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Ruscheweyh R, Lehnen N, Henningsen P. [Migraine and psychosomatic comorbidity]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024. [PMID: 38885653 DOI: 10.1055/a-2331-0840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
As a common neurological disorder (10-15% of the population), migraine is associated with numerous comorbidities, particularly other pain syndromes, mental illnesses and functional disorders. These 'psychosomatic' comorbidities increase with migraine severity. Severely affected, comorbid patients also often have a poorer response to specific migraine therapy. Interestingly, migraine and the comorbidities mentioned have a number of common aetiological or facilitating factors, e.g. genetic factors, and show a higher incidence in women and in people with previous traumatic experiences, as well as (in the case of pain syndromes) signs of central sensitization. Another common feature is the association with current or chronic stress. We propose an extended diathesis-stress model that takes into account interrelated but individually different vulnerabilities and, depending on the stress experience, can depict both the occurrence of individual disorders (e.g. an isolated migraine) and the joint occurrence of migraine with other pain syndromes and other psychosomatic comorbidities. In summary, psychosomatic comorbidities should always be kept in mind in migraine therapy and, if necessary, treated early and multimodally.
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Affiliation(s)
- Ruth Ruscheweyh
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, München, Germany
- Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar der TUM, München, Germany
| | - Nadine Lehnen
- Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar der TUM, München, Germany
| | - Peter Henningsen
- Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar der TUM, München, Germany
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Li Y, Cai J, Chong H. Psoriasis and risk of central neurological disorders in European populations: A mendelian randomization analysis. Heliyon 2024; 10:e24774. [PMID: 38318067 PMCID: PMC10839951 DOI: 10.1016/j.heliyon.2024.e24774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 01/04/2024] [Accepted: 01/14/2024] [Indexed: 02/07/2024] Open
Abstract
Background People with psoriasis are at a higher risk for having central neurological problems, according to previous studies; however, it is unclear if there is a genetic link between the risk of developing psoriasis and developing central neurological disorders. In this study, the possible link between genetically predisposed psoriasis and the risk of common central nervous system disorders was comprehensively investigated. Methods There was no overlap in the participant populations between the psoriasis and central neurological disorders genome-wide association studies, which provide the genetic resources. Inverse variance weighting, often used as Mendelian randomization (MR) analysis, is the main method. To guarantee the accuracy of our findings, a number of sensitivity studies were carried out. Results MR analysis revealed that although psoriasis was reported to increase the risk of Parkinson's disease (OR = 4.42, 95%CI[-3.81~6.79], P = 0.58) and epilepsy (OR = 4.71, 95%CI[-2.20~5.30], P = 0.42) in this study, they did not reach statistical significance. At the same time, this study did not observe that psoriasis would increase the risk of multiple sclerosis (OR = 0.01, 95%CI [-12.61~3.83], P = 0.30) and migraine (OR = 0.99, 95%CI [0.94~1.05], P = 0.78), they also did not reach statistical significance. Under all sensitivity assessments, the results remained stable. Conclusions Psoriasis does not appear to raise the risk of migraine, Parkinson's disease, multiple sclerosis, or epilepsy, according to our study.
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Affiliation(s)
- Ya Li
- Department of Clinical Laboratory and Pathology, Chongqing Municipal Corps Hospital, Chinese People's Armed Police Forces, Chongqing, 400061, China
| | - Jun Cai
- Department of Clinical Laboratory and Pathology, Chongqing Municipal Corps Hospital, Chinese People's Armed Police Forces, Chongqing, 400061, China
| | - Huimin Chong
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, 400042, China
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Mainland RL, Skinner CR, Saary J. Aeromedical Risk of Migraine. Aerosp Med Hum Perform 2024; 95:101-112. [PMID: 38263111 DOI: 10.3357/amhp.6291.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
INTRODUCTION: Migraine is a common condition that can carry considerable risk to aeromedical duties. Because randomized controlled trials are not an appropriate method to evaluate flight safety risk for medical conditions that may cause subtle or sudden incapacitation, the determination of fitness-to-fly must be based on risk assessments informed by extrapolated evidence. Therefore, we conducted a review of current literature to provide background information to inform the aeromedical risk assessment of migraine using a risk matrix approach.METHODS: We identified studies on topics pertinent to conducting an aeromedical risk assessment of migraine. We generated an overview of the literature synthesizing the findings of articles retrieved from searches of Scopus, Ovid, PubMed, and the Cochrane Library published in English from all years, in both general and aircrew populations. International headache and neurology guidelines, as well as headache policies from the U.S. Air Force, were also reviewed.RESULTS: This review includes information on the following topics relevant to conducting an evidence-based risk assessment of migraine: diagnosis, prevalence, incidence, natural course, clinical presentation, triggers, comorbidities, neuroimaging, implications of family history, and efficacy of pharmacological and nonpharmacological therapies.DISCUSSION: This review summarizes current literature on migraine for use in a risk matrix approach to the aeromedical assessment of migraine in prospective and current aircrew. Awareness of the most current epidemiological data related to a variety of migraine parameters facilitates an evidence-based risk assessment of migraine in aircrew and requires iterative updates as new information becomes available.Mainland RL, Skinner CR, Saary J. Aeromedical risk of migraine. Aerosp Med Hum Perform. 2024; 95(2):101-112.
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Wu X, Zhuang J. Association between migraine and epilepsy: a meta-analysis. Front Neurol 2024; 14:1276663. [PMID: 38249732 PMCID: PMC10796653 DOI: 10.3389/fneur.2023.1276663] [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: 08/12/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024] Open
Abstract
Background Epidemiological studies have demonstrated a comorbid association between migraine and epilepsy. However, despite the long history of this association, the exact nature of the relationship between migraine and epilepsy remains largely unresolved. Therefore, it is crucial to conduct a meta-analysis in order to thoroughly investigate the relationship between migraine and epilepsy. Methods Odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs) regarding association between migraine and epilepsy were summarized using STATA 12.0 software. Results There was an 80% increase in the lifetime prevalence of migraine among patients with epilepsy, compared to those without epilepsy with a random effects model (OR/RR: 1.80, 95% CI: 1.35 to 2.40, I2 = 97.5%, p < 0.001). There was an 80% increase in the lifetime prevalence of epilepsy among patients with migraine, compared to those without migraine with a random effects model (OR/RR: 1.80, 95% CI: 1.43 to 2.25, I2 = 80.6%, p < 0.001). Conclusions It is important to note the comorbid association between migraine and epilepsy examined in the study.
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Affiliation(s)
- Xiaohui Wu
- Department of Neurology, Quanzhou Children's Hospital, Quanzhou, Fujian, China
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Tian D, Zhao X, Ning Z, Gong Z, Wu J, Wang X. Migraine and risk of rheumatoid arthritis: A systematic review and meta-analysis of observational studies. Heliyon 2023; 9:e18430. [PMID: 37533976 PMCID: PMC10391958 DOI: 10.1016/j.heliyon.2023.e18430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
Background Exposure to Migraine may be one of the risk factors for the onset of rheumatoid arthritis (RA), while the relationship between the two is debatable. In this study, the connection between migraine and the risk of RA was investigated using a systematic review and meta-analysis of the pertinent literature. Methods Up to July 2022, the PubMed, EMBASE, Web of Science (WOS), and scopus databases were employed to search for observational studies on the risk of RA in migraineurs. The effect sizes were pooled using a random-effects model or a fixed-effects model. Results Out of 2345 records, 5 studies (3 case and control studies and 2 cohort studies) were identified and included in the meta-analysis. According to a pooled analysis, migraine sufferers had a higher chance of developing RA (pooled adjusted effect estimate: 1.94, 95% confidence interval: 1.74-2.17; p < 0.01). Conclusions Migraine can be legitimately regarded as a risk factor for RA since this study demonstrated a relationship between migraine and RA. This conclusion should be treated with caution due to low power and precision. Rigorous design and larger sample sizes of studies are needed to verify the findings.
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Affiliation(s)
- Dachen Tian
- Department of Critical Care Medicine, Linyi People's Hospital, Linyi, Shandong, China
| | - Xuan Zhao
- Department of Neurology, Linyi People's Hospital Affiliated to Shandong First Medical University, Linyi, Shandong, China
| | - Zhaoteng Ning
- Department of Neurology, Linyi People's Hospital Affiliated to Weifang Medical University, Linyi, Shandong, China
| | - Zixiang Gong
- Department of Neurology, Linyi People's Hospital Affiliated to Jinzhou Medical University, Linyi, Shandong, China
| | - Jincheng Wu
- Department of Neurology, Linyi People's Hospital Affiliated to Weifang Medical University, Linyi, Shandong, China
| | - Xianjun Wang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
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Karlsson WK, Ashina H, Cullum CK, Christensen RH, Al-Khazali HM, Amin FM, Ashina M. The Registry for Migraine (REFORM) study: methodology, demographics, and baseline clinical characteristics. J Headache Pain 2023; 24:70. [PMID: 37303034 DOI: 10.1186/s10194-023-01604-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/29/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Erenumab has demonstrated effectiveness for prevention of migraine attacks, but the treatment is costly, and a considerable proportion of patients do not respond to it. The Registry for Migraine study (REFORM) was initiated to discover biomarkers that can predict response to erenumab in patients with migraine. The specific objective was to investigate differences in erenumab efficacy based on clinical information, blood-based biomarkers, structural and functional magnetic resonance imaging (MRI), and response to intravenous infusion of calcitonin gene-related peptide (CGRP). In this first report of the REFORM study, we provide a comprehensive description of the study methodology, and present the baseline characteristics of the study population. METHODS The REFORM study was a single-center, prospective, longitudinal cohort study in adults with migraine who were scheduled to receive preventive treatment with erenumab as part of a separate, open-label, single-arm phase IV trial. The study included four periods: a 2-week screening period (Weeks -6 to -5), 4-week baseline period (Week -4 to Day 1), 24-week treatment period (Day 1 to Week 24), and a 24-week follow-up period without treatment (Week 25 to Week 48). Demographic and clinical characteristics were recorded using a semi-structured interview, whilst outcome data were obtained using a headache diary, patient-reported outcomes, blood sampling, brain MRI, and responsiveness to intravenous infusion of CGRP. RESULTS The study enrolled 751 participants, with a mean age ± SD of 43.8 ± 12.2 years, of which 88.8% (n = 667) were female. At enrollment, 64.7% (n = 486) were diagnosed with chronic migraine, and 30.2% (n = 227) had history of aura. The mean monthly migraine days (MMDs) was 14.5 ± 7.0. Concomitant preventive medications were used by 48.5% (n = 364) of the participants, and 39.9% (n = 300) had failed ≥ 4 preventive medications. CONCLUSION The REFORM study enrolled a population with a high migraine burden and frequent use of concomitant medications. The baseline characteristics were representative of patients with migraine in specialized headache clinics. Future publications will report the results of the investigations presented in this article. TRIAL REGISTRATION The study and sub-studies were registered on ClinicalTrials.gov (NCT04592952; NCT04603976; and NCT04674020).
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Affiliation(s)
- William Kristian Karlsson
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Håkan Ashina
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Brain and Spinal Cord Injury, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christopher Kjær Cullum
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rune Häckert Christensen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Haidar Muhsen Al-Khazali
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Faisal Mohammad Amin
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Brain and Spinal Cord Injury, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Messoud Ashina
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Huang IH, Hung WK, Chi CC. Bidirektionale Assoziationen zwischen Psoriasis und Migräne: Eine systematische Übersicht und Metaanalyse. J Dtsch Dermatol Ges 2023; 21:493-503. [PMID: 37183737 DOI: 10.1111/ddg.14994_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/20/2022] [Indexed: 05/16/2023]
Affiliation(s)
- I-Hsin Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Wei-Kai Hung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Tasnim S, Nyholt DR. Migraine and thyroid dysfunction: Co-occurrence, shared genes and biological mechanisms. Eur J Neurol 2023; 30:1815-1827. [PMID: 36807966 DOI: 10.1111/ene.15753] [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: 08/19/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND AND PURPOSE Migraine and thyroid dysfunction, particularly hypothyroidism, are common medical conditions and are known to have high heritability. Thyroid function measures, thyroid stimulating hormone (TSH) and free thyroxine (fT4), are also known to be genetically influenced. Although observational epidemiological studies report an increased co-occurrence of migraine and thyroid dysfunction, a clear and combined interpretation of the findings is currently lacking. A narrative review is provided of the epidemiological and genetic association evidence linking migraine, hypothyroidism, hyperthyroidism and thyroid hormones TSH and fT4. METHODS An extensive literature search was conducted in the PubMed database for epidemiological, candidate gene and genome-wide association studies using the terms migraine, headache, thyroid hormones, TSH, fT4, thyroid function, hypothyroidism and hyperthyroidism. RESULTS Epidemiological studies suggest a bidirectional relationship between migraine and thyroid dysfunction. However, the nature of the relationship remains unclear, with some studies suggesting migraine increases the risk for thyroid dysfunction whilst other studies suggest the reverse. Early candidate gene studies have provided nominal evidence for MTHFR and APOE, whilst more recently genome-wide association studies have provided robust evidence for THADA and ITPK1 being associated with both migraine and thyroid dysfunction. CONCLUSIONS These genetic associations improve our understanding of the genetic relationship between migraine and thyroid dysfunction, provide an opportunity to develop biomarkers to identify migraine patients most likely to benefit from thyroid hormone therapy, and indicate that further cross-trait genetic studies have excellent potential to provide biological insight into their relationship and inform clinical interventions.
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Affiliation(s)
- Sana Tasnim
- Statistical and Genomic Epidemiology Laboratory, School of Biomedical Sciences, Faculty of Health, and Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Dale R Nyholt
- Statistical and Genomic Epidemiology Laboratory, School of Biomedical Sciences, Faculty of Health, and Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Tasnim S, Wilson SG, Walsh JP, Nyholt DR. Shared genetics and causal relationships between migraine and thyroid function traits. Cephalalgia 2023; 43:3331024221139253. [PMID: 36739509 DOI: 10.1177/03331024221139253] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND Epidemiological studies have reported a comorbid relationship between migraine and thyroid dysfunction. METHODS We investigated the genetic relationship between migraine and thyroid function traits using genome-wide association study (GWAS) data. RESULTS We found a significant genetic correlation (rg) with migraine for hypothyroidism (rg = 0.0608), secondary hypothyroidism (rg = 0.195), free thyroxine (fT4) (rg = 0.0772), and hyperthyroidism (rg = -0.1046), but not thyroid stimulating hormone (TSH). Pairwise GWAS analysis revealed two shared loci with TSH and 11 shared loci with fT4. Cross-trait GWAS meta-analysis of migraine identified novel genome-wide significant loci: 17 with hypothyroidism, one with hyperthyroidism, five with secondary hypothyroidism, eight with TSH, and 15 with fT4. Of the genes at these loci, six (RERE, TGFB2, APLF, SLC9B1, SGTB, BTBD16; migraine + hypothyroidism), three (GADD45A, PFDN1, RSPH6A; migraine + TSH), and three (SSBP3, BRD3, TEF; migraine + fT4) were significant in our gene-based analysis (pFisher's combined P-value < 2.04 × 10-6). In addition, causal analyses suggested a negative causal relationship between migraine and hyperthyroidism (p = 8.90 × 10-3) and a positive causal relationship between migraine and secondary hypothyroidism (p = 1.30 × 10-3). CONCLUSION These findings provide strong evidence for genetic correlation and suggest complex causal relationships between migraine and thyroid traits.
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Affiliation(s)
- Sana Tasnim
- Statistical and Genomic Epidemiology Laboratory, School of Biomedical Sciences, Faculty of Health, and Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Australia
| | - Scott G Wilson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, Australia
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia
- Medical School, University of Western Australia, Nedlands, Australia
| | - Dale R Nyholt
- Statistical and Genomic Epidemiology Laboratory, School of Biomedical Sciences, Faculty of Health, and Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Australia
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Salahi M, Parsa S, Nourmohammadi D, Razmkhah Z, Salimi O, Rahmani M, Zivary S, Askarzadeh M, Tapak MA, Vaezi A, Sadeghsalehi H, Yaghoobpoor S, Mottahedi M, Garousi S, Deravi N. Immunologic aspects of migraine: A review of literature. Front Neurol 2022; 13:944791. [PMID: 36247795 PMCID: PMC9554313 DOI: 10.3389/fneur.2022.944791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Migraine headaches are highly prevalent, affecting 15% of the population. However, despite many studies to determine this disease's mechanism and efficient management, its pathophysiology has not been fully elucidated. There are suggested hypotheses about the possible mediating role of mast cells, immunoglobulin E, histamine, and cytokines in this disease. A higher incidence of this disease in allergic and asthma patients, reported by several studies, indicates the possible role of brain mast cells located around the brain vessels in this disease. The mast cells are more specifically within the dura and can affect the trigeminal nerve and cervical or sphenopalatine ganglion, triggering the secretion of substances that cause migraine. Neuropeptides such as calcitonin gene-related peptide (CGRP), neurokinin-A, neurotensin (NT), pituitary adenylate-cyclase-activating peptide (PACAP), and substance P (SP) trigger mast cells, and in response, they secrete pro-inflammatory and vasodilatory molecules such as interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) as a selective result of corticotropin-releasing hormone (CRH) secretion. This stress hormone contributes to migraine or intensifies it. Blocking these pathways using immunologic agents such as CGRP antibody, anti-CGRP receptor antibody, and interleukin-1 beta (IL-1β)/interleukin 1 receptor type 1 (IL-1R1) axis-related agents may be promising as potential prophylactic migraine treatments. This review is going to summarize the immunological aspects of migraine.
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Affiliation(s)
- Mehrnaz Salahi
- Student Research Committee, School of Pharmacy and Pharmaceutical Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sina Parsa
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Delaram Nourmohammadi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Razmkhah
- Student Research Committee, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Salimi
- Student Research Committee, Faculty of Medicine, Islamic Azad University of Najafabad, Isfahan, Iran
| | | | - Saeid Zivary
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Monireh Askarzadeh
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Tapak
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Vaezi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Sadeghsalehi
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Yaghoobpoor
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Mottahedi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Setareh Garousi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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The headache registry of the German Migraine and Headache Society (DMKG): baseline data of the first 1,351 patients. J Headache Pain 2022; 23:74. [PMID: 35773650 PMCID: PMC9248100 DOI: 10.1186/s10194-022-01447-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
Background Although good treatment options exist for many headache disorders, not all patients benefit and disability continues to be large. To design strategies for improving headache care, real-world data observing standard care is necessary. Therefore, the German Migraine and Headache Society (DMKG) has established the DMKG Headache Registry. Here we present methods and baseline data. Methods Accredited German headache centers (clinic-based or private practice) can offer participation to their patients. Patients provide headache history, current headache load (including a mobile headache diary), medication and comorbidities and answer validated questionnaires, prior to their physician appointment. Physicians use these data as the base of their history taking, and add, change or confirm some central information. Before the next visit, patients are asked to update their data. Patients will continuously be included over the next years. Results The present analysis is based on the first 1,351 patients (1110 females, 39.6 ± 12.9 years) with a completed first visit. Most participants had a migraine diagnosis. Participants had 14.4 ± 8.5 headache days and 7.7 ± 6.1 acute medication days per month and 63.9% had a migraine disability assessment (MIDAS) grade 4 (severe disability). 93.6% used at least one acute headache medication, most frequently a triptan (60.0%) or non-opioid analgesic (58.3%). 45.0% used at least one headache preventive medication, most frequently an antidepressant (11.4%, mostly amitriptyline 8.4%) or a CGRP(receptor) antibody (9.8%). Most common causes for discontinuation of preventive medication were lack of effect (54.2%) and side effects (43.3%). Conclusion The DMKG Headache Registry allows to continuously monitor headache care at German headache centers in both a cross-sectional and a longitudinal approach. Trial registration The DMKG Headache Registry is registered with the German Clinical Trials Register (DRKS 00021081).
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Togha M, Karimitafti MJ, Ghorbani Z, Farham F, Naderi-Behdani F, Nasergivehchi S, Vahabi Z, Ariyanfar S, Jafari E. Characteristics and comorbidities of headache in patients over 50 years of age: a cross-sectional study. BMC Geriatr 2022; 22:313. [PMID: 35399063 PMCID: PMC8994908 DOI: 10.1186/s12877-022-03027-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 04/04/2022] [Indexed: 01/04/2023] Open
Abstract
Abstract
Background
Although headache is a common complaint in younger individuals, it is one of the most common complaints among persons over the age of 50 and is a significant cause of morbidity. As there are differences in the causes and types of headache, the diagnosis and management of headache in older adults differ from that in younger individuals.
Methods
In this cross-sectional study, 570 patients ≥ 50 years were recruited at a university affiliated tertiary headache center between 2016 and 2019. Demographic data, headache characteristics, and comorbid medical conditions were recorded. The presence of depression was explored using the Beck Depression Inventory. The patients were evaluated using the STOP-BANG scale to determine the risk of obstructive sleep apnea.
Results
The mean age of the patients was 57.7 years. Seventy-three percent of the patients had primary headache disorders, with the most prevalent types being migraine, followed by tension-type headache. Secondary headaches were primarily the result of overuse of medication, cervical spine disease, and hypertension. Patients with medication-overuse headache were significantly more likely to suffer from hypothyroidism and gastrointestinal problems such as bleeding/ulcers. Irritable bowel syndrome was also more common in patients with medication-overuse headaches and migraines. The risk for obstructive sleep apnea was intermediate in 45.2% of the patients with hypertension-induced headache, but was lower in the majority of others. There was a high tendency for moderate-to-severe depression in the participants; however, the Beck Depression Inventory scores were significantly higher in medication-overuse headache patients.
Conclusion
Proper treatment of headache in middle-aged and older adults requires the recognition of secondary causes, comorbid diseases, and drug induced or medication overuse headaches. Special attention should be paid to depression and obstructive sleep apnea in such patients suffering from headache disorders.
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Revisiting the bipolar disorder with migraine phenotype: Clinical features and comorbidity. J Affect Disord 2021; 295:156-162. [PMID: 34464877 DOI: 10.1016/j.jad.2021.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 01/26/2023]
Abstract
INTRODUCTION To evaluate the prevalence and clinical correlates of lifetime migraine among patients with bipolar disorder (BD). METHODS In a cross-sectional study, we evaluated 721 adults with BD from the Mayo Clinic Bipolar Disorder Biobank and compared clinical correlates of those with and without a lifetime history of migraine. A structured clinical interview (DSM-IV) and a clinician-assessed questionnaire were utilized to establish a BD diagnosis, lifetime history of migraine, and clinical correlates. RESULTS Two hundred and seven (29%) BD patients had a lifetime history of migraine. BD patients with migraine were younger and more likely to be female as compared to those without migraine (p values <0.01). In a multivariate logistic regression model, younger age (OR=0.98, p<0.01), female sex (OR=2.02, p<0.01), higher shape/weight concern (OR=1.04, p=0.02), greater anxiety disorder comorbidities (OR=1.24, p<0.01), and evening chronotype (OR=1.65, p=0.03) were associated with migraine. In separate regression models for each general medical comorbidity (controlled for age, sex, and site), migraines were significantly associated with fibromyalgia (OR=3.17, p<0.01), psoriasis (OR=2.65, p=0.03), and asthma (OR=2.0, p<0.01). Participants with migraine were receiving ADHD medication (OR=1.53, p=0.05) or compounds associated with weight loss (OR=1.53, p=0.02) at higher rates compared to those without migraine. LIMITATIONS Study design precludes determination of causality. Migraine subtypes and features were not assessed. CONCLUSIONS Migraine prevalence is high in BD and is associated with a more severe clinical burden that includes increased comorbidity with pain and inflammatory conditions. Further study of the BD-migraine phenotype may provide insight into common underlying neurobiological mechanisms.
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Ibrahim EAA, Badri GAM, Ahmed KAHM, Omer MEA. Migraine headache in Sudan. Brain Behav 2021; 11:e2429. [PMID: 34775687 PMCID: PMC8671772 DOI: 10.1002/brb3.2429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Migraine is a main form of headache, it is also a chronic and complex neuroinflammatory disease; it is characterized by recurrent severe headaches, usually affecting one side of the head, and often accompanied by nausea and blurred vision. In susceptible individuals, irritants can trigger migraine attacks, which can be considered as triggers or accelerators. OBJECTIVE To describe the precipitating factors, clinical presentation, and treatment of migraine headache in Sudanese patients. METHODS This is a descriptive hospital-based prospective study covering 130 patients during the study period from January 2016 to December 2018. At the National Centre for Neurological Science, Khartoum, participants were Sudanese patients with migraine headache after exclusion of other causes of headache. Data was collected using structured questionnaire entered and analyzed using SPSS version 22.0, p value < .05 is considered significant. RESULTS The study covered 130 study participants most of them were females (80%), within 26-35 years of age (56.9%) and a considerable proportion of them were housewives (40%). The majority of the study participants had headache without aura in 81.5% and headache with aura in 18.5% (mainly visual type 87.5%). Photophobia and nausea were the main associated symptoms in 51.5% and 50%, respectively. Acetaminophen was the main prescribed treatment in 46.1%, beta blockers was the main prophylaxis in 29.2%. Environmental triggers were the prevalent predisposing factors (43.8%) followed by fasting, lack of sleep, and exertion (24.6% for each). CONCLUSION Environmental conditions were the commonest triggering factors of migraine headache, while Acetaminophen was the most common drug used for relieving migraine in this population.
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Affiliation(s)
- Etedal Ahmed A Ibrahim
- Faculty of Medicine, Al Neelain University, Department of Internal Medicine, Khartoum, Sudan.,The National Centre for Neurological Sciences, Department of Neurology, Khartoum, Sudan
| | - Ghada A Mutaal Badri
- The National Centre for Neurological Sciences, Department of Neurology, Khartoum, Sudan
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15
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Total health insurance costs in children with a migraine diagnosis compared to a control group. J Headache Pain 2021; 22:140. [PMID: 34800970 PMCID: PMC8605561 DOI: 10.1186/s10194-021-01349-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/28/2021] [Indexed: 12/27/2022] Open
Abstract
Background Health care costs of migraine constitute a major issue in health economics. Several publications analyzed health care costs for adult migraine patients, based on questionnaires or secondary (health insurance) data. Although migraine often starts already in primary school age, data on migraine related costs in children is scarce. In this paper we aimed to assess the migraine-related health care costs in 6 to 11 year old children in Germany. Methods Using claims data of a large German health insurer (BARMER), overall annual health care costs of 6 to 11 year old children with a diagnosis of migraine in 2017 (n = 2597) were compared to a control group of 6 to 11 year old children without a headache diagnosis between 2013 and 2017 (n = 306,926). The association of migraine and costs was modeled by generalized linear regression (Gamma regression) with adjustment for sex, age and comorbidities. Results Children with migraine caused considerably higher annual per capita health care costs than children without a headache diagnosis (migraine group: € 1018, control group: € 618). Excess costs directly related to migraine amounted to € 115. The remaining excess costs were related to comorbidities, which were more frequent in the migraine group. Mental and behavioural disorders constituted the most expensive comorbidity, accounting for € 105 of the € 400 annual excess costs in the migraine group. Conclusion 6 to 11 year old children with a migraine diagnosis cause significant direct and comorbidity related excess costs in the German health care system. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01349-w.
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16
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Biscetti L, De Vanna G, Cresta E, Corbelli I, Gaetani L, Cupini L, Calabresi P, Sarchielli P. Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms. J Neuroinflammation 2021; 18:259. [PMID: 34749743 PMCID: PMC8573865 DOI: 10.1186/s12974-021-02229-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/04/2021] [Indexed: 12/31/2022] Open
Abstract
Several lines of evidence support a role of the immune system in headache pathogenesis, with particular regard to migraine. Firstly, alterations in cytokine profile and in lymphocyte subsets have been reported in headache patients. Secondly, several genetic and environmental pathogenic factors seem to be frequently shared by headache and immunological/autoimmune diseases. Accordingly, immunological alterations in primary headaches, in particular in migraine, have been suggested to predispose some patients to the development of immunological and autoimmune diseases. On the other hand, pathogenic mechanisms underlying autoimmune disorders, in some cases, seem to favour the onset of headache. Therefore, an association between headache and immunological/autoimmune disorders has been thoroughly investigated in the last years. The knowledge of this possible association may have relevant implications in the clinical practice when deciding diagnostic and therapeutic approaches. The present review summarizes findings to date regarding the plausible relationship between headache and immunological/autoimmune disorders, starting from a description of immunological alteration of primary headaches, and moving onward to the evidence supporting a potential link between headache and each specific autoimmune/immunological disease.
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Affiliation(s)
- Leonardo Biscetti
- Istituto Nazionale di Riposo e Cura dell'Anziano a carattere scientifico, IRCSS- INRCA, Ancona, Italy
| | - Gioacchino De Vanna
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Cresta
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ilenia Corbelli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Lorenzo Gaetani
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Letizia Cupini
- Headache Center, UOC Neurologia-Stroke Unit, Emergency Department, Ospedale S. Eugenio, Rome, Italy
| | - Paolo Calabresi
- Department of Neuroscience, Università Cattolica Sacro Cuore, Rome, Italy
| | - Paola Sarchielli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
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El-Sonbaty HAE, Zarad CA, Mohamed MR, Abou Elmaaty AA. Migraine in patients with rheumatoid arthritis and its relation to disease activity. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00406-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The comorbidity between rheumatoid arthritis (RA) and migraine is complex and not completely understood.
Objective
This study aimed to evaluate migraine frequency in patients with RA and its relation to disease activity.
Methods
A cross-sectional study was carried out on 210 consecutive RA Egyptian patients fulfilling the 2010 EULAR/ACR criteria (joint distribution, serology, symptom duration and acute phase reaction).
Results
Prevalence of migraine in RA was 28.2%. Disease activity, fibromyalgia and functional losses were significantly higher in migraine group with RA versus non-migraine group (P < 0.001). Disease Activity Score (DAS-28) was independently significant predictor as increasing DAS-28 score was associated with an increased likelihood of exhibiting migraine (5.5-times higher odds per one-unit increase in DAS-28 score). Prevalence of brain MRI white matter hyper-intensities (WMHs) in RA with migraine was 54.8%. WMHs were significantly higher in migraine patients with aura than migraine patients without aura, especially in older patients, longer migraine duration, longer rheumatoid duration and elevated ESR (p < 0.047, p < 0.034, P < 0.004, P < 0.015 and P < 0.22, respectively).
Conclusions
Migraine is highly frequent in RA patients, especially migraine with aura. The presence of rheumatoid activity, fibromyalgia and secondary Sjogren’s syndrome, elevated ESR and CRP are associated with functional losses in RA patients with migraine, especially migraine with aura. MR imaging of brain is a mandatory tool for detection of white matter hyper-intensities in RA patients with migraine, especially migraine with aura.
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Filipchuk M, Gassmann J, Castro Zamparella T, Tibaldo MC, Carpinella M, Sesto Tagliavini P, Scarnato P, Goicochea MT, Bruera O, Conci Magris DM, Lisicki M. High rates of (treated) hypothyroidism among chronic migraine patients consulting a specialized headache clinic: are we missing something? Neurol Sci 2021; 43:1249-1254. [PMID: 34283344 DOI: 10.1007/s10072-021-05424-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Roughly three percent of episodic migraine patients evolve into the most burdensome chronic form of this condition every year. While some of the determinants behind this transformation are well established, others are still ill defined. Hypothyroidism is a prevalent endocrinological disorder that can both produce a secondary headache or aggravate a pre-existing primary headache disorder such as migraine. OBJECTIVE We aimed to re-assess the association between hypothyroidism and chronic migraine controlling for factors such as hormone replacement treatment status and bodyweight. METHODS We retrospectively analyzed the medical records of episodic and chronic migraine patients who consecutively consulted our headache clinic in order to determine the prevalence of adequately treated hypothyroidism in each group. Only patients receiving a stable dose regimen were included. The body mass index and other possibly confounding covariates were also collected. RESULTS Data from 111 migraine patients was included for analysis. Most (88.6%) of chronic migraine sufferers were overusing acute medication. Treated hypothyroidism was significantly more prevalent in chronic migraine patients (29.55%) compared to episodic migraine patients (8.96%). This association was independent of the patients' body mass index or other variables. CONCLUSION Alterations of neuronal metabolism, deficient calcitonin release, or focal inflammation causing local hormonal deactivation might explain why hypothyroidism, in spite of levothyroxine replacement therapy, is associated with migraine chronification. Further studies evaluating these factors are warranted.
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Affiliation(s)
- Marcelo Filipchuk
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina
| | - Jesica Gassmann
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina
| | - Tatiana Castro Zamparella
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina.,Institute of Psychological Investigations, National University of Córdoba, Córdoba, Argentina
| | | | - Mariela Carpinella
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina
| | - Pablo Sesto Tagliavini
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina
| | - Pablo Scarnato
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina
| | - Maria Teresa Goicochea
- Servicio de Dolor, Departamento de Neurología, Sección Cefaleas, Fleni, Buenos Aires, Argentina
| | - Osvaldo Bruera
- Headache Department, Buenos Aires Institute of Neuroscience (INEBA), Buenos Aires, Argentina.,Headache and Facial Pain Department, Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - Diego Martin Conci Magris
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina
| | - Marco Lisicki
- Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina.
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Kirik S, Ozkars MY. Association between Migraine and Asthma in School Age Children. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2021. [DOI: 10.29333/ejgm/11100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Caponnetto V, Deodato M, Robotti M, Koutsokera M, Pozzilli V, Galati C, Nocera G, De Matteis E, De Vanna G, Fellini E, Halili G, Martinelli D, Nalli G, Serratore S, Tramacere I, Martelletti P, Raggi A. Comorbidities of primary headache disorders: a literature review with meta-analysis. J Headache Pain 2021; 22:71. [PMID: 34261435 PMCID: PMC8278743 DOI: 10.1186/s10194-021-01281-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/22/2021] [Indexed: 12/27/2022] Open
Abstract
Background Primary headache disorders are common and burdensome conditions. They are associated to several comorbidities, such as cardiovascular or psychiatric ones, which, in turn, contribute to the global burden of headache. The aim of this study is to provide a comprehensive description of the pooled prevalence of comorbidities of primary headache disorders using a meta-analytical approach based on studies published between 2000 and 2020. Methods Scopus was searched for primary research (clinical and population studies) in which medical comorbidities were described in adults with primary headache disorders. Comorbidities were extracted using a taxonomy derived from the Global Burden of Disease (GBD) study. We compared prevalence of comorbidities among headache sufferers against general population using GBD-2019 estimates, and compared comorbidities’ proportions in clinical vs. population studies, and by age and gender. Results A total of 139 studies reporting information on 4.19 million subjects with primary headaches were included: in total 2.75 million comorbidities were reported (median per subject 0.64, interquartile range 0.32–1.07). The most frequently addressed comorbidities were: depressive disorders, addressed in 51 studies (pooled proportion 23 %, 95 % CI 20–26 %); hypertension, addressed in 48 studies (pooled proportion 24 %, 95 % CI 22–26 %); anxiety disorders addressed in 40 studies (pooled proportion 25 %, 95 % CI 22–28 %). For conditions such as anxiety, depression and back pain, prevalence among headache sufferers was higher than in GBD-2109 estimates. Associations with average age and female prevalence within studies showed that hypertension was more frequent in studies with higher age and less females, whereas fibromyalgia, restless leg syndrome, and depressive disorders were more frequent in studies with younger age and more female. Conclusions Some of the most relevant comorbidities of primary headache disorders – back pain, anxiety and depression, diabetes, ischemic heart disease and stroke – are among the most burdensome conditions, together with headache themselves, according to the GBD study. A joint treatment of headaches and of these comorbidities may positively impact on headache sufferers’ health status and contribute to reduce the impact of a group of highly burdensome diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01281-z.
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Affiliation(s)
| | - Manuela Deodato
- Department of Life Sciences, University of Trieste, Trieste, Italy. .,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Micaela Robotti
- Centro di Diagnosi e Cura delle Cefalee, Palazzo della Salute, Gruppo San Donato, Milano, Italy.,PainClinicMilano, Centro Medico Visconti di Modrone, Milano, Italy
| | | | - Valeria Pozzilli
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Cristina Galati
- UO Neuropsichiatria Infantile, Policlinico Universitario Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy
| | - Giovanna Nocera
- UO Neuropsichiatria Infantile, Policlinico Universitario Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy
| | - Eleonora De Matteis
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Gioacchino De Vanna
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy
| | - Emanuela Fellini
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Gleni Halili
- Department of Neurology, University Hospital Center 'Mother Teresa', Tirana, Albania
| | - Daniele Martinelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Gabriele Nalli
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Serena Serratore
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Irene Tramacere
- Dipartimento di Ricerca e Sviluppo Clinico, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Roma, Italy.,Regional Referral Headache Center, Sant'Andrea University Hospital, Roma, Italy
| | - Alberto Raggi
- UOC Neurologia, Salute Pubblica, Disabilità, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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Abstract
Background The complex relationship between migraine and epilepsy has frequently been described to represent a clinical and electrographic "borderland." These two conditions share clinical expressions such as paroxysmal and chronic nature, as well as semiology, particularly visual phenomenon. Objective We aimed to review the current literature on the overlapping phenomena of migraine and epilepsy. Materials and Methods We searched the PubMed for relevant literature and conducted a narrative review on migraine and epilepsy. Results Migraine and epilepsy share a complex and pathophysiologically intriguing relationship. The International Classification of Headache Disorders, 3rd edition (ICHD-3) makes diagnostic provisions for migraine aura-triggered seizures (Subchapter 1.4.4) and headache attributed to epileptic seizure (Subchapter 7.6), the latter being further categorized as 7.6.1 Ictal epileptic headache, and 7.6.2 post-ictal headache. Neurological conditions such as certain channelopathies and epilepsy syndromes exhibit both conditions within their phenotypic spectrum, suggesting shared genetic and molecular underpinnings. Diagnostic confusion may arise, particularly between occipital epilepsy and the visual aura of migraine. Antiseizure medications may be effective for the treatment of migraines that occur in concert with epilepsy. Conclusions Migraine and epilepsy share several clinical features and have intertwined genetic and molecular underpinnings, which may contribute to common pathogenesis. Electroencephalography may be useful as a diagnostic tool in selected cases.
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Affiliation(s)
- Divyani Garg
- Department of Neurology, Lady Hardinge Medical College, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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22
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Kim YH, Lee JW, Kim Y, Bae JS, Kim YJ, Min C, Choi HG. Bidirectional association between migraine and rheumatoid arthritis: two longitudinal follow-up studies with a national sample cohort. BMJ Open 2021; 11:e046283. [PMID: 34103319 PMCID: PMC8190043 DOI: 10.1136/bmjopen-2020-046283] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To investigate the bidirectional association between migraine and rheumatoid arthritis (RA). DESIGN Two longitudinal follow-up studies. SETTING Data collected from a national cohort between 2002 and 2013 by the Korean National Health Insurance Service-Health Screening Cohort. PARTICIPANTS In cohort 1, matching resulted in the inclusion of 31 589 migraine patients and 126 356 control I participants. In cohort 2, matching resulted in the inclusion of 9287 RA patients and 37 148 control II participants. PRIMARY AND SECONDARY OUTCOME MEASURES The HRs for RA in patients with migraine (cohort 1) and migraine in patients with RA (cohort 2) were analysed using stratified Cox proportional hazard models after adjusting for autoimmune disease, Charlson Comorbidity Index scores without rheumatoid diseases, obesity (body mass index), smoking and history of alcohol intake. Subgroup analyses stratified by age, sex, income and region of residence were also performed. RESULTS The incidence of RA in the migraine group (2.0% (640/31 589)) was higher than that in the control I group (1.4% (1709/126 356), p<0.001). The adjusted HR for RA in the migraine without aura group was 1.48 (95% CIs=1.34 to 1.63, p<0.001).The incidence of migraine in the RA group (6.4% (590/9287)) was higher than that in the control II group (4.6% (1721/37 148), p<0.001). The adjusted HR for migraine without aura in the RA group was 1.35 (95% CI=1.23 to 1.49, p<0.001). CONCLUSION Migraine increases the risk of RA, and RA is also associated with an increased risk of migraine.
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Affiliation(s)
- Yoo Hwan Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, The Republic of Korea
| | - Jung Woo Lee
- Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, Wonju, The Republic of Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, The Republic of Korea
| | - Jong Seok Bae
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, The Republic of Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, The Republic of Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, The Republic of Korea
- Graduate School of Public Health, Seoul National University, Seoul, The Republic of Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, The Republic of Korea
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, The Republic of Korea
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23
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Hosseinpour M, Maleki F, Khoramdad M, Sullman MJM, Nejadghaderi SA, Kolahi AA, Safiri S. A systematic literature review of observational studies of the bilateral association between diabetes and migraine. Diabetes Metab Syndr 2021; 15:673-678. [PMID: 33813240 DOI: 10.1016/j.dsx.2021.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM To conduct a systematic literature review and synthesize data from all epidemiological studies investigating the association between diabetes and migraine in adults. METHOD AND MATERIAL Electronic databases, including Web of Science, PubMed and Scopus in addition to Google Scholar search engine were systematically searched up to Jun 2020 to identify studies reporting the diabetes-migraine association. RESULTS A total of 15 studies were selected which were published from 2012 to 2019. Five out of 15 studies assessed the presence of migraine in diabetic subjects, while nine studies assessed the presence of diabetes in migraine subjects. The cohort study reported a hazard ratio for diabetes of 1.06 (95% confidence interval (CI): 0.91-1.24) for women with migraine with aura, 1.01 (95% CI: 0.89-1.16) for women without aura, and 1.13 (95% CI: 0.98-1.3) for women with a migraine history, compared with women with no history of migraine. Due to the high degree of heterogeneity, and the lack of statistical estimates of the association in several of the reviewed studies, meta-analysis of the available data was not possible. CONCLUSION This study is the first review to examine the association between diabetes and migraine. Further longitudinal studies are required to clarify the migraine-diabetes association. There is also a clear need for more studies with larger sample sizes and similar methodologies in order to provide necessary information to conduct a meta-analysis.
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Affiliation(s)
- Marjan Hosseinpour
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Farzad Maleki
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Maliheh Khoramdad
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus; Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Seyed Aria Nejadghaderi
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Saeid Safiri
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Social Determinants of Health Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Altamura C, Corbelli I, de Tommaso M, Di Lorenzo C, Di Lorenzo G, Di Renzo A, Filippi M, Jannini TB, Messina R, Parisi P, Parisi V, Pierelli F, Rainero I, Raucci U, Rubino E, Sarchielli P, Li L, Vernieri F, Vollono C, Coppola G. Pathophysiological Bases of Comorbidity in Migraine. Front Hum Neurosci 2021; 15:640574. [PMID: 33958992 PMCID: PMC8093831 DOI: 10.3389/fnhum.2021.640574] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Despite that it is commonly accepted that migraine is a disorder of the nervous system with a prominent genetic basis, it is comorbid with a plethora of medical conditions. Several studies have found bidirectional comorbidity between migraine and different disorders including neurological, psychiatric, cardio- and cerebrovascular, gastrointestinal, metaboloendocrine, and immunological conditions. Each of these has its own genetic load and shares some common characteristics with migraine. The bidirectional mechanisms that are likely to underlie this extensive comorbidity between migraine and other diseases are manifold. Comorbid pathologies can induce and promote thalamocortical network dysexcitability, multi-organ transient or persistent pro-inflammatory state, and disproportionate energetic needs in a variable combination, which in turn may be causative mechanisms of the activation of an ample defensive system with includes the trigeminovascular system in conjunction with the neuroendocrine hypothalamic system. This strategy is designed to maintain brain homeostasis by regulating homeostatic needs, such as normal subcortico-cortical excitability, energy balance, osmoregulation, and emotional response. In this light, the treatment of migraine should always involves a multidisciplinary approach, aimed at identifying and, if necessary, eliminating possible risk and comorbidity factors.
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Affiliation(s)
- Claudia Altamura
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Ilenia Corbelli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Marina de Tommaso
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Bari Aldo Moro University, Policlinico General Hospital, Bari, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS-Fondazione Santa Lucia, Rome, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Tommaso B Jannini
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberta Messina
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | | | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.,Headache Clinic, IRCCS-Neuromed, Pozzilli, Italy
| | - Innocenzo Rainero
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Umberto Raucci
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Elisa Rubino
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Paola Sarchielli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Linxin Li
- Nuffield Department of Clinical Neurosciences, Centre for Prevention of Stroke and Dementia, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Fabrizio Vernieri
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Catello Vollono
- Department of Neurology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Catholic University, Rome, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
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Kim KM, Cho SJ, Shin HJ, Yang KI, Kim D, Yun CH, Chu MK. Prevalence, Disability, and Management Patterns of Migraine in Korea: Nationwide Survey Data from 2009 and 2018. J Clin Neurol 2021; 17:77-85. [PMID: 33480202 PMCID: PMC7840323 DOI: 10.3988/jcn.2021.17.1.77] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 12/24/2022] Open
Abstract
Background and Purpose Identifying changes in the prevalence, disability, and management patterns of migraine is important for reducing the burden of this disease. However, data on the changes in these variables are scarce. Methods We compared data obtained in the 2009 Korean Headache Survey and the 2018 Korean Sleep-Headache Survey. Results The 1-year migraine prevalence did not differ significantly between 2018 and 2009 [5.2% (114/2,200) vs. 6.0% (91/1,507), p=0.492]. The number of days with missed activity due to headache during the previous 3 months was larger in the 2018 survey than in the 2009 survey [1.1±2.9 vs. 0.3±1.0 days (mean±standard deviation), p=0.013]. The number of days with reduced productivity during the previous 3 months did not differ significantly between the two surveys (0.8±2.8 vs. 1.4±1.4 days, p=0.679). The proportion of subjects with a substantial-to-severe headache impact (Headache Impact Test-6 score ≥56) was marginally larger in the 2018 survey than in the 2009 survey [42.1% (48/114) vs. 29.7% (27/91), p=0.066]. The rate of lifetime medical consultations did not differ between the 2018 and 2009 surveys [34.2% (39/114) vs. 30.8% (28/91), p=0.615]. Conclusions Migraine prevalence was stable over the 9-year period between the surveys, but disability due to missed activity was greater in 2018 than in 2009 in Korea.
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Affiliation(s)
- Kyung Min Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Soo Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Hye Jung Shin
- Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Ik Yang
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
| | - Daeyoung Kim
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
| | - Chang Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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26
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Wang L, Deng ZR, Zu MD, Zhang J, Wang Y. The Comorbid Relationship Between Migraine and Asthma: A Systematic Review and Meta-Analysis of Population-Based Studies. Front Med (Lausanne) 2021; 7:609528. [PMID: 33521020 PMCID: PMC7838157 DOI: 10.3389/fmed.2020.609528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/25/2020] [Indexed: 01/11/2023] Open
Abstract
Objective: Recent studies have indicated a pathophysiologic link between migraine and asthma. This meta-analysis aimed to comprehensively estimate the risk ratio for migraine in asthma as well as that of asthma in migraine based on available evidence. Method: We systematically searched the electronic databases including PubMed, Web of Science, and SCOPUS for population-based studies that measured either the odds or the risk of asthma in subjects with migraine as well as that of migraine in subjects with asthma. The titles and abstracts were screened by two independent reviewers to identify eligible studies, and this was followed by full-text review of the included studies. Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias of included literature. A meta-analysis was conducted with Review Manager 5.3 Software to calculate the odds ratio (OR) for case-control and cross-sectional studies and either relative ratio (RR) or hazard ratio (HR) for cohort studies, and the source of heterogeneity was assessed. Subgroup and sensitivity analyses were conducted, and the I2 test were used to assess the source of heterogeneity. The funnel plot, Galbraith plot, and Egger's test were used to evaluate publication bias. Results: Fifteen published studies covering a total of 1,188,780 individuals were identified. Pooled analysis indicated that migraine was associated with increased odds (OR = 1.54; 95% CI: 1.34~1.77) and risk for asthma (HR = 1.42; 95% CI: 1.26~1.60), and asthma associated with increased odds (OR = 1.45; 95% CI: 1.22~1.72) and risk for migraine (HR = 1.47; 95% CI: 1.41~1.52). Conclusion: Migraine is a potential risk indicator for asthma, and vice versa, asthma is a potential risk indicator for migraine. However, future prospective cohort studies are warranted to provide more evidence concerning the detailed association between migraine and asthma.
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Affiliation(s)
- Long Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Neurology, The Second People Hospital of Hefei, Hefei, China
| | - Zi-Ru Deng
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mei-Dan Zu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Juan Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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27
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Hirata K, Takeshima T, Sakai F, Tatsuoka Y, Suzuki N, Igarashi H, Nakamura T, Ozeki A, Yamazaki H, Skljarevski V. A long-term open-label safety study of galcanezumab in Japanese patients with migraine. Expert Opin Drug Saf 2021; 20:721-733. [PMID: 33393835 DOI: 10.1080/14740338.2021.1866536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Because of the burden of migraine in Japan, there is a need for safe and effective preventive treatments. This study assessed the long-term safety and tolerability of galcanezumab in Japanese patients with episodic (EM) or chronic (CM) migraine. RESEARCH DESIGN AND METHODS In this 12-month open-label study, adult patients with EM who previously completed a 6-month, double-blind, placebo-controlled trial were newly randomized to either galcanezumab dose from placebo or continued their assigned galcanezumab doses (all: 120 mg, n = 120; 240 mg, n = 126). Newly enrolled patients with CM were randomized to 120-mg (n = 32) or 240-mg (n = 33) galcanezumab. The primary outcome was long-term safety and tolerability. RESULTS The incidence of TEAEs was similar between treatment groups. Nasopharyngitis was the most common TEAE, followed by injection site reactions. The discontinuation rate was low (EM = 9.3%; CM = 15.4%) and no deaths were reported. Patients with EM who received galcanezumab in the placebo-controlled trial had sustained efficacy. Both doses reduced the number of migraine headache days in patients with CM. CONCLUSIONS Long-term treatment with 120-mg or 240-mg galcanezumab was safe and effective in Japanese patients with EM or CM. TRIAL REGISTRATION https://clinicaltrials.gov, identifier: NCT02959190.
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Affiliation(s)
- Koichi Hirata
- Department of Neurology, Headache Center, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Osaka, Japan
| | - Fumihiko Sakai
- Saitama International Headache Center, Saitama Neuropsychiatric Institute, Saitama, Japan
| | | | - Norihiro Suzuki
- Department of Neurology, Shonan Keiiku Hospital, Fujisawa, Japan
| | - Hisaka Igarashi
- Department of Internal Medicine, Fujitsu Clinic, Kawasaki, Japan
| | - Tomomi Nakamura
- Medicines Development Unit Japan and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
| | - Akichika Ozeki
- Medicines Development Unit Japan and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
| | - Hiroyoshi Yamazaki
- Medicines Development Unit Japan and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
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28
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Chee YC, Abdul Halim S. Cerebral venous sinus thrombosis in a patient with concomitant Graves' disease and squamous cell carcinoma of the cervix. BMJ Case Rep 2020; 13:13/12/e236730. [PMID: 33298481 DOI: 10.1136/bcr-2020-236730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cerebral venous sinus thrombosis (CVST) is caused by either acquired or inherited pro-thrombotic states. Hyperthyroidism is a less recognised predisposing factor of CVST, and the causality has been debated. We report a case of a life-threatening CVST in a 40-year-old woman, with uncommon dual risk factors: hyperthyroidism and advanced squamous cell carcinoma of the cervix. CVST should be considered as a differential diagnosis when a patient with hyperthyroidism presents with new-onset headache or other neurological symptoms. Further assessment to elucidate other covert risk factors may need to be continuously carried out, when the causal relationship of one apparent cause has not been well established.
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Affiliation(s)
- Yong Chuan Chee
- Department of Internal Medicine (Neurology), School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Sanihah Abdul Halim
- Department of Internal Medicine (Neurology), School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia .,Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Brain and Behaviour Cluster, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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29
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Spanou I, Christidi F, Liakakis G, Rizonaki K, Bougea A, Anagnostou E, Kararizou E. Primary headache subtypes and thyroid dysfunction: Is there any association? ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:695-699. [PMID: 33146240 DOI: 10.1590/0004-282x20200070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/17/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Primary headaches, and particularly migraine and tension-type headache (TTH) as well as hypothyroidism are common medical conditions. To date, numerous studies have suggested a possible bidirectional relationship between migraine and hypothyroidism, although certain studies had contradictory results. OBJECTIVE To investigate whether there is any association between primary headache subtypes and thyroid disorders. METHODS A retrospective study of consecutive patients aged ≥18 years referred to the Headache Outpatient Clinic of Aeginition Hospital and diagnosed with primary headache and any thyroid disorder. RESULTS Out of 427 patients (males/females=76/351), 253 (59.3%) were diagnosed with migraine without aura, 53 (12.4%) with TTH, 49 (11.5%) with migraine with aura, 29 (6.8%) with medication-overuse headache, 23 (5.4%) with mixed-type headache (migraine with/without aura and TTH), nine (2.1%) with cluster headache, and 11 (2.6%) with other types of primary headaches. The prevalence of any type of thyroid disorder was 20.8% (89/427 patients). In the total sample, 27 patients (6.3%) reported hypothyroidism, 18 (4.2%) unspecified thyroidopathy, 14 (3.3%) thyroid nodules, 12 (2.8%) Hashimoto thyroiditis, 12 (2.8%) thyroidectomy, three (0.7%) thyroid goiter, and three (0.7%) hyperthyroidism. Further statistical analysis between categorical variables did not reveal any significant association between headache subtypes and thyroid dysfunction. CONCLUSIONS No specific association was found between primary headache subtypes and specific thyroid disorder. However, a high prevalence of thyroid dysfunction in general and specifically hypothyroidism was demonstrated among patients with primary headaches, which lays the foundation for further clarification in prospective longitudinal studies.
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Affiliation(s)
- Ioanna Spanou
- National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece
| | - Foteini Christidi
- National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece
| | - Georgios Liakakis
- National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece
| | - Konstantina Rizonaki
- National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece
| | - Anastasia Bougea
- National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece
| | - Evangelos Anagnostou
- National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece
| | - Evangelia Kararizou
- National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece
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30
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Clemow DB, Baygani SK, Hauck PM, Hultman CB. Lasmiditan in patients with common migraine comorbidities: a post hoc efficacy and safety analysis of two phase 3 randomized clinical trials. Curr Med Res Opin 2020; 36:1791-1806. [PMID: 32783644 DOI: 10.1080/03007995.2020.1808780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Determine whether common migraine comorbidities affect the efficacy and safety of lasmiditan, a 5-HT1F receptor agonist approved in the United States for the acute treatment of migraine. METHODS In SPARTAN and SAMURAI (double-blind Phase 3 clinical trials), patients with migraine were randomized to oral lasmiditan 50 mg (SPARTAN only), 100mg, 200 mg, or placebo. Lasmiditan increased the proportion of pain-free and most bothersome symptom (MBS)-free patients at 2 h after dose compared with placebo. Most common treatment-emergent adverse events (TEAEs) were dizziness, paraesthesia, somnolence, fatigue, nausea, muscular weakness, and hypoesthesia. Based upon literature review of common migraine comorbidities, Anxiety, Allergy, Bronchial, Cardiac, Depression, Fatigue, Gastrointestinal, Hormonal, Musculoskeletal/Pain, Neurological, Obesity, Sleep, and Vascular Comorbidity Groups were created. Using pooled results, efficacy and TEAEs were assessed to compare patients with or without a given common migraine comorbidity. To compare treatment groups, p-values were calculated for treatment-by-subgroup interaction, based on logistic regression with treatment-by-comorbidity condition status (Yes/No) as the interaction term; study, treatment group, and comorbidity condition status (Yes/No) were covariates. Differential treatment effect based upon comorbidity status was also examined. Trial registration at clinicaltrials.gov: SAMURAI (NCT02439320) and SPARTAN (NCT02605174). RESULTS Across all the Comorbidity Groups, with the potential exception of fatigue, treatment-by-subgroup interaction analyses did not provide evidence of a lasmiditan-driven lasmiditan versus placebo differential treatment effect dependent on Yes versus No comorbidity subgroup for either efficacy or TEAE assessments. CONCLUSIONS The efficacy and safety of lasmiditan for treatment of individual migraine attacks appear to be independent of comorbid conditions.
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Affiliation(s)
- David B Clemow
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Simin K Baygani
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Paula M Hauck
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Cory B Hultman
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
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31
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Abou Elmaaty AA, Flifel ME, Belal T, Zarad CA. Migraine and tension headache comorbidity with hypothyroidism in Egypt. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00208-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Abstract
Background
Migraine, tension type headache (TTH), and hypothyroidism are clinical problems that affect patient daily activities and quality of life.
Objectives
The purpose of this study was to investigate the potential association between hypothyroidism in patients with migraine and TTH.
Patients and methods
Two hundred and twelve patients with migraine and TTH and one hundred control subjects underwent clinical evaluation, assessment of thyroid hormones, and thyroid ultrasound.
Results
Subclinical and overt hypothyroidism were significantly higher in patients with migraine and TTH (P = 0.001) than control subjects. Patients with migraine and TTH showed significantly more abnormal thyroid gland morphology than healthy control (P = 0.027). Hypothyroidism is significantly expressed in chronic TTH more than TTH with infrequent or frequent TTH (P = 0.009).
Conclusions
Patients having migraine and TTH more prone to develop hypothyroidism when compared with control group. Also patients with chronic TTH are susceptible to develop hypothyroidism (either subclinical or overt) when compared with patients having frequent or infrequent TTH.
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32
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Mathieu S, Couderc M, Pereira B, Dubost JJ, Malochet-Guinamand S, Tournadre A, Soubrier M, Moisset X. Prevalence of Migraine and Neuropathic Pain in Rheumatic Diseases. J Clin Med 2020; 9:jcm9061890. [PMID: 32560321 PMCID: PMC7356241 DOI: 10.3390/jcm9061890] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/14/2022] Open
Abstract
To investigate the physiopathology of pain in chronic inflammatory rheumatic diseases (CIRDs), we assessed the prevalence of migraine and neuropathic pain in 499 patients with CIRDs. We studied 238 patients with rheumatoid arthritis, 188 with spondyloarthritis (SpA), 72 with psoriatic arthritis (PsA), and 1 unclassified. Migraine was diagnosed according to IHS migraine diagnostic criteria. Neuropathic pain was diagnosed when patients scored at least 3 on the DN4 questionnaire. Participants completed a validated self-assessment questionnaire. Migraine prevalence was 34% (165/484), and it was highest in PsA. Risk factors for migraine were a high level of anxiety, female sex, young age, and TNF-alpha inhibitor treatment (OR = 1.90 (1.13–3.25)). Besides, high disease activity was a risk factor in SpA. Blood CRP level was not significantly associated with migraine. Of 493 patients with CIRDs, 21.5% had chronic pain with neuropathic characteristics. Compared to the French general population, these patients had significantly higher prevalences of migraine (two-fold) and neuropathic pain (three-fold). This study showed that migraine and neuropathic pain frequently occurred in patients with rheumatic diseases. Therefore, upon reporting residual pain, these patients should be checked for the presence of migraine or neuropathic pain, despite adequate clinical control of rheumatic disease.
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Affiliation(s)
- Sylvain Mathieu
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
- Rheumatology Department, Gabriel Montpied Teaching Hospital, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
- Correspondence:
| | - Marion Couderc
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Bruno Pereira
- Unité de biostatistiques (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Jean-Jacques Dubost
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Sandrine Malochet-Guinamand
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Anne Tournadre
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Martin Soubrier
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Xavier Moisset
- Neurology Department, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, F-63000 Clermont Ferrand, France;
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Safety and tolerability of monthly galcanezumab injections in patients with migraine: integrated results from migraine clinical studies. BMC Neurol 2020; 20:25. [PMID: 31952501 PMCID: PMC6966798 DOI: 10.1186/s12883-020-1609-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/09/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Galcanezumab, a humanized monoclonal antibody that selectively binds to calcitonin gene-related peptide, has demonstrated a significant reduction in monthly migraine headache days in phase 2 and 3 trials. In these analyses, we aimed to evaluate the safety and tolerability of galcanezumab compared with placebo for prevention of episodic or chronic migraine. METHODS Data were integrated from three double-blind clinical studies for the up to 6-month galcanezumab exposure group (N = 1435), and from five clinical studies for the up to 1-year all-galcanezumab exposure group (N = 2276). Patients received a monthly 120 mg subcutaneous injection of galcanezumab (with a 240 mg loading dose in month 1), 240 mg galcanezumab, or placebo. Outcomes measured were treatment-emergent adverse events (TEAEs), serious AEs (SAEs), and discontinuation due to AEs (DCAEs). Laboratory results, vital signs, electrocardiogram (ECG), suicidal ideation and behavior results were evaluated. RESULTS TEAEs that occurred more frequently in galcanezumab-treated patients included injection site pain, injection site reactions excluding pain, constipation, vertigo, and pruritus. The proportion of DCAEs among galcanezumab-treated patients ranged between 1.8 and 3.0%, and differed from placebo group for galcanezumab 240 mg (P < 0.05). Fewer than 2.0% of patients in either galcanezumab dose-group compared with 1.0% of placebo-treated patients reported a SAE. There were no clinically meaningful differences between galcanezumab and placebo in laboratory measures, vital signs including blood pressure, ECGs, cardiovascular-related AEs, or suicidal ideation and behavior. CONCLUSIONS Galcanezumab demonstrated a favorable safety and tolerability profile for up to 1 year of treatment for the prevention of migraine. TRIAL REGISTRATION Clinical Trials CGAB = NCT02163993, EVOLVE-1 = NCT02614183, EVOLVE-2 = NCT02614196, REGAIN = NCT02614261, and CGAJ = NCT02614287. All were first posted on 25 November 2015, except CGAB posted on 16 June 2014, and before enrolling the first patient.
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Oakes TM, Kovacs R, Rosen N, Doty E, Kemmer P, Aurora SK, Camporeale A. Evaluation of Cardiovascular Outcomes in Adult Patients With Episodic or Chronic Migraine Treated With Galcanezumab: Data From Three Phase 3, Randomized, Double-Blind, Placebo-Controlled EVOLVE-1, EVOLVE-2, and REGAIN Studies. Headache 2019; 60:110-123. [PMID: 31721185 DOI: 10.1111/head.13684] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Blood pressure (BP), pulse, electrocardiogram (ECG), and clinical cardiovascular (CV) outcomes in patients with episodic or chronic migraine treated for up to 6 months with galcanezumab compared to placebo were evaluated. BACKGROUND Calcitonin gene-related peptide, a potent microvascular vasodilator, has a hypothesized protective role in CV health. Increased CV risks have been reported in patients with migraine. METHODS In 2 similarly designed episodic migraine 6-month studies and 1 chronic migraine 3-month study, data from patients randomized (1:1:2) to subcutaneous injection of galcanezumab 120 mg/month (following initial 240 mg loading dose) or 240 mg/month or placebo were pooled. Treatment comparisons for cardiovascular treatment-emergent adverse events (CV TEAE) and categorical and mean changes in BP, pulse, and ECG were evaluated using the Cochran-Mantel-Haenszel test. Mean changes from baseline in BP, pulse, and ECG were evaluated using the analysis of covariance model. RESULTS Overall, among galcanezumab 120 mg (n = 705) and 240 mg (n = 730), and placebo (n = 1451) groups, the percentage of patients reporting ≥1 CV TEAE was low and was similar between the galcanezumab 120 mg (2.6%; odds ratio [OR] = 0.9; 95% confidence interval [CI]: 0.5,1.5) and galcanezumab 240 mg (3.3%; OR = 1.1; 95% CI: 0.7,1.9), and placebo (2.9%) groups. The frequency of any individual CV TEAE, broad or narrow term, was ≤1.4%. The CV-related serious adverse events that occurred in the galcanezumab 240 mg group (n = 3; acute myocardial infarction, pulmonary embolism, and transient ischemic attack) and placebo group (n = 3; pulmonary embolism, deep vein thrombosis, and myocardial infarction) were not considered treatment related. Four placebo- and 1 galcanezumab-treated patient discontinued due to a CV TEAE. Least squares mean and categorical changes from baseline in BP, pulse, and QT interval corrected using Fridericia's correction were similar across treatment groups. CONCLUSIONS In this 6-month treatment trial, the percentages of galcanezumab- and placebo-treated patients that reported CV TEAEs or serious adverse events were low and similar between groups with few discontinuations. Thus, no clinically meaningful treatment group differences were observed for changes in BP, pulse, or ECG parameters. Additional longer-term studies in a broader and larger cohort are required to better characterize CV safety.
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Affiliation(s)
| | - Richard Kovacs
- School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Noah Rosen
- Department of Neurology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Erin Doty
- Eli Lilly and Company, Indianapolis, IN, USA
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Guler MA, Celik OF, Ayhan FF. The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases. Clin Rheumatol 2019; 39:269-274. [PMID: 31446538 DOI: 10.1007/s10067-019-04749-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/31/2019] [Accepted: 08/12/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This study explored the role of central sensitization (CS) pain in patients with various rheumatic diseases using the CS inventory (CSI). METHODS A total of 193 patients of mean age 50.72 ± 9.65 years were included; they were divided into four different groups in terms of their rheumatic diseases. Patients with rheumatoid arthritis (RA), spondyloarthropathy (SpA), osteoarthritis (OA), and fibromyalgia syndrome (FMS) were evaluated in tertiary care rheumatology/pain medicine settings. Disease duration and activity, the Bath Ankylosing Spondylitis Disease Activity Index, the Disease Activity Score-28, and pain severity (evaluated using a visual analog scale) were assessed, and the Turkish version of the CSI administered. RESULTS CS syndromes were present in almost half the patients (45% of SpA, 41% of RA, 62% of OA, and 94% of FMS patients). We found no significant relationship between disease activity and the CSI-A scores in SpA or RA patients (p = 0.731 and p = 0.390, respectively). As expected, the CSI-A scores were highest in the FMS group (p = 0.000), but were similar in the other groups (p < 0.05). CS-related syndromes (CSI-B conditions) were present at similar frequencies in the RA, SpA, and OA groups, but were less common in the FMS group (p = 0.000). CONCLUSIONS The CSI usefully detects CS pain in patients with rheumatic diseases. Treatment of such pain can enhance the quality of daily life in patients with rheumatic diseases.Key Point• Central sensitization pain is common in patients with rheumatic diseases including rheumatoid arthritis, spondyloarthropathies, and osteoarthritis.
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Affiliation(s)
- Mehmet Akif Guler
- Department of Physical Medicine and Rehabilitation, Gaziosmanpasa Taksim Training and Research Hospital, Mevlana District, 884. Street No: 23, 34255 Gaziosmanpasa, Istanbul, Turkey.
| | - Omer Faruk Celik
- Department of Physical Medicine and Rehabilitation, Divisions of Rheumatology, Pain Medicine, Health Sciences University, Ankara Training and Research Hospital, Ankara, Turkey
| | - Fikriye Figen Ayhan
- Department of Physical Medicine and Rehabilitation, Divisions of Rheumatology, Pain Medicine, Health Sciences University, Ankara Training and Research Hospital, Ankara, Turkey
- Department of Physical Therapy and Rehabilitation, Usak University, High School of Health Sciences, Usak, Turkey
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Spanou I, Bougea A, Liakakis G, Rizonaki K, Anagnostou E, Duntas L, Kararizou E. Relationship of Migraine and Tension-Type Headache With Hypothyroidism: A Literature Review. Headache 2019; 59:1174-1186. [PMID: 31310335 DOI: 10.1111/head.13600] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Migraine, tension-type headache, and hypothyroidism constitute very common medical conditions. Headache is one of the most common symptoms of hypothyroidism, occurring in approximately one-third of the patients. To date, data about the relationship between migraine and tension-type headache and thyroid dysfunction, and in particular hypothyroidism have been contradictory, while the underlying pathophysiological basis explaining this association is still unclear. OBJECTIVE In this review, we investigated the association between primary headaches and hypothyroidism, with the aim of shedding light on its pathophysiological basis. METHODS We conducted a systematic search in the MEDLINE database using both subject headings and keywords for headache, migraine, tension-type headache, thyroid hormones, and hypothyroidism, and we also examined manually the reference lists of all articles that met the inclusion criteria. Included studies were related to headache and thyroid disease comorbidity, with emphasis on hypothyroidism (ideally demonstrated by hormonal measurements), and with the term headache including migraine, tension-type headache, and headache attributed to hypothyroidism (HAH) based on the International Classification of Headache Disorders IIIb. Quality of studies was assessed by the Newcastle-Ottawa scale. RESULTS Of a total of 640 identified articles, 9 studies were included. Overall, there was vast heterogeneity across the included studies concerning population, study design and outcomes. Two studies investigated the HAH, with emphasis on the clinical characteristics of headache (time of onset, localization, quality, intensity, and response to hormonal replacement treatment). Five studies investigated comorbidity between migraine and thyroid disorders, especially hypothyroidism, and in the majority of them a positive association was demonstrated. One study found that headache, and particularly migraine, may increase the risk of developing hypothyroidism. Finally, only 1 study on chronic tension-type headache found coexistence of migraine and hypoactivity of the hypothalamus-pituitary-thyroid axis. The strengths and limitations of these studies are analyzed and possible pathophysiological mechanisms are suggested. CONCLUSIONS The existing data are considered inadequate to answer with certainty the relationship between headaches and thyroid disorders. According to our analysis, it seems that suggestions for a possible bidirectional association between headaches and especially migraine and hypothyroidism could exist. It hence lays the foundation for further research into the aforementioned association and its pathogenesis via large prospective multicenter studies.
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Affiliation(s)
- Ioanna Spanou
- Department of Headache, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Anastasia Bougea
- Department of Headache, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - George Liakakis
- Department of Headache, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Konstantina Rizonaki
- Department of Headache, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Evangelos Anagnostou
- Department of Headache, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Leonidas Duntas
- Department of Headache, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Evangelia Kararizou
- Department of Headache, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
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Karpova MI, Zariada AA, Dolgushina VF, Korotkova DG, Ekusheva EV, Osipova VV. [Migraine in women: clinical and therapeutical aspects]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:98-107. [PMID: 31089104 DOI: 10.17116/jnevro201911903198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Migraine is one of the most common neurological disorders, affecting women. Physiological changes in the hormonal status can modulate the functional status of pain and analgesic systems of the brain and, by involving different pathophysiological mechanisms, change the course of migraine. In addition to an analysis of epidemiological data, the review provides current views on the clinical features of the disease in women population at different periods of life, particular attention was focused on menstrual migraine. It has certain features, such as acute and long attacks and treatment difficulties. One of main issues is the use of oral contraceptives in women with migraine according to the ratio of potential benefit to cardiovascular risk. The problems of treatment headaches in pregnant and breastfeeding women are also considered. An influence of migraine on the course and outcome of pregnancy was shown. The authors analysed the results of the studies on the course of migraine during perimenopause and postmenopause and recommendations for women with migraine attacks and climacteric syndrome. The data presented in the review are useful for clinicians, because this information represents new views on pathogenetic mechanisms, clinical features and treatment of migraine in women.
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Affiliation(s)
- M I Karpova
- South Ural State Medical University, Russian Ministry of Health, Chelyabinsk
| | - A A Zariada
- South Ural State Medical University, Russian Ministry of Health, Chelyabinsk
| | - V F Dolgushina
- South Ural State Medical University, Russian Ministry of Health, Chelyabinsk
| | - D G Korotkova
- South Ural State Medical University, Russian Ministry of Health, Chelyabinsk
| | - E V Ekusheva
- Academy of Postgraduate Education under FSBU FSCC of FMBA of Russia, Moscow, Russia
| | - V V Osipova
- Research Department of Neurology, Research-technological park of Biomedicine, Sechenov First Moscow State Medical University; Moscow Research Clinical Centre for Neuropsychiatry, Moscow Health Department, Moscow, Russia
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Female versus male migraine: an event-related potential study of visual neurocognitive processing. J Headache Pain 2019; 20:38. [PMID: 31014235 PMCID: PMC6734427 DOI: 10.1186/s10194-019-0995-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/12/2019] [Indexed: 01/29/2023] Open
Abstract
Background Several studies have suggested cognitive deficits in migraineurs, and sex differences have also been observed in migraine, such as a higher prevalence in females. Nevertheless, little is known about gender-related differences in cognitive processing. In this study, we aimed to investigate the effect of gender on neurocognitive processing in migraineurs. Methods Altogether, 46 migraine patients without aura (23 females; mean age 32.848 years) during the interictal period and 46 age-matched healthy controls (23 females; mean age 32.652 years) were recruited. The emotional characteristics of participants were evaluated, and attentive processing was analyzed via event-related potential examinations using a three-stimulus visual oddball paradigm. Results We found that migraineurs suffered from emotional and visual cognitive processing abnormalities compared with healthy controls, including higher levels of anxiety and reduced P3 amplitude. These parameters were modulated by gender in migraine patients, but not in healthy participants. Our findings indicated that female patients seemed to be more anxious and have more severe impairment in attentive processing of visual stimuli than their male counterparts. The gender-related differences in migraineurs were further validated using event-related potential difference waveforms. Conclusions These results suggested that migraine might have an additional influence on females and lead to more dysfunction in their interictal neurocognitive processing. Our findings provide evidence that a gender effect exists in migraineurs, which should be considered when designing experiments and exploring treatment approaches. The gender-related differences and underlying mechanisms deserve further investigation for patients with migraine. Electronic supplementary material The online version of this article (10.1186/s10194-019-0995-y) contains supplementary material, which is available to authorized users.
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Diener HC, Holle-Lee D, Nägel S, Dresler T, Gaul C, Göbel H, Heinze-Kuhn K, Jürgens T, Kropp P, Meyer B, May A, Schulte L, Solbach K, Straube A, Kamm K, Förderreuther S, Gantenbein A, Petersen J, Sandor P, Lampl C. Treatment of migraine attacks and prevention of migraine: Guidelines by the German Migraine and Headache Society and the German Society of Neurology. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2019. [DOI: 10.1177/2514183x18823377] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In collaboration with some of the leading headache centres in Germany, Switzerland and Austria, we have established new guidelines for the treatment of migraine attacks and the prevention of migraine. A thorough literature research of the last 10 years has been the basis of the current recommendations. At the beginning, we present therapeutic novelties, followed by a summary of all recommendations. After an introduction, we cover topics like drug therapy and practical experience, non-effective medication, migraine prevention, interventional methods, non-medicational and psychological methods for prevention and therapies without proof of efficacy.
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Affiliation(s)
- Hans-Christoph Diener
- Klinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Dagny Holle-Lee
- Klinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Steffen Nägel
- Klinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Thomas Dresler
- Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Tübingen, Germany
- Graduiertenschule & Forschungsnetzwerk LEAD, Universität Tübingen, Tübingen, Germany
| | - Charly Gaul
- Migräne- und Kopfschmerzklinik Königstein, Königstein im Taunus, Germany
| | | | | | - Tim Jürgens
- Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Klinik und Poliklinik für Neurologie, Rostock, Germany
| | - Peter Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Rostock, Germany
| | - Bianca Meyer
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Rostock, Germany
| | - Arne May
- Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg, Germany
| | - Laura Schulte
- Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg, Germany
| | - Kasja Solbach
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Germany
| | - Andreas Straube
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Germany
| | - Katharina Kamm
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Germany
| | - Stephanie Förderreuther
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Germany
| | | | - Jens Petersen
- Klinik für Neurologie, Universitätsspital Zürich, Zürich, Swizterland
| | - Peter Sandor
- RehaClinic Bad Zurzach, Bad Zurzach, Swizterland
| | - Christian Lampl
- Ordensklinikum Linz, Krankenhaus der Barmherzigen Schwestern Linz Betriebsgesellschaft m.b.H., Linz, Austria
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Amanat M, Salehi M, Rezaei N. Neurological and psychiatric disorders in psoriasis. Rev Neurosci 2018; 29:805-813. [PMID: 29509545 DOI: 10.1515/revneuro-2017-0108] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 01/26/2018] [Indexed: 12/26/2022]
Abstract
Psoriasis used to be known as a skin disorder; however, it can now be considered as a systemic disease with the involvement of multiple organs. Neurological and psychiatric disorders are some of the associated problems that can be observed in patients with psoriasis. Stroke, multiple sclerosis, seizure, migraine, restless leg syndrome, Parkinson's disease, Guillain-Barré syndrome, and myasthenia gravis are the reported neurological diseases, while depression, bipolar mood disorder, anxiety, psychosis, cognitive impairment, personality disorders, sexual disorders, sleep disturbance, and eating disorders are the recognized psychiatric presentations in patients with psoriasis. Herein, the neurological and psychiatric disorders of psoriasis are described.
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Affiliation(s)
- Man Amanat
- NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 1417755331, Iran
| | - Mona Salehi
- NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 1417755331, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran 14194, Iran.,Department of Immunology and Biology, School of Medicine, Tehran University of Medical Sciences, Tehran 14155-6447, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Boston, MA 1419733151, USA
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Zhang L, Zhu X, Qiu X, Li Y, Chen Y, Wang H, He S, Lai W, Peng A, Ning M, Chen L. Relationship between right-to-left shunt and migraine in patients with epilepsy: a single-centre, cross-sectional study in China. BMJ Open 2018; 8:e024144. [PMID: 30297353 PMCID: PMC6194457 DOI: 10.1136/bmjopen-2018-024144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To investigate the relationship between right-to-left shunt and migraine to account for the unexplained high prevalence of migraine in patients with epilepsy. DESIGN This is a cross-sectional study. The diagnosis and interview process of patients with migraine was based on the International Classification of Headache Disorders-3 beta in patients with epilepsy. Participants underwent transthoracic echocardiography (TTE) with contrast medium to identify right-to-left shunt. The highest number of microbubbles were recorded in the left atrium before the complete microbubble outflow of the right atrium. A moderate-to-large shunt was defined as the presence of 10 or more microbubbles. SETTING A single-centre, cross-sectional study in China, 2015-2017. PARTICIPANTS Patients with epilepsy. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measures were the prevalence of migraine, the prevalence of right-to-left shunt in patients with migraine and those without migraine, and the prevalence of migraine in different degrees of shunting. RESULTS Three hundred thirty-nine participants with epilepsy who completed TTE were included in the analysis. The overall prevalence of migraine was 23.0%. One-third of the migraineurs had mild right-to-left shunt and one-fifth of the migraineurs had moderate-to-large right-to-left shunt. Patients with mild shunt did not have a higher prevalence of migraine than those without shunt (26.3% vs 18.1%, p=0.102); however, a higher prevalence of migraine was found in patients with moderate-to-large shunt (39.0% vs 18.1%, OR=2.90, 95% CI=1.41 to 5.98, p=0.003). Patients with migraine and patients without migraine had similar prevalence of mild shunt; however, patients with migraine had more moderate-to-large shunt (20.5% vs 9.6%, p=0.002). Right-to-left shunt and female were factors predicting migraine prevalence. CONCLUSIONS One-fifth of migraineurs were correlated with moderate-to-large right-to-left shunt which could be an underlying cause of migraine in epilepsy.
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Affiliation(s)
- Lin Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xi Zhu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiangmiao Qiu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yajiao Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hui Wang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shixu He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wanlin Lai
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Anjiao Peng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mingming Ning
- Department of Neurology, Cardio-Neurology Clinic, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lei Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Graif Y, Shohat T, Machluf Y, Farkash R, Chaiter Y. Association between asthma and migraine: A cross-sectional study of over 110 000 adolescents. CLINICAL RESPIRATORY JOURNAL 2018; 12:2491-2496. [PMID: 30004178 DOI: 10.1111/crj.12939] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Epidemiological studies have reported an association between asthma and migraine, mainly in adults. OBJECTIVE To examine the association between specialist-diagnosed asthma and migraine among adolescents. METHODS The electronic database of a recruitment center was retrospectively searched for all 17-year-old draftees during the years 1987-2010. Diagnoses of asthma and migraine were made by certified specialists. The prevalence of migraine was compared among draftees with and without asthma. Covariate data on socio-demographics and associated medical conditions were recorded. RESULTS A total of 113 671 adolescents were available for analysis. Asthma was diagnosed among 4.0% and migraine among 1.9%. Migraine was significantly more prevalent among adolescents with asthma [174 of the 4581 subjects (3.8%)] compared to those without asthma [1946 of the 109 090 (1.8%)] [OR = 2.17 (95% CI 1.86-2.55; P < 0.001)]. Rates of migraine among subjects with and without allergic rhinitis were 6.3% and 1.7%, respectively [OR = 4.04 (95% CI 3.58-4.56; P < 0.001)]. On multivariate analysis, there was a significant association between migraine and both asthma [OR = 1.42 (95% CI 1.19-1.68)] and allergic rhinitis [OR = 3.18 (95% CI 2.80-3.63)]. Other factors significantly associated with migraine were female gender, urban area of residence, recent immigration to Israel, having three or fewer siblings, and abnormal body mass index. CONCLUSION Clinicians should be aware that asthma and allergic rhinitis are potential risk factors for migraine in adolescents. A combined finding of these conditions and recurrent headache is highly suggestive of migraine and warrants a different diagnosis and treatment approach from sinusitis.
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Affiliation(s)
- Yael Graif
- Allergy and Immunology Clinic, Pulmonary Institute, Rabin Medical Center, Petach Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yossy Machluf
- Medical Corps, Israel Defense Forces, Tel Hashomer, Israel.,Shamir Research Institute, University of Haifa, Kazerin, Israel
| | | | - Yoram Chaiter
- Medical Corps, Israel Defense Forces, Tel Hashomer, Israel
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Schroeder RA, Brandes J, Buse DC, Calhoun A, Eikermann-Haerter K, Golden K, Halker R, Kempner J, Maleki N, Moriarty M, Pavlovic J, Shapiro RE, Starling A, Young WB, Nebel RA. Sex and Gender Differences in Migraine—Evaluating Knowledge Gaps. J Womens Health (Larchmt) 2018; 27:965-973. [DOI: 10.1089/jwh.2018.7274] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Jan Brandes
- Nashville Neuroscience Group, Nashville, Tennessee
- Department of Neurology, Vanderbilt University, Nashville, Tennessee
| | - Dawn C. Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Anne Calhoun
- Carolina Headache Institute, Durham, North Carolina
| | | | | | - Rashmi Halker
- Department of Neurology, Mayo Clinic, Phoenix, Arizona
| | - Joanna Kempner
- Department of Sociology, Rutgers University, New Brunswick, New Jersey
| | - Nasim Maleki
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Maureen Moriarty
- Department of Nursing, Marymount University, Arlington, Virginia
| | - Jelena Pavlovic
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Robert E. Shapiro
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont
| | | | - William B. Young
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rebecca A. Nebel
- Society for Women's Health Research, Washington, District of Columbia
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Andreeva VA, Fezeu LK, Hercberg S, Galan P. Obesity and Migraine: Effect Modification by Gender and Perceived Stress. Neuroepidemiology 2018; 51:25-32. [PMID: 29843127 DOI: 10.1159/000489663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 04/25/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The association between obesity and migraine has been established; however, it is unclear whether it varies by perceived stress within each gender. METHODS This cross-sectional study used data from the ongoing NutriNet-Santé e-cohort with enrollees from the general population. Anthropometric and migraine data were provided via self-report questionnaires (2013-2016). Migraine was defined using established criteria. Perceived stress was assessed with Cohen's Perceived Stress Scale-10. Associations were estimated via gender- and stress-stratified multivariable polytomous logistic regression models. RESULTS Among 32,835 participants with complete data (75% women; mean age = 51.9 ± 13.8 years), 34% reported no headache, 44% non-migraine headache, and 22% migraine with or without aura during one's lifetime. In these groups, obesity was present in 8.6, 9.9, and 11.6%, respectively. Stress was a significant moderator of the obesity-migraine association only among women. The largest significant adjusted odds ratio (aOR) was found between obesity and migraine in women with high stress (aOR 1.61, 95% CI 1.35-1.91). CONCLUSIONS We found support for gender- and stress-dependent associations between obesity and migraine using a large, heterogeneous adult sample. This underscores the need for evidence-based strategies for weight loss and stress reduction for female migraineurs.
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Affiliation(s)
- Valentina A Andreeva
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Léopold K Fezeu
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne, Bobigny, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
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45
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The relationship with restless legs syndrome, fibromyalgia, and depressive symptoms in migraine patients. Neurol Sci 2018; 39:1409-1414. [DOI: 10.1007/s10072-018-3438-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/07/2018] [Indexed: 12/26/2022]
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46
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Chalmer MA, Esserlind AL, Olesen J, Hansen TF. Polygenic risk score: use in migraine research. J Headache Pain 2018; 19:29. [PMID: 29623444 PMCID: PMC5887014 DOI: 10.1186/s10194-018-0856-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/21/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The latest Genome-Wide Association Study identified 38 genetic variants associated with migraine. In this type of studies the significance level is very difficult to achieve (5 × 10- 8) due to multiple testing. Thus, the identified variants only explain a small fraction of the genetic risk. It is expected that hundreds of thousands of variants also confer an increased risk but do not reach significance levels. One way to capture this information is by constructing a Polygenic Risk Score. Polygenic Risk Score has been widely used with success in genetics studies within neuropsychiatric disorders. The use of polygenic scores is highly relevant as data from a large migraine Genome-Wide Association Study are now available, which will form an excellent basis for Polygenic Risk Score in migraine studies. RESULTS Polygenic Risk Score has been used in studies of neuropsychiatric disorders to assess prediction of disease status in case-control studies, shared genetic correlation between co-morbid diseases, and shared genetic correlation between a disease and specific endophenotypes. CONCLUSION Polygenic Risk Score provides an opportunity to investigate the shared genetic risk between known and previously unestablished co-morbidities in migraine research, and may lead to better and personalized treatment of migraine if used as a clinical assistant when identifying responders to specific drugs. Polygenic Risk Score can be used to analyze the genetic relationship between different headache types and migraine endophenotypes. Finally, Polygenic Risk Score can be used to assess pharmacogenetic effects, and perhaps help to predict efficacy of the Calcitonin Gene-Related Peptide monoclonal antibodies that soon become available as migraine treatment.
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Affiliation(s)
- Mona Ameri Chalmer
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, DK-2600, Glostrup, Denmark.
| | - Ann-Louise Esserlind
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, DK-2600, Glostrup, Denmark
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, DK-2600, Glostrup, Denmark
| | - Thomas Folkmann Hansen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, DK-2600, Glostrup, Denmark
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Dai YJ, Zhang X, Yang Y, Nan HY, Yu Y, Sun Q, Yan LF, Hu B, Zhang J, Qiu ZY, Gao Y, Cui GB, Chen BL, Wang W. Gender differences in functional connectivities between insular subdivisions and selective pain-related brain structures. J Headache Pain 2018. [PMID: 29541875 PMCID: PMC5852124 DOI: 10.1186/s10194-018-0849-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background The incidence of pain disorders in women is higher than in men, making gender differences in pain a research focus. The human insular cortex is an important brain hub structure for pain processing and is divided into several subdivisions, serving different functions in pain perception. Here we aimed to examine the gender differences of the functional connectivities (FCs) between the twelve insular subdivisions and selected pain-related brain structures in healthy adults. Methods Twenty-six healthy males and 11 age-matched healthy females were recruited in this cross-sectional study. FCs between the 12 insular subdivisions (as 12 regions of interest (ROIs)) and the whole brain (ROI-whole brain level) or 64 selected pain-related brain regions (64 ROIs, ROI-ROI level) were measured between the males and females. Results Significant gender differences in the FCs of the insular subdivisions were revealed: (1) The FCs between the dorsal dysgranular insula (dId) and other brain regions were significantly increased in males using two different techniques (ROI-whole brain and ROI-ROI analyses); (2) Based on the ROI-whole brain analysis, the FC increases in 4 FC-pairs were observed in males, including the left dId - the right median cingulate and paracingulate/ right posterior cingulate gyrus/ right precuneus, the left dId - the right median cingulate and paracingulate, the left dId - the left angular as well as the left dId - the left middle frontal gyrus; (3) According to the ROI-ROI analysis, increased FC between the left dId and the right rostral anterior cingulate cortex was investigated in males. Conclusion In summary, the gender differences in the FCs of the insular subdivisions with pain-related brain regions were revealed in the current study, offering neuroimaging evidence for gender differences in pain processing. Trial registration ClinicalTrials.gov, NCT02820974. Registered 28 June 2016.
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Affiliation(s)
- Yu-Jie Dai
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China.,Department of Obstetrics and Gynecology, Xijing Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 15 West Changle Road, Xi'an, Shaanxi Province, 710032, China.,Department of Clinical Nutrition, Xijing Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 15 West Changle Road, Xi'an, Shaanxi Province, 710032, China
| | - Xin Zhang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Yang Yang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Hai-Yan Nan
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Ying Yu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Qian Sun
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Lin-Feng Yan
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Bo Hu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Jin Zhang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China
| | - Zi-Yu Qiu
- Student Brigade, the Military Medical University of PLA Airforce (Fourth Military Medical University), 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China
| | - Yi Gao
- Student Brigade, the Military Medical University of PLA Airforce (Fourth Military Medical University), 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China
| | - Guang-Bin Cui
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China.
| | - Bi-Liang Chen
- Department of Obstetrics and Gynecology, Xijing Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 15 West Changle Road, Xi'an, Shaanxi Province, 710032, China.
| | - Wen Wang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), 569 Xinsi Road, Xi'an, Shaanxi Province, 710038, China.
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Hiekkala ME, Vuola P, Artto V, Häppölä P, Häppölä E, Vepsäläinen S, Cuenca-León E, Lal D, Gormley P, Hämäläinen E, Ilmavirta M, Nissilä M, Säkö E, Sumelahti ML, Harno H, Havanka H, Keski-Säntti P, Färkkilä M, Palotie A, Wessman M, Kaunisto MA, Kallela M. The contribution of CACNA1A, ATP1A2 and SCN1A mutations in hemiplegic migraine: A clinical and genetic study in Finnish migraine families. Cephalalgia 2018; 38:1849-1863. [PMID: 29486580 DOI: 10.1177/0333102418761041] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective To study the position of hemiplegic migraine in the clinical spectrum of migraine with aura and to reveal the importance of CACNA1A, ATP1A2 and SCN1A in the development of hemiplegic migraine in Finnish migraine families. Methods The International Classification of Headache Disorders 3rd edition criteria were used to determine clinical characteristics and occurrence of hemiplegic migraine, based on detailed questionnaires, in a Finnish migraine family collection consisting of 9087 subjects. Involvement of CACNA1A, ATP1A2 and SCN1A was studied using whole exome sequencing data from 293 patients with hemiplegic migraine. Results Overall, hemiplegic migraine patients reported clinically more severe headache and aura episodes than non-hemiplegic migraine with aura patients. We identified two mutations, c.1816G>A (p.Ala606Thr) and c.1148G>A (p.Arg383His), in ATP1A2 and one mutation, c.1994C>T (p.Thr665Met) in CACNA1A. Conclusions The results highlight hemiplegic migraine as a clinically and genetically heterogeneous disease. Hemiplegic migraine patients do not form a clearly separate group with distinct symptoms, but rather have an extreme phenotype in the migraine with aura continuum. We have shown that mutations in CACNA1A, ATP1A2 and SCN1A are not the major cause of the disease in Finnish hemiplegic migraine patients, suggesting that there are additional genetic factors contributing to the phenotype.
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Affiliation(s)
| | - Pietari Vuola
- 1 Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,2 Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Ville Artto
- 2 Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Paavo Häppölä
- 3 Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Elisa Häppölä
- 1 Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
| | - Salli Vepsäläinen
- 2 Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Ester Cuenca-León
- 4 Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK.,5 Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, USA
| | - Dennis Lal
- 5 Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, USA.,6 Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA.,7 Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, USA.,8 Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Padhraig Gormley
- 5 Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, USA.,6 Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA.,9 Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.,10 Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, USA
| | - Eija Hämäläinen
- 3 Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Matti Ilmavirta
- 11 Department of Neurology, Central Hospital Central Finland, Jyväskylä, Finland
| | | | - Erkki Säkö
- 13 Turku Headache Center, Turku, Finland
| | | | - Hanna Harno
- 15 Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Havanka
- 16 Regional State Administrative Agency for Northern Finland, Oulu, Finland
| | | | - Markus Färkkilä
- 2 Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Aarno Palotie
- 3 Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland.,4 Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK.,5 Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, USA.,6 Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA.,7 Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, USA.,9 Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.,10 Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, USA
| | - Maija Wessman
- 1 Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,3 Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Mari Anneli Kaunisto
- 3 Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Mikko Kallela
- 2 Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
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Andreeva VA, Galan P, Julia C, Fezeu L, Hercberg S, Kesse-Guyot E. A systematic literature review of observational studies of the bidirectional association between metabolic syndrome and migraine. DIABETES & METABOLISM 2017; 45:11-18. [PMID: 29336986 DOI: 10.1016/j.diabet.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/24/2017] [Accepted: 12/07/2017] [Indexed: 01/03/2023]
Abstract
AIMS To evaluate all epidemiological evidence in the literature linking the metabolic syndrome (MetS) and migraine in adults. METHODS Database (Medline, Embase; published reports up to November 2017) and manual searches were performed. Information on data collection, sample characteristics, study design, MetS and migraine assessment, and results was extracted from each relevant publication. The methodological quality of each study was also assessed. RESULTS A total of 15 observational epidemiological studies in adults, published between 2009 and 2017, were retrieved. Of these, one employed a prospective design, while the rest had a cross-sectional (13 studies) or case-control (one study) design. Five studies assessed the presence of migraine in individuals with MetS, whereas 10 studies assessed the presence or risk of MetS in migraineurs. Most participants were female hospital outpatients. The sole prospective cohort study reported 11-year MetS incidence of 21.8% in migraineurs with aura, 16.8% in migraineurs without aura and 14.5% in subjects without headaches. Most studies (60%) provided no statistical estimates of association. Methodological flaws included selection biases, lack of power analysis, unsuitable research plans and no multivariable analyses. Meta-analysis was not feasible with the available data. CONCLUSION Our systematic review has identified major gaps in knowledge and weaknesses in research that should provide an impetus for future epidemiological investigations using more rigorous methodology, large general-population prospective cohorts, and substantial data on dietary behaviours and lifestyle.
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Affiliation(s)
- V A Andreeva
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France.
| | - P Galan
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - C Julia
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France; Département de santé publique, Hôpital Avicenne, 93017 Bobigny, France
| | - L Fezeu
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - S Hercberg
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France; Département de santé publique, Hôpital Avicenne, 93017 Bobigny, France
| | - E Kesse-Guyot
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France
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50
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Grassini S, Nordin S. Comorbidity in Migraine with Functional Somatic Syndromes, Psychiatric Disorders and Inflammatory Diseases: A Matter of Central Sensitization? Behav Med 2017; 43:91-99. [PMID: 26431372 DOI: 10.1080/08964289.2015.1086721] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
To approach the questions as to why migraine appears to be associated with functional somatic syndromes (FSSs) and whether central sensitization may be an underlying mechanism, the present study investigated (a) comorbidity with diagnoses of three FSSs, three psychiatric disorders, and three inflammatory diseases, (b) degree of mental health problems (stress, burnout, anxiety, depression and somatization), and (c) prevalence of ten cognitive/affective and nine airway symptoms in persons with migraine in the general population. From a randomized and stratified Swedish adult sample, questionnaire data were analyzed from 151 individuals with a diagnosis of migraine and 3,255 without migraine. The results showed (a) significant comorbidity in migraine with all FSSs, psychiatric disorders and inflammatory diseases, (b) significantly elevated scores on stress, burnout, anxiety, depression, and somatization, and (c) relatively high prevalence rates on almost all symptoms. Taken together, the results motivate future study of central sensitization as a mechanism underlying migraine.
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Affiliation(s)
- Simone Grassini
- a Department of Psychology , Umeå University , Umeå , Sweden
| | - Steven Nordin
- a Department of Psychology , Umeå University , Umeå , Sweden
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