Detection of possible factors favouring the evolution of migraine without aura into chronic migraine

Background Brain excitability is changed in migraine but not fully characterized yet. This study explored if somatosensory gating is altered in migraine and linked to migraine chronification. Methods Paired electrical stimuli were delivered to the left index fingers of 21 patients with migraine without aura (MO), 22 patients with chronic migraine (CM), and 36 controls. The first and second responses to the paired stimuli were obtained from the contralateral primary (cSI), contralateral secondary (cSII) and ipsilateral secondary (iSII) somatosensory cortices to compute the gating ratios (second vs. first response strengths). Results The first and second cSI responses and gating ratios differed in all groups ( p < 0.05); the responses were typically smaller in the MO and CM groups. The cSI gating ratio increased as a continuum across controls (0.73 ± 0.04, p < 0.001), MO (0.83 ± 0.04) to CM (0.97 ± 0.06) and was higher in CM vs. controls ( p < 0.001). When MO and CM were combined, cSI gating ratio was associated with headache frequency (r = 0.418, p = 0.005). Paired responses and gating ratios of cSII and iSII did not differ among the groups. Conclusions Somatosensory gating is altered in migraine and associated with headache chronification. Further studies must clarify if this abnormal sensory modulation is a true gating deficit independent of low preexcitation level.

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Migraine

Oxford Textbook of Neurologic and Neuropsychiatric Epidemiology ◽

10.1093/med/9780198749493.003.0022 ◽

2020 ◽

pp. 213-224

Author(s):

Julio R Vieira ◽

Richard B Lipton

Keyword(s):

Chronic Migraine ◽

Migraine With Aura ◽

Cortical Spreading Depression ◽

Migraine Without Aura ◽

Spreading Depression ◽

Headache Frequency ◽

Motor Symptoms ◽

Migraine Aura ◽

Younger Age ◽

Psychiatric Conditions

This chapter examines migraine. The incidence of migraine varies depending on multiple aspects, including age, sex, and the presence of aura. At an earlier age (younger than age ten), migraine initially affects more boys than girls, with migraine with aura (MA) occurring at a younger age than migraine without aura (MO). Later in life, when puberty starts, this relationship changes and it becomes more common in women than men. Migraine aura are focal neurological symptoms that typically occur prior to the onset of a headache due to a phenomenon called cortical spreading depression. The prevalence of migraine with aura vary between visual, sensory, or motor symptoms. It can also present as diplopia, slurred speech, aphasia, dizziness, vertigo, and hemiparesis. Moreover, the prevalence of migraine varies according to headache frequency. The chapter then looks at chronic migraine and menstrual migraine. It also explores several comorbidities associated with migraine, including many neurologic, medical, and psychiatric conditions.

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Presence of vestibular symptoms and related disability in migraine with and without aura and chronic migraine

Cephalalgia ◽

10.1177/0333102418769948 ◽

2018 ◽

Vol 39 (1) ◽

pp. 29-37 ◽

Cited By ~ 7

Author(s):

Gabriela F Carvalho ◽

Flávia Heck Vianna-Bell ◽

Lidiane L Florencio ◽

Carina F Pinheiro ◽

Fabiola Dach ◽

...

Keyword(s):

Chronic Migraine ◽

Migraine With Aura ◽

Migraine Without Aura ◽

Cross Sectional Study ◽

Control Group ◽

Dizziness Handicap Inventory ◽

Cross Sectional ◽

Severe Handicap ◽

Migraine Frequency ◽

Vestibular Symptoms

Objective To assess the presence and handicap due to vestibular symptoms in three subgroups of patients with migraine and controls. Methods Women between 18–55 years old were diagnosed by headache specialists and stratified as migraine with aura (n = 60), migraine without aura (n = 60), chronic migraine (n = 60) and controls (n = 60). Information regarding demographics, headache and vestibular symptoms were collected in this cross-sectional study. The self-perceived handicap related to vestibular symptoms was assessed through the Dizziness Handicap Inventory questionnaire. Results A total of 85% of women with migraine with aura and chronic migraine had vestibular symptoms contrasted to 70% of the migraine without aura group ( p < 0.05), and 12% of the control group reported symptoms ( p < 0.0001). Patients with migraine exhibited greater Dizziness Handicap Inventory scores than controls ( p < 0.001); and migraine with aura and chronic migraine groups reached greater scores than migraine without aura ( p < 0.01). Presence of migraine is associated with a greater risk of vestibular symptoms (migraine without aura: 5.20, migraine with aura: 6.60, chronic migraine:6.20, p < 0.0003) and with a greater risk of moderate-to-severe handicap (migraine without aura: 20.0, migraine with aura: 40.0, chronic migraine: 40.0, p < 0.0003). The presence of aura and greater migraine frequency adds to the risk of any handicap (migraine with aura: 1.9, chronic migraine: 1.7, p < 0.04) and to the risk of moderate-to-severe handicap (migraine with aura: 2.0, chronic migraine: 2.0, p < 0.0003). Migraine aura, intensity and frequency predict 36% of the dizziness handicap. Conclusion The prevalence of vestibular symptoms is increased in migraine during and between headache attacks, particularly in migraine with aura and chronic migraine along with an increased handicap due to those symptoms. Vestibular symptoms among subgroups of migraine should be considered when evaluating the functional impact of migraine.

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Erenumab and OnabotulinumtoxinA Combination Therapy for the Prevention of Intractable Chronic Migraine without Aura: A Retrospective Analysis

Journal of Pain & Palliative Care Pharmacotherapy ◽

10.1080/15360288.2020.1829249 ◽

2020 ◽

pp. 1-6

Author(s):

Mark Armanious ◽

Nadia Khalil ◽

Yuanyuan Lu ◽

Rebecca Jimenez-Sanders

Keyword(s):

Combination Therapy ◽

Chronic Migraine ◽

Retrospective Analysis ◽

Migraine Without Aura

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Headache and psychiatry

Oxford Textbook of Headache Syndromes ◽

10.1093/med/9780198724322.003.0052 ◽

2020 ◽

pp. 475-483

Author(s):

Maurizio Pompili ◽

Dorian A. Lamis ◽

Frank Andrasik ◽

Paolo Martelletti

Keyword(s):

Mental Illness ◽

Chronic Migraine ◽

Migraine With Aura ◽

Migraine Headache ◽

Migraine Without Aura ◽

Psychiatric Comorbidity ◽

Somatic Symptoms ◽

Migraine Aura ◽

Migraine Headaches ◽

History Of

Patients suffering from different types of headache typically complain of numerous associated symptoms (e.g. behavioural and somatic), which may be partially related to psychiatric comorbidity. Somatic symptoms have been demonstrated to be more common in patients with chronic migraine, especially for severe headaches with accompanying depression or anxiety. Moreover, chronic migraine may be considered as distinct from an episodic type of migraine with aura, migraine without aura, and migraine aura without headache (without a history of characteristic migraine headaches). Accordingly, the present chapter explores the prevalence and impact of mental illness in patients diagnosed with migraine headache.

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Efficacy of moxomdme m chronic migraine

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2006-12-4-362-364 ◽

2006 ◽

Vol 12 (4) ◽

pp. 362-364

Author(s):

A. V. Amelin ◽

S. V. Tarasova ◽

A. A. Skorometz

Keyword(s):

Chronic Migraine ◽

Migraine Without Aura ◽

Controlled Trial ◽

Baseline Period ◽

Effective Drug ◽

Dry Mouth ◽

Mean Frequency ◽

Placebo Period ◽

Daily Headache ◽

The Mean

This study is the first blind placebo-controlled trial of moxonidine for chronic migraine. The subjects with migraine without aura (n= 30), mean frequency attacks of 5,6 per 4 weeks, were randomy assigned to a three month trial of moxonidine (0,2-0,4 mg/ day) or an identical placebo. Patients kept daily headache records. Twenty-one of 30 included patients completed the study. Five patients stopped medication because of drowsiness and dry mouth with moxonidine. and four other non-related reasons (one on M, two on placebo). The mean frequency attacks was signifcantly decreased, from 5,2 per 4 weeks during placebo period to 3,1 attacs during M (Wile. P=0.0017), as well as compared with the baseline period (Wile. P=0.0007). Forty nine percent were responders (i.e. showed a reduction of the midraine days to 50 percent or less of the migraine attaks during M treatment compared with baseline period), whereas 9 percent deteriorated. During the placebo period, 9 percent were responders, whereas 38 percent deteriorated. These findings suggest that moxonidine may be an effective drug in chronic migraine.

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Interictal Photophobia and Phonophobia Are Related to the Presence of Aura and High Frequency of Attacks in Patients with Migraine

Applied Sciences ◽

10.3390/app11062474 ◽

2021 ◽

Vol 11 (6) ◽

pp. 2474

Author(s):

Carina F. Pinheiro ◽

Jessica R. Moreira ◽

Gabriela F. Carvalho ◽

Leticia Zorzin ◽

Fabiola Dach ◽

...

Keyword(s):

Chronic Migraine ◽

Migraine With Aura ◽

High Frequency ◽

Migraine Without Aura ◽

Daily Life ◽

Likert Scale ◽

Daily Activities ◽

Social Situations ◽

Daily Life Activities ◽

Positive Correlations

Background: Despite that photophobia and phonophobia are well-known symptoms related to migraine, it is unclear whether they affect daily life activities during the headache-free period. Objective: To evaluate the interictal photophobia/phonophobia intensity during daily activities in migraineurs and non-headache individuals. Methods: Women with migraine without aura (MoA, n = 30), migraine with aura (MA, n = 30), chronic migraine (CM, n = 30) and without headache (CG, n = 30) reported the photophobia and phonophobia intensity during daily activities using a Likert scale ranging from 0 (no discomfort) to 10 (maximum discomfort). Results: The migraine groups reported higher intensity of interictal photophobia and phonophobia than CG during “driving” and “social situations”, respectively (p < 0.05). MA and CM groups presented higher intensity of phonophobia than CG, hearing sounds in everyday situations and listening to conversations in noisy places (p < 0.05). Also, the MA group presented higher interictal phonophobia than the CG to keep concentration in noisy places (p < 0.05). Weak positive correlations were observed between the intensity of both photophobia and phonophobia with migraine intensity, frequency of migraine and frequency of aura (p < 0.05). Conclusion: Interictally, the intensity of photophobia and phonophobia reported during daily activities is higher in patients with migraine, especially those with aura and chronic migraine, than in non-headache subjects.

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The 1246 G/A polymorphism of the HCRTR2 gene is not associated with migraine

Cephalalgia ◽

10.1111/j.1468-2982.2007.01347.x ◽

2007 ◽

Vol 27 (8) ◽

pp. 945-949 ◽

Cited By ~ 11

Author(s):

L Pinessi ◽

E Binello ◽

P De Martino ◽

S Gallone ◽

S Gentile ◽

...

Keyword(s):

Risk Factor ◽

Chronic Migraine ◽

Genetic Risk ◽

Migraine Without Aura ◽

Control Design ◽

Case Control ◽

Healthy Controls ◽

Experimental Animals ◽

Significant Difference ◽

Migraine Pathophysiology

Studies in experimental animals have suggested that the hypocretin/orexin system may be involved in migraine pathophysiology. Using a case-control design study, we genotyped 246 migraine patients and 239 healthy controls for the 1246G→A polymorphism of the hypocretin receptor 2 ( HCRTR2) gene. Genotypic and allelic frequencies of the examined polymorphism were similarly distributed between cases and controls (χ2 = 2.22, P = 0.14 and χ2 = 2.45, P = 0.29, respectively). When different migraine subgroups were compared (migraine with aura vs. migraine without aura and episodic vs. chronic migraine) no significant difference was found. Comparison of the clinical features of the disease with the 1246G→A genotypes showed no significant difference. Our data suggest that the HCRTR2 gene is not a genetic risk factor in migraine.

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