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Migraine Disorders: HELP
Articles by Angeliki Vgontzas
Based on 6 articles published since 2010
(Why 6 articles?)

Between 2010 and 2020, Angeliki Vgontzas wrote the following 6 articles about Migraine Disorders.
+ Citations + Abstracts
1 Review Episodic Migraine With and Without Aura: Key Differences and Implications for Pathophysiology, Management, and Assessing Risks. 2018

Vgontzas, Angeliki / Burch, Rebecca. ·Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, 1153 Centre St Suite 4H, Jamaica Plain, Boston, MA, 02130, USA. · Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, 1153 Centre St Suite 4H, Jamaica Plain, Boston, MA, 02130, USA. rburch@bwh.harvard.edu. ·Curr Pain Headache Rep · Pubmed #30291554.

ABSTRACT: PURPOSE OF REVIEW: To review the pathophysiologic, epidemiologic, and clinical evidence for similarities and differences between migraine with and without aura. RECENT FINDINGS: The ICHD-3 has recently refined the diagnostic criteria for aura to include positive symptomatology, which better differentiates aura from TIA. Although substantial evidence supports cortical spreading depression as the cause of visual aura, the role (if any) of CSD in headache pain is not well understood. Recent imaging evidence suggests a possible hypothalamic origin for a headache attack, but further research is needed. Migraine with aura is associated with a modest increase in the risk of ischemic stroke. The etiology for this association remains unclear. There is a paucity of evidence regarding treatments specifically aimed at the migraine with aura subtype, or whether migraine with vs without aura responds to treatment differently. Migraine with typical aura is therefore often treated similarly to migraine without aura. Lamotrigine, daily aspirin, and flunarizine have evidence for efficacy in prevention of migraine with aura, and magnesium, ketamine, furosemide, and single-pulse transcranial magnetic stimulation have evidence for use as acute treatments. Although triptans have traditionally been contraindicated in hemiplegic migraine and migraine with brainstem aura, this prohibition is being reconsidered in the face of evidence suggesting that use may be safe. The debate as to whether migraine with and without aura are different entities is ongoing. In an era of sophisticated imaging, genetic advancement, and ongoing clinical trials, efforts to answer this question are likely to yield important and clinically meaningful results.

2 Review Sleep Disorders and Migraine: Review of Literature and Potential Pathophysiology Mechanisms. 2018

Vgontzas, Angeliki / Pavlović, Jelena M. ·John R. Graham Headache Center, Department of Neurology, Brigham and Women's Faulkner Hospital, Harvard Medical School, Boston, MA, USA. · Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA. ·Headache · Pubmed #30091160.

ABSTRACT: Migraine shares a complex and poorly understood relationship with sleep. Patients consistently report poor sleep prior to migraine attacks and during them, identifying poor sleep as a migraine trigger. However, anecdotally, sleep is reported to serve a therapeutic role in terminating headache. Are the associations between migraine and sleep simply the result of various bidirectional relationships? A growing body of evidence suggests there may be a common underlying etiology as well. Our objective was to review studies of sleep and migraine from the last 2 decades utilizing validated subjective and objective measures of sleep and to explore potential mechanisms underlying this complex relationship by incorporating recent advances in neuroscience. We specifically focus on insomnia, obstructive sleep apnea, parasomnias, sleep related movement disorders, and REM sleep related disorders and their relationship to migraine. Parts of brainstem-cortical networks involved in sleep physiology are unintentionally being identified as important factors in the common migraine pathway. Recent discoveries on anatomic localization (the hypothalamus as a key and early mediator in the pathophysiology of migraine), common mediating signaling molecules (such as serotonin and dopamine), and the discovery of a new CNS waste removal system, the glymphatic system, all point to a common pathophysiology manifesting in migraine and sleep problems.

3 Article Associations between migraine attacks and nightly sleep characteristics among adults with episodic migraine: a prospective cohort study. 2020

Vgontzas, Angeliki / Li, Wenyuan / Mostofsky, Elizabeth / Rueschman, Michael / Mittleman, Murray A / Bertisch, Suzanne M. ·Department of Neurology, Brigham and Women's Hospital, Boston, MA. · Harvard Medical School, Boston, MA. · Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA. · Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA. · Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA. ·Sleep · Pubmed #31930318.

ABSTRACT: STUDY OBJECTIVES: Given the unknown immediate impact of migraine on nighttime sleep, we prospectively examined whether migraine headaches were associated with subsequent shorter sleep duration, higher fragmentation and poorer quality in a cohort of 98 adults with episodic migraine. METHODS: Participants completed twice-daily electronic diaries and wore actigraphs continuously for 6 weeks. We examined whether days with headaches were associated with changes in that night's sleep characteristics compared to non-headache days, using adjusted multivariable linear mixed models with subject-specific intercepts. RESULTS: Participants were 35 ± 12 years old, 88% women, with an average of five migraine headaches/month. Over 4406 days, we observed 1077 headache days, representing 823 discrete headaches. Average nightly objective sleep duration was 7.3 ± 1.2 hours, efficiency 89.5 ± 3.3% and wake after sleep onset (WASO) 44.8 ± 17.0 minutes. Objective sleep duration was 7.3 minutes (95% CI:1.5, 13.0) longer on nights following a headache day compared to nights on a headache-free day. Objective sleep efficiency, WASO, and reported sleep quality were not significantly different on headache days compared to headache-free days (sleep efficiency: -0.06 min. CONCLUSIONS: Sleep periods immediately following migraine headaches are not associated with shorter sleep duration, higher sleep disruption, or poorer sleep quality in patients with episodic migraine. These results suggest that clinical evaluation of sleep disturbance in patients with episodic migraine should be approached independently of their migraine status.

4 Article Migraine-associated gene expression in cell types of the central and peripheral nervous system. 2019

Vgontzas, Angeliki / Renthal, William. ·Department of Neurology, John R. Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. ·Cephalalgia · Pubmed #31660761.

ABSTRACT: BACKGROUND: Genome-wide association studies have implicated dozens of genes with migraine susceptibility, but it remains unclear in which nervous system cell types these genes are expressed. METHODS: Using single-cell RNA sequencing data from the central and peripheral nervous system, including the trigeminal ganglion, the expression of putative migraine-associated genes was compared across neuronal, glial and neurovascular cell types within these tissues. RESULTS: Fifty-four putative migraine-associated genes were expressed in the central nervous system, peripheral nervous system or neurovascular cell types analyzed. Six genes (11.1%) were selectively enriched in central nervous system cell types, three (5.5%) in neurovascular cell types, and two (3.7%) in peripheral nervous system cell types. The remaining genes were expressed in multiple cell types. CONCLUSIONS: Single-cell RNA sequencing of the brain and peripheral nervous system localizes each migraine-associated gene to its respective nervous system tissue and the cell types in which it is expressed. While the majority of migraine-associated genes are broadly expressed, we identified several cell-type-specific migraine-associated genes in the central nervous system, peripheral nervous system, and neurovasculature.

5 Article Online Migraine Education and Support for Patients: Perspectives from the American Headache Society Emerging Leaders Program. 2019

VanderPluym, Juliana H / Hamilton, Katherine / Hindiyeh, Nada A / Robbins, Matthew S / Starling, Amaal J / Vargas, Bert B / Gibbons, Sarah K / Vgontzas, Angeliki. ·Mayo Clinic, Scottsdale, AZ, USA. · University of Pennsylvania, Philadelphia, PA, USA. · Stanford University Medical Center, Palo Alto, CA, USA. · Weill Cornell Medical College, New York, NY, USA. · University of Texas Southwestern, Dallas, TX, USA. · Saint Luke's Health System, Kansas City, MO, USA. · Graham Headache Center, Brigham and Women's Hospital, Boston, MA, USA. ·Headache · Pubmed #31508808.

ABSTRACT: -- No abstract --

6 Article Papilledema in Idiopathic Intracranial Hypertension. 2018

Vgontzas, Angeliki / Prasad, Sashank / Burch, Rebecca C. ·Department of Neurology, Harvard Medical School, Brigham and Women's Faulkner Hospital, John R. Graham Headache Center, Boston, MA, USA. · Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. ·Headache · Pubmed #29399792.

ABSTRACT: -- No abstract --