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Migraine Disorders: HELP
Articles from Austria
Based on 74 articles published since 2008
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These are the 74 published articles about Migraine Disorders that originated from Austria during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Migraine and cluster headache - the common link. 2018

Vollesen, Anne Luise / Benemei, Silvia / Cortese, Francesca / Labastida-Ramírez, Alejandro / Marchese, Francesca / Pellesi, Lanfranco / Romoli, Michele / Ashina, Messoud / Lampl, Christian / Anonymous5040974. ·Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. · Health Sciences Department, University of Florence and Headache Centre, Careggi University Hospital, Florence, Italy. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza, University of Rome, Polo Pontino, Latina, Italy. · Dep Internal Medicine, Division of Vascular Pharmacology, Erasmus Medical Center, Rotterdam, The Netherlands. · Child Neuropsichiatry Unit, University of Palermo, Palermo, Italy. · Medical Toxicology, Headache and Drug Abuse Center, University of Modena and Reggio Emilia, Modena, Italy. · Neurology Clinic, University of Perugia - S.M. Misericordiae Hospital, Perugia, Italy. · Department of Neurogeriatric Medicine, Headache Medical Center Linz, Ordensklinikum Linz Barmherzige Schwestern, Seilerstaette 4, 4010, Linz, Austria. christian.lampl@ordensklinikum.at. ·J Headache Pain · Pubmed #30242519.

ABSTRACT: Although clinically distinguishable, migraine and cluster headache share prominent features such as unilateral pain, common pharmacological triggers such glyceryl trinitrate, histamine, calcitonin gene-related peptide (CGRP) and response to triptans and neuromodulation. Recent data also suggest efficacy of anti CGRP monoclonal antibodies in both migraine and cluster headache. While exact mechanisms behind both disorders remain to be fully understood, the trigeminovascular system represents one possible common pathophysiological pathway and network of both disorders. Here, we review past and current literature shedding light on similarities and differences in phenotype, heritability, pathophysiology, imaging findings and treatment options of migraine and cluster headache. A continued focus on their shared pathophysiological pathways may be important in paving future treatment avenues that could benefit both migraine and cluster headache patients.

2 Review Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH). 2018

Sacco, Simona / Merki-Feld, Gabriele S / Ægidius, Karen Lehrmann / Bitzer, Johannes / Canonico, Marianne / Gantenbein, Andreas R / Kurth, Tobias / Lampl, Christian / Lidegaard, Øjvind / Anne MacGregor, E / MaassenVanDenBrink, Antoinette / Mitsikostas, Dimos-Dimitrios / Nappi, Rossella Elena / Ntaios, George / Paemeleire, Koen / Sandset, Per Morten / Terwindt, Gisela Marie / Vetvik, Kjersti Grøtta / Martelletti, Paolo / Anonymous32610960. ·Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy. simona.sacco@univaq.it. · Clinic for Reproductive Endocrinology, Department of Gynecology, University Hospital, Zürich, Switzerland. · Department of Neurology, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark. · Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland. · Université Paris-Saclay, University Paris-Sud, UVSQ, CESP, Inserm UMRS1018, Paris, France. · Neurology & Neurorehabilitation, RehaClinic, Bad Zurzach, University of Zurich, Zürich, Switzerland. · Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Headache Medical Center Seilerstaette Linz, Linz, Austria. · Department of Geriatric Medicine Ordensklinikum Linz, Linz, Austria. · Department of Obstetrics & Gynaecology, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. · Centre for Neuroscience & Trauma, BICMS, Barts and the London School of Medicine and Dentistry, London, UK. · Barts Health NHS Trust, London, UK. · Erasmus Medical Center Rotterdam, Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Rotterdam, The Netherlands. · Department of Neurology, University of Athens, Athens, Greece. · Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. · University Consortium for Adaptive Disorders and Head Pain (UCADH), University of Pavia, Pavia, Italy. · Department of Medicine, University of Thessaly, Larissa, Greece. · Department of Neurology, Ghent University Hospital, Ghent, Belgium. · University Hospital Rikshospitalet, University of Oslo, Oslo, Norway. · Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands. · Department of Neurology, Akershus University Hospital, Lørenskog, Norway. · Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. ·J Headache Pain · Pubmed #30171365.

ABSTRACT: We systematically reviewed data about the effect of exogenous estrogens and progestogens on the course of migraine during reproductive age. Thereafter a consensus procedure among international experts was undertaken to develop statements to support clinical decision making, in terms of possible effects on migraine course of exogenous estrogens and progestogens and on possible treatment of headache associated with the use or with the withdrawal of hormones. Overall, quality of current evidence is low. Recommendations are provided for all the compounds with available evidence including the conventional 21/7 combined hormonal contraception, the desogestrel only oral pill, combined oral contraceptives with shortened pill-free interval, combined oral contraceptives with estradiol supplementation during the pill-free interval, extended regimen of combined hormonal contraceptive with pill or patch, combined hormonal contraceptive vaginal ring, transdermal estradiol supplementation with gel, transdermal estradiol supplementation with patch, subcutaneous estrogen implant with cyclical oral progestogen. As the quality of available data is poor, further research is needed on this topic to improve the knowledge about the use of estrogens and progestogens in women with migraine. There is a need for better management of headaches related to the use of hormones or their withdrawal.

3 Review Headache in mitochondrial disorders. 2018

Finsterer, Josef / Zarrouk-Mahjoub, Sinda. ·Krankenanstalt Rudolfstiftung, Vienna, Austria. Electronic address: fifigs1@yahoo.de. · University of Tunis El Manar and Genomics Platform, Pasteur Institute of Tunis, Tunisia. ·Clin Neurol Neurosurg · Pubmed #29408771.

ABSTRACT: Headache is a prominent feature in mitochondrial disorders (MIDs) but no comprehensive overview is currently available. This review aims at summarising and discussing findings concerning type, frequency, pathogenesis, and treatment of headache in MIDs. The most frequent headache types in MIDs are migraine and migraine-like headache (MLH). MLH is classified as secondary headache. More rarely, tension-type headache, trigemino-autonomic headache, or different secondary headaches can be found. Migraine or MLH may manifest with or without aura. MLH is frequently associated with an ongoing or previous stroke-like episode (SLE) or a seizure but may also occur independently of other neurological features. MLH may be associated with prolonged aura or visual phenomena after headache. Except for MLH, treatment of headache in MIDs is not at variance from other causes of headache. Beyond the broadly accepted subtype-related headache treatment, diet, cofactors, vitamins, and antioxidants may provide a supplementary benefit. Midazolam, l-arginine, or l-citrulline may be beneficial for MLH. The pathogenesis of headache in MIDs largely remains unsolved. However, since migraine and MLH respond both to triptanes, a shared pathomechanism is likely. In conclusion, migraine and MLH are the prominent headache types in MIDs. MLH may or may not be associated with current or previous SLEs. MLH is pathophysiologically different from migraine and requires treatment at variance from that of migraine with aura.

4 Review Triptans and CGRP blockade - impact on the cranial vasculature. 2017

Benemei, Silvia / Cortese, Francesca / Labastida-Ramírez, Alejandro / Marchese, Francesca / Pellesi, Lanfranco / Romoli, Michele / Vollesen, Anne Luise / Lampl, Christian / Ashina, Messoud / Anonymous10660923. ·Health Sciences Department, University of Florence, and Headache Centre, Careggi University Hospital, Viale Pieraccini 6, 50134, Florence, Italy. silvia.benemei@unifi.it. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Latina, Italy. · Dept Internal Medicine, Division of Vascular Pharmacology, Erasmus Medical Center, Rotterdam, The Netherlands. · Child Neuropsichiatry Unit, University of Palermo, Palermo, Italy. · Medical Toxicology Headache and Drug Abuse Center, University of Modena and Reggio Emilia, Modena, Italy. · Neurology Clinic, University Hospital of Perugia, Perugia, Italy. · Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medicl Sciences, University of Copenhagen, Copenhagen, Denmark. · Department of Neurogeriatric Medicine, Headache Medical Center Linz, Linz, Austria. · Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. ·J Headache Pain · Pubmed #29019093.

ABSTRACT: The trigeminovascular system plays a key role in the pathophysiology of migraine. The activation of the trigeminovascular system causes release of various neurotransmitters and neuropeptides, including serotonin and calcitonin gene-related peptide (CGRP), which modulate pain transmission and vascular tone. Thirty years after discovery of agonists for serotonin 5-HT

5 Review Adipokines and Migraine: A Systematic Review. 2016

Peterlin, B Lee / Sacco, Simona / Bernecker, Claudia / Scher, Ann I. ·Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA. · University of L'Aquila, Department of Applied Clinical Sciences and Biotechnology, Institute of Neurology, L'Aquila, Italy. · Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria. · Medical University of Graz, Department of Blood Group Serology and Transfusion Medicine, Graz, Austria. · Uniformed Services University, Bethesda, MD, USA. ·Headache · Pubmed #27012149.

ABSTRACT: BACKGROUND: Migraine is comorbid with obesity. Recent research suggests an association between migraine and adipocytokines, proteins that are predominantly secreted from adipose tissue and which participate in energy homeostasis and inflammatory processes. OBJECTIVES: In this review, we first briefly discuss the association between migraine and obesity and the importance of adipose tissue as a neuroendocrine organ. We then present a systematic review of the extant literature evaluating circulating levels of adiponectin and leptin in those with migraine. METHODS: A search of the PubMed database was conducted using the keywords "migraine," "adiponectin," and "leptin." In addition reference lists of relevant articles were reviewed for possible inclusion. English language studies published between 2005 and 2015 evaluating circulating blood concentration of adiponectin or leptin in those with migraine were included. CONCLUSIONS: While the existing data are suggestive that adipokines may be associated with migraine, substantial study design differences and conflicting results limit definitive conclusions. Future research utilizing carefully considered designs and methodology is warranted. In particular careful and systematic characterization of pain states at the time of samples, as well as systematic consideration of demographic (e.g., age, sex) and other vital covariates (e.g., obesity status, lipids) are needed to determine if adipokines play a role in migraine pathophysiology and if any adipokine represents a viable, novel migraine biomarker, or drug target.

6 Review Epidemiology of migraine and headache in children and adolescents. 2013

Wöber-Bingöl, Ciçek. ·Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. yasar.woeber-bingoel@meduniwien.ac.at ·Curr Pain Headache Rep · Pubmed #23700075.

ABSTRACT: Migraine and headache are global disabling conditions causing considerable individual suffering and impaired quality of life in adults as well as in children and adolescents. Therefore, epidemiological studies are essential to assess the scope of the problem. This review covers epidemiological studies on migraine and headache in children and adolescents published in the past 25 years. A total of 64 cross-sectional studies have been identified, published in 32 different countries and including a total of 227,249 subjects. The estimated overall mean prevalence of headache was 54.4% (95% CI 43.1-65.8) and the overall mean prevalence of migraine was 9.1% (95% CI 7.1-11.1). There is a lack of population-based studies from low and low-middle income countries. In addition, there is very little information about the prevalence of probable migraine and chronic migraine and no information about menstrual migraine in the young.

7 Review Pharmacological treatment of acute migraine in adolescents and children. 2013

Wöber-Bingöl, Çiçek. ·Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. yasar.woeber-bingoel@meduniwien.ac.at ·Paediatr Drugs · Pubmed #23575981.

ABSTRACT: Migraine is a common disease in children and adolescents. The incidence of migraine has increased alarmingly in the general population during recent decades. Migraine causes considerable individual suffering and impaired quality of life. Therefore, appropriate management is essential. In this article, the treatment of acute migraine in children and adolescents will be reviewed. Only a few randomized controlled studies have been published and high placebo rates are a major problem for proving superiority of active drugs. Generally, acetaminophen (paracetamol) and ibuprofen are accepted as drugs of first choice, even though the evidence is poor for the former and limited for latter. Among 14 studies on triptans in adolescents, 9 showed some superiority over placebo with respect to pain relief and pain freedom, and among 6 studies in children, 5 suggest some superiority over placebo. Sumatriptan nasal spray and zolmitriptan nasal spray have been approved for adolescents in Europe; almotriptan has been approved for adolescents in the USA, as has rizatriptan for patients aged 6-17 years. A recent study demonstrated the efficacy of a fixed combination of sumatriptan and naproxen in adolescents with migraine. In conclusion, evidence for the pharmacological treatment of acute migraine in children is very poor and evidence for adolescents is better but still limited.

8 Review [Migraine - diagnostic features, acute therapy and prophylactics]. 2011

Lampl, Christian. ·Konventhospital Barmherzige Brüder Linz, Österreich. christian.lampl@bblinz.at ·Ther Umsch · Pubmed #21882146.

ABSTRACT: Migraine is a chronic. disabling, biologically determined, inherited brain disorder rendering life much less tolerable. The International Headache Society (IHS) offers guidelines for the classification and diagnosis of migraine headaches, in a document called 'The International Classification of Headache Disorders, 2nd edition' (ICHD-2). Migraine affects 10-16% of the population world-wide. For the 20-30% of migraine sufferers who experience migraine with aura, this aura comprises focal neurological phenomena that precede or accompany the attack. There are three main aspects of treatment: trigger avoidance, acute symptomatic control, and pharmacological prevention. Acute medications are more effective if used earlier in an attack. The goals of preventive therapy are to reduce the frequency, painfulness, and/or duration of migraines, and to increase quality of life.

9 Review Sex hormones and primary headaches other than migraine. 2011

Lieba-Samal, Doris / Wöber, Christian. ·Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. ·Curr Pain Headache Rep · Pubmed #21573925.

ABSTRACT: The relation between sex hormones and migraine has been examined in a series of studies, leading to the definitions of pure menstrual migraine and menstrually-related migraine. The relation between sex hormones and other types of primary headache has been studied less extensively, but there is at least some evidence that hormones in general, and menstruation, pregnancy, or menopause in particular, also impact these disorders. This article reviews the available literature on changes of tension-type headache, cluster headache, other trigeminal autonomic cephalalgias, and hemicrania continua during women's reproductive periods.

10 Clinical Trial Early onset of efficacy with erenumab in patients with episodic and chronic migraine. 2018

Schwedt, Todd / Reuter, Uwe / Tepper, Stewart / Ashina, Messoud / Kudrow, David / Broessner, Gregor / Boudreau, Guy P / McAllister, Peter / Vu, Thuy / Zhang, Feng / Cheng, Sunfa / Picard, Hernan / Wen, Shihua / Kahn, Joseph / Klatt, Jan / Mikol, Daniel. ·Department of Neurology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA. Schwedt.Todd@mayo.edu. · Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany. · Geisel School of Medicine at Dartmouth, Hanover, NH, USA. · Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark. · California Medical Clinic for Headache, Santa Monica, CA, USA. · Department of Neurology, Headache Outpatient Clinic, Medical University of Innsbruck, Innsbruck, Austria. · Clinique de la Migraine et Céphalées, Département de Neurologie, Centre Hospitalier de L'Université de Montréal, Hôpital Notre-Dame, Montréal, QC, Canada. · New England Institute for Neurology & Headache, Stamford, CT, USA. · Amgen Inc., Thousand Oaks, CA, USA. · Novartis Pharmaceuticals Corp., East Hanover, NJ, USA. · Novartis Pharma AG, Basel, Switzerland. ·J Headache Pain · Pubmed #30276500.

ABSTRACT: BACKGROUND: Subcutaneous erenumab reduced monthly migraine days and increased the likelihood of achieving a ≥ 50% reduction at all monthly assessment points tested in 2 pivotal trials in episodic migraine (EM) and chronic migraine (CM). Early efficacy of migraine preventive medications is an important treatment characteristic to patients. Delays in achievement of efficacy can result in failed adherence. The objective of these post-hoc analyses were to evaluate efficacy in the first 4 weeks after initial subcutaneous administration of erenumab 70 mg, erenumab 140 mg, or placebo. METHODS: There is no generally accepted methodology to measure onset of action for migraine preventive medications. We used a comprehensive approach with data from both studies to evaluate change from baseline in weekly migraine days (WMD), achievement of ≥ 50% reduction in WMD, and proportion of patients experiencing migraine measured on a daily basis. The 7-day moving averages were overlaid with observed data. RESULTS: In both studies (EM: N = 955; CM: N = 667), there was evidence of onset of efficacy of erenumab vs. placebo during the first week of treatment, which in some cases reached nominal significance. For EM the changes in WMD were (least squares mean [LSM] [95% CI]): placebo, - 0.1 (- 0.3, 0.0); erenumab 70 mg, - 0.3 (- 0.5, - 0.2) p = 0.130; erenumab 140 mg, - 0.6 (- 0.7, - 0.4) p < 0.001. For CM the changes were: placebo, - 0.5 (- 0.8, - 0.3); erenumab 70 mg, - 0.9 (- 1.2, - 0.7) p = 0.047; erenumab 140 mg, - 0.8 (- 1.1, - 0.5) p = 0.18. Achievement of ≥ 50% reduction in WMD was observed as early as Week 1 (adjusted OR [95% CI] erenumab vs placebo) in EM: erenumab 70 mg, 1.3 (1.0, 1.9) p = 0.097; erenumab 140 mg, 2.0 (1.4, 2.7) p < 0.001. A similar outcome was observed for CM: erenumab 70 mg, 1.8 (1.1, 2.8) p = 0.011; erenumab 140 mg, 1.9 (1.2, 2.9) p = 0.009. Seven-day moving averages of observed data showed each treatment arm differed from placebo by Week 1 (OR [95% CI]): in EM Day 3 for erenumab 140 mg, 0.7 (0.5, 1.0) p = 0.031 and at Day 7 for 70 mg, 0.6 (0.4, 0.8) p = 0.002; in CM: Day 6 for erenumab 70 mg, 0.6 (0.4, 0.9) p = 0.022 and at Day 7 for 140 mg, 0.7 (0.4, 1.0); p = 0.038. CONCLUSION: Erenumab showed early onset of efficacy with separation from placebo within the first week of treatment in both chronic and episodic migraine patients.

11 Clinical Trial A Controlled Trial of Erenumab for Episodic Migraine. 2017

Goadsby, Peter J / Reuter, Uwe / Hallström, Yngve / Broessner, Gregor / Bonner, Jo H / Zhang, Feng / Sapra, Sandhya / Picard, Hernan / Mikol, Daniel D / Lenz, Robert A. ·From the National Institute for Health Research-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London (P.J.G.) · the Department of Neurology, Charité Universitätsmedizin Berlin, Berlin (U.R.) · the Neuro Center, St. Göran Hospital, Stockholm (Y.H.) · the Department of Neurology, Headache Outpatient Clinic, Medical University of Innsbruck, Innsbruck, Austria (G.B.) · Mercy Research, St. Louis (J.H.B.) · and the Departments of Global Biostatistical Science (F.Z.), Global Health Economics (S.S.), and Global Development (H.P., D.D.M., R.A.L.), Amgen, Thousand Oaks, CA. ·N Engl J Med · Pubmed #29171821.

ABSTRACT: BACKGROUND: We tested erenumab, a fully human monoclonal antibody that inhibits the calcitonin gene-related peptide receptor, for the prevention of episodic migraine. METHODS: We randomly assigned patients to receive a subcutaneous injection of either erenumab, at a dose of 70 mg or 140 mg, or placebo monthly for 6 months. The primary end point was the change from baseline to months 4 through 6 in the mean number of migraine days per month. Secondary end points were a 50% or greater reduction in mean migraine days per month, change in the number of days of use of acute migraine-specific medication, and change in scores on the physical-impairment and everyday-activities domains of the Migraine Physical Function Impact Diary (scale transformed to 0 to 100, with higher scores representing greater migraine burden on functioning). RESULTS: A total of 955 patients underwent randomization: 317 were assigned to the 70-mg erenumab group, 319 to the 140-mg erenumab group, and 319 to the placebo group. The mean number of migraine days per month at baseline was 8.3 in the overall population; by months 4 through 6, the number of days was reduced by 3.2 in the 70-mg erenumab group and by 3.7 in the 140-mg erenumab group, as compared with 1.8 days in the placebo group (P<0.001 for each dose vs. placebo). A 50% or greater reduction in the mean number of migraine days per month was achieved for 43.3% of patients in the 70-mg erenumab group and 50.0% of patients in the 140-mg erenumab group, as compared with 26.6% in the placebo group (P<0.001 for each dose vs. placebo), and the number of days of use of acute migraine-specific medication was reduced by 1.1 days in the 70-mg erenumab group and by 1.6 days in the 140-mg erenumab group, as compared with 0.2 days in the placebo group (P<0.001 for each dose vs. placebo). Physical-impairment scores improved by 4.2 and 4.8 points in the 70-mg and 140-mg erenumab groups, respectively, as compared with 2.4 points in the placebo group (P<0.001 for each dose vs. placebo), and everyday-activities scores improved by 5.5 and 5.9 points in the 70-mg and 140-mg erenumab groups, respectively, as compared with 3.3 points in the placebo group (P<0.001 for each dose vs. placebo). The rates of adverse events were similar between erenumab and placebo. CONCLUSIONS: Erenumab administered subcutaneously at a monthly dose of 70 mg or 140 mg significantly reduced migraine frequency, the effects of migraines on daily activities, and the use of acute migraine-specific medication over a period of 6 months. The long-term safety and durability of the effect of erenumab require further study. (Funded by Amgen and Novartis; STRIVE ClinicalTrials.gov number, NCT02456740 .).

12 Article Use and overuse of triptans in Austria - a survey based on nationwide healthcare claims data. 2018

Zebenholzer, Karin / Gall, Walter / Wöber, Christian. ·Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. karin.zebenholzer@meduniwien.ac.at. · Center for Medical Statistics, Informatics and Intelligent Systems, Institute of Medical Information Management, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. · Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. ·J Headache Pain · Pubmed #29777424.

ABSTRACT: BACKGROUND: To evaluate triptan use and overuse as well as prescription patterns in Austria based on a nationwide healthcare database because data on triptan use and overuse in Austria is missing. METHODS: We included all persons insured with one of 19 Austrian social security institutions in 2007. Inclusion criteria comprised an age of 18-99 years, known sex, and receipt of insurance benefits. We defined triptan use as ≥1 package of a triptan dispensed in 2007 and triptan overuse as ≥30 defined daily doses dispensed in at least one quarter. RESULTS: Out of 8.295 million inhabitants in Austria, 7,426,412 persons (89.5%) were insured with a social insurance carrier and 5,918,487 persons of those insured (79.7%) fulfilled the inclusion criteria. Among the latter 33,062 persons (0,56%) were triptan users and 1970 (0.033%) were triptan overusers. The estimated proportion of persons with migraine using a triptan was less than 6%. Among users 5.9% were overusers of whom 55% overused triptans in ≥2 quarters of 2007. The median number of days of sick-leave was higher in triptan users than in non-users: due to any reason of sick-leave 12 vs. 10, p < 0.001, due to migraine 3 vs. 2, p < 0.001. The proportion of hospital admissions did not differ between triptan users and non-users. CONCLUSION: The rate of triptan use is low in Austria but triptan users are at risk for triptan overuse. In triptan users more days of sick-leave and the same proportion of hospital admissions as in the older non-users suggest poorer health.

13 Article A dual mechanism promotes switching of the Stormorken STIM1 R304W mutant into the activated state. 2018

Fahrner, Marc / Stadlbauer, Michael / Muik, Martin / Rathner, Petr / Stathopulos, Peter / Ikura, Mitsu / Müller, Norbert / Romanin, Christoph. ·Institute of Biophysics, Johannes Kepler University Linz, Gruberstrasse 40, 4020, Linz, Austria. marc.fahrner@jku.at. · Institute of Biophysics, Johannes Kepler University Linz, Gruberstrasse 40, 4020, Linz, Austria. · Institute of Organic Chemistry, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria. · Department of Physiology and Pharmacology, University of Western Ontario, London, ON N6A 5C1, Canada. · Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G 1L7, Canada. · Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada. · Faculty of Science, University of South Bohemia, Branišovská 1645/31A, 370 05, České Budějovice, Czech Republic. · Institute of Biophysics, Johannes Kepler University Linz, Gruberstrasse 40, 4020, Linz, Austria. christoph.romanin@jku.at. ·Nat Commun · Pubmed #29483506.

ABSTRACT: STIM1 and Orai1 are key components of the Ca

14 Article Poor medical care for people with migraine in Europe - evidence from the Eurolight study. 2018

Katsarava, Zaza / Mania, Maka / Lampl, Christian / Herberhold, Johanna / Steiner, Timothy J. ·Evangelical Hospital Unna, University of Duisburg-Essen, Essen, Germany. Zaza.katsarava@gmail.com. · Aversi Hospital, Tbilisi, Georgia. · Headache Medical Center, Department of Neurogeriatric Medicine and Remobilisation, Hospital of the Sisters of Charity, Linz, Austria. · Medical Faculty, Stradins University, Riga, Latvia. · Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway. · Division of Brain Sciences, Imperial College London, London, UK. ·J Headache Pain · Pubmed #29392600.

ABSTRACT: BACKGROUND: Migraine is prevalent everywhere, and disabling. It is also neglected: consequently, it is under-diagnosed and undertreated. We analysed data from the Eurolight study on consultations and utilization of migraine-specific medications as indicators of adequacy of medical care in Europe. METHODS: Eurolight was a cross-sectional questionnaire-based survey in 10 European countries. Sampling was population-based in six (Germany, Italy, Lithuania, Luxembourg, Netherlands, Spain) and from consecutive patients attending general practitioners (GPs) for any reason in three (Austria, France, UK). Additional samples in Netherlands and Spain, and the only sample from Ireland, were recruited by lay headache organisations. We recorded migraine prevalence and frequency, and utilization of medical services and medications (acute and preventative). RESULTS: Among 9247 participants (mean age 43.9 ± 13.9 years, M/F ratio 1:1.4), 3466 (37.6%) were diagnosed with migraine (definite or probable). Of these, 1175 (33.8%) reported frequent migraine (> 5 days/month) and might clearly expect benefit from, and therefore had need of, preventative medication. In population-based samples, minorities of participants with migraine had seen a GP (9.5-18.0%) or specialist (3.1-15.0%), and smaller minorities received adequate treatment: triptans 3.4-11.0%, with Spain outlying at 22.4%; preventative medication (1.6-6.4% of those eligible, with Spain again outlying at 13.7%). Proportions were greater in GP-based samples (13.6-24.5% using triptans, 4.4-9.1% on preventative medication) and among those from lay organisations (46.2-68.2% and 16.0-41.7%). Participants with migraine who had consulted specialists (3.1-33.8%) were receiving the best care by these indicators; those treated by GPs (9.5-29.6%) fared less well, and those dependent on self-medication (48.0-84.2%) were, apparently, inadequately treated. CONCLUSION: In wealthy European countries, too few people with migraine consult physicians, with proportionately too many of these seeing specialists, and migraine-specific medications are used inadequately even among those who do. These findings represent yet another call for action in Europe to improve care for people with headache. Education of both health-care providers and the public should be central to this action.

15 Article Effect of a calcitonin gene-related peptide-binding L-RNA aptamer on neuronal activity in the rat spinal trigeminal nucleus. 2018

Fischer, Michael J M / Schmidt, Jakob / Koulchitsky, Stanislav / Klussmann, Sven / Vater, Axel / Messlinger, Karl. ·Institute of Physiology and Pathophysiology, University of Erlangen-Nürnberg, Universitätstrasse 17, D-91054, Erlangen, Germany. · Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria. · Department of Pharmacology, University of Liège, Liège, Belgium. · Aptarion Biotech, Berlin, Germany. · Institute of Physiology and Pathophysiology, University of Erlangen-Nürnberg, Universitätstrasse 17, D-91054, Erlangen, Germany. karl.messlinger@fau.de. ·J Headache Pain · Pubmed #29335794.

ABSTRACT: BACKGROUND: Calcitonin gene-related peptide (CGRP) plays a major role in the pathogenesis of migraine and other primary headaches. Spinal trigeminal neurons integrate nociceptive afferent input from trigeminal tissues including intracranial afferents, and their activity is thought to reflect facial pain and headache in man. CGRP receptor inhibitors and anti-CGRP antibodies have been demonstrated to be therapeutically effective in migraine. In parallel, CGRP receptor inhibition has been shown to lower spinal trigeminal neuron activity in animal models of meningeal nociception. METHODS: In a rat model of meningeal nociception, single cell activity of neurons in the spinal trigeminal nucleus with meningeal afferent input was recorded to test a further pharmacological approach, scavenging CGRP with a CGRP-binding L-RNA oligonucleotide, the L-aptamer NOX-C89. Cumulative ascending doses of NOX-C89 were intravenously infused. RESULTS: Spontaneous activity of spinal trigeminal neurons did not change after 0.05 mg/kg NOX-C89, however, after additional infusion of 0.5 mg/kg and 5 mg/kg NOX-C89, spontaneous activity was dose-dependently reduced. Identical doses of a control L-aptamer had no effect. This pharmacological effect of NOX-C89 was observed 10-25 min after infusion, but no difference was detected in the period 0-5 min. For comparison, the previously investigated CGRP receptor antagonist olcegepant had reduced activity within 5 min after infusion. Alongside the reduced spontaneous activity, after infusion of NOX-C89 the heat-induced neuronal activity was abolished. CONCLUSIONS: Scavenging CGRP by mirror-image RNA aptamers provides further evidence that this approach can be used to control spinal trigeminal activity.

16 Article Magnesium in Migraine Prophylaxis-Is There an Evidence-Based Rationale? A Systematic Review. 2018

von Luckner, Alexander / Riederer, Franz. ·Department of Neurology, University Hospital Zurich, Switzerland. · Faculty of Medicine, University of Zurich, Switzerland. · Neurological Center Rosenhuegel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria. ·Headache · Pubmed #29131326.

ABSTRACT: OBJECTIVE: The primary objective was to systematically evaluate the existing evidence base on magnesium in migraine prophylaxis. METHODS: The search for clinical trials published from 1990 to 2016 was separately conducted by AvL and FR using standard search terms as well as MeSh terms on PubMed and EMBASE. Randomized, double-blind, placebo-controlled trials investigating prophylactic magnesium administration in migraineurs aged 18-65 were considered eligible. In a mutual effort, the studies found were sorted and analyzed under consideration of the guidelines for controlled trials for drugs in migraine by the International Headache Society and using predefined eligibility criteria. The resulting clinical trials were jointly analyzed by FR and AvL applying the evidence classification scheme by the American Academy of Neurology and the Cochrane bias tool to assess the evidence-base. In accordance with the guidelines for controlled trials, the number of migraine days and number of migraine attacks were chosen as primary efficacy parameters. The present review was not registered. RESULTS: Out of 204 search results, five clinical trials fulfilling the selection procedure were found. One out of two Class I evidence trials showed a significant reduction of the number of migraine attacks compared with placebo, while two out of three Class III trials evinced a statistically significant reduction of the primary efficacy parameters compared with placebo. CONCLUSION: This systematic review provides Grade C (possibly effective) evidence for prevention of migraine with magnesium. Prophylactic treatment of migraine by means of high levels of magnesium dicitrate (600 mg) seems to be a safe and cost efficient strategy in clinical use.

17 Article Ten years of follow-up in a large family with familial hemiplegic migraine type 1: Clinical course and implications for treatment. 2018

Indelicato, Elisabetta / Nachbauer, Wolfgang / Eigentler, Andreas / Donnemiller, Evelin / Wagner, Michaela / Unterberger, Iris / Boesch, Sylvia. ·1 Department of Neurology, Medical University Innsbruck, Anichstrasse, Innsbruck, Austria. · 2 Department of Nuclear Medicine, 27280 Medical University Innsbruck , Anichstrasse, Innsbruck, Austria. · 3 Department of Neuroradiology, 27280 Medical University Innsbruck , Anichstrasse, Innsbruck, Austria. ·Cephalalgia · Pubmed #28856914.

ABSTRACT: Background Familial hemiplegic migraine (FHM) is a rare, genetic form of migraine with aura. The severity of the aura imposes an effective prophylaxis that is currently based on standard anti-migraine drugs. To this concern, only short-term reports are currently available. Methods Eight patients from a multigenerational FHM type 1 family harbouring a T666M mutation in the CACNA1A gene were referred to our ataxia outpatient clinic. Medical history, general and neurological examination as well as therapeutic approaches were recorded regularly on a routine basis for an average period of 13 years (range 9-15 years). Brain imaging studies and EEG data were also collected. Results Our long-term follow-up revealed that ictal manifestations, which usually improve after the adolescence, may reoccur later in the adulthood. Permanent neurological signs as assessed by means of clinical evaluation as well as follow-up MRIs, EEGs and neuropsychological testing remained stable. Interval therapy with non-selective calcium antagonists reduced the burden of migraine attacks and was well tolerated in the long term.

18 Article Does myofascial and trigger point treatment reduce pain and analgesic intake in patients undergoing onabotulinumtoxinA injection due to chronic intractable migraine? 2018

Gandolfi, Marialuisa / Geroin, Christian / Valè, Nicola / Marchioretto, Fabio / Turrina, Andrea / Dimitrova, Eleonora / Tamburin, Stefano / Serina, Anna / Castellazzi, Paola / Meschieri, Andrea / Ricard, François / Saltuari, Leopold / Picelli, Alessandro / Smania, Nicola. ·Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy - marialuisa.gandolfi@univr.it. · UOC Neurorehabilitation, AOUI Verona, Verona, Italy - marialuisa.gandolfi@univr.it. · Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. · UOC Neurorehabilitation, AOUI Verona, Verona, Italy. · Unit of Neurology, Sacro Cuore Don Calabria Hospital, Verona, Italy. · International Madrid School of Osteopathy, Italian Section, Verona, Italy. · School of Specialization in Physical Medicine and Rehabilitation, University of Verona, Verona, Italy. · Madrid School of Osteopathy, Madrid, Spain. · Research Department for Neurorehabilitation South Tyrol, Bolzano, Italy. · Department of Neurology, Hochzirl Hospital, Zirl, Austria. ·Eur J Phys Rehabil Med · Pubmed #28750504.

ABSTRACT: BACKGROUND: Chronic migraine is a disabling disorder associated with myofascial and trigger point disorders in the neck. Pharmacological management is the first line of treatment; however, rehabilitation procedures aimed at lessening symptoms of myofascial and trigger point disorders may add value in the management of headache symptoms. AIM: The aim of this study was to evaluate the feasibility of myofascial and trigger point treatment in chronic migraine patients receiving prophylactic treatment with onabotulinumtoxinA. To evaluate the treatment effects on headache frequency and intensity, analgesic consumption, cervical range of motion, trigger point pressure pain threshold, quality of life, and disability. DESIGN: Pilot, single-blind randomized controlled trial with two parallel groups. SETTING: Neurorehabilitation Unit. POPULATION: Twenty-two outpatients with chronic migraine. METHODS: Patients were randomly assigned to receive either cervicothoracic manipulative treatment (N.=12) or transcutaneous electrical nerve stimulation (TENS) in the upper trapezius (N.=10). Treatment consisted of 4 sessions (30 min/session, 1 session/week for 4 weeks). A rater blinded to treatment allocation evaluated outcomes before treatment, during treatment, and 1 month after the end of treatment. Consistent with the pilot nature of the study, feasibility was considered the primary outcome and efficacy the secondary outcome. RESULTS: All patients completed the study. No adverse events were reported. No significant between-group differences in pain intensity were observed during the study period. At post-treatment evaluation, the total consumption of analgesics (P=0.02) and non-steroidal anti-inflammatory (P=0.02) drugs was significantly lower in the manipulative treatment group than in the TENS group. These effects paralleled significant improvements in trigger point sensitivity and cervical active range of motion. CONCLUSIONS: Manipulative techniques aimed at reducing peripheral nociceptive triggers might add value in the management of chronic migraine symptoms and lower acute medication use. CLINICAL REHABILITATION IMPACT: An interdisciplinary approach comprising pharmacological and non-pharmacological strategies can reduce analgesic consumption and myofascial dysfunction symptoms in chronic migraine patients.

19 Article Hormonal contraceptives and risk of ischemic stroke in women with migraine: a consensus statement from the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC). 2017

Sacco, Simona / Merki-Feld, Gabriele S / Ægidius, Karen Lehrmann / Bitzer, Johannes / Canonico, Marianne / Kurth, Tobias / Lampl, Christian / Lidegaard, Øjvind / Anne MacGregor, E / MaassenVanDenBrink, Antoinette / Mitsikostas, Dimos-Dimitrios / Nappi, Rossella Elena / Ntaios, George / Sandset, Per Morten / Martelletti, Paolo / Anonymous2680925. ·Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy. simona.sacco@univaq.it. · Department of Gynecology, Clinic for Reproductive Endocrinology, University Hospital, Zürich, Switzerland. · Department of Neurology, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark. · Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland. · Université Paris-Saclay, University Paris-Sud, UVSQ, CESP, Inserm UMRS1018, Orsay, France. · Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Headache Medical Center Seilerstaette Linz, Linz, Austria. · Department of Geriatric Medicine Ordensklinikum Linz, Linz, Austria. · Department of Obstetrics & Gynaecology, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. · Centre for Neuroscience & Trauma, BICMS, Barts and the London School of Medicine and Dentistry, London, UK. · Barts Sexual Health Centre, St Bartholomew's Hospital, London, UK. · Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands. · Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece. · Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. · University Consortium for Adaptive Disorders and Head Pain (UCADH), University of Pavia, Pavia, Italy. · Department of Medicine, University of Thessaly, Larissa, Greece. · Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway. · Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. · Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy. ·J Headache Pain · Pubmed #29086160.

ABSTRACT: Several data indicate that migraine, especially migraine with aura, is associated with an increased risk of ischemic stroke and other vascular events. Of concern is whether the risk of ischemic stroke in migraineurs is magnified by the use of hormonal contraceptives. As migraine prevalence is high in women of reproductive age, it is common to face the issue of migraine and hormonal contraceptive use in clinical practice. In this document, we systematically reviewed data about the association between migraine, ischemic stroke and hormonal contraceptive use. Thereafter a consensus procedure among international experts was done to develop statements to support clinical decision making, in terms of cardiovascular safety, for prescription of hormonal contraceptives to women with migraine. Overall, quality of current evidence regarding the risk of ischemic stroke in migraineurs associated with the use of hormonal contraceptives is low. Available data suggest that combined hormonal contraceptive may further increase the risk of ischemic stroke in those who have migraine, specifically migraine with aura. Thus, our current statements privilege safety and provide several suggestions to try to avoid possible risks. As the quality of available data is poor further research is needed on this topic to increase safe use of hormonal contraceptives in women with migraine.

20 Article [Migraine prophylaxis with trigger point therapy and lymphatic drainage : A pilot study]. 2017

Yedikardachian, Delphine / Quasthoff, Stefan / Lechner, Anita T / Giuliani, Albrecht / Fazekas, Franz. ·Universitätsklinik für Neurologie, LKH-Universitätsklinikum Graz, Auenbruggerplatz 22, 8036, Graz, Österreich. Delphine.Yedikardachian@klinikum-graz.at. · Universitätsklinik für Neurologie, LKH-Universitätsklinikum Graz, Auenbruggerplatz 22, 8036, Graz, Österreich. · Abteilung für Gynäkologie und Geburtshilfe, Krankenhaus St. Vinzenz, Zams, Österreich. ·Wien Med Wochenschr · Pubmed #28770409.

ABSTRACT: Migraine is a complex, multifactorial, neurovascular disorder of the brain. Patients frequently have pericranial trigger points, but trigger point (TP) therapy for migraine has not yet been adequately studied. In contrast, lymphatic drainage (LD) has been studied in patients with migraine. The multifactorial origin of migraine suggests using a combination of approaches such as TP therapy and lymphatic drainage. The present study evaluated the effectiveness of TP therapy alone and in combination with LD in preventing migraine during treatment period and over an 8‑week period after completion of treatment. A wait list control group served as a control group. Patients completed a headache calendar. The results of this pilot study suggest a beneficial effect for TP alone and TP combined with LD for migraine prophylaxis for 8 weeks after completion of treatment.

21 Article The supraorbital region revisited: An anatomic exploration of the neuro-vascular bundle with regard to frontal migraine headache. 2017

Berchtold, Valeria / Stofferin, Hannes / Moriggl, Bernhard / Brenner, Erich / Pauzenberger, Reinhard / Konschake, Marko. ·Division of Clinical and Functional Anatomy, Department for Anatomy, Histology and Embryology, Medical University of Innsbruck (MUI), Austria. · Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Austria. · Division of Clinical and Functional Anatomy, Department for Anatomy, Histology and Embryology, Medical University of Innsbruck (MUI), Austria. Electronic address: marko.konschake@i-med.ac.at. ·J Plast Reconstr Aesthet Surg · Pubmed #28712884.

ABSTRACT: BACKGROUND: Recent findings on the pathogenesis of frontal migraine headache support, besides a central vasogenic cause, an alternative peripheral mechanism involving compressed craniofacial nerves. This is further supported by the efficiency of botulinum toxin injections as a new treatment option in frontal migraine headache patients. METHODS: The supraorbital regions of 22 alcohol-glycerine-embalmed facial halves of both sexes were dissected. Both the supratrochlear and supraorbital nerves (STN and SON, respectively) were identified, and their relationship with the corrugator supercilii muscle (CSM) was investigated by dissection and ultrasound. The course of both nerves was defined, and the interaction between the supraorbital artery (SOA) and SON was determined. RESULTS: We discovered a new possible compression point of the STN passing through the orbital septum and verified previously described compression points of both STN and SON. Osteofibrous channels used by the STN and SON were found constantly. We described the varying topography of the STN and CSM, the SON and CSM, and the SON and SOA. Further, we provide an algorithm for the ultrasound visualization of the supraorbital neurovascular bundle. CONCLUSION: Our data support the hypothesis of a peripheral mechanism for frontal migraine headache because of following potential irritation points: first, the CSM is constantly perforated by the SON and frequently by the STN; second, the topographic proximity between SOA and SON and the osteofibrous channels is used by the SON and STN; and third, the STN passes through the orbital septum.

22 Article Psychiatric comorbidities and photophobia in patients with migraine. 2017

Seidel, Stefan / Beisteiner, Roland / Manecke, Maike / Aslan, Tuna Stefan / Wöber, Christian. ·Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria. Stefan.seidel@meduniwien.ac.at. · Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria. ·J Headache Pain · Pubmed #28185159.

ABSTRACT: BACKGROUND: Based on recent findings and our own impressions we took a closer look at the relationship between (inter)ictal photophobia and psychometric variables in migraine patients with photophobia. FINDINGS: For this study we included 29 (27 female) migraine patients and 31 (18 female) controls with a mean age of 31.6 ± 12.5 years and 24.0 ± 4.1 years, respectively. All participants filled out the Depression Anxiety Stress Scale (DASS). Interictal photophobia in patients was significantly higher than photophobia in controls (p = .001). Patients showed statistically significantly higher levels of depressive symptoms (p < .001), anxiety symptoms (p < .001) and stress (p < .001) than controls. Among all participants, (interictal) photophobia correlated positively with age (rho = .318, p = .013) as well as with the levels of depressive symptoms (rho = .459, p < .001), anxiety symptoms (rho = .346, p = .008) and stress (rho = .368, p = .005), but not with gender. In the patients, ictal photophobia correlated positively with age (rho = .473, p = .01) and interictal photophobia (rho = .423, p = .022). Linear regression analysis revealed only a trend towards statistical significance for (interictal) photophobia as a predictor for the level of depressive symptoms (rho = .457, p = 0.056) in the whole sample. CONCLUSIONS: Considering higher levels of photophobia in depression and the comorbidity of migraine and depression, it might be possible that depression contributes to interictal photophobia in patients with migraine. The same may be true for anxiety and stress. Both are also related to migraine and their possible impact on photophobia in migraine may be explained by pupillary dysfunction.

23 Article Similar impact of multiple sclerosis and migraine on sexual function in women : Is the multiple sclerosis impact scale questionnaire useful? 2017

Salhofer-Polanyi, Sabine / Wöber, Christian / Prohazka, Ricarda / Dal-Bianco, Assunta / Bajer-Kornek, Barbara / Zebenholzer, Karin. ·Medical University of Vienna, Vienna, Austria. sabine.salhofer-polanyi@meduniwien.ac.at. · Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. sabine.salhofer-polanyi@meduniwien.ac.at. · Medical University of Vienna, Vienna, Austria. ·Wien Klin Wochenschr · Pubmed #27596229.

ABSTRACT: BACKGROUND: Sexuality is an integral part of overall health but the impact of neurological diseases on sexual function still receives too little attention. AIM: The aim of this case control study was to compare frequencies and characteristics of sexual dysfunction in women with stable relapsing-remitting multiple sclerosis (MS) and migraine. METHODS: Sexually active women aged 18-50 years were recruited at the MS and headache outpatient clinics of a university hospital and asked to complete questionnaires on sexual function using the multiple sclerosis intimacy and sexuality questionnaire (MSISQ-19) adapted for patients with migraine, depression using the Beck depression inventory (BDI-II) and quality of life using the short form-36 questionnaire (SF-36). RESULTS: At least one symptom of sexual dysfunction was "almost always" or "always" present in 35.7 % of 42 patients with MS and in 22.6 % of 30 patients with migraine (p = 0.3). The MSISQ-19 total score did not differ between the two groups (31.6 ± 10.8 vs. 28.2 ± 11.6, respectively, p = 0.2). Sexual dysfunction was categorized as primary, secondary and tertiary in 66.7 %, 40 % and 33.3 % of MS patients and in 57.1 % (p = 0.7), 71.4 % (p = 0.2) and 71.4 % (p = 0.1) of migraine patients, respectively. Depressive symptoms were more common in women with sexual dysfunction than in those without both in MS (p = 0.001) and migraine (p = 0.006). The SF-36 showed decreasing quality of life with increasing MSISQ-19 sum scores (mental subscale p < 0.001 and physical subscale p = 0.04). CONCLUSIONS: Sexual dysfunction is a major problem both in women with MS and in women with migraine and is strongly associated with comorbid depression and impaired quality of life. Thus, categorizing sexuality as done by MSISQ-19 is limited by its complex biopsychosocial interactions.

24 Article Towards improved migraine management: Determining potential trigger factors in individual patients. 2017

Peris, Francesc / Donoghue, Stephen / Torres, Ferran / Mian, Alec / Wöber, Christian. ·1 Curelator, Inc, Cambridge, MA, USA. · 2 Biostatistics and Data Management Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Hospital Clinic Barcelona, Barcelona, Spain. · 3 Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. · 4 Headache Group, Department of Neurology, Medical University of Vienna, Vienna, Austria. ·Cephalalgia · Pubmed #27179352.

ABSTRACT: Background Certain chronic diseases such as migraine result in episodic, debilitating attacks for which neither cause nor timing is well understood. Historically, possible triggers were identified through analysis of aggregated data from populations of patients. However, triggers common in populations may not be wholly responsible for an individual's attacks. To explore this hypothesis we developed a method to identify individual 'potential trigger' profiles and analysed the degree of inter-individual variation. Methods We applied N = 1 statistical analysis to a 326-migraine-patient database from a study in which patients used paper-based diaries for 90 days to track 33 factors (potential triggers or premonitory symptoms) associated with their migraine attacks. For each patient, univariate associations between factors and migraine events were analysed using Cox proportional hazards models. Results We generated individual factor-attack association profiles for 87% of the patients. The average number of factors associated with attacks was four per patient: Factor profiles were highly individual and were unique in 85% of patients with at least one identified association. Conclusion Accurate identification of individual factor-attack profiles is a prerequisite for testing which are true triggers and for development of trigger avoidance or desensitisation strategies. Our methodology represents a necessary development toward this goal.

25 Article MTHFR and ACE Polymorphisms Do Not Increase Susceptibility to Migraine Neither Alone Nor in Combination. 2016

Essmeister, Rafaela / Kress, Hans-Georg / Zierz, Stephan / Griffith, Lyn / Lea, Rod / Wieser, Thomas. ·Abteilung Anästhesie, KH Barmherzige Brüder, Vienna, Austria. · Abteilung Spezielle Anästhesie und Schmerztherapie, Medizinische Universität Wien, Vienna, Austria. · Abteilung Neurologie, Martin-Luther-Universität Halle/Wittenberg, Halle/Saale, Germany. · Genomics Research Centre, Institute of Health and Biomedical Innovation, QUT, Brisbane, Australia. · Fachkrankenhaus Jerichow, Abteilung Neurologie, Jerichow, Germany. thomas.wieser@awo-khbg.de. ·Headache · Pubmed #27483173.

ABSTRACT: OBJECTIVE: The aim of this study was to confirm previous reports in order to substantiate the hypothesis that functional variants of two genes, namely methylenetetrahydrofolate reductase and angiotensin I converting enzyme, both involved in an important pathway of migraine, increase migraine susceptibility when present in combination. BACKGROUND: Migraine is a complex genetic disease. The migraine attack is thought to be the result of an interaction of neuronal and vascular events, possibly originating in the brainstem leading to activation of the pain processing trigeminovascular system. Functional variants in the methylenetetrahydrofolate gene and the angiotensin I converting enzyme have influence on vascular mechanism and have been investigated intensively in migraine. The published results were inconsistent; however, both polymorphisms in combination have been shown to increase migraine susceptibility. METHODS: In this genetic association study, the prevalence of the functionally relevant polymorphisms C677T in the MTHFR gene and I/D polymorphism in the ACE gene was compared in 420 patients with migraine vs 258 migraine-free controls using a chi-square statistic and binary logistic regression. RESULTS: Susceptibility to any type of migraine (migraine with aura, migraine without aura, and both types combined) was neither increased by each polymorphism on its own, nor in combination (MTHFR: X(2)  = 0.18 [P = .91]; ACE: X(2)  = 1.62 [P = .45]; combined: OR = 1.02 [95% CI 0.98-1.05] P = .97). CONCLUSIONS: We could not replicate a previous study that showed significant increase in migraine susceptibility for two functional polymorphisms in genes affecting relevant pathways.

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