Salivary CGRP can monitor the different migraine phases: CGRP (in)dependent attacks

Background CGRP plays a key role in the transmission and modulation of nociceptive signals and is a critical component in the pathogenesis of migraine. Objective To assess saliva as a substrate to measure CGRP by comparing interictal levels in patients with episodic migraine and controls; and to evaluate CGRP’s temporal profile during migraine attacks. Methods This prospective observational pilot study included young women with episodic migraine and healthy controls. We monitored salivary CGRP-like immunoreactivity (CGRP-LI) during 30 consecutive days and during migraine attacks. We considered six timepoints for the analysis: interictal (72h headache free), preictal (PRE-24h before the attack), ictal (headache onset, after 2h, after 8h), postictal (POST-24h after the attack). CGRP levels were quantified by ELISA. Results 44 women (22 with episodic migraine, 22 healthy controls) were recruited. Differences in interictal salivary levels of CGRP between patients and controls (Me [IQR]: 98.0 [80.3] (95% CI 56.6, 124.0) vs. 54.3 [44.0] (95% CI 42.2, 70.1) pg/mL, p = 0.034) were found. An increase in CGRP levels during migraine attacks was detected (pre:169.0 [95% CI 104.2–234.0]; headache onset: 247.0 [181.9–312.0]; after 2h: 143.0 [77.6–208.0]; after 8h: 169.0 [103.5–234.0], post: 173.0 [107.8–238.0]). Patients were classified as having CGRP-dependent (79.6%) and non-CGRP dependent migraine attacks (20.4%) according to the magnitude of change between preictal and ictal phase. Accompanying symptoms such as photophobia and phonophobia were significantly associated to the first group. Conclusions Salivary CGRP-LI levels, which interictally are elevated in episodic migraine patients, usually increase during a migraine attack in the majority of patients. However, not every attack is CGRP-dependent, which in turn, might explain different underlying pathophysiology and response to treatment.

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Salivary CGRP as diagnostic and migraine attack phase monitor biomarker: CGRP (in)dependent attacks

10.1101/2020.11.18.20233841 ◽

2020 ◽

Author(s):

Alicia Alpuente ◽

Victor J Gallardo ◽

Laila Asskour ◽

Edoardo Caronna ◽

Marta Torres-Ferrus ◽

...

Keyword(s):

Observational Study ◽

Migraine Attack ◽

Longitudinal Analysis ◽

Prospective Observational Study ◽

Preventive Treatment ◽

Episodic Migraine ◽

Healthy Controls ◽

Temporal Profile ◽

Attack Phase ◽

Accompanying Symptoms

ABSTRACTObjectiveTo assess saliva as a substrate to measure CGRP by comparing interictal levels of CGRP in patients with episodic migraine and controls; and to evaluate saliva CGRP temporal profile during migraine attacks.MethodsThis prospective observational study included women with episodic migraine and healthy controls. Participants collected daily saliva samples for 30 consecutive days and 3 additional ones during migraine attacks. 4 timepoints were considered: interictal (72h headache-free), preictal (PRE-24h before the attack), ictal (0h,2h,8h), postictal (POST-24h after the attack). CGRP levels were quantified by ELISA.Results35 women (22 patients, 13 controls) were included. Statistically significant differences were found in interictal salivary levels of CGRP between patients and controls (median[IQR]: 98.0 [86.7] vs. 42.2 [44.7] pg/mL; p=0.010). An increase in CGRP levels during migraine attacks was detected (median[IQR]: preictal 113.5 [137.8], 0h 164.6 [204.5], 2h 101.7 [159.1], 8h 82.6 [166.2], postictal 79.6 [124.3] pg/ml; p<0.001). Patients were classified as having CGRP-dependent (80.0%) and non-CGRP dependent migraine attacks (20.0%) according to the magnitude of change between preictal and ictal phase (0h). Accompanying symptoms were different depending on the type of attack. In the longitudinal analysis, we observed that the amount of CGRP measured during attacks were phase dependent and it was influenced by the frequency of monthly headache days (p=0.02).InterpretationPatients with episodic migraine have higher interictal salivary levels of CGRP than controls. These levels usually increase during a migraine attack, however, not every attack is CGRP-dependent, which in turn, might explain different underline pathophysiology and response to acute and preventive treatment.

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Influence of chronotype on daily mood fluctuations: pilot study in patients with depression

BJPsych Open ◽

10.1192/bjo.2019.103 ◽

2020 ◽

Vol 6 (2) ◽

Author(s):

Konstantin F. Brückmann ◽

Jürgen Hennig ◽

Matthias J. Müller ◽

Stanislava Fockenberg ◽

Anne-Marthe Schmidt ◽

...

Keyword(s):

Clinical Trials ◽

Pilot Study ◽

Negative Affect ◽

Clinical Setting ◽

Early Morning ◽

Healthy Controls ◽

Patient Subgroup ◽

Depression Risk ◽

Gender And Age ◽

The Relationship

Summary Depression risk is associated with a late chronotype pattern often described as an ‘evening chronotype’. Fluctuations in mood over consecutive days have not yet been measured according to chronotype in in-patients with depression. A total of 30 in-patients with depression and 32 healthy controls matched for gender and age completed a chronotype questionnaire and twice-daily ratings on mood for 10 consecutive days (registered in the German Clinical Trials Register: DRKS00010215). The in-patients had Saturdays and Sundays as hospital-leave days. The relationship between chronotype and daily mood was mediated by the weekday–weekend schedule with higher levels of negative affect in the evening-chronotype patient subgroup at weekends. Results are discussed with respect to a probably advantageous standardised clinical setting with early morning routines, especially for patients with evening chronotypes.

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Su1664 Development of a New Algorithm for an Automated Detection and Characterization of Bile Ducts From ERCP Images: a Pilot Study in Patients With Primary Sclerosing Cholangitis and Healthy Controls

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.02.408 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB358-AB359

Author(s):

Carsten Schmidt ◽

Christian LautenschläGER ◽

Janin LautenschläGER ◽

Herbert SüSse ◽

Joachim Denzler ◽

...

Keyword(s):

Pilot Study ◽

Primary Sclerosing Cholangitis ◽

Sclerosing Cholangitis ◽

Bile Ducts ◽

Automated Detection ◽

Healthy Controls

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Why do normal weight young women look for diet-therapy? Findings from a pilot study in a clinical and non-clinical population

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/bf03327588 ◽

2007 ◽

Vol 12 (2) ◽

pp. e35-e38 ◽

Cited By ~ 2

Author(s):

V. Boschi ◽

O. Bellini ◽

G. Matrone ◽

F. Ricciardi Lo Schiavo ◽

M. Siervo

Keyword(s):

Pilot Study ◽

Young Women ◽

Diet Therapy ◽

Normal Weight ◽

Clinical Population

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Systems Approaches to Treatment Response to Imatinib in Severe Asthma: A Pilot Study

Journal of Personalized Medicine ◽

10.3390/jpm11040240 ◽

2021 ◽

Vol 11 (4) ◽

pp. 240

Author(s):

Seung Han Baek ◽

Dinah Foer ◽

Katherine N. Cahill ◽

Elliot Israel ◽

Enrico Maiorino ◽

...

Keyword(s):

Gene Expression ◽

Clinical Trial ◽

Systems Biology ◽

Pilot Study ◽

Severe Asthma ◽

Treated Patient ◽

Expression Patterns ◽

Airflow Limitation ◽

Response To Treatment ◽

Imatinib Treatment

There is an acute need for advances in pharmacologic therapies and a better understanding of novel drug targets for severe asthma. Imatinib, a tyrosine kinase inhibitor, has been shown to improve forced expiratory volume in 1 s (FEV1) in a clinical trial of patients with severe asthma. In a pilot study, we applied systems biology approaches to epithelium gene expression from these clinical trial patients treated with imatinib to better understand lung function response with imatinib treatment. Bronchial brushings from ten imatinib-treated patient samples and 14 placebo-treated patient samples were analyzed. We used personalized perturbation profiles (PEEPs) to characterize gene expression patterns at the individual patient level. We found that strong responders—patients with greater than 20% increase in FEV1—uniquely shared multiple downregulated mitochondrial-related pathways. In comparison, weak responders (5–10% FEV1 increase), and non-responders to imatinib shared none of these pathways. The use of PEEP highlights its potential for application as a systems biology tool to develop individual-level approaches to predicting disease phenotypes and response to treatment in populations needing innovative therapies. These results support a role for mitochondrial pathways in airflow limitation in severe asthma and as potential therapeutic targets in larger clinical trials.

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Assessment of Pain Modulatory and Somatosensory Profiles in Chronic Tension-Type Headache Patients

Pain Medicine ◽

10.1093/pm/pnab084 ◽

2021 ◽

Author(s):

Fernando G Exposto ◽

Karina H Bendixen ◽

Malin Ernberg ◽

Flemming W Bach ◽

Peter Svensson

Keyword(s):

Pain Catastrophizing ◽

Tension Type Headache ◽

Pain Modulation ◽

Normative Values ◽

Healthy Controls ◽

Single Session ◽

Chronic Tension Type Headache ◽

Type Headache ◽

Underlying Pathophysiology

Abstract Objective The aim of this study was to thoroughly phenotype a group of chronic tension-type headache (CTTH) patients. Methods Fifteen CTTH patients diagnosed according to the International Classification of Headache Disorders–3 and 15 healthy controls were included in this study. Furthermore, 70 healthy controls were included to establish normative values. Quantitative sensory testing (QST), including temporal summation of pain (TSP), conditioned pain modulation (CPM), and psychological and sleep variables, was assessed in a single session. TSP and CPM were then combined to build pain modulation profiles (PMP) for each individual. Results No difference was found between groups for PMP, TSP, and CPM. However, 10 CTTH patients showed a pronociceptive PMP, with 8 related to a deficient CPM and 2 to both a deficient CPM and increased TSP. Increased cold detection thresholds were the most common sensory disturbance found in CTTH patients. Significant differences were seen between groups for pain catastrophizing, depression, and sleep quality although not all patient’s scores were above the clinically meaningful cutoffs. Conclusions In summary, CTTH patients presented with different PMP. These PMP may be related to increased TSP, deficient CPM, alterations in thermal detection that may be related to autonomic dysregulation, or a combination of all three. Overall, this suggests that due to their heterogeneous pathophysiology, CTTH patients should be managed according to their underlying pathophysiology and not with a one-size-fits-all approach.

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Case-Control Pilot Study of Soft Contact Lens Wearers With Corneal Infiltrative Events and Healthy Controls

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.15-18512 ◽

2016 ◽

Vol 57 (1) ◽

pp. 47 ◽

Cited By ~ 23

Author(s):

Kathryn Richdale ◽

Dawn Y. Lam ◽

Heidi Wagner ◽

Aaron B. Zimmerman ◽

Beth T. Kinoshita ◽

...

Keyword(s):

Pilot Study ◽

Contact Lens ◽

Case Control ◽

Healthy Controls ◽

Soft Contact ◽

Soft Contact Lens

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Monitoring Migraine Cycle Dynamics with an Easy-to-Use Electrophysiological Marker—A Pilot Study

Sensors ◽

10.3390/s18113918 ◽

2018 ◽

Vol 18 (11) ◽

pp. 3918 ◽

Cited By ~ 7

Author(s):

Goded Shahaf ◽

Pora Kuperman ◽

Yuval Bloch ◽

Shahak Yariv ◽

Yelena Granovsky

Keyword(s):

Pilot Study ◽

Stress Level ◽

Event Related Potentials ◽

Healthy Controls ◽

Preliminary Results ◽

Auditory Oddball ◽

Control Subjects ◽

Related Potentials ◽

Auditory Oddball Task ◽

The Brain

Migraine attacks can cause significant discomfort and reduced functioning for days at a time, including the pre-ictal and post-ictal periods. During the inter-ictsal period, however, migraineurs seem to function normally. It is puzzling, therefore, that event-related potentials of migraine patients often differ in the asymptomatic and inter-ictal period. Part of the electrophysiological dynamics demonstrated in the migraine cycle are attention related. In this pilot study we evaluated an easy-to-use new marker, the Brain Engagement Index (BEI), for attention monitoring during the migraine cycle. We sampled 12 migraine patients for 20 days within one calendar month. Each session consisted of subjects’ reports of stress level and migraine-related symptoms, and a 5 min EEG recording, with a 2-electrode EEG device, during an auditory oddball task. The first minute of the EEG sample was analyzed. Repetitive samples were also obtained from 10 healthy controls. The brain engagement index increased significantly during the pre-ictal (p ≈ 0.001) and the ictal (p ≈ 0.020) periods compared with the inter-ictal period. No difference was observed between the pre-ictal and ictal periods. Control subjects demonstrated intermediate Brain Engagement Index values, that is, higher than inter-ictal, yet lower than pre-ictal. Our preliminary results demonstrate the potential advantage of the use of a simple EEG system for improved prediction of migraine attacks. Further study is required to evaluate the efficacy of the Brain Engagement Index in monitoring the migraine cycle and the possible effects of interventions.

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