P060. Vitamin D deficiency in episodic migraine, chronic migraine and medication-overuse headache patients

Introduction In a previous study exploring central pain modulation with heterotopic stimuli in healthy volunteers, we found that transitions between sustained noxious and innocuous thermal stimulations on the foot activated the “salience matrix”. Knowing that central sensory processing is abnormal in migraine, we searched in the present study for possible abnormalities of these salient transitional responses in different forms of migraine and at different time points of the migraine cycle. Methods Participants of both sexes, mostly females, took part in a conditioned pain modulation experiment: Migraineurs between (n = 14) and during attacks (n = 5), chronic migraine patients with medication overuse headache (n = 7) and healthy volunteers (n = 24). To evoke the salience response, continuous noxious cold or innocuous warm stimulations were alternatively applied on the right foot. Cerebral blood oxygenation level dependent responses were recorded with fMRI. Results Switching between the two stimulations caused a significant transition response in the “salience matrix” in all subject groups (effect of the condition). Moreover, some group effects appeared on subsequent post-hoc analyses. Augmented transitional blood oxygenation level dependent responses in the motor cortex and superior temporal sulcus were found in two patient groups compared to healthy controls: chronic migraine with medication overuse headache patients and migraineurs recorded during an attack. In chronic migraine with medication overuse headache patients, salience-related responses were moreover greater in the premotor cortex, supplementary motor area, lingual gyrus and dorso-medial prefrontal cortex and other “salience matrix” areas, such as the anterior cingulate and primary somatosensory cortices. Conclusion This study shows salience-related hyperactivation of affective and motor control areas in chronic migraine with medication overuse headache patients and, to a lesser extent, in episodic migraine patients during an attack. The greater extension of exaggerated blood oxygenation level dependent responses to unspecific salient stimuli in chronic migraine with medication overuse headache than during a migraine attack could be relevant for headache chronification.

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Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache

Cephalalgia ◽

10.1177/0333102413497600 ◽

2013 ◽

Vol 34 (1) ◽

pp. 37-41 ◽

Cited By ~ 5

Author(s):

Song Guo ◽

Sarvnaz Shalchian ◽

Pascale Gérard ◽

Michael Küper ◽

Zaza Katsarava ◽

...

Keyword(s):

Chronic Migraine ◽

Transcranial Doppler ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Episodic Migraine ◽

Severe Form ◽

Cross Sectional ◽

Headache Clinic ◽

Chronic Headaches ◽

Chronic Migraineurs

Background It was suggested that right-to-left shunt (RLS) may be highly prevalent in chronic migraine (CM) patients, indicating that patent foramen ovale (PFO) might be an aggravating and chronifying factor of migraine. Since a high proportion of chronic migraineurs also have medication-overuse headache (MOH), one may wonder if they have a more severe form of the disorder and more frequently a PFO. Objective The objective of this study is to determine the prevalence and grade of RLS in patients suffering from CM and MOH. Methods A cross-sectional multicenter study of air-contrast transcranial Doppler was conducted in 159 patients with CM ( n = 57) or MOH ( n = 102) attending a tertiary headache clinic. Results The prevalence of RLS in CM was 37% (11% large shunts) and in MOH patients 31% (13% large shunts). There was no difference between the two groups ( p = 0.49). Conclusion RLS prevalence in CM is within the upper range of those reported in episodic migraine without aura or in the general population, and not higher in MOH. PFO is thus unlikely to have a significant causal role in these chronic headaches.

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Analysis of Leukocytes in Medication-Overuse Headache, Chronic Migraine, and Episodic Migraine

Headache The Journal of Head and Face Pain ◽

10.1111/j.1526-4610.2011.01902.x ◽

2011 ◽

Vol 51 (8) ◽

pp. 1228-1238 ◽

Cited By ~ 8

Author(s):

Cassiano M. Forcelini ◽

Denise C. M. Dantas ◽

Clarice Luz ◽

Ricardo Santin ◽

Airton T. Stein ◽

...

Keyword(s):

Chronic Migraine ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Episodic Migraine

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Vitamin D, Chronic Migraine, and Extracranial Pain: Is There a Link? Data From an Observational Study

Frontiers in Neurology ◽

10.3389/fneur.2021.651750 ◽

2021 ◽

Vol 12 ◽

Author(s):

Valentina Rebecchi ◽

Daniela Gallo ◽

Lucia Princiotta Cariddi ◽

Eliana Piantanida ◽

Payam Tabaee Damavandi ◽

...

Keyword(s):

Vitamin D ◽

Chronic Migraine ◽

Medication Overuse ◽

Primary Headache ◽

Episodic Migraine ◽

Tension Type Headache ◽

Exact Test ◽

Pain Chronification ◽

Type Headache

Several studies focused on the role of vitamin D (vitD) in pain chronification. This study focused on vitD level and pain chronification and extension in headache disorders. Eighty patients with primary headache underwent neurological examination, laboratory exams, including serum calcifediol 25(OH)D, and headache features assessment along with three questionnaires investigating depression, anxiety, and allodynia. The 86.8% of the population had migraine (48% episodic and 52% chronic). The 44.1% of patients had extracranial pain, and 47.6% suffered from allodynia. A vitD deficit, namely a serum 25(OH)D level <20 ng/ml, was detectable in 46.1% of the patients, and it occurred more frequently (p = 0.009) in patients suffering from chronic migraine (CM)–medication overuse migraine (MOH) (62.9%) than in episodic migraine (EM, 25.7%) or tension-type headache (TTH, 11.4%). The occurrence of extracranial pain and allodynia was higher in the CM-MOH than in the EM and in the TTH groups but was not related to the co-occurrence of vitD deficiency (Fisher's exact test p = 0.11 and p = 0.32, respectively). Our findings show that 25(OH)D deficit is also related to chronic headache, probably because of vitD anti-inflammatory and tolerogenic properties, reinforcing the idea of a neuroinflammatory mechanism underpinning migraine chronification.

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Endocannabinoids in platelets of chronic migraine patients and medication-overuse headache patients: relation with serotonin levels

European Journal of Clinical Pharmacology ◽

10.1007/s00228-007-0391-4 ◽

2007 ◽

Vol 64 (1) ◽

pp. 1-8 ◽

Cited By ~ 43

Author(s):

Cristiana Rossi ◽

Luigi Alberto Pini ◽

Maria Letizia Cupini ◽

Paolo Calabresi ◽

Paola Sarchielli

Keyword(s):

Chronic Migraine ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Headache Patients

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Vitamin D, Chronic Migraine and Extracranial Pain: Is there a Link? Data from an Observational Study.

10.21203/rs.3.rs-97689/v1 ◽

2020 ◽

Author(s):

Valentina Rebecchi ◽

Daniela Gallo ◽

Lucia Princiotta Cariddi ◽

Eliana Piantanida ◽

Payam Tabaee Damavandi ◽

...

Keyword(s):

Vitamin D ◽

Chronic Migraine ◽

Medication Overuse ◽

Antinociceptive Effect ◽

Primary Headache ◽

Episodic Migraine ◽

Tension Type Headache ◽

Exact Test ◽

Type Headache

Abstract Background: Several studies focused on the possible role of vitamin D (vitD) in pain chronicization.. The aim of this study was to assess the potential implications of VitD deficit on headache characteristics and extracranial pain extension.Methods: Eighty consecutive patients with primary headache underwent neurological examination, laboratory exams including serum calcifediol 25(OH)D and headache features assessment along with three questionnaires investigating depression, anxiety and allodynia. Results: The 82.6% of the population had migraine (48% episodic and 52% chronic form). The 45% of patients had extracranial pain and 47% suffered from allodynia. In the 45% of patients had a VitD deficit since the serum 25(OH)D levels fell below the cut-off level of 20 ng/ml. The occurrence of VitD deficit was significantly higher (p=0.009) in patients suffering from chronic migraine (CM)- medication overuse migraine (MOH) (64.7%) than in episodic migraine (EM) or tension type headache (TTH). The occurrence of subjects with extracranial pain and allodynia was higher, as expected, in the CM-MOH than in the EM and in the TTH groups but was not related to the co-occurrence of vit-D deficiency (Fischer’s exact test p=0.11 and p=0.32 respectively).Conclusions: Our findings show that 25(OH)D deficit is related to chronic pain suggesting that vitD probably has anti-inflammatory and tolerogenic properties, rather than a direct antinociceptive effect, and reinforce the idea of a neuroinflammatory mechanisms underpinning migraine chronicization.

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Differences in Frontal Lobe Dysfunction in Patients with Episodic and Chronic Migraine

Journal of Clinical Medicine ◽

10.3390/jcm10132779 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2779

Author(s):

Sang-Hwa Lee ◽

Yeonkyeong Lee ◽

Minji Song ◽

Jae Jun Lee ◽

Jong-Hee Sohn

Keyword(s):

Chronic Migraine ◽

Frontal Lobe ◽

Iowa Gambling Task ◽

Medication Overuse Headache ◽

Wisconsin Card Sorting Test ◽

Episodic Migraine ◽

Frontal Lobe Dysfunction ◽

Card Sorting ◽

Cross Sectional ◽

Frontal Lobe Function

Neuroimaging and neuropsychological investigations have indicated that migraineurs exhibit frontal lobe-related cognitive impairment. We investigated whether orbitofrontal and dorsolateral functioning differed between individuals with episodic migraine (EM) and chronic migraine (CM), focusing on orbitofrontal dysfunction because it is implicated in migraine chronification and medication overuse headache (MOH) in migraineurs. This cross-sectional study recruited women with CM with/without MOH (CM + MOH, CM − MOH), EM, and control participants who were matched in terms of age and education. We conducted neuropsychological assessments of frontal lobe function via the Trail Making Test (TMT) A and B, the Wisconsin Card Sorting Test (WCST), and the Iowa Gambling Task (IGT). We enrolled 36 CM (19 CM + MOH, 17 CM–MOH), 30 EM, and 30 control participants. The CM patients performed significantly (p < 0.01) worse on the TMT A and B than the EM patients and the control participants. The WCST also revealed significant differences, with poorer performance in the CM patients versus the EM patients and the control participants. However, the net scores on the IGT did not significantly differ among the three groups. Our findings suggest that the CM patients exhibited frontal lobe dysfunction, and, particularly, dorsolateral dysfunction. However, we found no differences in frontal lobe function according to the presence or absence of MOH.

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Headache characteristics and burden from chronic migraine with medication overuse headache: Cross‐sectional observations from the Medication Overuse Treatment Strategy trial

Headache The Journal of Head and Face Pain ◽

10.1111/head.14056 ◽

2021 ◽

Author(s):

Todd J. Schwedt ◽

Joseph G. Hentz ◽

Soma Sahai‐Srivastava ◽

Nicole M. Spare ◽

Vincent T. Martin ◽

...

Keyword(s):

Chronic Migraine ◽

Treatment Strategy ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Cross Sectional

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Proteomic analysis of urine in medication-overuse headache patients: possible relation with renal damages

The Journal of Headache and Pain ◽

10.1007/s10194-011-0390-9 ◽

2011 ◽

Vol 13 (1) ◽

pp. 45-52 ◽

Cited By ~ 9

Author(s):

Elisa Bellei ◽

Aurora Cuoghi ◽

Emanuela Monari ◽

Stefania Bergamini ◽

Luca Isaia Fantoni ◽

...

Keyword(s):

Proteomic Analysis ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Headache Patients ◽

Analysis Of Urine

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An underrepresented majority: A systematic review utilizing allodynic criteria to examine the present scarcity of discrete animal models for episodic migraine

Cephalalgia ◽

10.1177/0333102420966984 ◽

2020 ◽

pp. 033310242096698

Author(s):

Aidan Levine ◽

Todd W Vanderah ◽

Tally M Largent-Milnes

Keyword(s):

Animal Models ◽

Chronic Migraine ◽

Medication Overuse ◽

Episodic Migraine ◽

Non Invasive ◽

The Past ◽

Inflammatory Soup ◽

Distinct Disease ◽

Post Traumatic ◽

Episodic Migraineurs

Background Despite increasing evidence differentiating episodic and chronic migraine, little work has determined how currently utilized animal models of migraine best represent each distinct disease state. Aim In this review, we seek to characterize accepted preclinical models of migraine-like headache by their ability to recapitulate the clinical allodynic features of either episodic or chronic migraine. Methods From a search of the Pu bMed database for “animal models of migraine”, “headache models” and “preclinical migraine”, we identified approximately 80 recent (within the past 20 years) publications that utilized one of 10 different models for migraine research. Models reviewed fit into one of the following categories: Dural KCl application, direct electrical stimulation, nitroglycerin administration, inflammatory soup injection, CGRP injection, medication overuse, monogenic animals, post-traumatic headache, specific channel activation, and hormone manipulation. Recapitulation of clinical features including cephalic and extracephalic hypersensitivity were evaluated for each and compared. Discussion Episodic migraineurs comprise over half of the migraine population, yet the vast majority of current animal models of migraine appear to best represent chronic migraine states. While some of these models can be modified to reflect episodic migraine, there remains a need for non-invasive, validated models of episodic migraine to enhance the clinical translation of migraine research.

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