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Migraine Disorders: HELP
Articles from Denmark
Based on 347 articles published since 2009
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These are the 347 published articles about Migraine Disorders that originated from Denmark during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14
1 Guideline Aids to management of headache disorders in primary care (2nd edition) : on behalf of the European Headache Federation and Lifting The Burden: the Global Campaign against Headache. 2019

Steiner, T J / Jensen, R / Katsarava, Z / Linde, M / MacGregor, E A / Osipova, V / Paemeleire, K / Olesen, J / Peters, M / Martelletti, P. ·Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway. t.steiner@imperial.ac.uk. · Division of Brain Sciences, Imperial College London, London, UK. t.steiner@imperial.ac.uk. · Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark. · Department of Neurology, Evangelical Hospital Unna, Unna, Germany. · Medical Faculty, University of Duisburg-Essen, Essen, Germany. · Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway. · Norwegian Advisory Unit on Headache, St. Olavs Hospital, Trondheim, Norway. · Centre for Neuroscience and Trauma, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK. · Research Department of Neurology, First "I. Sechenov" Moscow State Medical University, Moscow, Russian Federation. · Research Center for Neuropsychiatry, Moscow, Russian Federation. · Department of Neurology, Ghent University Hospital, Ghent, Belgium. · Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. · Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. · Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy. ·J Headache Pain · Pubmed #31113373.

ABSTRACT: The Aids to Management are a product of the Global Campaign against Headache, a worldwide programme of action conducted in official relations with the World Health Organization. Developed in partnership with the European Headache Federation, they update the first edition published 11 years ago.The common headache disorders (migraine, tension-type headache and medication-overuse headache) are major causes of ill health. They should be managed in primary care, firstly because their management is generally not difficult, and secondly because they are so common. These Aids to Management, with the European principles of management of headache disorders in primary care as the core of their content, combine educational materials with practical management aids. They are supplemented by translation protocols, to ensure that translations are unchanged in meaning from the English-language originals.The Aids to Management may be individually downloaded and, as is the case for all products of the Global Campaign against Headache, are available without restriction for non-commercial use.

2 Guideline European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. 2019

Sacco, Simona / Bendtsen, Lars / Ashina, Messoud / Reuter, Uwe / Terwindt, Gisela / Mitsikostas, Dimos-Dimitrios / Martelletti, Paolo. ·Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, via Vetoio, 67100, L'Aquila, Italy. simona.sacco@univaq.it. · Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. · Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany. · Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. · 1st Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece. · Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. ·J Headache Pain · Pubmed #30651064.

ABSTRACT: BACKGROUND AND AIM: Monoclonal antibodies acting on the calcitonin gene-related peptide or on its receptor are new drugs to prevent migraine. Four monoclonal antibodies have been developed: one targeting the calcitonin gene-related peptide receptor (erenumab) and three targeting the calcitonin gene-related peptide (eptinezumab, fremanezumab, and galcanezumab). The aim of this document by the European Headache Federation (EHF) is to provide an evidence-based and expert-based guideline on the use of the monoclonal antibodies acting on the calcitonin gene-related peptide for migraine prevention. METHODS: The guideline was developed following the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The working group identified relevant questions, performed systematic review and analysis of the literature, assessed the quality of available evidence, and wrote recommendations. Where the GRADE approach was not applicable, expert opinion was provided. RESULTS: We found low to high quality of evidence to recommend eptinezumab, erenumab, fremanezumab, and galcanezumab in patients with episodic migraine and medium to high quality of evidence to recommend erenumab, fremanezumab, and galcanezumab in patients with chronic migraine. For several clinical questions, there was not enough evidence to provide recommendations using the GRADE approach and recommendations relied on experts' opinion. CONCLUSION: Monoclonal antibodies acting on the calcitonin gene-related peptide are new drugs which can be recommended for migraine prevention. Real life data will be useful to improve the use of those drugs in clinical practice.

3 Guideline Guidelines of the International Headache Society for controlled trials of preventive treatment of chronic migraine in adults. 2018

Tassorelli, Cristina / Diener, Hans-Christoph / Dodick, David W / Silberstein, Stephen D / Lipton, Richard B / Ashina, Messoud / Becker, Werner J / Ferrari, Michel D / Goadsby, Peter J / Pozo-Rosich, Patricia / Wang, Shuu-Jiun / Anonymous2421236. ·1 Headache Science Center, C. Mondino Foundation, Pavia, Italy. · 2 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. · 3 Department of Neurology, University Hospital Essen, Essen, Germany. · 4 Department of Neurology, Mayo Clinic, Phoenix, AZ, USA. · 5 Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA, USA. · 6 Montefiore Headache Center, Department of Neurology and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA. · 7 Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark. · 8 Dept of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. · 9 Hotchkiss Brain Institute, Calgary, Alberta, Canada. · 10 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands. · 11 National Institute for Health Research-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, England. · 12 Headache Research Group, VHIR, Universitat Autònoma de Barcelona, Barcelona Spain. · 13 Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain. · 14 Neurological Institute, Taipei Veterans General Hospital and Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan. ·Cephalalgia · Pubmed #29504482.

ABSTRACT: Background Quality clinical trials form an essential part of the evidence base for the treatment of headache disorders. In 1991, the International Headache Society Clinical Trials Standing Committee developed and published the first edition of the Guidelines for Controlled Trials of Drugs in Migraine. In 2008, the Committee published the first specific guidelines on chronic migraine. Subsequent advances in drug, device, and biologicals development, as well as novel trial designs, have created a need for a revision of the chronic migraine guidelines. Objective The present update is intended to optimize the design of controlled trials of preventive treatment of chronic migraine in adults, and its recommendations do not apply to trials in children or adolescents.

4 Guideline European Headache Federation consensus on technical investigation for primary headache disorders. 2015

Mitsikostas, D D / Ashina, M / Craven, A / Diener, H C / Goadsby, P J / Ferrari, M D / Lampl, C / Paemeleire, K / Pascual, J / Siva, A / Olesen, J / Osipova, V / Martelletti, P / Anonymous5730857. ·Neurology Department, Athens Naval Hospital, Athens, Greece. dimosmitsikostas@me.com. · Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. ashina@dadlnet.dk. · European Headache Alliance, President, Dublin, Ireland. audreycraven@migraine.ie. · Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany. hans.diener@uk-essen.de. · Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, and King's Clinical Research Facility, Kings College London, Wellcome Foundation Building, King's College Hospital, London, SE5 9PJ, UK. peter.goadsby@kcl.ac.uk. · Center for Proteomics and Metabolomics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. M.D.Ferrari@lumc.nl. · Medical Headache Center, Hospital Sisters of Mercy, Seilerstaette Linz, Linz, 4020, Austria. christian.lampl@bhs.at. · Department of Neurology, Ghent University Hospital, Ghent, Belgium. Koen.Paemeleire@uzgent.be. · University Hospital Marqués de Valdecilla and IDIVAL, 39011, Santander, Spain. juliopascual@telefonica.net. · Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Millet Cad, 34390, Capa/Istanbul, Turkey. akselsiva@gmail.com. · Danish Headache Centre and Department of Neurology, Rigshospitalet, Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. jes.olesen@regionh.dk. · Department of Neurology, First Moscow State Medical University, Moscow, Russia. osipova_v@mail.ru. · Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. paolo.martelletti@uniroma1.it. ·J Headache Pain · Pubmed #26857820.

ABSTRACT: The diagnosis of primary headache disorders is clinical and based on the diagnostic criteria of the International Headache Society (ICHD-3-beta). However several brain conditions may mimic primary headache disorders and laboratory investigation may be needed. This necessity occurs when the treating physician doubts for the primary origin of headache. Features that represent a warning for a possible underlying disorder causing the headache are new onset headache, change in previously stable headache pattern, headache that abruptly reaches the peak level, headache that changes with posture, headache awakening the patient, or precipitated by physical activity or Valsalva manoeuvre, first onset of headache ≥50 years of age, neurological symptoms or signs, trauma, fever, seizures, history of malignancy, history of HIV or active infections, and prior history of stroke or intracranial bleeding. All national headache societies and the European Headache Alliance invited to review and comment the consensus before the final draft. The consensus recommends brain MRI for the case of migraine with aura that persists on one side or in brainstem aura. Persistent aura without infarction and migrainous infarction require brain MRI, MRA and MRV. Brain MRI with detailed study of the pituitary area and cavernous sinus, is recommended for all TACs. For primary cough headache, exercise headache, headache associated with sexual activity, thunderclap headache and hypnic headache apart from brain MRI additional tests may be required. Because there is little and no good evidence the committee constructed a consensus based on the opinion of experts, and should be treated as imperfect.

5 Guideline Guidelines for controlled trials of drugs in migraine: third edition. A guide for investigators. 2012

Tfelt-Hansen, Peer / Pascual, Julio / Ramadan, Nabih / Dahlöf, Carl / D'Amico, Domenico / Diener, Hans-Christopher / Hansen, Jakob Møller / Lanteri-Minet, Michel / Loder, Elisabeth / McCrory, Douglas / Plancade, Sandra / Schwedt, Todd / Anonymous5150719. ·Danish Headache Center, Department of Neurology, University of Copenhagen, Glostrup, Denmark. ptha@glo.regionh.dk ·Cephalalgia · Pubmed #22384463.

ABSTRACT: -- No abstract --

6 Editorial Testing the diagnostic criteria of tension-type headache. 2018

Schytz, Henrik Winther. ·Danish Headache Center, Glostrup, Denmark. ·Cephalalgia · Pubmed #29528691.

ABSTRACT: -- No abstract --

7 Editorial Migraine is first cause of disability in under 50s: will health politicians now take notice? 2018

Steiner, Timothy J / Stovner, Lars J / Vos, Theo / Jensen, R / Katsarava, Z. ·Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway. t.steiner@imperial.ac.uk. · Division of Brain Sciences, Imperial College London, London, UK. t.steiner@imperial.ac.uk. · Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway. · Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St Olavs University Hospital, Trondheim, Norway. · Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA. · Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark. · Department of Neurology, Evangelical Hospital Unna, Unna, Germany. · Medical Faculty, University of Duisburg-Essen, Essen, Germany. ·J Headache Pain · Pubmed #29468450.

ABSTRACT: -- No abstract --

8 Editorial Editorial. 2017

Messlinger, Karl / Jensen, Rigmor Højland. ·1 University of Erlangen-Nuernberg Institute of Physiology & Pathophysiology, Erlangen, Germany. · 2 Danish Headache Center, Department of Neurology, University of Copenhagen, Rigshospitalet/Glostrup Hospital, Glostrup, Denmark. ·Cephalalgia · Pubmed #27352855.

ABSTRACT: -- No abstract --

9 Editorial Triptans and ergot alkaloids in the acute treatment of migraine: similarities and differences. 2013

Tfelt-Hansen, Peer C. ·Department of Neurology, Danish Headache Center, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark +45 3863 3050 +45 3863 2639 ptha@regionh.dk. ·Expert Rev Neurother · Pubmed #23980649.

ABSTRACT: -- No abstract --

10 Editorial Early responses in randomized clinical trials of triptans in acute migraine treatment. Are they clinically relevant? A comment. 2010

Tfelt-Hansen, Peer. ·Danish Headache Centre, Department of Neurology, University of Copenhagen, Glostrup Hospital, DK-2600 Glostrup, Denmark. ·Headache · Pubmed #19178578.

ABSTRACT: One can question the clinical relevance of early headache responses after oral and intranasal triptans. Thus, for pain-free the early responses were significant but in absolute values they were only a few percentages: the therapeutic gains (TGs) were 1.8% (95% CI = 0.3-3%) for oral almotriptan 12.5 after 30 minutes and 1.0% (95% CI = 0-2%) after intranasal zolmitriptan 5 mg after 15 minutes. These results are compared with subcutaneous sumatriptan 6 mg which has TGs of 11% (95% CI = 7-15%) to 14% (95% CI = 11-17%) for pain-free after 30 minutes. Subcutaneous sumatriptan has a 2 times higher response rate than intranasal zolmitriptan and is 5 times more effective than oral almotriptan at these early time points. It is concluded that if a very early and clinically relevant effect is desired then the migraine patient should use the subcutaneous administration form of sumatriptan.

11 Editorial Is there an inherent limit to the efficacy of calcitonin gene-related peptide receptor antagonists in the acute treatment of migraine? A comment. 2009

Tfelt-Hansen, Peer C. ·Danish Headache Centre, Glostrup Hospital, Glostrup, Denmark. ptha@glo.regionh.dk ·J Headache Pain · Pubmed #19779958.

ABSTRACT: Calcitonin gene-related peptide (CGRP) receptor antagonists are a new treatment principle in acute migraine attacks. Intravenous olcegepant 2.5 mg resulted in 66% headache relief after 2 h, whereas subcutaneous sumatriptan resulted in 81-92% headache relief after 2 h. The intrinsic activity of a parenteral triptan, a 5HT(1B/1D) receptor agonist, is thus higher than the maximum effect of the parenteral CGRP receptor antagonist olcegepant. For the orally bioavailable CGRP antagonist telcagepant 300 mg, the headache relief was only 55% in one phase III study. These results indicate that CGRP receptor antagonism results in success in the acute treatment of migraine in only a certain fraction of the patients.

12 Review Post-traumatic headache: epidemiology and pathophysiological insights. 2019

Ashina, Håkan / Porreca, Frank / Anderson, Trent / Amin, Faisal Mohammad / Ashina, Messoud / Schytz, Henrik Winther / Dodick, David W. ·Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. · Department of Pharmacology, University of Arizona, Tucson, Phoenix, AZ, USA. · Department of Neurology, Mayo Clinic, Phoenix, AZ, USA. · Department of Basic Medical Sciences, University of Arizona, Phoenix, AZ, USA. · Department of Neurology, Mayo Clinic, Phoenix, AZ, USA. Dodick.David@mayo.edu. ·Nat Rev Neurol · Pubmed #31527806.

ABSTRACT: Post-traumatic headache (PTH) is a highly disabling secondary headache disorder and one of the most common sequelae of mild traumatic brain injury, also known as concussion. Considerable overlap exists between PTH and common primary headache disorders. The most common PTH phenotypes are migraine-like headache and tension-type-like headache. A better understanding of the pathophysiological similarities and differences between primary headache disorders and PTH could uncover unique treatment targets for PTH. Although possible underlying mechanisms of PTH have been elucidated, a substantial void remains in our understanding, and further research is needed. In this Review, we describe the evidence from animal and human studies that indicates involvement of several potential mechanisms in the development and persistence of PTH. These mechanisms include impaired descending modulation, neurometabolic changes, neuroinflammation and activation of the trigeminal sensory system. Furthermore, we outline future research directions to establish biomarkers involved in progression from acute to persistent PTH, and we identify potential drug targets to prevent and treat persistent PTH.

13 Review New daily persistent headache: a systematic review on an enigmatic disorder. 2019

Yamani, Nooshin / Olesen, Jes. ·Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Nooshin.yamani@yahoo.com. · Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark. Nooshin.yamani@yahoo.com. · Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark. ·J Headache Pain · Pubmed #31307396.

ABSTRACT: BACKGROUND: New daily persistent headache (NDPH) presents with a sudden onset headache which continues without remission within 24 h. Although rare, NDPH is important because it is one of the most treatment refractory primary headache disorders and can be highly disabling to the individuals. In this structured review, we describe the current knowledge of epidemiology, clinical features, trigger factors, pathophysiology, diagnosis and therapeutic options of NDPH to better understand this enigmatic disorder. The prevalence of NDPH estimated to be 0.03% to 0.1% in the general population and is higher in children and adolescents than in adults. Individuals with NDPH can pinpoint the exact date their headache started. The pain is constant and lacks special characteristics but in some has migraine features. The exact pathogenic mechanism of NDPH is unknown, however pro-inflammatory cytokines and cervicogenic problems might play a role in its development. The diagnosis of NDPH is mainly clinical and based on a typical history, but proper laboratory investigation is needed to exclude secondary causes of headache. Regarding treatment strategy, controlled drug trials are absent. It is probably best to treat NDPH based upon the predominant headache phenotype. For patients who do not respond to common prophylactic drugs, ketamine infusion, onabotulinum toxin type A, intravenous (IV) lidocaine, IV methylprednisolone and nerve blockade are possible treatment options, but even aggressive treatment is usually ineffective. CONCLUSION: NDPH remains poorly understood but very burdensome for the individual. Multi-center randomized controlled trials are recommended to gain better understanding of NDPH and to establish evidence based treatments.

14 Review Therapeutic novelties in migraine: new drugs, new hope? 2019

Do, Thien Phu / Guo, Song / Ashina, Messoud. ·Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. · Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. ashina@dadlnet.dk. ·J Headache Pain · Pubmed #30995909.

ABSTRACT: BACKGROUND: In the past decade, migraine research has identified novel drug targets. In this review, we discuss recent data on emerging anti-migraine therapies. MAIN BODY: The development of ditans, gepants and anti-calcitonin gene-related peptide monoclonal antibodies for the treatment of migraine is one of the greatest advances in the migraine field. Lasmiditan, rimegepant and ubrogepant will extend our therapeutic armamentarium for managing acute migraine attacks when triptans are not effective or contraindicated due to cardiovascular disorders. The monoclonal antibodies are migraine specific prophylactic drugs with high responder rates and favorable adverse event profiles. Furthermore, they offer convenient treatment regimens of 4- or 12-week intervals. CONCLUSION: Collectively, novel migraine therapies represent a major progress in migraine treatment and will undoubtedly transform headache medicine.

15 Review Histamine and migraine revisited: mechanisms and possible drug targets. 2019

Worm, Jacob / Falkenberg, Katrine / Olesen, Jes. ·Danish Headache Center and Department of Neurology N39, University of Copenhagen, Rigshospitalet Glostrup, DK-2600, Copenhagen, Denmark. · Danish Headache Center and Department of Neurology N39, University of Copenhagen, Rigshospitalet Glostrup, DK-2600, Copenhagen, Denmark. jes.olesen@regionh.dk. ·J Headache Pain · Pubmed #30909864.

ABSTRACT: OBJECTIVE: To review the existing literature on histamine and migraine with a focus on the molecule, its receptors, its use in inducing migraine, and antihistamines in the treatment of migraine. BACKGROUND: Histamine has been known to cause a vascular type headache for almost a hundred years. Research has focused on antihistamines as a possible treatment and histamine as a migraine provoking agent but there has been little interest in this field for the last 25 years. In recent years two additional histamine (H METHODS: For this review the PubMed/MEDLINE database was searched for eligible studies. We searched carefully for all articles on histamine, antihistamines and histamine receptors in relation to migraine and the nervous system. The following search terms were used: histamine, migraine disorders, migraine, headache, antihistamines, histamine antagonists, clinical trials, induced headache, histamine H FINDINGS: Early studies of H CONCLUSION: There is insufficient support for first generation antihistamines (both H

16 Review Treatment of medication overuse headache-A review. 2019

Munksgaard, Signe B / Madsen, Samuel K / Wienecke, Troels. ·Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Glostrup, Denmark. · Neurovascular Center, Department of Neurology, Zealand University Hospital, Roskilde, Denmark. · Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. ·Acta Neurol Scand · Pubmed #30710346.

ABSTRACT: Medication overuse headache (MOH) is the most prevalent chronic headache disorder with a prevalence between 1% and 2% worldwide. The disease has been acknowledged for almost 30 years, yet experts still disagree on how best to treat MOH. By performing a search in PubMed on the terms "medication overuse headache," "analgesics abuse headache," "rebound headache," "drug induced headache," and "headache AND drug misuse" limited to human studies published in English between January 1, 2004, and November 1, 2017, we aimed to evaluate current literature concerning predictors of treatment outcome, inpatient and outpatient treatment programs, initial versus latent administration of prophylactic medications, and to review the effect of prophylactic medications. Selection criteria were prospective, comparative, or controlled trials on treatment of MOH in persons of at least 18 years of age. Several studies evaluated risk factors to predict the outcome of MOH treatment, but many studies were underpowered. Psychiatric comorbidity, high dependence score, and overuse of barbiturates, benzodiazepines, and opioids predicted a poorer outcome of withdrawal therapy. Patients with these risk factors benefit from inpatient treatment, whereas patients without risk factors benefit equally from inpatient and outpatient treatment. Some medications for migraine prophylactics have shown better effect on MOH compared with placebo, but not when combined with withdrawal. We conclude that detoxification programs are of great importance in MOH treatment. Latent administration of prophylactic medications reduces the number of patients needing prophylactic medication. Individualizing treatment according to the predictors of outcome may improve treatment outcome and thus reduce work-related and treatment-related costs.

17 Review Neurostimulation for the treatment of chronic migraine and cluster headache. 2019

Vukovic Cvetkovic, Vlasta / Jensen, Rigmor H. ·Danish Headache Center, Rigshospital-Glostrup, Glostrup, Denmark. ·Acta Neurol Scand · Pubmed #30291633.

ABSTRACT: Small subsets of patients who fail to respond to pharmacological treatment may benefit from alternative treatment methods. In the last decade, neurostimulation is being explored as a potential treatment option for the patients with chronic, severely disabling refractory primary headaches. To alleviate pain, specific nerves and brain areas have been stimulated, and various methods have been explored: deep brain stimulation, occipital nerve stimulation, and sphenopalatine ganglion stimulation are among the more invasive ones, whereas transcranial magnetic stimulation and supraorbital nerve stimulation are noninvasive. Vagal nerve stimulation can be invasive or noninvasive, though this review included only data for noninvasive VNS. Most of these methods have been tested in small open-label patient series; recently, more data from randomized, controlled, and blinded studies are available. Although neurostimulation treatments have demonstrated good efficacy in many studies, it still has not been established as a standard treatment in refractory patients. This review analyzes the available evidence regarding efficacy and safety of different neurostimulation modalities for the treatment of chronic migraine and cluster headache.

18 Review Male and female sex hormones in primary headaches. 2018

Delaruelle, Zoë / Ivanova, Tatiana A / Khan, Sabrina / Negro, Andrea / Ornello, Raffaele / Raffaelli, Bianca / Terrin, Alberto / Mitsikostas, Dimos D / Reuter, Uwe / Anonymous1761500. ·Department of Neurology, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium. zoe.delaruelle@uzgent.be. · First Moscow State Medical University, Moscow, Russia. · Danish Headache Center, Glostrup Hospital, Copenhagen, Denmark. · Dipartimento di Medicina Clinica e Molecolare, Universita degli Studi di Roma La Sapienza, Rome, Italy. · Department of Neurology, University of La'Aquila, L'Aquila, Italy. · Departmentt of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany. · Department of Neurosciences, Headache Center, University of Padua, Padua, Italy. · Neurology Department, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece. · Charite Universitatsmedizin Berlin, Berlin, Germany. ·J Headache Pain · Pubmed #30497379.

ABSTRACT: BACKGROUND: The three primary headaches, tension-type headache, migraine and cluster headache, occur in both genders, but all seem to have a sex-specific prevalence. These gender differences suggest that both male and female sex hormones could have an influence on the course of primary headaches. This review aims to summarise the most relevant and recent literature on this topic. METHODS: Two independent reviewers searched PUBMED in a systematic manner. Search strings were composed using the terms LH, FSH, progesteron*, estrogen*, DHEA*, prolactin, testosterone, androgen*, headach*, migrain*, "tension type" or cluster. A timeframe was set limiting the search to articles published in the last 20 years, after January 1st 1997. RESULTS: Migraine tends to follow a classic temporal pattern throughout a woman's life corresponding to the fluctuation of estrogen in the different reproductive stages. The estrogen withdrawal hypothesis forms the basis for most of the assumptions made on this behalf. The role of other hormones as well as the importance of sex hormones in other primary headaches is far less studied. CONCLUSION: The available literature mainly covers the role of sex hormones in migraine in women. Detailed studies especially in the elderly of both sexes and in cluster headache and tension-type headache are warranted to fully elucidate the role of these hormones in all primary headaches.

19 Review A PRISMA-compliant systematic review of the endpoints employed to evaluate symptomatic treatments for primary headaches. 2018

García-Azorin, D / Yamani, N / Messina, L M / Peeters, I / Ferrili, M / Ovchinnikov, D / Speranza, M L / Marini, V / Negro, A / Benemei, S / Barloese, M / Anonymous4901478. ·Headache Unit Neurology Department, Hospital Clínico Universitario Valladolid, Avda. Ramón y Cajal 3, 47005, Valladolid, Spain. davilink@hotmail.com. · Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark. · Headache Department, Iranian Center of Neurological Research Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. · Child Neuropsychiatry School, University of Palermo, Palermo, Italy. · U.O. Neuropsychiatry - ARNAS Civico, PO Di Cristina, Palermo, Italy. · Neurology Department, University Hospital of Brussels, Brussels, Belgium. · Headache Center, Bambino Gesù Children Hospital IRCCS, Rome, Italy. · Pavlov First Saint Petersburg State Medical University, Saint Petesburg, Russia. · Almazov National Medical Research Centre, Saint Petesburg, Russia. · Internal Medicine Department, Sant'Andrea Hospital, Rome, Italy. · Regional Referral Headache Centre, Sant'Andrea Hospital, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. · Headache Centre, Careggi University Hospital, University of Florence, Florence, Italy. · Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark. · Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging, Hvidovre Hospital, Copenhagen, Denmark. ·J Headache Pain · Pubmed #30242571.

ABSTRACT: BACKGROUND: Primary headache are prevalent and debilitating disorders. Acute pain cessation is one of the key points in their treatment. Many drugs have been studied but the design of the trials is not usually homogeneous. Efficacy of the trial is determined depending on the selected primary endpoint and usually other different outcomes are measured. We aim to critically appraise which were the employed outcomes through a systematic review. METHODS: We conducted a systematic review of literature focusing on studies on primary headache evaluating acute relief of pain, following the PRISMA guideline. The study population included patients participating in a controlled study about symptomatic treatment. The comparator could be placebo or the standard of care. The collected information was the primary outcome of the study and all secondary outcomes. We evaluated the studied drug, the year of publication and the type of journal. We performed a search and we screened all the potential papers and reviewed them considering inclusion/exclusion criteria. RESULTS: The search showed 4288 clinical trials that were screened and 794 full articles were assessed for eligibility for a final inclusion of 495 papers. The studies were published in headache specific journals (58%), general journals (21.6%) and neuroscience journals (20.4%). Migraine was the most studied headache, in 87.8% studies, followed by tension type headache in 4.7%. Regarding the most evaluated drug, triptans represented 68.6% of all studies, followed by non-steroidal anti-inflammatories (25.1%). Only 4.6% of the papers evaluated ergots and 1.6% analyzed opioids. The most frequent primary endpoint was the relief of the headache at a determinate moment, in 54.1%. Primary endpoint was evaluated at 2-h in 69.9% of the studies. Concerning other endpoints, tolerance was the most frequently addressed (83%), followed by headache relief (71.1%), improvement of other symptoms (62.5%) and presence of relapse (54%). The number of secondary endpoints increased from 4.2 (SD = 2.0) before 1991 to 6.39 after 2013 (p = 0.001). CONCLUSION: Headache relief has been the most employed primary endpoint but headache disappearance starts to be firmly considered. The number of secondary endpoints increases over time and other outcomes such as disability, quality of life and patients' preference are receiving attention.

20 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 / Anonymous1331500. ·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.

21 Review Myofascial trigger points in migraine and tension-type headache. 2018

Do, Thien Phu / Heldarskard, Gerda Ferja / Kolding, Lærke Tørring / Hvedstrup, Jeppe / Schytz, Henrik Winther. ·Headache Diagnostic Laboratory, Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health Sciences, University of Copenhagen, Glostrup, Denmark. · Headache Diagnostic Laboratory, Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health Sciences, University of Copenhagen, Glostrup, Denmark. henrik.winther.schytz.01@regionh.dk. ·J Headache Pain · Pubmed #30203398.

ABSTRACT: BACKGROUND: A myofascial trigger point is defined as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. It has been suggested that myofascial trigger points take part in chronic pain conditions including primary headache disorders. The aim of this narrative review is to present an overview of the current imaging modalities used for the detection of myofascial trigger points and to review studies of myofascial trigger points in migraine and tension-type headache. FINDINGS: Different modalities have been used to assess myofascial trigger points including ultrasound, microdialysis, electromyography, infrared thermography, and magnetic resonance imaging. Ultrasound is the most promising of these modalities and may be used to identify MTrPs if specific methods are used, but there is no precise description of a gold standard using these techniques, and they have yet to be evaluated in headache patients. Active myofascial trigger points are prevalent in migraine patients. Manual palpation can trigger migraine attacks. All intervention studies aiming at trigger points are positive, but this needs to be further verified in placebo-controlled environments. These findings may imply a causal bottom-up association, but studies of migraine patients with comorbid fibromyalgia syndrome suggest otherwise. Whether myofascial trigger points contribute to an increased migraine burden in terms of frequency and intensity is unclear. Active myofascial trigger points are prevalent in tension-type headache coherent with the hypothesis that peripheral mechanisms are involved in the pathophysiology of this headache disorder. Active myofascial trigger points in pericranial muscles in tension-type headache patients are correlated with generalized lower pain pressure thresholds indicating they may contribute to a central sensitization. However, the number of active myofascial trigger points is higher in adults compared with adolescents regardless of no significant association with headache parameters. This suggests myofascial trigger points are accumulated over time as a consequence of TTH rather than contributing to the pathophysiology. CONCLUSIONS: Myofascial trigger points are prevalent in both migraine and tension-type headache, but the role they play in the pathophysiology of each disorder and to which degree is unclarified. In the future, ultrasound elastography may be an acceptable diagnostic test.

22 Review The association between migraine and physical exercise. 2018

Amin, Faisal Mohammad / Aristeidou, Stavroula / Baraldi, Carlo / Czapinska-Ciepiela, Ewa K / Ariadni, Daponte D / Di Lenola, Davide / Fenech, Cherilyn / Kampouris, Konstantinos / Karagiorgis, Giorgos / Braschinsky, Mark / Linde, Mattias / Anonymous1051094. ·Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, University of Copenhagen, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark. faisal@dadlnet.dk. · 1st Neurology of Department, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. · Department of Diagnostic, Medical Toxicology, Headache and Drug Abuse Research Center, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Epilepsy and Migraine Treatment Centre, Kraków, Poland. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy. · Headache Centre, Guys and St Thomas NHS Trust, London, UK. · Neurology Clinic's Headache Clinic, Tartu University Clinics, Tartu, Estonia. · Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway. · Norwegian Advisory Unit on Headache, St Olavs University Hospital, Trondheim, Norway. ·J Headache Pain · Pubmed #30203180.

ABSTRACT: BACKGROUND: There is an unmet need of pharmacological and non-pharmacological treatment options for migraine patients. Exercise can be used in the treatment of several pain conditions, including. However, what exact role exercise plays in migraine prevention is unclear. Here, we review the associations between physical exercise and migraine from an epidemiological, therapeutical and pathophysiological perspective. METHODS: The review was based on a primary literature search on the PubMed using the search terms "migraine and exercise". RESULTS: Low levels of physical exercise and high frequency of migraine has been reported in several large population-based studies. In experimental studies exercise has been reported as a trigger factor for migraine as well as migraine prophylaxis. Possible mechanisms for how exercise may trigger migraine attacks, include acute release of neuropeptides such as calcitonin gene-related peptide or alternation of hypocretin or lactate metabolism. Mechanisms for migraine prevention by exercise may include increased beta-endorphin, endocannabinoid and brain-derived neurotrophic factor levers in plasma after exercise. CONCLUSION: In conclusion, it seems that although exercise can trigger migraine attacks, regular exercise may have prophylactic effect on migraine frequency. This is most likely due to an altered migraine triggering threshold in persons who exercise regularly. However, the frequency and intensity of exercise that is required is still an open question, which should be addressed in future studies to delineate an evidence-based exercise program to prevent migraine in sufferers.

23 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.

24 Review E-Health interventions for anxiety and depression in children and adolescents with long-term physical conditions. 2018

Thabrew, Hiran / Stasiak, Karolina / Hetrick, Sarah E / Wong, Stephen / Huss, Jessica H / Merry, Sally N. ·Department of Psychological Medicine, University of Auckland, Level 12 Support Building, Auckland Hospital, Park Road, Grafton, Auckland, New Zealand. ·Cochrane Database Syst Rev · Pubmed #30110718.

ABSTRACT: BACKGROUND: Long-term physical conditions affect 10% to 12% of children and adolescents worldwide; these individuals are at greater risk of developing psychological problems, particularly anxiety and depression. Access to face-to-face treatment for such problems is often limited, and available interventions usually have not been tested with this population. As technology improves, e-health interventions (delivered via digital means, such as computers and smart phones and ranging from simple text-based programmes through to multimedia and interactive programmes, serious games, virtual reality and biofeedback programmes) offer a potential solution to address the psychological needs of this group of young people. OBJECTIVES: To assess the effectiveness of e-health interventions in comparison with attention placebos, psychological placebos, treatment as usual, waiting-list controls, or non-psychological treatments for treating anxiety and depression in children and adolescents with long-term physical conditions. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Group's Controlled Trials Register (CCMDTR to May 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 8, 2017), Web of Science (1900 - 18 August 2016, updated 31 August 2017) and Ovid MEDLINE, Embase, PsycINFO (cross-search 2016 to 18 Aug 2017). We hand-searched relevant conference proceedings, reference lists of included articles, and the grey literature to May 2016. We also searched international trial registries to identify unpublished or ongoing trials. SELECTION CRITERIA: We included randomised controlled trials (RCTs), cluster-randomised trials, and cross-over trials of e-health interventions for treating any type of long-term physical condition in children and adolescents (aged 0 to 18 years), and that measured changes in symptoms or diagnoses of anxiety, depression, or subthreshold depression. We defined long-term physical conditions as those that were more than three-months' duration. We assessed symptoms of anxiety and depression using patient- or clinician-administered validated rating scales based on DSM III, IV or 5 (American Psychological Association 2013), or ICD 9 or 10 criteria (World Health Organization 1992). Formal depressive and anxiety disorders were diagnosed using structured clinical interviews. Attention placebo, treatment as usual, waiting list, psychological placebo, and other non-psychological therapies were eligible comparators. DATA COLLECTION AND ANALYSIS: Two review authors independently reviewed titles, abstracts, and full-text articles; discrepancies were resolved through discussion or addressed by a third author. When available, we used odds ratio (OR) to compare dichotomous data and standardised mean differences (SMD) to analyse continuous data, both with 95% confidence intervals (CI). We undertook meta-analysis when treatments, participants, and the underlying clinical question were adequately similar. Otherwise, we undertook a narrative analysis. MAIN RESULTS: We included five trials of three interventions (Breathe Easier Online, Web-MAP, and multimodal cognitive behavioural therapy (CBT)), which included 463 participants aged 10 to 18 years. Each trial contributed to at least one meta-analysis. Trials involved children and adolescents with long-term physical conditions, such as chronic headache (migraine, tension headache, and others), chronic pain conditions (abdominal, musculoskeletal, and others), chronic respiratory illness (asthma, cystic fibrosis, and others), and symptoms of anxiety or depression. Participants were recruited from community settings and hospital clinics in high income countries.For the primary outcome of change in depression symptoms versus any control, there was very low-quality evidence meaning that it could not be determined whether e-health interventions were clearly better than any comparator (SMD -0.06, 95% CI -0.35 to 0.23; five RCTs, 441 participants). For the primary outcome of change in anxiety symptoms versus any comparator, there was very low-quality evidence meaning that it could not be determined whether e-health interventions were clearly better than any comparator (SMD -0.07, 95% CI -0.29 to 0.14; two RCTs, 324 participants). For the primary outcome of treatment acceptability, there was very low-quality evidence that e-health interventions were less acceptable than any comparator (SMD 0.46, 95% CI 0.23 to 0.69; two RCTs, 304 participants).For the secondary outcome of quality of life, there was very low-quality evidence meaning that it could not be determined whether e-health interventions were clearly better than any comparator (SMD -0.83, 95% CI -1.53 to -0.12; one RCT, 34 participants). For the secondary outcome of functioning, there was very low-quality evidence meaning that it could not be determined whether e-health interventions were clearly better than any comparator (SMD -0.08, 95% CI -0.33 to 0.18; three RCTs, 368 participants). For the secondary outcome of status of long-term physical condition, there was very low-quality evidence meaning that it could not be determined whether e-health interventions were clearly better than any comparator (SMD 0.06, 95% CI -0.12 to 0.24; five RCTs, 463 participants).The risk of selection bias was considered low in most trials. However, the risk of bias due to inadequate blinding of participants or outcome assessors was considered unclear or high in all trials. Only one study had a published protocol; two trials had incomplete outcome data. All trials were conducted by the intervention developers, introducing another possible bias. No adverse effects were reported by any authors. AUTHORS' CONCLUSIONS: At present, the field of e-health interventions for the treatment of anxiety or depression in children and adolescents with long-term physical conditions is limited to five low quality trials. The very low-quality of the evidence means the effects of e-health interventions are uncertain at this time, especially in children aged under 10 years.Although it is too early to recommend e-health interventions for this clinical population, given their growing number, and the global improvement in access to technology, there appears to be room for the development and evaluation of acceptable and effective technologically-based treatments to suit children and adolescents with long-term physical conditions.

25 Review PACAP38 and PAC 2018

Rubio-Beltrán, Eloisa / Correnti, Edvige / Deen, Marie / Kamm, Katharina / Kelderman, Tim / Papetti, Laura / Vigneri, Simone / MaassenVanDenBrink, Antoinette / Edvinsson, Lars / Anonymous6340957. ·Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. a.rubiobeltran@erasmusmc.nl. · Department of Child Neuropsychiatry, University of Palermo, Palermo, Italy. · Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark. · Department of Neurology, University Hospital, LMU Munich, Munich, Germany. · Department of Neurology, Ghent University Hospital, Ghent, Belgium. · Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. · Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo; Pain Medicine Unit, Santa Maria Maddalena Hospital, Occhiobello, Italy. · Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. · Department of Internal Medicine, Institute of Clinical Sciences, Lund University, Lund, Sweden. ·J Headache Pain · Pubmed #30088106.

ABSTRACT: Pituitary adenylate cyclase activating polypeptide-38 (PACAP38) is a widely distributed neuropeptide involved in neuroprotection, neurodevelopment, nociception and inflammation. Moreover, PACAP38 is a potent inducer of migraine-like attacks, but the mechanism behind this has not been fully elucidated.Migraine is a neurovascular disorder, recognized as the second most disabling disease. Nevertheless, the antibodies targeting calcitonin gene-related peptide (CGRP) or its receptor are the only prophylactic treatment developed specifically for migraine. These antibodies have displayed positive results in clinical trials, but are not effective for all patients; therefore, new pharmacological targets need to be identified.Due to the ability of PACAP38 to induce migraine-like attacks, its location in structures previously associated with migraine pathophysiology and the 100-fold selectivity for the PAC

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