie Wei
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tianqi Du
- Center of Human Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Lili Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuhao Li
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhe Wang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yike Ning
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yu Tang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xinyu Wu
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jing Han
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
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Liang W, Zhong K, Lai T, Zeng Y, Huang Z, Zhou J, Huang J, Shi Z, Zhang J, Ding F. Causal relationship between depression and metabolic dysfunction-associated steatotic liver disease: a bidirectional Mendelian randomized study. Front Psychiatry 2024; 15:1384003. [PMID: 38903646 PMCID: PMC11187267 DOI: 10.3389/fpsyt.2024.1384003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/08/2024] [Indexed: 06/22/2024] Open
Abstract
Background With the global rise in obesity, metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most common chronic liver disease. Concurrently, depression is a highly prevalent mental disorder. As the incidence of MASLD and depression continues to increase, a growing body of research indicates a potential association between the two conditions. However, the direction of causality between depression and MASLD remains uncertain. To address this gap, our study utilizes a two-sample Mendelian randomization (MR) approach to explore the bidirectional causal relationship between depression and MASLD. Methods We extracted single nucleotide polymorphisms (SNPs) associated with depression and MASLD from pooled data of genome-wide association studies (GWAS). A comprehensive assessment of possible causality was also performed. Possible mediating effects of liver enzymes on MASLD were also assessed. Results A total of three GWAS pooled data on depression as well as GWAS data related to MASLD and GWAS data on four liver enzymes were used in this study. Our findings indicated a strong causal relationship between depression and MASLD (OR, 1.557; 95% CI, 1.097-2.211; P = 0.016). And we found a mediating effect of gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). ALT 10% (95% CI: 7% - 13%, P< 0.0002). AST, 4.14% (95% CI: 2.34% - 5.94%, P < 0.05). GGT 0.19% (95% CI: 0.15% - 0.22%, P< 0.000000002). However, we did not find a mediating effect of alkaline phosphatase (ALP). Our inverse MR analysis did not reveal any causal relationship between MASLD and depression. Conclusions The MR analysis revealed a positive causal relationship between depression and MASLD, while no reverse causal relationship was identified. Liver enzymes may mediate the role between depression and MASLD.
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Affiliation(s)
- Weiyu Liang
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kunting Zhong
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tingting Lai
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuhao Zeng
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhanhui Huang
- Traditional Chinese Medicine Department, Yihui Fund Hospital, Shanwei, China
| | - Jiqing Zhou
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jin Huang
- Clinic Department of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhenni Shi
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jin Zhang
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fuping Ding
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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11
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Xu D, Wu B. Investigating the causal association between systemic lupus erythematosus and migraine using Mendelian randomization analysis. Headache 2024; 64:624-631. [PMID: 38679912 DOI: 10.1111/head.14723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/09/2024] [Accepted: 02/24/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To assess whether systemic lupus erythematosus (SLE) may be genetically causally associated with migraine, including the two primary subtypes: migraine with aura (MWA) and migraine without aura (MWoA). BACKGROUND The association between SLE and migraine has been investigated extensively. Previous studies have shown a higher prevalence of migraine in patients with SLE, although the exact relationship remains unclear. This study investigated the potential causal association between SLE and migraine using the powerful analytical tool of Mendelian randomization (MR). METHODS We performed two-sample MR analysis of publicly available summary statistic datasets using inverse variance-weighted (IVW), weighted median, and MR-Egger methods based on an SLE genome-wide association study (GWAS; 5201 cases; 9066 controls; the exposure frequency is 36.5%) as an exposure and migraine GWAS (15,905 cases; 264,662 controls) in individuals with European ancestry as outcomes, focusing on the two migraine subtypes MWA (6780 cases; 264,662 controls) and MWoA (5787 cases; 264,662 controls). Thepleiotropy and heterogeneity were performed. RESULTS We selected 42 single-nucleotide polymorphisms from SLE GWAS as instrumental variables (IVs) for SLE on migraine, and 41 SNP IVs for SLE on MWA or MWoA. The IVW (odds ratio [OR] = 1.01, 95% confidence interval [CI] = [0.99, 1.03], p = 0.271), weighted median (OR = 1.00, 95% CI = [0.97, 1.03], p = 0.914), and MR-Egger (OR = 1.04, 95% CI = [0.99, 1.09], p = 0.153) methods showed no causal effect of SLE on migraine. A causal effect of SLE was observed on MWA (IVW: OR = 1.05, 95% CI = [1.02, 1.08], p = 0.001; weighted median: OR = 1.05, 95% CI = [1.01, 1.10], p = 0.018; MR-Egger: OR = 1.07, 95% CI = [1.01, 1.14], p = 0.035 and pIVW < 0.017 [Bonferroni correction]) but not MWoA (IVW: OR = 0.99, 95% CI = [0.96, 1.02], p = 0.331; weighted median: OR = 0.98, 95% CI = [0.94, 1.03], p = 0.496; MR-Egger: OR = 1.02, 95% CI = [0.95, 1.09], p = 0.652). The results showed no significant pleiotropy or heterogeneity. CONCLUSION Our MR analysis demonstrated the complex relationship between SLE and migraine, suggesting a potential effect of SLE on the risk of MWA but not MWoA. These findings can aid in the development of improved subtype-specific management of migraine in patients with SLE.
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Affiliation(s)
- Danfeng Xu
- Shaoxing Central Hospital, The Hospital Affiliated to Shaoxing University, Shaoxing, China
- Central Laboratory, The Central Hospital of Shaoxing University, Shaoxing, China
| | - Bing Wu
- Shaoxing Central Hospital, The Hospital Affiliated to Shaoxing University, Shaoxing, China
- Central Laboratory, The Central Hospital of Shaoxing University, Shaoxing, China
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12
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Kitamura E, Kanazawa N, Iizuka T, Nishiyama K. Elevation in body temperature may increase susceptibility to cortical spreading depression in a rat model. Neurosci Res 2024:S0168-0102(24)00055-5. [PMID: 38615849 DOI: 10.1016/j.neures.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/16/2024]
Abstract
One characteristic of migraine is recurrent headache attacks, which are known to be induced by changes in climatic variables such as atmospheric pressure, humidity, and outside temperature. However, the relationship between temperature changes and migraine remains unclear. Therefore, we investigated the relationship between body temperature changes and cortical spreading depression (CSD) using KCl-induced rat models of CSD. We initially induced CSD under controlled conditions at a room temperature of 28°C on an operating table maintained at 37°C. Subsequently, we controlled the operating table temperature to induce a second round of CSD under conditions of either a 10 ± 1% increase or decrease in body temperature. We ensured 1 h rest period between the first and second inductions of CSD. The results indicated that the number of CSDs significantly increased after body temperature elevation (before, 8.8 ± 1.2 times vs. after, 13.4 ± 1.3 times; p = 0.0003). The mean percentage change in cerebral blood flow decreased after body temperature increased (before, 33.1 ± 2.4% vs. after, 18.2 ± 1.4%; p = 0.006). There were no significant changes in CSD after body temperature decreased. The susceptibility of the cortex to CSD may increase under conditions of elevated body temperature.
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Affiliation(s)
- Eiji Kitamura
- Department of Neurology, Kitasato University School of Medicine, Kanagawa, Japan.
| | - Naomi Kanazawa
- Department of Neurology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takahiro Iizuka
- Department of Neurology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kazutoshi Nishiyama
- Department of Neurology, Kitasato University School of Medicine, Kanagawa, Japan
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13
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Li G, Duan S, Zheng T, Zhu T, Qu B, Liu L, Liu Z. Genetic causal relationship between immune diseases and migraine: a Mendelian randomization study. Front Immunol 2024; 15:1376698. [PMID: 38650934 PMCID: PMC11033421 DOI: 10.3389/fimmu.2024.1376698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Background Migraine has an increased prevalence in several immune disorders, but genetic cause-effect relationships remain unclear. Mendelian randomization (MR) was used in this study to explore whether immune diseases are causally associated with migraine and its subtypes. Methods We conducted a two-sample bidirectional multivariate Mendelian randomization study. Single-nucleotide polymorphisms (SNP) for six immune diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), type 1 diabetes mellitus (T1D), allergic rhinitis (AR), asthma and psoriasis, were used as genetic instrumental variables. Summary statistics for migraine were obtained from 3 databases: the International Headache Genetics Consortium (IHGC), UK Biobank, and FinnGen study. MR analyses were performed per outcome database for each exposure and subsequently meta-analyzed. Reverse MR analysis was performed to determine whether migraine were risk factors for immune diseases. In addition, we conducted a genetic correlation to identify shared genetic variants for these two associations. Results No significant causal relationship was found between immune diseases and migraine and its subtypes. These results were robust with a series of sensitivity analyses. Using the linkage disequilibrium score regression method (LDSC), we detected no genetic correlation between migraine and immune diseases. Conclusion The evidence from our study does not support a causal relationship between immune diseases and migraine. The mechanisms underlying the frequent comorbidity of migraine and several immune diseases need to be further elucidated.
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Affiliation(s)
- Guanglu Li
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Shaojie Duan
- Department of Geriatrics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Tao Zheng
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Tiantian Zhu
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baoquan Qu
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Lei Liu
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Zunjing Liu
- Department of Neurology, Peking University People’s Hospital, Beijing, China
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14
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Riederer F, Beiersdorf J, Lang C, Pirker-Kees A, Klein A, Scutelnic A, Platho-Elwischger K, Baumgartner C, Dreier JP, Schankin C. Signatures of migraine aura in high-density-EEG. Clin Neurophysiol 2024; 160:113-120. [PMID: 38422969 DOI: 10.1016/j.clinph.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/17/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Cortical spreading depolarization is highly conserved among the species. It is easily detectable in direct cortical surface recordings and has been recorded in the cortex of humans with severe neurological disease. It is considered the pathophysiological correlate of human migraine aura, but direct electrophysiological evidence is still missing. As signatures of cortical spreading depolarization have been recognized in scalp EEG, we investigated typical spontaneous migraine aura, using full band high-density EEG (HD-EEG). METHODS In this prospective study, patients with migraine with aura were investigated during spontaneous migraine aura and interictally. Time compressed HD-EEG were analyzed for the presence of cortical spreading depolarization characterized by (a) slow potential changes below 0.05 Hz, (b) suppression of faster activity from 0.5 Hz - 45 Hz (c) spreading of these changes to neighboring regions during the aura phase. Further, topographical changes in alpha-power spectral density (8-14 Hz) during aura were analyzed. RESULTS In total, 26 HD-EEGs were recorded in patients with migraine with aura, thereof 10 HD-EEGs during aura. Eight HD-EEGs were recorded in the same subject. During aura, no slow potentials were recorded, but alpha-power was significantly decreased in parieto-occipito-temporal location on the hemisphere contralateral to visual aura, lasting into the headache phase. Interictal alpha-power in patients with migraine with aura did not differ significantly from age- and sex-matched healthy controls. CONCLUSIONS Unequivocal signatures of spreading depolarization were not recorded with EEG on the intact scalp in migraine. The decrease in alpha-power contralateral to predominant visual symptoms is consistent with focal depression of spontaneous brain activity as a consequence of cortical spreading depolarization but is not specific thereof. SIGNIFICANCE Cortical spreading depolarization is relevant in migraine, other paroxysmal neurological disorders and neurointensive care.
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Affiliation(s)
- Franz Riederer
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; University of Zurich, Medical Faculty, Zurich, Switzerland.
| | - Johannes Beiersdorf
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology
| | - Clemens Lang
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology; Department of Neurology, Clinic Hietzing, Vienna, Austria
| | - Agnes Pirker-Kees
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology; Department of Neurology, Clinic Hietzing, Vienna, Austria
| | - Antonia Klein
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Adrian Scutelnic
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kirsten Platho-Elwischger
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology; Department of Neurology, Clinic Hietzing, Vienna, Austria
| | - Christoph Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology; Department of Neurology, Clinic Hietzing, Vienna, Austria
| | - Jens P Dreier
- Department of Neurology and Experimental Neurology Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Schankin
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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15
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Braca S, Miele A, Stornaiuolo A, Cretella G, De Simone R, Russo CV. Are anti-calcitonin gene-related peptide monoclonal antibodies effective in treating migraine aura? A pilot prospective observational cohort study. Neurol Sci 2024; 45:1655-1660. [PMID: 38091211 DOI: 10.1007/s10072-023-07241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/28/2023] [Indexed: 03/16/2024]
Abstract
BACKGROUND About 15% to one third of migraineurs experience aura symptoms. Aura is a reversible focal neurological phenomenon involving visual, sensory, speech, and motor symptoms that usually precede migraine pain. Monoclonal antibodies against calcitonin-related peptide (anti- CGRP mAbs) are effective in preventing chronic and episodic migraine, but little is known about their effectiveness on specifically preventing migraine with aura. METHODS This is a pilot prospective observational cohort study, aiming at evaluating the effectiveness and safety of Erenumab, Fremanezumab or Galcanezumab for the treatment of migraine aura. We enrolled 14 patients at the Headache Centre of University Federico II of Naples. Duration of follow-up was 12 months. We assessed mean monthly days with aura symptoms, with or without subsequent headache, as well as mean monthly days with headache and mean monthly MIDAS score, by reviewing standardized paper patient headache diaries every three months. RESULTS A significant decrease in mean monthly aura days was observed throughout the observation period (median baseline: 13, interquartile range: 4-16; after 12 months: 1, interquartile range: 0-3, p < 0.001). We observed a statistically significant decrease in mean monthly headache days as well (median baseline 21, interquartile range: 16-30; after 12 months: 5, interquartile range: 4-7, p < 0.001). During the 12-month treatment period, none of the 14 patients reported mild or serious adverse events. CONCLUSION Our findings suggest that anti-CGRP mAbs are highly effective in migraine with aura, both in reducing mean monthly aura days and mean monthly days with headache.
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Affiliation(s)
- Simone Braca
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Angelo Miele
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Antonio Stornaiuolo
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Gennaro Cretella
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Roberto De Simone
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Cinzia Valeria Russo
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy.
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Adamczyk B, Morawiec N, Boczek S, Dańda K, Herba M, Spyra A, Sowa A, Szczygieł J, Adamczyk-Sowa M. Headache in Multiple Sclerosis: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:572. [PMID: 38674218 PMCID: PMC11052044 DOI: 10.3390/medicina60040572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system characterized by autoimmune-mediated damage to oligodendrocytes and subsequent myelin destruction. Clinical implications: Clinically, the disease presents with many symptoms, often evolving over time. The insidious onset of MS often manifests with non-specific symptoms (prodromal phase), which may precede a clinical diagnosis by several years. Among them, headache is a prominent early indicator, affecting a significant number of MS patients (50-60%). Results: Headache manifests as migraine or tension-type headache with a clear female predilection (female-male ratio 2-3:1). Additionally, some disease-modifying therapies in MS can also induce headache. For instance, teriflunomide, interferons, ponesimod, alemtuzumab and cladribine are associated with an increased incidence of headache. Conclusions: The present review analyzed the literature data on the relationship between headache and MS to provide clinicians with valuable insights for optimized patient management and the therapeutic decision-making process.
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Affiliation(s)
- Bożena Adamczyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13-15, 41-800 Zabrze, Poland; (S.B.); (K.D.); (M.H.); (A.S.); (A.S.); (J.S.); (M.A.-S.)
| | - Natalia Morawiec
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13-15, 41-800 Zabrze, Poland; (S.B.); (K.D.); (M.H.); (A.S.); (A.S.); (J.S.); (M.A.-S.)
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17
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Vittorini MG, Sahin A, Trojan A, Yusifli S, Alashvili T, Bonifácio GV, Paposhvili K, Tischler V, Lampl C, Sacco S. The glymphatic system in migraine and other headaches. J Headache Pain 2024; 25:34. [PMID: 38462633 PMCID: PMC10926631 DOI: 10.1186/s10194-024-01741-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024] Open
Abstract
Glymphatic system is an emerging pathway of removing metabolic waste products and toxic solutes from the brain tissue. It is made of a network of perivascular spaces, filled in cerebrospinal and interstitial fluid, encompassing penetrating and pial vessels and communicating with the subarachnoid space. It is separated from vessels by the blood brain barrier and from brain tissue by the endfeet of the astrocytes rich in aquaporin 4, a membrane protein which controls the water flow along the perivascular space. Animal models and magnetic resonance (MR) studies allowed to characterize the glymphatic system function and determine how its impairment could lead to numerous neurological disorders (e.g. Alzheimer's disease, stroke, sleep disturbances, migraine, idiopathic normal pressure hydrocephalus). This review aims to summarize the role of the glymphatic system in the pathophysiology of migraine in order to provide new ways of approaching to this disease and to its therapy.
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Affiliation(s)
- Maria Grazia Vittorini
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Aysenur Sahin
- Faculty of Medicine-Acibadem Mehmet, Ali Aydinlar University, Istanbul, Turkey
| | - Antonin Trojan
- Department of Neurology, Strakonice Hospital, Strakonice, Czechia
| | - Sevil Yusifli
- Faculty of Medicine-Istanbul University, Istanbul, Turkey
| | - Tamta Alashvili
- Department of Internal Medicine, New Vision University Hospital, Tbilisi, Georgia
| | | | - Ketevan Paposhvili
- Department of Neurology, Tbilisi State Medical University, Tbilisi, Georgia
| | - Viktoria Tischler
- Department of Neurology, Konventhospital Barmherzige Brüder Linz, Linz, Austria
| | - Christian Lampl
- Department of Neurology, Konventhospital Barmherzige Brüder Linz, Linz, Austria.
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Pizer JH, Aita SL, Myers MA, Hawley NA, Ikonomou VC, Brasil KM, Hernandez KA, Pettway EC, Owen T, Borgogna NC, Smitherman TA, Hill BD. Neuropsychological Function in Migraine Headaches: An Expanded Comprehensive Multidomain Meta-Analysis. Neurology 2024; 102:e208109. [PMID: 38252898 DOI: 10.1212/wnl.0000000000208109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 11/07/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES A sizable literature has studied neuropsychologic function in persons with migraine (PwM), but despite this, few quantitative syntheses exist. These focused on circumscribed areas of the literature. In this study, we conducted an expanded comprehensive meta-analysis comparing performance on clinical measures of neuropsychological function both within and across domains, between samples of PwM and healthy controls (HCs). METHODS For this Meta-analyses Of Observational Studies in Epidemiology-compliant meta-analysis, a unified search strategy was applied to OneSearch (a comprehensive collection of electronic databases) to identify peer-reviewed original research published across all years up until August 1, 2023. Using random-effects modeling, we examined aggregated effect sizes (Hedges' g), between-study heterogeneity (Cochran Q and I2), moderating variables (meta-regression and subgroup analyses), and publication bias (Egger regression intercept and Duval and Tweedie Trim-and-Fill procedure). Study bias was also coded using the NIH Study Quality Assessment Tools. RESULTS Omnibus meta-analysis from the 58 studies included (PwM n = 5,452, HC n = 16,647; 612 effect sizes extracted) indicated lower overall cognitive performance in PwM vs HCs (g = -0.37; 95% CI -0.47 to -0.28; p < 0.001), and high between-study heterogeneity (Q = 311.25, I2 = 81.69). Significant domain-specific negative effects were observed in global cognition (g = -0.46, p < 0.001), executive function (g = -0.45, p < 0.001), processing speed (g = -0.42, p < 0.001), visuospatial/construction (g = -0.39, p = 0.006), simple/complex attention (g = -0.38, p < 0.001), learning/memory (g = -0.25, p < 0.001), and language (g = -0.24, p < 0.001). Orientation (p = 0.146), motor (p = 0.102), and intelligence (p = 0.899) were not significant. Moderator analyses indicated that age (particularly younger HCs), samples drawn from health care facility settings (e.g., tertiary headache centers) vs community-based populations, and higher attack duration were associated with larger (negative) effects and accounted for a significant proportion of between-study heterogeneity in effects. Notably, PwM without aura yielded stronger (negative) effects (omnibus g = -0.37) vs those with aura (omnibus g = -0.10), though aura status did not account for heterogeneity observed between studies. DISCUSSION Relative to HCs, PwM demonstrate worse neurocognition, as detected by neuropsychological tests, especially on cognitive screeners and tests within executive functioning and processing speed domains. Effects were generally small to moderate in magnitude and evident only in clinic (vs community) samples. Aura was not meaningfully associated with neurocognitive impairment.
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Affiliation(s)
- Jasmin H Pizer
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Stephen L Aita
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Melissa A Myers
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Nanako A Hawley
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Vasilios C Ikonomou
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Kyle M Brasil
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Katherine A Hernandez
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Erika C Pettway
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Tyler Owen
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Nicholas C Borgogna
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Todd A Smitherman
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
| | - Benjamin D Hill
- From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford
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19
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Jokubaitis M, Lengvenis G, Burnytė B, Audronytė E, Ryliškienė K. Case report: Late onset type 3 hemiplegic migraine with permanent neurologic sequelae after attacks. Front Neurol 2024; 15:1359994. [PMID: 38405404 PMCID: PMC10884170 DOI: 10.3389/fneur.2024.1359994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 02/27/2024] Open
Abstract
This case study describes a 57-year-old woman with a six-year history of recurrent episodes characterized by visual, sensory, speech disturbances, hemiparesis and severe one-sided headaches accompanied by fever and altered consciousness. Initially misdiagnosed as a stroke, the atypical disease course and MRI findings led to additional genetic testing which revealed a sodium voltage-gated channel gene mutation (T1174S), confirming a diagnosis of sporadic hemiplegic migraine. The migraine prophylaxis showed some improvement in episode frequency and severity. Despite an initial improvement, the patient underwent severe cognitive decline and developed new permanent neurological symptoms during the subsequent 7 years of follow-up.
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Affiliation(s)
- Mantas Jokubaitis
- Center of Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Givi Lengvenis
- Department of Radiology, Nuclear Medicine and Medical Physics, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
| | - Birutė Burnytė
- Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
| | - Eglė Audronytė
- Center of Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Kristina Ryliškienė
- Center of Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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20
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Enger R, Heuser K. Astrocytes as critical players of the fine balance between inhibition and excitation in the brain: spreading depolarization as a mechanism to curb epileptic activity. FRONTIERS IN NETWORK PHYSIOLOGY 2024; 4:1360297. [PMID: 38405021 PMCID: PMC10884165 DOI: 10.3389/fnetp.2024.1360297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024]
Abstract
Spreading depolarizations (SD) are slow waves of complete depolarization of brain tissue followed by neuronal silencing that may play a role in seizure termination. Even though SD was first discovered in the context of epilepsy research, the link between SD and epileptic activity remains understudied. Both seizures and SD share fundamental pathophysiological features, and recent evidence highlights the frequent occurrence of SD in experimental seizure models. Human data on co-occurring seizures and SD are limited but suggestive. This mini-review addresses possible roles of SD during epileptiform activity, shedding light on SD as a potential mechanism for terminating epileptiform activity. A common denominator for many forms of epilepsy is reactive astrogliosis, a process characterized by morphological and functional changes to astrocytes. Data suggest that SD mechanisms are potentially perturbed in reactive astrogliosis and we propose that this may affect seizure pathophysiology.
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Affiliation(s)
- Rune Enger
- Letten Centre and GliaLab, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kjell Heuser
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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21
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Ou Y, Ni X, Gao X, Yu Y, Zhang Y, Wang Y, Liu J, Yin Z, Rong J, Sun M, Chen J, Tang Z, Xiao W, Zhao L. Structural and functional changes of anterior cingulate cortex subregions in migraine without aura: relationships with pain sensation and pain emotion. Cereb Cortex 2024; 34:bhae040. [PMID: 38342690 PMCID: PMC10859245 DOI: 10.1093/cercor/bhae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/13/2024] Open
Abstract
Migraine without aura is a multidimensional neurological disorder characterized by sensory, emotional, and cognitive symptoms linked to structural and functional abnormalities in the anterior cingulate cortex. Anterior cingulate cortex subregions play differential roles in the clinical symptoms of migraine without aura; however, the specific patterns and mechanisms remain unclear. In this study, voxel-based morphometry and seed-based functional connectivity were used to investigate structural and functional alterations in the anterior cingulate cortex subdivisions in 50 patients with migraine without aura and 50 matched healthy controls. Compared with healthy controls, patients exhibited (1) decreased gray matter volume in the subgenual anterior cingulate cortex, (2) increased functional connectivity between the bilateral subgenual anterior cingulate cortex and right middle frontal gyrus, and between the posterior part of anterior cingulate cortex and right middle frontal gyrus, orbital part, and (3) decreased functional connectivity between the anterior cingulate cortex and left anterior cingulate and paracingulate gyri. Notably, left subgenual anterior cingulate cortex was correlated with the duration of each attack, whereas the right subgenual anterior cingulate cortex was associated with migraine-specific quality-of-life questionnaire (emotion) and self-rating anxiety scale scores. Our findings provide new evidence supporting the hypothesis of abnormal anterior cingulate cortex subcircuitry, revealing structural and functional abnormalities in its subregions and emphasizing the potential involvement of the left subgenual anterior cingulate cortex-related pain sensation subcircuit and right subgenual anterior cingulate cortex -related pain emotion subcircuit in migraine.
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Affiliation(s)
- Yangxu Ou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Xixiu Ni
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Xiaoyu Gao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Yang Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Yutong Zhang
- Department of Scientific Research and Education and Training Management, the Third People’s Hospital of Chengdu, Chengdu, Sichuan 610000, China
| | - Yanan Wang
- Department of Pain Treatment, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China
| | - Jie Liu
- Department of Neurology, Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, China
| | - Zihan Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Jing Rong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Mingsheng Sun
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
- Sichuan Clinical Medical Research Center for Acupuncture and Moxibustion, Chengdu, Sichuan 611137, China
| | - Jiao Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
- Sichuan Clinical Medical Research Center for Acupuncture and Moxibustion, Chengdu, Sichuan 611137, China
| | - Zili Tang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Wang Xiao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
| | - Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu, Sichuan 611137, China
- Sichuan Clinical Medical Research Center for Acupuncture and Moxibustion, Chengdu, Sichuan 611137, China
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22
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Viudez-Martínez A, Torregrosa AB, Navarrete F, García-Gutiérrez MS. Understanding the Biological Relationship between Migraine and Depression. Biomolecules 2024; 14:163. [PMID: 38397400 PMCID: PMC10886628 DOI: 10.3390/biom14020163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/25/2024] Open
Abstract
Migraine is a highly prevalent neurological disorder. Among the risk factors identified, psychiatric comorbidities, such as depression, seem to play an important role in its onset and clinical course. Patients with migraine are 2.5 times more likely to develop a depressive disorder; this risk becomes even higher in patients suffering from chronic migraine or migraine with aura. This relationship is bidirectional, since depression also predicts an earlier/worse onset of migraine, increasing the risk of migraine chronicity and, consequently, requiring a higher healthcare expenditure compared to migraine alone. All these data suggest that migraine and depression may share overlapping biological mechanisms. Herein, this review explores this topic in further detail: firstly, by introducing the common epidemiological and risk factors for this comorbidity; secondly, by focusing on providing the cumulative evidence of common biological aspects, with a particular emphasis on the serotoninergic system, neuropeptides such as calcitonin-gene-related peptide (CGRP), pituitary adenylate cyclase-activating polypeptide (PACAP), substance P, neuropeptide Y and orexins, sexual hormones, and the immune system; lastly, by remarking on the future challenges required to elucidate the etiopathological mechanisms of migraine and depression and providing updated information regarding new key targets for the pharmacological treatment of these clinical entities.
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Affiliation(s)
- Adrián Viudez-Martínez
- Hospital Pharmacy Service, Hospital General Dr. Balmis de Alicante, 03010 Alicante, Spain;
| | - Abraham B. Torregrosa
- Instituto de Neurociencias, Universidad Miguel Hernández, 03550 San Juan de Alicante, Spain; (A.B.T.); (F.N.)
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández, 03550 San Juan de Alicante, Spain; (A.B.T.); (F.N.)
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández, 03550 San Juan de Alicante, Spain; (A.B.T.); (F.N.)
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
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23
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Yang YC, Wei XY, Zhang YY, Xu CY, Cheng JM, Gong ZG, Chen H, Huang YW, Yuan J, Xu HH, Wang H, Zhan SH, Tan WL. Modulation of temporal and occipital cortex by acupuncture in non-menstrual MWoA patients: a rest BOLD fMRI study. BMC Complement Med Ther 2024; 24:43. [PMID: 38245739 PMCID: PMC10799457 DOI: 10.1186/s12906-024-04349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE To investigate the changes in amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) values before and after acupuncture in young women with non-menstrual migraine without aura (MWoA) through rest blood-oxygen-level-dependent functional magnetic resonance imaging (BOLD fMRI). METHODS Patients with non-menstrual MWoA (Group 1, n = 50) and healthy controls (Group 2, n = 50) were recruited. fMRI was performed in Group 1 at 2 time points: before acupuncture (time point 1, TP1); and after the end of all acupuncture sessions (time point 2, TP2), and performed in Group 2 as a one-time scan. Patients in Group 1 were assessed with the Migraine Disability Assessment Questionnaire (MIDAS) and the Short-Form McGill Pain Questionnaire (SF-MPQ) at TP1 and TP2 after fMRI was performed. The ALFF and DC values were compared within Group 1 at two time points and between Group 1 and Group2. The correlation between ALFF and DC values with the statistical differences and the clinical scales scores were analyzed. RESULTS Brain activities increased in the left fusiform gyrus and right angular gyrus, left middle occipital gyrus, and bilateral prefrontal cortex and decreased in left inferior parietal lobule in Group 1, which had different ALFF values compared with Group 2 at TP1. The bilateral fusiform gyrus, bilateral inferior temporal gyrus and right middle temporal gyrus increased and right angular gyrus, right superior marginal gyrus, right inferior parietal lobule, right middle occipital gyrus, right superior frontal gyrus, right middle frontal gyrus, right anterior central gyrus, and right supplementary motor area decreased in activity in Group 1 had different DC values compared with Group 2 at TP1. ALFF and DC values of right inferior temporal gyrus, right fusiform gyrus and right middle temporal gyrus were decreased in Group1 at TP1 compared with TP2. ALFF values in the left middle occipital area were positively correlated with the pain degree at TP1 in Group1 (correlation coefficient r, r = 0.827, r = 0.343; P < 0.01, P = 0.015). The DC values of the right inferior temporal area were positively correlated with the pain degree at TP1 in Group 1 (r = 0.371; P = 0.008). CONCLUSION Spontaneous brain activity and network changes in young women with non-menstrual MwoA were altered by acupuncture. The right temporal area may be an important target for acupuncture modulated brain function in young women with non-menstrual MwoA.
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Affiliation(s)
- Yu-Chan Yang
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xiang-Yu Wei
- Institute of Acupuncture and Anesthesia, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ying-Ying Zhang
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Chun-Yang Xu
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jian-Ming Cheng
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Zhi-Gang Gong
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Hui Chen
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yan-Wen Huang
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jie Yuan
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Hui-Hui Xu
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Hui Wang
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Song-Hua Zhan
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Wen-Li Tan
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
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24
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Cancino-Fuentes N, Manasanch A, Covelo J, Suarez-Perez A, Fernandez E, Matsoukis S, Guger C, Illa X, Guimerà-Brunet A, Sanchez-Vives MV. Recording physiological and pathological cortical activity and exogenous electric fields using graphene microtransistor arrays in vitro. NANOSCALE 2024; 16:664-677. [PMID: 38100059 DOI: 10.1039/d3nr03842d] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Graphene-based solution-gated field-effect transistors (gSGFETs) allow the quantification of the brain's full-band signal. Extracellular alternating current (AC) signals include local field potentials (LFP, population activity within a reach of hundreds of micrometers), multiunit activity (MUA), and ultimately single units. Direct current (DC) potentials are slow brain signals with a frequency under 0.1 Hz, and commonly filtered out by conventional AC amplifiers. This component conveys information about what has been referred to as "infraslow" activity. We used gSGFET arrays to record full-band patterns from both physiological and pathological activity generated by the cerebral cortex. To this end, we used an in vitro preparation of cerebral cortex that generates spontaneous rhythmic activity, such as that occurring in slow wave sleep. This examination extended to experimentally induced pathological activities, including epileptiform discharges and cortical spreading depression. Validation of recordings obtained via gSGFETs, including both AC and DC components, was accomplished by cross-referencing with well-established technologies, thereby quantifying these components across different activity patterns. We then explored an additional gSGFET potential application, which is the measure of externally induced electric fields such as those used in therapeutic neuromodulation in humans. Finally, we tested the gSGFETs in human cortical slices obtained intrasurgically. In conclusion, this study offers a comprehensive characterization of gSGFETs for brain recordings, with a focus on potential clinical applications of this emerging technology.
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Affiliation(s)
| | - Arnau Manasanch
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Joana Covelo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Alex Suarez-Perez
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | | | - Stratis Matsoukis
- g.tec medical engineering, Schiedlberg, Austria
- Institute of Computational Perception, Johannes Kepler University, Linz, Austria
| | | | - Xavi Illa
- Instituto de Microelectrónica de Barcelona (IMB-CNM, CSIC), Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain
| | - Anton Guimerà-Brunet
- Instituto de Microelectrónica de Barcelona (IMB-CNM, CSIC), Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain
| | - Maria V Sanchez-Vives
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- ICREA, Barcelona, Spain
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25
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Podraza K, Bangera N, Feliz A, Charles A. Reduction in retinal microvascular perfusion during migraine attacks. Headache 2024; 64:16-36. [PMID: 38031892 DOI: 10.1111/head.14654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To determine if there are changes in structure and function of the retinal vasculature during and between migraine attacks using optical coherence tomography angiography (OCTA). BACKGROUND Migraine attacks commonly include visual symptoms, but the potential role of the retina in these symptoms is not well understood. OCTA is a rapid, non-invasive imaging technique that is used to visualize the retinal microvasculature with high spatial resolution in a clinical setting. In this study we used OCTA to quantify different features of the retinal vasculature in patients with migraine during and between attacks, as well as in healthy controls (HCs). METHODS We performed a prospective cohort study of 37 patients with migraine with aura (MA) (median [interquartile range, IQR] age of 37 [14] years, 86% female) and 30 with migraine without aura (MO) (median [IQR] age of 37 [17] years, 77% female) and 20 HCs (median [IQR] age of 35 [7] years, 50% female). Macular OCTA scans were obtained for all participants for the interictal analysis. In 12 MA and eight MO, scans were captured both during and outside of migraine attacks and five HCs had initial and repeat scans. In addition to analyzing the morphology of the foveal avascular zone, we calculated the vessel flux index (VFI), which is an indicator of retinal perfusion and conventional metrics (such as vessel area density) in the foveal and parafoveal regions. RESULTS There was a significant difference in the parafoveal VFI in the ictal state between the groups (p = 0.009). During migraine attacks there was a significant reduction in the parafoveal region VFI in MA (-7%, 95% confidence interval [CI] -10% to -4%; p = 0.006) and MO (-7%, 95% CI -10% to -3%; p = 0.016) from their interictal baseline as compared to the change between repeat scans in HCs (2%, 95% CI -3% to 7%). Interictally, there was a mean (standard deviation [SD]) 13% (10%) (p = 0.003) lower blood perfusion in the MA group as compared to the MO group in the foveal region (mean [SD] 0.093 [0.023] vs. 0.107 [0.021], p = 0.003). Interictal analysis also revealed higher circularity in the superficial foveal avascular zone in the MA group compared with the MO group (mean [SD] 0.686 [0.088] vs. 0.629 [0.120], p = 0.004). In addition, interictal analysis of the patients with MA or MO and unilateral headache showed increased retinal vascular parameters consistent with greater perfusion in the eye ipsilateral to the side of the pain as compared with the contralateral eye. CONCLUSIONS These results indicate that perfusion is reduced in MA and MO in the parafoveal retina during the ictal period. Interictally, the foveal retina in MA has reduced perfusion when compared to the foveal retina in MO. Patients with unilateral headache showed interictal asymmetry of retinal perfusion between eyes. These results indicate that changes in retinal perfusion could be a part of migraine pathophysiology, and that distinct retinal vascular signatures identified with OCTA could represent biomarkers for migraine.
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Affiliation(s)
- Katherine Podraza
- Department of Neurology, University of California, Los Angeles, California, USA
- Hartford Healthcare Headache Center, Mystic, Connecticut, USA
| | - Nitin Bangera
- Department of Neurology, University of California, Los Angeles, California, USA
- Center for Advanced Diagnostics, Evaluation and Therapeutics (CADET NM Inc.), Albuquerque, New Mexico, USA
| | - Akira Feliz
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Andrew Charles
- Department of Neurology, University of California, Los Angeles, California, USA
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Zhe X, Zhang H, Tang M, Lei X, Zhang X, Jin C. Brain functional connectivity patterns associated with symptoms of vestibular migraine. Front Neurosci 2023; 17:1231273. [PMID: 38156263 PMCID: PMC10753008 DOI: 10.3389/fnins.2023.1231273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Background Several functional magnetic resonance imaging (fMRI) investigations of patients with vestibular migraine (VM) have revealed abnormal functionality in different networks, indicating that VM is related to alterations in brain function. We sought to investigate the resting-state functional connectivity (FC) patterns during the interictal period in VM by combining data-driven voxel-wise degree centrality (DC) calculations and seed-based FC analyses, and thereby determine the associations between cerebral function and clinical symptoms. Methods Thirty-eight patients with VM and 33 matched normal controls were recruited. DC was calculated and compared between the groups, and the FC of locations showing DC alterations was further tested using a seed-based technique. The participants' clinical indicators were correlated with the DC and FC values of the brain areas. Results In contrast to the control group, the VM group showed considerably lower DC values in the bilateral medial prefrontal cortex (mPFC) and significantly higher DC values in the right occipital lobe. In the seed-based FC analyses, patients with VM demonstrated fewer connections of the bilateral mPFC with the bilateral posterior cingulate cortex, right parahippocampus, right cerebellar posterior lobe, bilateral cuneus, and left precuneus. In addition, clinical data from patients, such as pain intensity, episode frequency, and the Dizziness Handicap Inventory score, were negatively related to these FC and DC impairments. Conclusion Our findings showed changes in the default mode network and visual cortex in patients with VM, providing further insights into the complexity of the mechanisms underlying VM.
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Affiliation(s)
- Xia Zhe
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Hailian Zhang
- Department of Radiology, The Fifth People's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Chenwang Jin
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Zhu A, Zhong X, Zhu Y, Li P, Zhang J, Hou Y, Song L. Ratanasampil is more effective than flunarizine in relieving migraine. Int J Neurosci 2023; 133:1326-1337. [PMID: 35583486 DOI: 10.1080/00207454.2022.2079503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
Aims: Migraine is a common neurological disorder with high incidence in population. This study aimed to investigate the therapeutic efficacy of Tibetan medicine Ratanasampil (RNSP) and to identify the serum biomarkers for diagnosis and response assessment.Materials and methods: We prospectively recruited 108 migraine patients living at high altitude (2,260 m), including 40 patients for RNSP group, 40 patients for flunarizine (FLZ) group, and 28 patients for placebo group. Serum levels of 5-hydroxytryptamine (5-HT), brain-derived neurotrophic factor (BDNF), calcitonin gene related peptide (CGRP), nerve growth factor (NGF) and β-endorphin (β-EP) before and after therapy were measured.Results: In comparison with placebo, both FLZ and RNSP significantly reduced the migraine days, HIT-6 score and verbal rating scale, headache intensity, duration, accompanying symptoms and headache score in four and eight weeks treatment. RNSP showed no significant difference to FLZ in the above parameters after four weeks treatment, but showed significantly better relief after eight weeks treatment. The overall effective rate of RNSP (92.5%) was also significantly higher than FLZ (74.4%, p < 0.05), mainly due to significantly higher ratio of patients with full recovery. The serum levels of biomarkers, including 5-HT, BDNF, NGF and β-EP, significantly elevated after eight weeks of treatment with RNSP, whereas the level of CGRP significantly decreased. The serum level of 5-HT exhibited significantly bigger percentage changes than other markers.Conclusion: In conclusion, RNSP was more effective than FLZ in relieving migraine after eight weeks continuous treatment. Serum 5-HT, BDNF, CGRP, NGF and β-EP were effective markers reflecting the response to RNSP and FLZ therapy.
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Affiliation(s)
- Aiqin Zhu
- Institution of Geriatric, Qinghai Provincial People's Hospital, Xining, China
| | - Xing Zhong
- Institution of Geriatric, Qinghai Provincial People's Hospital, Xining, China
| | - Yi Zhu
- Hospital Infection Management Office, Hospital of Xinjiang Production and Construction Corps, Urumqi, Xinjiang, China
| | - Peng Li
- Institution of Geriatric, Qinghai Provincial People's Hospital, Xining, China
- Department of Clinical Medicine, Medical School of Qinghai University, Xining, China
| | - Junxia Zhang
- Institution of Geriatric, Qinghai Provincial People's Hospital, Xining, China
| | - Yonglan Hou
- Institution of Geriatric, Qinghai Provincial People's Hospital, Xining, China
| | - Lele Song
- Institution of Geriatric, Qinghai Provincial People's Hospital, Xining, China
- Department of Radiotherapy, the 8th Medical Center of the Chinese PLA General Hospital, Beijing, China
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Zhang L, Zhang H, Zhou X, Zhao J, Wang X. Bibliometric Analysis of Research on Migraine-Stroke Association from 2013 to 2023. J Pain Res 2023; 16:4089-4112. [PMID: 38058980 PMCID: PMC10697147 DOI: 10.2147/jpr.s438745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
Background Both migraine and stroke heavily burden individuals, health systems, and society. The migraine-stroke association is of concern and has been studied widely. Our objective is to explore and overview the current research status and emerging trends. Materials and Methods Studies on migraine-stroke association from January 2013 to May 2023 were retrieved and screened from the Web of Science Core Collection (WOSCC) database. Records fulfilling the selection criteria were downloaded and imported into CiteSpace for data mining and visualization. Results A total of 862 papers on migraine-stroke association were included. Annual publications grew slowly. The United States and European countries dominated research in this area. Harvard University published the largest number of articles, while the University of London was most active with other institutions. Ayata Cenk contributed the most articles, while KURTH T and NEUROLOGY were co-cited most. Research hotspots included migraine with aura, ischemic stroke, patent foramen ovale, cortical spreading depolarization, meta-analysis, cross-sectional study, and risk factors. Pathophysiology and small vessel disease represented research frontiers and emerging trends. Conclusion Our study scientifically outlines the migraine-stroke association over the past decade, presenting useful information.
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Affiliation(s)
- Long Zhang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
- Department of Traditional Chinese Medicine, Zibo TCM-Integrated Hospital, Zibo, Shandong, People’s Republic of China
| | - Hongyan Zhang
- Department of Traditional Chinese Medicine, Shanghai Sixth People’s Hospital, Shanghai, People’s Republic of China
- Shaanxi Key Laboratory of Research on TCM Physical Constitution and Diseases Prevention and Treatment, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People’s Republic of China
| | - Xue Zhou
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
| | - Jing Zhao
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
| | - Xingchen Wang
- Division of Neurology, the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
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Shu H, Liu S, Crawford J, Tao F. A female-specific role for trigeminal dynorphin in orofacial pain comorbidity. Pain 2023; 164:2801-2811. [PMID: 37463238 PMCID: PMC10790138 DOI: 10.1097/j.pain.0000000000002980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/01/2023] [Indexed: 07/20/2023]
Abstract
ABSTRACT Migraine is commonly reported in patients with temporomandibular disorders (TMDs), but little is known about the mechanisms underlying the comorbid condition. Here, we prepared a mouse model to investigate this comorbidity, in which masseter muscle tendon ligation (MMTL) was performed to induce a myogenic TMD, and the pre-existing TMD enabled a subthreshold dose of nitroglycerin (NTG) to produce migraine-like pain in mice. RNA sequencing followed by real-time quantitative polymerase chain reaction confirmation showed that MMTL plus NTG treatment increased prodynorphin ( Pdyn ) mRNA expression in the spinal trigeminal nucleus caudalis (Sp5C) of female mice but not in male mice. Chemogenetic inhibition of Pdyn -expressing neurons or microinjection of antidynorphin antiserum in the Sp5C alleviated MMTL-induced masseter hypersensitivity and diminished the MMTL-enabled migraine-like pain in female mice but not in male mice. Moreover, chemogenetic activation of Pdyn -expressing neurons or microinjection of dynorphin A (1-17) peptide in the Sp5C enabled a subthreshold dose of NTG to induce migraine-like pain in female mice but not in male mice. Taken together, our results suggest that trigeminal dynorphin has a female-specific role in the modulation of comorbid TMDs and migraine.
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Affiliation(s)
- Hui Shu
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Sufang Liu
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Joshua Crawford
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Feng Tao
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
- Center for Craniofacial Research and Diagnosis, Texas
A&M University School of Dentistry, Dallas, Texas, USA
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Wang P, Yao F, Zhang H, Yu Q, Wang Y. Disappearance of aura symptoms in patients with hemiplegic migraine after patent foramen ovale closure: a case report and literature review. Front Neurol 2023; 14:1267100. [PMID: 37900612 PMCID: PMC10602885 DOI: 10.3389/fneur.2023.1267100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/15/2023] [Indexed: 10/31/2023] Open
Abstract
Hemiplegic migraine (HM) can cause significant functional impairment and negatively affect the quality of life of affected individuals. Emerging evidence suggests an association between migraines and congenital patent foramen ovale (PFO), which is a small opening between the atria of the heart that normally closes shortly after birth. This report describes a 34 years-old woman with sporadic hemiplegic migraine (SHM) who was diagnosed with PFO. Following percutaneous PFO closure, her hemiplegic symptoms disappeared, but her headache exacerbated. After 3 years of follow-up, her headache severity gradually reduced, and the frequency remained consistent at 2-3 times per year with no aura symptoms. This case highlights the dissociation between the resolution of hemiplegic symptoms and the persistence of headaches after PFO closure in sporadic HM. Patients with HM may experience changes in aura symptoms and headache severity after PFO closure. Before performing PFO closure in patients with hemiplegic migraine, the indications should be thoroughly understood.
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Affiliation(s)
- Pian Wang
- Department of Neurology, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Fengyou Yao
- Department of Cardiology, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Hongbo Zhang
- Department of Neurology, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Qian Yu
- Department of Cardiology, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Yan Wang
- Department of Neurology, Chengdu Fifth People’s Hospital, Chengdu, China
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Miller A, York EM, Stopka SA, Martínez-François JR, Hossain MA, Baquer G, Regan MS, Agar NYR, Yellen G. Spatially resolved metabolomics and isotope tracing reveal dynamic metabolic responses of dentate granule neurons with acute stimulation. Nat Metab 2023; 5:1820-1835. [PMID: 37798473 PMCID: PMC10626993 DOI: 10.1038/s42255-023-00890-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 08/09/2023] [Indexed: 10/07/2023]
Abstract
Neuronal activity creates an intense energy demand that must be met by rapid metabolic responses. To investigate metabolic adaptations in the neuron-enriched dentate granule cell (DGC) layer within its native tissue environment, we employed murine acute hippocampal brain slices, coupled with fast metabolite preservation and followed by mass spectrometry (MS) imaging, to generate spatially resolved metabolomics and isotope-tracing data. Here we show that membrane depolarization induces broad metabolic changes, including increased glycolytic activity in DGCs. Increased glucose metabolism in response to stimulation is accompanied by mobilization of endogenous inosine into pentose phosphates via the action of purine nucleotide phosphorylase (PNP). The PNP reaction is an integral part of the neuronal response to stimulation, because inhibition of PNP leaves DGCs energetically impaired during recovery from strong activation. Performing MS imaging on brain slices bridges the gap between live-cell physiology and the deep chemical analysis enabled by MS.
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Affiliation(s)
- Anne Miller
- Department of Neurobiology, Harvard Medical School, Boston, MA, USA
- Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria
| | - Elisa M York
- Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - Sylwia A Stopka
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Md Amin Hossain
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerard Baquer
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael S Regan
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nathalie Y R Agar
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
| | - Gary Yellen
- Department of Neurobiology, Harvard Medical School, Boston, MA, USA.
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Raffaelli B, Kull P, Mecklenburg J, Lange KS, Overeem LH, Fitzek MP, Siebert A, Steinicke M, Triller P, Neeb L, Dreier JP, Reuter U, Kondziella D. Near-death experiences are associated with rapid eye movement (REM) sleep intrusions in migraine patients, independent of migraine aura. Eur J Neurol 2023; 30:3322-3331. [PMID: 37489579 DOI: 10.1111/ene.15991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/20/2023] [Accepted: 07/19/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND AND PURPOSE Migraine aura, near-death experiences (NDEs), and rapid eye movement (REM) sleep intrusions might share common mechanisms. Here, we investigated the prevalence of NDEs and REM sleep intrusions in people with migraine. We hypothesized that NDEs and REM sleep intrusions are more prevalent in migraine patients with aura than in those without. METHODS We conducted a prospective cross-sectional cohort study at a tertiary headache center, based on a prespecified sample size (n = 808). Migraine patients completed a series of questionnaires, including questions about demographic and headache characteristics, the 16-item Greyson NDE scale, four questions about REM sleep intrusions, and the Depression, Anxiety, and Stress Scale 21 (DASS-21). RESULTS Of 808 migraine patients (mean age 44.4 ± 13.3 years, 87.0% women), 353 (43.7%) had a current or previous history of migraine aura. Prevalence of NDE was 2.7% and not different in patients with and without aura (2.8% vs. 2.6%; p > 0.999). REM sleep intrusions were reported by 5.4% of participants and in a similar proportion of patients with and without aura (6.3% vs. 4.9%; p = 0.43). However, participants with REM sleep intrusions had had an NDE more often than participants without REM sleep intrusions (n = 5/44, 11.4% vs. n = 17/754, 2.2%; p = 0.005). Higher DASS-21 scores were associated with REM sleep intrusions (p < 0.001). CONCLUSIONS In this tertiary center cohort study, the prevalence of NDE and REM sleep intrusions was not influenced by migraine aura status. However, we identified an association between NDE and REM sleep intrusions, which corroborates the notion that they might share pathophysiological mechanisms.
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Affiliation(s)
- Bianca Raffaelli
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health at Charité (BIH), Berlin, Germany
| | - Pia Kull
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jasper Mecklenburg
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Kristin S Lange
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lucas H Overeem
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- International Graduate Program Medical Neurosciences, Humboldt Graduate School, Berlin, Germany
| | - Mira P Fitzek
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Anke Siebert
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Maureen Steinicke
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Triller
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lars Neeb
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Helios Global Health, Berlin, Germany
| | - Jens P Dreier
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Uwe Reuter
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Universitätsmedizin Greifswald, Greifswald, Germany
| | - Daniel Kondziella
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Noseda R, Villanueva L. Central generators of migraine and autonomic cephalalgias as targets for personalized pain management: Translational links. Eur J Pain 2023; 27:1126-1138. [PMID: 37421221 PMCID: PMC10979820 DOI: 10.1002/ejp.2158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Migraine oscillates between different states in association with internal homeostatic functions and biological rhythms that become more easily dysregulated in genetically susceptible individuals. Clinical and pre-clinical data on migraine pathophysiology support a primary role of the central nervous system (CNS) through 'dysexcitability' of certain brain networks, and a critical contribution of the peripheral sensory and autonomic signalling from the intracranial meningeal innervation. This review focuses on the most relevant back and forward translational studies devoted to the assessment of CNS dysfunctions involved in primary headaches and discusses the role they play in rendering the brain susceptible to headache states. METHODS AND RESULTS We collected a body of scientific literature from human and animal investigations that provide a compelling perspective on the anatomical and functional underpinnings of the CNS in migraine and trigeminal autonomic cephalalgias. We focus on medullary, hypothalamic and corticofugal modulation mechanisms that represent strategic neural substrates for elucidating the links between trigeminovascular maladaptive states, migraine triggering and the temporal phenotype of the disease. CONCLUSION It is argued that a better understanding of homeostatic dysfunctional states appears fundamental and may benefit the development of personalized therapeutic approaches for improving clinical outcomes in primary headache disorders. SIGNIFICANCE This review focuses on the most relevant back and forward translational studies showing the crucial role of top-down brain modulation in triggering and maintaining primary headache states and how these central dysfunctions may interact with personalized pain management strategies.
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Affiliation(s)
- Rodrigo Noseda
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Luis Villanueva
- Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris-Cité, Team Imaging Biomarkers of Brain Disorders (IMA-Brain), INSERM U1266, Paris, France
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Vallese A, Cordone V, Pecorelli A, Valacchi G. Ox-inflammasome involvement in neuroinflammation. Free Radic Biol Med 2023; 207:161-177. [PMID: 37442280 DOI: 10.1016/j.freeradbiomed.2023.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/26/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023]
Abstract
Neuroinflammation plays a crucial role in the onset and the progression of several neuropathologies, from neurodegenerative disorders to migraine, from Rett syndrome to post-COVID 19 neurological manifestations. Inflammasomes are cytosolic multiprotein complexes of the innate immune system that fuel inflammation. They have been under study for the last twenty years and more recently their involvement in neuro-related conditions has been of great interest as possible therapeutic target. The role of oxidative stress in inflammasome activation has been described, however the exact way of action of specific endogenous and exogenous oxidants needs to be better clarified. In this review, we provide the current knowledge on the involvement of inflammasome in the main neuropathologies, emphasizing the importance to further clarify the role of oxidative stress in its activation including the role of mitochondria in inflammasome-induced neuroinflammation.
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Affiliation(s)
- Andrea Vallese
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Valeria Cordone
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Alessandra Pecorelli
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Giuseppe Valacchi
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy; Department of Animal Science, North Carolina State University, 28081, Kannapolis, USA; Department of Food and Nutrition, Kyung Hee University, Seoul, South Korea.
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Martinez CI, Liktor-Busa E, Largent-Milnes TM. Molecular mechanisms of hormones implicated in migraine and the translational implication for transgender patients. FRONTIERS IN PAIN RESEARCH 2023; 4:1117842. [PMID: 37795389 PMCID: PMC10546064 DOI: 10.3389/fpain.2023.1117842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
Migraine is a primary headache disorder recognized by the World Health Organization as one of the most poorly understood and debilitating neurological conditions impacting global disability. Chronic pain disorders are more frequently diagnosed among cisgender women than men, suggesting that female sex hormones could be responsible for mediating chronic pain, including migraine and/or that androgens can be protective. This review discusses the major gonadal hormones, estrogens, progesterone, and testosterone in the context of molecular mechanisms by which they play a role in migraine pathophysiology. In addition, the literature to date describing roles of minor sex hormones including prolactin, luteinizing hormone, follicular stimulating hormone, and gonadotropin releasing hormone in migraine are presented. Because transgender and gender non-conforming (trans*) individuals are an underserved patient population in which gender-affirming sex hormone replacement therapy (HRT) is often medically necessary to align biological sex with gender identity, results from cisgender patient populations are discussed in the context of these major and minor sex hormones on migraine incidence and management in trans* patients.
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Affiliation(s)
| | | | - Tally M. Largent-Milnes
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, United States
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Cao J, Grover P, Kainerstorfer JM. A model of neurovascular coupling and its application to cortical spreading depolarization. J Theor Biol 2023; 572:111580. [PMID: 37459953 DOI: 10.1016/j.jtbi.2023.111580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/09/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
Cortical spreading depolarization (CSD) is a neuropathological condition involving propagating waves of neuronal silence, and is related to multiple diseases, such as migraine aura, traumatic brain injury (TBI), stroke, and cardiac arrest, as well as poor outcome of patients. While CSDs of different severity share similar roots on the ion exchange level, they can lead to different vascular responses (namely spreading hyperemia and spreading ischemia). In this paper, we propose a mathematical model relating neuronal activities to predict vascular changes as measured with near-infrared spectroscopy (NIRS) and fMRI recordings, and apply it to the extreme case of CSD, where sustained near-complete neuronal depolarization is seen. We utilize three serially connected models (namely, ion exchange, neurovascular coupling, and hemodynamic model) which are described by differential equations. Propagating waves of ion concentrations, as well as the associated vasodynamics and hemodynamics, are simulated by solving these equations. Our proposed model predicts vasodynamics and hemodynamics that agree both qualitatively and quantitatively with experimental literature. Mathematical modeling and simulation offer a powerful tool to help understand the underlying mechanisms of CSD and help interpret the data. In addition, it helps develop novel monitoring techniques prior to data collection. Our simulated results strongly suggest that fMRI is unable to reliably distinguish between spreading hyperemia and spreading ischemia, while NIRS signals are substantially distinct in the two cases.
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Affiliation(s)
- Jiaming Cao
- Department of Biomedical Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, 15213, PA, United States
| | - Pulkit Grover
- Department of Biomedical Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, 15213, PA, United States; Department of Electrical and Computer Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, 15213, PA, United States; Neuroscience Institute, Carnegie Mellon University, 4400 Fifth Avenue, Pittsburgh, 15213, PA, United States
| | - Jana M Kainerstorfer
- Department of Biomedical Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, 15213, PA, United States; Department of Electrical and Computer Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, 15213, PA, United States; Neuroscience Institute, Carnegie Mellon University, 4400 Fifth Avenue, Pittsburgh, 15213, PA, United States.
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Riederer F, Beiersdorf J, Scutelnic A, Schankin CJ. Migraine Aura-Catch Me If You Can with EEG and MRI-A Narrative Review. Diagnostics (Basel) 2023; 13:2844. [PMID: 37685382 PMCID: PMC10486733 DOI: 10.3390/diagnostics13172844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Roughly one-third of migraine patients suffer from migraine with aura, characterized by transient focal neurological symptoms or signs such as visual disturbance, sensory abnormalities, speech problems, or paresis in association with the headache attack. Migraine with aura is associated with an increased risk for stroke, epilepsy, and with anxiety disorder. Diagnosis of migraine with aura sometimes requires exclusion of secondary causes if neurological deficits present for the first time or are atypical. It was the aim of this review to summarize EEG an MRI findings during migraine aura in the context of pathophysiological concepts. This is a narrative review based on a systematic literature search. During visual auras, EEG showed no consistent abnormalities related to aura, although transient focal slowing in occipital regions has been observed in quantitative studies. In contrast, in familial hemiplegic migraine (FHM) and migraine with brain stem aura, significant EEG abnormalities have been described consistently, including slowing over the affected hemisphere or bilaterally or suppression of EEG activity. Epileptiform potentials in FHM are most likely attributable to associated epilepsy. The initial perfusion change during migraine aura is probably a short lasting hyperperfusion. Subsequently, perfusion MRI has consistently demonstrated cerebral hypoperfusion usually not restricted to one vascular territory, sometimes associated with vasoconstriction of peripheral arteries, particularly in pediatric patients, and rebound hyperperfusion in later phases. An emerging potential MRI signature of migraine aura is the appearance of dilated veins in susceptibility-weighted imaging, which may point towards the cortical regions related to aura symptoms ("index vein"). Conclusions: Cortical spreading depression (CSD) cannot be directly visualized but there are probable consequences thereof that can be captured Non-invasive detection of CSD is probably very challenging in migraine. Future perspectives will be elaborated based on the studies summarized.
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Affiliation(s)
- Franz Riederer
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, CH 3010 Bern, Switzerland (C.J.S.)
- Department of Neurology, University Hospital Zurich, Medical Faculty, University of Zurich, CH 8091 Zurich, Switzerland
| | - Johannes Beiersdorf
- Karl Landsteiner Institute for Clinical Epilepsy Reserach and Cognitive Neurology, AT 1130 Vienna, Austria;
| | - Adrian Scutelnic
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, CH 3010 Bern, Switzerland (C.J.S.)
| | - Christoph J. Schankin
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, CH 3010 Bern, Switzerland (C.J.S.)
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Tang Y, Ji S, Li H, Dong B, Li Y, Zhu C, Chen L. Association of patent foramen ovale with epilepsy: A hospital-based case-control study. Epilepsia Open 2023; 8:1075-1083. [PMID: 37422851 PMCID: PMC10472407 DOI: 10.1002/epi4.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/01/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the proportion of patent foramen ovale (PFO) in people with epilepsy (PWE) compared to controls without epilepsy and to assess whether PWEs with and without PFO exhibit distinctive clinical features. METHODS This is a case-control study conducted in a hospital. Contrast transthoracic echocardiography with a venous microbubble bolus and provocative maneuvers (Valsalva and coughing) were used to identify PFO and its right-to-left shunt (RLS) among 741 PWEs and 800 controls without epilepsy. The risk of having PFO in PWEs was explored using multiple matching methods and logistic regression with adjusted congenital factors that may affect the occurrence of PFO. RESULTS The proportion of PFO in PWEs and controls was 39.00% and 24.25%, respectively. After 1:1 propensity score matching, the risk of suffering PFO in PWEs was 1.71 times (OR, 1.71; 95% CI, 1.24-2.36) higher than that in controls. PWEs also had a higher risk of having a high RLS grade (βepilepsy = 0.390, P < 0.001). Among clinical characteristics of PWEs, migraine, and drug-resistant epilepsy showed significantly different distributions between those without RLS and those with RLS grade I to III. PWEs with PFO had higher risk of suffering from migraine and drug-resistant epilepsy (OR in migraine, 2.54, 95% CI, 1.65-3.95; OR in drug-resistant epilepsy, 1.47, 95% CI, 1.06-2.03). SIGNIFICANCE The proportion of PFO was found to be higher in PWE than in controls without epilepsy, especially in patients with drug-resistant epilepsy, suggesting potential relationship between the two disorders. Large multicentric study will be needed to confirm this finding.
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Affiliation(s)
- Yusha Tang
- Department of NeurologySichuan University West China HospitalChengduChina
| | - Shuming Ji
- Department of Project Design and StatisticsSichuan University West China HospitalChengduChina
| | - Hua Li
- Department of NeurologySichuan University West China HospitalChengduChina
| | - Bosi Dong
- Department of NeurologySichuan University West China HospitalChengduChina
| | - Yajiao Li
- Department of Cardiology, West China HospitalSichuan UniversityChengduChina
| | - Chenxing Zhu
- Department of Clinical Research ManagementSichuan University West China HospitalChengduChina
| | - Lei Chen
- Department of NeurologySichuan University West China HospitalChengduChina
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Charles A. Aura is a symptom of a migraine attack, not its cause. Headache 2023; 63:1029-1030. [PMID: 37665161 DOI: 10.1111/head.14623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Andrew Charles
- Professor of Neurology, UCLA Goldberg Migraine Program, Los Angeles, California, USA
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Mehnert J, Fischer-Schulte L, May A. Aura phenomena do not initiate migraine attacks-Findings from neuroimaging. Headache 2023; 63:1040-1044. [PMID: 37449553 DOI: 10.1111/head.14597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES/BACKGROUND As cortical spreading depolarization (CSD) has been suggested to be the cause of migraine aura and as CSD can activate trigeminal nociceptive neurons in animals, it has been suggested that CSD may be the cause of migraine attacks. This raises the question of how migraine pain is generated in migraine attacks without aura and has led to the hypothesis that CSD may also occur in subcortical regions in the form of "silent" CSDs, and accordingly "silent auras". METHODS In this case study, we provide evidence for common neuronal alterations preceding headache attacks with and without aura in a male patient with migraine, who underwent daily event-correlated functional magnetic resonance imaging of trigeminal nociception for a period of 30 days. During these days the man experienced migraine attacks with and without aura. RESULTS Comparing the preictal phases between both attack types revealed a common hyperactivation of the hypothalamus (p < 0.01), which was already present 2 days before the actual attack. CONCLUSION The time frame of the central pathophysiological orchestration of migraine attacks, irrelevant of the presence of later aura, strongly suggests that the aura is an epiphenomenon that is unrelated and does not initiate headache attacks.
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Affiliation(s)
- Jan Mehnert
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Fischer-Schulte
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Messina R, Rocca MA, Goadsby PJ, Filippi M. Insights into migraine attacks from neuroimaging. Lancet Neurol 2023; 22:834-846. [PMID: 37478888 DOI: 10.1016/s1474-4422(23)00152-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/15/2023] [Accepted: 04/12/2023] [Indexed: 07/23/2023]
Abstract
Migraine is one of the most common neurological diseases and it has a huge social and personal impact. Although head pain is the core symptom, individuals with migraine can have a plethora of non-headache symptoms that precede, accompany, or follow the pain. Neuroimaging studies have shown that the involvement of specific brain areas can explain many of the symptoms reported during the different phases of migraine. Recruitment of the hypothalamus, pons, spinal trigeminal nucleus, thalamus, and visual and pain-processing cortical areas starts during the premonitory phase and persists through the headache phase, contributing to the onset of pain and associated symptoms. Once the pain stops, the involvement of most brain areas ends, although the pons, hypothalamus, and visual cortex remain active after acute treatment intake and resolution of migraine symptoms. A better understanding of the correlations between imaging findings and migraine symptomatology can provide new insight into migraine pathophysiology and the mechanisms of novel migraine-specific treatments.
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Affiliation(s)
- Roberta Messina
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Peter J Goadsby
- NIHR King's Clinical Research Facility, King's College, London, UK; Department of Neurology, University of California, Los Angeles, CA, USA
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Nsugbe E. Mathematical Psychiatry: On Cortical Spreading Depression-A Review. Brain Sci 2023; 13:1241. [PMID: 37759842 PMCID: PMC10527382 DOI: 10.3390/brainsci13091241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
The concept of migraine with aura (MwA) is a widespread condition that can affect up to 30% of migraine patients and manifests itself as a temporary visual illusion followed by a prolonged headache. It was initially pitched as a neurological disease, and observed that the spread of accompanying electrophysiological waves as part of the condition, which came to be known as cortical spreading depression (CSD). A strong theoretical basis for a link between MwA and CSD has eventually led to knowledge of the dynamics between the pair. In addition to experiment-based observations, mathematical models make an important contribution towards a numerical means of expressing codependent neural-scale manifestations. This provides alternate means of understanding and observing the phenomena while helping to visualize the links between the variables and their magnitude in contributing towards the emanation and dynamic pulsing of the condition. A number of biophysical mechanisms are believed to contribute to the MwA-CSD, spanning ion diffusion, ionic currents of membranes, osmosis, spatial buffering, neurotransmission, gap junctions, metabolic pumping, and synapse connections. As part of this review study, the various mathematical models for the description of the condition are expressed, reviewed, and contrasted, all of which vary in their depth, perspective, and level of information presented. Subsequent to this, the review looked into links between electrophysiological data-driven manifestations from measurements such as EEG and fMRI. While concluding remarks forged a structured pathway in the area on sub-themes that need to be investigated in order to strengthen and robustify the existing models, they include an accounting for inter-personal variability in models, sex and hormonal factors, and age groups, i.e., pediatrics vs. adults.
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Mastria G, Mancini V, Viganò A, Piervincenzi C, Petsas N, Puma M, Giannì C, Pantano P, Di Piero V. Neuroimaging markers of Alice in Wonderland syndrome in patients with migraine with aura. Front Neurol 2023; 14:1210811. [PMID: 37767534 PMCID: PMC10520557 DOI: 10.3389/fneur.2023.1210811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/09/2023] [Indexed: 09/29/2023] Open
Abstract
Background The Alice in Wonderland syndrome (AIWS) is a transient neurological disturbance characterized by sensory distortions most frequently associated with migraine in adults. Some lines of evidence suggest that AIWS and migraine might share common pathophysiological mechanisms, therefore we set out to investigate the common and distinct neurophysiological alterations associated with these conditions in migraineurs. Methods We conducted a case-control study acquiring resting-state fMRI data from 12 migraine patients with AIWS, 12 patients with migraine with typical aura (MA) and 24 age-matched healthy controls (HC). We then compared the interictal thalamic seed-to-voxel and ROI-to-ROI cortico-cortical resting-state functional connectivity between the 3 groups. Results We found a common pattern of altered thalamic connectivity in MA and AIWS, compared to HC, with more profound and diffuse alterations observed in AIWS. The ROI-to-ROI functional connectivity analysis highlighted an increased connectivity between a lateral occipital region corresponding to area V3 and the posterior part of the superior temporal sulcus (STS) in AIWS, compared to both MA and HC. Conclusion The posterior STS is a multisensory integration area, while area V3 is considered the starting point of the cortical spreading depression (CSD), the neural correlate of migraine aura. This interictal hyperconnectivity might increase the probability of the CSD to directly diffuse to the posterior STS or deactivating it, causing the AIWS symptoms during the ictal phase. Taken together, these results suggest that AIWS in migraineurs might be a form of complex migraine aura, characterized by the involvement of associative and multisensory integration areas.
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Affiliation(s)
- Giulio Mastria
- My Space Lab, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Valentina Mancini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | | | | | | | - Marta Puma
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Costanza Giannì
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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Kim SJ, Lee HJ, Lee SH, Cho S, Kim KM, Chu MK. Visual Aura in Non-Migraine Headaches: A Population Study. J Korean Med Sci 2023; 38:e237. [PMID: 37550805 PMCID: PMC10412033 DOI: 10.3346/jkms.2023.38.e237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/04/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Visual aura (VA) occurs mostly in migraine with aura (MA), but some case studies have reported aura in non-migraine headaches. Thus, information of VA in non-migraine headaches is scarce. Aim of this study was to investigate the prevalence and impact of VA in non-migraine headache and compare it with that of migraine headache. METHODS This study was a nationwide population-based study. We used an internet-based headache diagnosis questionnaire to diagnose headache, and various modules to evaluate clinical features and comorbidities of participants with headache. We defined migraine headache as migraine and probable migraine (PM), whereas non-migraine headache was defined as a headache but not migraine or PM. VA was defined as a self-reporting VA rating scale score ≥ 3. RESULTS Of the 3,030 participants, 1,431 (47.2%) and 507 (16.7%) had non-migraine headache and migraine headache, respectively. VA prevalence was much lower in the non-migraine headache group than in the migraine headache group (14.5% [207/1,431] vs. 26.0% [132/507], P < 0.001). In subjects with non-migraine headache, those with VA had a markedly higher number of headache days per 30 days (median [25th-75th percentiles]: 2.0 [1.0-5.0] vs. 2.0 [1.0-3.0], P < 0.001), and headache-related disability (6.0 [3.0-16.0] vs. 2.0 [0.0-7.0], P < 0.001) than those without VA. VA prevalence did not differ significantly according to age and sex. CONCLUSION Non-migraine headache with VA patients had more severe symptoms than those without VA. These findings may improve the understanding of VA and the management of individuals with non-migraine headache.
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Affiliation(s)
- Seung Jae Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Jeong Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Sue Hyun Lee
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Soomi Cho
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Miller A, York E, Stopka S, Martínez-François J, Hossain MA, Baquer G, Regan M, Agar N, Yellen G. Spatially resolved metabolomics and isotope tracing reveal dynamic metabolic responses of dentate granule neurons with acute stimulation. RESEARCH SQUARE 2023:rs.3.rs-2276903. [PMID: 37546759 PMCID: PMC10402263 DOI: 10.21203/rs.3.rs-2276903/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Neuronal activity creates an intense energy demand that must be met by rapid metabolic responses. To investigate metabolic adaptations in the neuron-enriched dentate granule cell (DGC) layer within its native tissue environment, we employed murine acute hippocampal brain slices coupled with fast metabolite preservation, followed by mass spectrometry imaging (MALDI-MSI) to generate spatially resolved metabolomics and isotope tracing data. Here we show that membrane depolarization induces broad metabolic changes, including increased glycolytic activity in DGCs. Increased glucose metabolism in response to stimulation is accompanied by mobilization of endogenous inosine into pentose phosphates, via the action of purine nucleotide phosphorylase (PNP). The PNP reaction is an integral part of the neuronal response to stimulation, as inhibiting PNP leaves DGCs energetically impaired during recovery from strong activation. Performing MSI on brain slices bridges the gap between live cell physiology and the deep chemical analysis enabled by mass spectrometry.
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Zhang S, Azubuine J, Schmeer C. A systematic literature review on the role of glial cells in the pathomechanisms of migraine. Front Mol Neurosci 2023; 16:1219574. [PMID: 37456527 PMCID: PMC10347403 DOI: 10.3389/fnmol.2023.1219574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Background The pathomechanisms underlying migraine are intricate and remain largely unclear. Initially regarded as a neuronal disorder, migraine research primarily concentrated on understanding the pathophysiological changes within neurons. However, recent advances have revealed the significant involvement of neuroinflammation and the neuro-glio-vascular interplay in migraine pathogenesis. Methods A systematic search was conducted in PubMed, Scopus, and Web of Science databases from their inception until November 2022. The retrieved results underwent a screening process based on title and abstract, and the full texts of the remaining papers were thoroughly assessed for eligibility. Only studies that met the predetermined inclusion criteria were included in the review. Results Fifty-nine studies, consisting of 6 human studies and 53 animal studies, met the inclusion criteria. Among the 6 human studies, 2 focused on genetic analyses, while the remaining studies employed functional imaging, serum analyses and clinical trials. Regarding the 53 animal studies investigating glial cells in migraine, 19 of them explored the role of satellite glial cells and/or Schwann cells in the trigeminal ganglion and/or trigeminal nerve. Additionally, 17 studies highlighted the significance of microglia and/or astrocytes in the trigeminal nucleus caudalis, particularly in relation to central sensitization during migraine chronification. Furthermore, 17 studies examined the involvement of astrocytes and/or microglia in the cortex. Conclusion Glial cells, including astrocytes, microglia, satellite glial cells and Schwann cells in the central and peripheral nervous system, participate both in the development as well as chronic progression of migraine in disease-associated regions such as the trigeminovascular system, trigeminal nucleus caudalis and cortex, among other brain regions.
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Stanton AA. Are We Sure We Know the Risk Factors for Cardiovascular Disease? J Am Coll Cardiol 2023; 81:2255-2257. [PMID: 37286255 DOI: 10.1016/j.jacc.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 06/09/2023]
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Wang M, Gu Y, Meng S, Kang L, Yang J, Sun D, Liu Y, Wan Z, Shan Y, Xue D, Su C, Li S, Yan R, Liu Y, Zhao Y, Pan Y. Association between TRP channels and glutamatergic synapse gene polymorphisms and migraine and the comorbidities anxiety and depression in a Chinese population. Front Genet 2023; 14:1158028. [PMID: 37303955 PMCID: PMC10250607 DOI: 10.3389/fgene.2023.1158028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023] Open
Abstract
Background: Genetic and environmental factors contribute to migraine and the comorbidities of anxiety and depression. However, the association between genetic polymorphisms in the transient receptor potential (TRP) channels and glutamatergic synapse genes with the risk of migraine and the comorbidities of anxiety and depression remain unclear. Methods: 251 migraine patients containing 49 comorbidities with anxiety and 112 with depression and 600 controls were recruited. A customized 48-plex SNPscan kit was used for genotyping 13 SNPs of nine target genes. Logistic regression was conducted to analyze these SNPs' association with the susceptibility of migraine and comorbidities. The generalized multifactor dimension reduction (GMDR) was applied to analyze the SNP-SNP and gene-environment interactions. The GTEx database was used to examine the effects of the significant SNPs on gene expressions. Results: The TRPV1 rs8065080 and TRPV3 rs7217270 were associated with an increased risk of migraine in the dominant model [ORadj (95% CI): 1.75 (1.09-2.90), p = 0.025; 1.63 (1.02-2.58), p = 0.039, respectively]. GRIK2 rs2227283 was associated with migraine in the edge of significance [ORadj (95% CI) = 1.36 (0.99-1.89), p = 0.062]. In migraine patients, TRPV1 rs222741 was associated with both anxiety risk and depression risk in the recessive model [ORadj (95% CI): 2.64 (1.24-5.73), p = 0.012; 1.97 (1.02-3.85), p = 0.046, respectively]. TRPM8 rs7577262 was associated with anxiety (ORadj = 0.27, 95% CI = 0.10-0.76, p = 0.011). TRPV4 rs3742037, TRPM8 rs17862920 and SLC17A8 rs11110359 were associated with depression in dominant model [ORadj (95% CI): 2.03 (1.06-3.96), p = 0.035; 0.48 (0.23-0.96), p = 0.042; 0.42 (0.20-0.84), p = 0.016, respectively]. Significant eQTL and sQTL signals were observed for SNP rs8065080. Individuals with GRS (Genetic risk scores) of Q4 (14-17) had a higher risk of migraine and a lower risk of comorbidity anxiety than those with Genetic risk scores scores of Q1 (0-9) groups [ORadj (95% CI): 2.31 (1.39-3.86), p = 0.001; 0.28 (0.08-0.88), p = 0.034, respectively]. Conclusion: This study suggests that TRPV1 rs8065080, TRPV3 rs7217270, and GRIK2 rs2227283 polymorphism may associate with migraine risk. TRPV1 rs222741 and TRPM8 rs7577262 may associate with migraine comorbidity anxiety risk. rs222741, rs3742037, rs17862920, and rs11110359 may associate with migraine comorbidity depression risk. Higher GRS scores may increase migraine risk and decrease comorbidity anxiety risk.
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Affiliation(s)
- Mingxue Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yujia Gu
- Chronic Disease Prevention and Treatment Clinic, Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Shuhan Meng
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Lixin Kang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Jing Yang
- Department of Neurology, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Degang Sun
- Department of Neurology, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Yuxing Liu
- Catheterization Room, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Ze Wan
- Science and Education Section, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Yi Shan
- Physical Examination Section, Beidahuang Group Baoquanling Hospital, Hegang, China
| | - Dongjie Xue
- Department of Neurology, Hegang He Mine Hospital, Hegang, China
| | - Chang Su
- Department of Internal Medicine, Baoquanling Farm Hospital, Hegang, China
| | - Shufen Li
- Vaccination Clinic, Baoquanling Farm Hospital, Hegang, China
| | - Ran Yan
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yu Liu
- Chronic Disease Prevention and Treatment Clinic, Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yonghui Pan
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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49
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Song D, Li P, Wang Y, Cao J. Noninvasive vagus nerve stimulation for migraine: a systematic review and meta-analysis of randomized controlled trials. Front Neurol 2023; 14:1190062. [PMID: 37251233 PMCID: PMC10213755 DOI: 10.3389/fneur.2023.1190062] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Background Medication is commonly used to treat migraine. However, patients may experience adverse events or fail to respond to medication. In recent years, neuromodulation techniques have emerged as potential non-pharmacological therapy for migraine. This article focuses on a systematic review and meta-analysis of randomized controlled trials of non-invasive vagus nerve stimulation (n-VNS) for migraine to determine the efficacy, safety and tolerability of n-VNS. Methods We searched PUBMED, EMBASE, and Cochrane Center Register of Controlled Trials databases up to July 15, 2022. Primary outcomes were monthly reduced migraine/headache days, and pain-free rates within 2 h. Secondary outcomes were ≥ 50% responder rate, headache intensity, monthly acute medication reduction days, and adverse events. Results Meta-analysis shows that non-invasive cervical vagus nerve stimulation (n-cVNS) significantly impacted ≥50% responder rate (OR, 1.64; 95% CI, 1.1 to 2.47; p = 0.02), but had no significant effect on reducing migraine days (MD, -0.46; 95% CI, -1.21 to 0.29; p = 0.23) and headache days (MD, -0.68; 95% CI, -1.52 to 0.16; p = 0.11). In contrast, low-frequency non-invasive auricular vagus nerve stimulation (n-aVNS) was found to significantly reduce the number of migraine days (MD, -1.8; 95% CI, -3.34 to -0.26; p = 0.02) and headache intensity (SMD, -0.7; 95% CI, -1.23 to -0.17; p = 0.009), but not the number of acute medication days per month (MD, -1.1; 95% CI, -3.84 to 1.64; p = 0.43). In addition, n-cVNS was found safe and well-tolerated in most patients. Conclusion These findings show that n-VNS is a promising method for migraine management.
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Affiliation(s)
- Dong Song
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Piaoyi Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Yonggang Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jin Cao
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
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50
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D’Agnano D, Lo Cascio S, Correnti E, Raieli V, Sciruicchio V. A Narrative Review of Visual Hallucinations in Migraine and Epilepsy: Similarities and Differences in Children and Adolescents. Brain Sci 2023; 13:643. [PMID: 37190608 PMCID: PMC10136509 DOI: 10.3390/brainsci13040643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 05/17/2023] Open
Abstract
Since the earliest descriptions of the simple visual hallucinations in migraine patients and in subjects suffering from occipital lobe epilepsy, several important issues have arisen in recognizing epileptic seizures of the occipital lobe, which often present with symptoms mimicking migraine. A detailed quantitative and qualitative clinical scrutiny of timing and characteristics of visual impairment can contribute to avoiding mistakes. Differential diagnosis, in children, might be challenging because of the partial clinical, therapeutic, and pathophysiological overlaps between the two diseases that often coexist. Ictal elementary visual hallucinations are defined by color, shape, size, location, movement, speed of appearance and duration, frequency, and associated symptoms and their progression. The evaluation of the distinctive clinical features of visual aura in migraine and visual hallucinations in occipital epilepsy could contribute to understanding the pathogenetic mechanisms of these two conditions. This paper aims to critically review the available scientific evidence on the main clinical criteria that address diagnosis, as well as similarities and differences in the pathophysiological mechanisms underlying the visual impairment in epilepsy and migraine.
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Affiliation(s)
- Daniela D’Agnano
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Salvatore Lo Cascio
- Child Neuropsychiatry Unit Department, Pro.MI.S.E. “G. D’Alessandro, University of Palermo, 90100 Palermo, Italy
| | - Edvige Correnti
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
| | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
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