Efficacy of fremanezumab in patients with chronic and episodic migraine stratified by migraine frequency

2021 ◽  
Vol 429 ◽  
pp. 119302
Author(s):  
Stephanie Nahas ◽  
Xiaoping Ning ◽  
Verena Ramirez Campos ◽  
Steve Barash ◽  
Joshua Cohen ◽  
...  
Keyword(s):  
Episodic Migraine ◽  
Migraine Frequency

scholarly journals Inter-individual differences in pain anticipation and pain perception in migraine: Neural correlates of migraine frequency and cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261570
Author(s):  
Gyöngyi Kökönyei ◽  
Attila Galambos ◽  
Natália Kocsel ◽  
Edina Szabó ◽  
Andrea Edit Édes ◽  
...  
Keyword(s):  
Individual Differences ◽  
Allostatic Load ◽  
Pain Perception ◽  
Dehydroepiandrosterone Sulfate ◽  
Brain Regions ◽  
Episodic Migraine ◽  
Neural Activation ◽  
Migraine Frequency ◽  
Two Phases ◽  
The Brain

Previous studies targeting inter-individual differences in pain processing in migraine mainly focused on the perception of pain. Our main aim was to disentangle pain anticipation and perception using a classical fear conditioning task, and investigate how migraine frequency and pre-scan cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio as an index of neurobiological stress response would relate to neural activation in these two phases. Functional Magnetic Resonance Imaging (fMRI) data of 23 participants (18 females; mean age: 27.61± 5.36) with episodic migraine without aura were analysed. We found that migraine frequency was significantly associated with pain anticipation in brain regions comprising the midcingulate and caudate, whereas pre-scan cortisol-to DHEA-S ratio was related to pain perception in the pre-supplementary motor area (pre-SMA). Both results suggest exaggerated preparatory responses to pain or more general to stressors, which may contribute to the allostatic load caused by stressors and migraine attacks on the brain.

scholarly journals Beneficial Effects of Kiatsu™ with Ki Training on Episodic Migraine: A Single Arm, Pilot, Exploratory Study

2021 ◽  
Author(s):  
Calvin Y Tabata ◽  
Philip Coppenhaver ◽  
Shirley McCartney ◽  
Saman Vazinkhoo ◽  
Terry Copperman
Keyword(s):  
Quality Of Life ◽  
Exploratory Study ◽  
Treatment Options ◽  
Episodic Migraine ◽  
Effective Treatment Option ◽  
Beneficial Effects ◽  
Migraine Frequency ◽  
Initial Session ◽  
Potential Alternative

Abstract BackgroundCurrent therapies for migraine have proven partially effective, highlighting the need for alternative treatment options. In this report, the authors conducted a single arm pilot exploratory study to evaluate the effect of Kiatsu with Ki training in adult females with episodic migraine.MethodsStudy subjects established a baseline migraine frequency over 4 weeks. During the following 4 weeks, each subject received instruction in Ki training (to improve concentration, balance, and relaxation), accompanied by Kiatsu (a focused touch method that reduces tension, swelling, and pain). Subjects then participated in one session a month for an additional 6 months. The initial session was 1 hour; subsequent sessions averaged 30 minutes. Subjects documented migraine frequency, migraine-specific quality of life scores, and medication use.ResultSixty-nine subjects met the study inclusion criteria and 21 completed the study. Subjects reported a significant reduction in migraine frequency after 1 month (from 7.2 to 3.8 migraines/month; p < 0.05), with an overall 53% reduction at 8 months (p < 0.001). Significant improvements in quality of life (QoL) were reported after 1 month, with continued improvements until study completion (p < 0.0001). A moderate reduction in medication use was also documented (p < 0.03), corresponding with improved QoL scores.ConclusionKiatsu with Ki training may be an effective treatment option for females with migraines, either in combination with medications or as a potential alternative to medications for patients who do not benefit from conventional therapies.

Open Label Trial of Coenzyme Q10 as A Migraine Preventive

Cephalalgia ◽  
2002 ◽  
Vol 22 (2) ◽  
pp. 137-141 ◽  
Author(s):  
TD Rozen ◽  
ML Oshinsky ◽  
CA Gebeline ◽  
KC Bradley ◽  
WB Young ◽  
...  
Keyword(s):  
Coenzyme Q10 ◽  
Preventive Treatment ◽  
Baseline Period ◽  
Episodic Migraine ◽  
Significant Response ◽  
Open Label ◽  
Migraine Headaches ◽  
Migraine Frequency ◽  
History Of ◽  
Open Label Trial

The objective was to assess the efficacy of coenzyme Q10 as a preventive treatment for migraine headaches. Thirty-two patients (26 women, 6 men) with a history of episodic migraine with or without aura were treated with coenzyme Q10 at a dose of 150 mg per day. Thirty-one of 32 patients completed the study; 61.3% of patients had a greater than 50% reduction in number of days with migraine headache. The average number of days with migraine during the baseline period was 7.34 and this decreased to 2.95 after 3 months of therapy, which was a statistically significant response ( P < 0.0001). Mean reduction in migraine frequency after 1 month of treatment was 13.1% and this increased to 55.3% by the end of 3 months. Mean migraine attack frequency was 4.85 during the baseline period and this decreased to 2.81 attacks by the end of the study period, which was a statistically significant response ( P < 0.001). There were no side-effects noted with coenzyme Q10. From this open label investigation coenzyme Q10 appears to be a good migraine preventive. Placebo-controlled trials are now necessary to determine the true efficacy of coenzyme Q10 in migraine prevention.

Multimodal chiropractic care for migraine: A pilot randomized controlled trial

Cephalalgia ◽  
2020 ◽  
pp. 033310242096384
Author(s):  
Pamela M Rist ◽  
Carolyn Bernstein ◽  
Matthew Kowalski ◽  
Kamila Osypiuk ◽  
Julie P Connor ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Episodic Migraine ◽  
Chiropractic Care ◽  
Adult Women ◽  
Serious Adverse Events ◽  
Randomized Controlled ◽  
Migraine Frequency ◽  
Pilot Randomized Controlled Trial

Background Spinal manipulation may reduce migraine frequency, but effects of multimodal chiropractic care on migraine frequency have not been evaluated. Methods We conducted a pilot randomized controlled trial comparing multimodal chiropractic care + enhanced usual care (MCC+) versus enhanced usual care alone (EUC) among adult women with episodic migraine. EUC was comprised of usual medical care and migraine education literature. MCC+ participants received 10 sessions of chiropractic care over 14 weeks. Primary aims evaluated feasibility of recruitment, retention, protocol adherence, and safety. Change in migraine days was a secondary aim. Results Of 422 patients screened, 61 were randomized over 20 months. Fifty-seven (93%) completed daily migraine logs during the intervention, 51 (84%) completed final follow-up, and 45 (74%) completed all assessments. Twenty-four of 29 MCC+ participants (83%) attended > 75% of the chiropractic sessions. Ninety-eight non-serious adverse events were reported by 26 participants (43%) with 39 events among 11 EUC participants and 59 events among 15 MCC+ participants. MCC+ participants experienced greater reductions in migraine days (−2.9 days for MCC+ vs. −1.0 days for EUC, difference = −1.9; 95% confidence interval: −3.5, −0.4). Conclusions Pre-specified feasibility criteria were not met, but deficits were remediable. Preliminary data support a definitive trial of MCC+ for migraine. Trial Registration This study is registered at Clinicaltrials.gov (NCT03177616).

scholarly journals Endogenous glucocorticoids may serve as biomarkers for migraine chronification

2020 ◽  
Vol 11 ◽  
pp. 204062232093979 ◽  
Author(s):  
Yohannes W. Woldeamanuel ◽  
Bharati M. Sanjanwala ◽  
Robert P. Cowan
Keyword(s):  
Self Efficacy ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Elevated Serum ◽  
Episodic Migraine ◽  
Liquid Chromatography Mass Spectrometry ◽  
Migraine Frequency ◽  
Csf Levels ◽  
Monitoring Treatment ◽  
Monitoring Treatment Response

Aims: The aims of this study were to: (a) identify differences in serum and cerebrospinal fluid (CSF) glucocorticoids among episodic migraine (EM) and chronic migraine (CM) patients compared with controls; (b) determine longitudinal changes in serum glucocorticoids in CM patients; and (c) determine migraine-related clinical features contributing to glucocorticoid levels. Methods: Serum and CSF levels of cortisol and corticosterone were measured using liquid chromatography-mass spectrometry among adult patients with EM, CM, and controls. Serum and CSF samples were collected from 26 and four participants in each group, respectively. Serum glucocorticoids were measured at a second timepoint after 2 years among 10 of the CM patients, six of whom reverted to EM while four persisted as CM. Receiver operating characteristic (ROC) analysis was made to assess the migraine diagnostic performance of glucocorticoids. Regression analysis was conducted to determine the link between glucocorticoid levels and migraine-related clinical variables. Results: CM patients exhibited significantly elevated serum and CSF levels of cortisol and corticosterone compared with controls and EM patients (age, sex, body mass index adjusted; Kruskal–Wallis p < 0.05). ROC showed area-under-curve of 0.89 to differentiate CM from EM. CM patients with remission had their serum glucocorticoids return to control or near EM levels ( p < 0.05). Persistent CM showed unremitting serum glucocorticoids. Migraine frequency and disability contributed to increased cortisol, while pain self-efficacy predicted lower cortisol levels ( p < 0.005). Conclusion: Endogenous glucocorticoids may be biomarkers for migraine progression and for monitoring treatment response. Improving pain self-efficacy skills may help optimize endogenous glucocorticoid levels, which in turn may prevent migraine attacks.

Topiramate in the Preventive Treatment of Episodic Migraine: A Combined Analysis From Pilot, Double-Blind, Placebo-Controlled Trials

CNS Spectrums ◽  
2003 ◽  
Vol 8 (6) ◽  
pp. 428-432 ◽  
Author(s):  
Keith R. Edwards ◽  
Doreen L. Potter ◽  
Shu-Chen Wu ◽  
Marc Kamin ◽  
Joseph Hulihan
Keyword(s):  
Placebo Group ◽  
Preventive Treatment ◽  
Episodic Migraine ◽  
Common Side Effect ◽  
Double Blind ◽  
Baseline Phase ◽  
Double Blind Placebo ◽  
Migraine Headaches ◽  
Migraine Frequency ◽  
Efficacy Measure

ABSTRACTThe safety and efficacy of medications for preventive treatment of migraine is the subject of current concern and investigation in health care. Two single-center, double-blind, placebo-controlled studies were conducted to evaluate the efficacy and safety of topiramate for migraine prophylaxis. Seventy patients with a diagnosis of migraine were randomly assigned to topiramate-treated and placebo groups. The studies consisted of a 4-week baseline phase, a 6—8 week titration, and 8–12 weeks of maintenance. Topiramate was titrated from an initial dose of 25 mg/day to a target dose of 100 mg BID. The primary efficacy measure, the mean 28-day migraine frequency, was lower in topiramate-treated patients than in the placebo group (3.2 versus 3.8, P=.001). Similarly, topiramate treatment resulted in a significantly greater mean reduction in migraine frequency than did placebo (1.55 versus 0.47, P=.001) and a significantly higher responder rate (35.3% versus 8.3%, P=.008). Paresthesia was the most common side effect reported with topiramate treatment. Other topiramate-associated adverse events included altered taste, memory impairment, diarrhea, and appetite suppression/weight loss. The rates of discontinuation were similar for the topiramate group (n=10) and the placebo group (n=8). These results suggest that topiramate is effective and well tolerated in the preventive treatment of migraine headaches.

scholarly journals Comparison of cervical muscle isometric force between migraine subgroups or migraine-associated neck pain: a controlled study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lidiane Lima Florencio ◽  
Anamaria Siriani de Oliveira ◽  
Carina Ferreira Pinheiro ◽  
Tenysson Will-Lemos ◽  
Fabíola Dach ◽  
...  
Keyword(s):  
Neck Pain ◽  
Isometric Force ◽  
Episodic Migraine ◽  
Controlled Study ◽  
Electromyographic Activity ◽  
Antagonist Activity ◽  
Cervical Muscle ◽  
Migraine Frequency ◽  
Cutaneous Allodynia ◽  
Flexion Extension

AbstractThis study aimed to verify if migraine frequency or migraine-associated neck pain were associated with a reduction of normalized force and altered electromyographic activity during maximal cervical muscle isometric contractions. Additionally, it aimed to assess the correlation of normalized isometric force with years with migraine, headache frequency, headache intensity, migraine-related disability, and severity of cutaneous allodynia. The sample comprises 71 women with migraine (40/31 episodic/chronic, 42/18 with/without neck pain) and 32 women without headache. Cervical muscle isometric force in flexion, extension, and lateral flexion was assessed synchronized with the acquisition of superficial electromyography from the cervical muscles. Women with episodic migraine presented lower normalized isometric force in extension, flexion, and right and left lateral flexions than controls (P < 0.05). Women with migraine and neck pain exhibited lower cervical extension and right/left lateral-flexions normalized isometric force than controls (P < 0.05). No significant differences were observed in antagonist activity. Normalized isometric force in all directions showed weak to moderate correlations with the severity of self-reported symptoms of cutaneous allodynia (− 0.25 ≥ r ≥ − 0.39). No additional linear correlation with clinical migraine features was observed. In conclusion, cervical muscle weakness may be associated with episodic migraine and neck pain concurrent with migraine attacks without altered antagonist activity. Additionally, it may also be related to the severity of cutaneous allodynia.

scholarly journals Migraine and Complex Regional Pain Syndrome: A Case-Referent Clinical Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yohannes W. Woldeamanuel ◽  
Corinne Cooley ◽  
Katharine Foley-Saldena ◽  
Robert P. Cowan
Keyword(s):  
Clinical Phenotype ◽  
Pain Syndrome ◽  
Episodic Migraine ◽  
Headache Disorders ◽  
Medical Comorbidities ◽  
Medical Disorders ◽  
Migraine Frequency ◽  
Budapest Criteria ◽  
Made In

We studied clinical phenotype differences between migraineurs with CRPS (Mig + CRPS) and those without (Mig − CRPS). Mig + CRPS cases and Mig − CRPS referents aged ≥18 years were enrolled. Diagnosis was made in accordance with International Classification of Headache Disorders-3 beta (ICHD-3 beta) for migraine and Budapest Criteria for CRPS. Migraines both with and without aura were included. A total of 70 Mig + CRPS cases (13% males, mean age 48 years) and 80 Mig − CRPS referents (17% males, mean age 51 years) were included. 33% of Mig + CRPS and 38% of Mig − CRPS exhibited episodic migraine (EM) while 66% of Mig + CRPS and 62% of Mig − CRPS had chronic migraine (CM) (OR = 0.98, CI 0.36, 2.67). Median duration of CRPS was 3 years among EM + CRPS and 6 years among CM + CRPS cohort (p<0.02). Mig + CRPS (57%) carried higher psychological and medical comorbidities compared to Mig − CRPS (6%) (OR 16.7, CI 10.2, 23.6). Higher migraine frequency was associated with longer CRPS duration. Migraineurs who developed CRPS had higher prevalence of psychological and medical disorders. Alleviating migraineurs’ psychological and medical comorbidities may help lower CRPS occurrence.

scholarly journals Beneficial Effects of Kiatsu™ with Ki Training on Episodic Migraine: An Exploratory Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Calvin Y. Tabata ◽  
Philip F. Copenhaver ◽  
Shirley McCartney ◽  
Saman Vazinkhoo ◽  
Terry Copperman
Keyword(s):  
Quality Of Life ◽  
Exploratory Study ◽  
Medication Use ◽  
Episodic Migraine ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Effective Treatment Option ◽  
Randomized Controlled ◽  
Migraine Frequency

Objective. To conduct an exploratory study of KiatsuTM with Ki training as a potential therapy for treating episodic migraine in women. Background. Current therapies for migraine have proven partially effective, highlighting the need for alternative treatment options. In preparation for development of a randomized controlled study, the authors conducted a single arm pilot exploratory study to evaluate the effect of Kiatsu with Ki training in adult females with episodic migraine. Methods. Study subjects established a baseline migraine frequency over 4 weeks. During the following 4 weeks, each subject received instruction in Ki training (to improve concentration, balance, and relaxation), accompanied by Kiatsu (a focused touch method that reduces tension, swelling, and pain). Subjects then participated in one session a month for additional 6 months. The initial session was 1 hour; subsequent sessions averaged 30 minutes. Subjects documented migraine frequency, migraine-specific quality of life scores, and medication use. Result. Sixty-nine subjects met the study inclusion criteria, and 21 completed the study. Subjects reported a significant reduction in migraine frequency after 1 month (from 7.2 to 3.8 migraines/month; p < 0.05 ), with an overall 53% reduction at 6 months ( p < 0.001 ). Significant improvements in quality of life (QoL) were reported after 1 month, with continued improvements until study completion ( p < 0.0001 ). A moderate reduction in medication use was also documented ( p < 0.03 ), corresponding to improved QoL scores. Conclusion. Kiatsu with Ki training may be an effective treatment option for females with migraines, either in combination with medications or as a potential alternative to medications for patients who do not benefit from conventional therapies. The results of this pilot study justify the development of a randomized controlled study designed to investigate the potential benefits of this novel therapeutic method for treating migraine.

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