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Migraine Disorders: HELP
Articles from United Kingdom
Based on 488 articles published since 2008

These are the 488 published articles about Migraine Disorders that originated from United Kingdom during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Latest clinical recommendations on valproate use for migraine prophylaxis in women of childbearing age: overview from European Medicines Agency and European Headache Federation. 2018

Vatzaki, Efstratia / Straus, Sabine / Dogne, Jean-Michel / Garcia Burgos, Juan / Girard, Thomas / Martelletti, Paolo. ·European Medicines Agency, 30 Churchill Place, London, E14 5EU, UK. Efstratia.Vatzaki@ema.europa.eu. · Medicines Evaluation Board, Utrecht, The Netherlands. · PRAC member, European Medicines Agency, London, UK. · Department of Pharmacy, Namur Thrombosis and Haemostasis Centre - Narilis University of Namur, Namur, Belgium. · European Medicines Agency, 30 Churchill Place, London, E14 5EU, UK. · European Headache Federation,. ·J Headache Pain · Pubmed #30109437.

ABSTRACT: Migraine is a common and burdensome neurological condition which affects mainly female patients during their childbearing years. Valproate has been widely used for the prophylaxis of migraine attacks and is also included in the main European Guidelines. Previous (2014) European recommendations on limiting the use of valproate in women of childbearing age did not achieve their objective in terms of limiting the use of valproate in women of childbearing age and raising awareness regarding the hazardous effect of valproate to children exposed in utero. The teratogenic and foetotoxic effects of valproate are well documented, and more recent studies show that there is an even greater neurodevelopmental risk to children exposed to valproate in the womb. The latest 2018 European review from the European Medicines Agency, with the active participation of the European Headache Federation, concluded that not enough has been done to mitigate the risks associated with in utero exposure to valproate. The review called for more extensive restrictions to the conditions for prescribing, better public awareness, and a more effective education campaign in migrainous women.

2 Editorial Migraine Therapy: Current Approaches and New Horizons. 2018

Goadsby, Peter J / Holland, Philip R. ·NIHR-Wellcome Trust, King's Clinical Research Facility, King's College Hospital, London, UK. peter.goadsby@kcl.ac.uk. · Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK. peter.goadsby@kcl.ac.uk. · Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK. ·Neurotherapeutics · Pubmed #29667112.

ABSTRACT: -- No abstract --

3 Editorial Cilostazol as a chemically induced preclinical model of migraine. 2018

Holland, Philip R / Strother, Lauren. ·Department of Basic and Clinical Neuroscience, Headache Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. ·Cephalalgia · Pubmed #28952338.

ABSTRACT: -- No abstract --

4 Editorial The effects of stress on the dorsal raphe nucleus of the reticular formation and its role in the aetiology of disparate medical and neuropsychiatric disorders. 2016

Puri, B K. ·Department of Medicine, Imperial College London, London, UK. Electronic address: basant.puri@imperial.ac.uk. ·Med Hypotheses · Pubmed #27663632.

ABSTRACT: -- No abstract --

5 Editorial Editorial for Therapeutic Monoclonal Antibodies: What Headache Specialists Need to Know. 2015

Markley, Herbert G. ·New England Regional Headache Center, Worcester, MA, USA. · University of Massachusetts Medical School, Worcester, MA, USA. ·Headache · Pubmed #26255883.

ABSTRACT: -- No abstract --

6 Editorial Putting migraine to sleep: Rexants as a preventive strategy. 2015

Goadsby, Peter J. ·NIHR-Wellcome Trust King's Clinical Research Facility, King's College London, UK Department of Neurology, University of California, San Francisco, USA peter.goadsby@kcl.ac.uk. ·Cephalalgia · Pubmed #25576464.

ABSTRACT: -- No abstract --

7 Editorial Stress and migraine: something expected, something unexpected. 2014

Goadsby, Peter J. ·From the Headache Group, NIHR-Wellcome Trust Clinical Research Facility, King's College London, UK; and Department of Neurology, University of California, San Francisco. ·Neurology · Pubmed #24670890.

ABSTRACT: -- No abstract --

8 Review [Significance of the endocannabinoid system in migraine]. 2019

Gecse, Kinga / Bagdy, Gyorgy / Juhasz, Gabriella. ·SE-NAP 2 Genetikai Agyi Képalkotó Migrén Kutató Csoport, Nemzeti Agykutatási Program, Semmelweis Egyetem, Budapest, Hungary. gabriella.juhasz@manchester.ac.uk. ·Neuropsychopharmacol Hung · Pubmed #30962405.

ABSTRACT: Based on the traditional pain-relieving effect of Cannabis species an endogenous cannabinoidlike system was discovered in the human body. Endocannabinoids have important role in the homeostasis of the body, such as stress response and mood control, feeding behaviour, energy balance and metabolism, immunological processes, and also play important role in controlling pain processing. Previous studies suggested that an endokannabinoid dysfunction, namely endokannabinoid deficit, might contribute to the development of migraine and its chronification. Although, the exact nature of the relationship between migraine and endokannabinoid system is not fully understood yet, in this brief review we summarise research results suggesting that the endokannabinoid system may be a potential drug target in the migraine therapy.

9 Review Primary headaches during lifespan. 2019

Straube, Andreas / Andreou, Anna. ·Department of Neurology, University Hospital LMU, Ludwig-Maximilians-University, 81377, Munich, Germany. andreas.straube@med.uni-muenchen.de. · Headache Research, Wolfson CARD, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. · The Headache Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK. ·J Headache Pain · Pubmed #30961531.

ABSTRACT: Primary headaches are one of the most prevalent neurological disorders and can occur during a wide range of lifespan. Primary headaches, especially migraine, are cyclic disorders with a complex sequence of symptoms within every headache attack. There is no systematic review of whether these symptoms changes during lifespan. Indeed, the clinical presentation of migraine shows an age-dependent change with a significantly shorter duration of the attacks and occurrence of different paroxysmal symptoms, such as vomiting, abdominal pain or vertigo, in childhood and, in contrast, largely an absence of autonomic signs and a more often bilateral headache in the elderly. The age-dependent differences in the clinical presentation are less distinct in cluster headache and, especially, in tension-type headache. The differences in the clinical presentation are in agreement with the idea that the connectivity of hypothalamic areas with different brainstem areas, especially the central parasympathetic areas, is important for the clinical manifestation of migraine, as well as, the change during lifespan.

10 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.

11 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.

12 Review Botulinum toxins for the prevention of migraine in adults. 2018

Herd, Clare P / Tomlinson, Claire L / Rick, Caroline / Scotton, W J / Edwards, Julie / Ives, Natalie / Clarke, Carl E / Sinclair, Alexandra. ·Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK, B15 2TT. ·Cochrane Database Syst Rev · Pubmed #29939406.

ABSTRACT: BACKGROUND: Migraine occurs in around 15% of adults and is ranked as the seventh most disabling disease amongst all diseases globally. Despite the available treatments many people suffer prolonged and frequent attacks which have a major impact on their quality of life. Chronic migraine is defined as 15 or more days of headache per month, at least eight of those days being migraine. People with episodic migraine have fewer than 15 headache days per month. Botulinum toxin type A has been licensed in some countries for chronic migraine treatment, due to the results of just two trials. OBJECTIVES: To assess the effects of botulinum toxins versus placebo or active treatment for the prevention or reduction in frequency of chronic or episodic migraine in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE & MEDLINE in Process, Embase, ClinicalTrials.gov and World Health Organization International Clinical Trials Registry (to December 2017). We examined reference lists and carried out citation searches on key publications. We sent correspondence to major manufacturers of botulinum toxin. SELECTION CRITERIA: Randomised, double-blind, controlled trials of botulinum toxin (any sero-type) injections into the head and neck for prophylaxis of chronic or episodic migraine in adults. Eligible comparators were placebo, alternative prophylactic agent or different dose of botulinum toxin. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials and extracted data. For continuous outcomes we used mean change data when available. For dichotomous data we calculated risk ratios (RRs). We used data from the 12-week post-treatment follow-up time point. We assessed the evidence using GRADE and created two 'Summary of findings' tables. MAIN RESULTS: Description of trialsWe found 90 articles describing 28 trials (4190 participants), which were eligible for inclusion. The longest treatment duration was three rounds of injections with three months between treatments, so we could not analyse long-term effects. For the primary analyses, we pooled data from both chronic and episodic participant populations. Where possible, we also separated data into chronic migraine, episodic migraine and 'mixed group' classification subgroups. Most trials (21 out of 28) were small (fewer than 50 participants per trial arm). The risk of bias for included trials was low or unclear across most domains, with some trials reporting a high risk of bias for incomplete outcome data and selective outcome reporting.Botulinum toxin versus placeboTwenty-three trials compared botulinum toxin with placebo. Botulinum toxin may reduce the number of migraine days per month in the chronic migraine population by 3.1 days (95% confidence interval (CI) -4.7 to -1.4, 4 trials, 1497 participants, low-quality evidence). This was reduced to -2 days (95% CI -2.8 to -1.1, 2 trials, 1384 participants; moderate-quality evidence) when we removed small trials.A single trial of people with episodic migraine (N = 418) showed no difference between groups for this outcome measure (P = 0.49).In the chronic migraine population, botulinum toxin reduces the number of headache days per month by 1.9 days (95% CI -2.7 to -1.0, 2 trials, 1384 participants, high-quality evidence). We did not find evidence of a difference in the number of migraine attacks for both chronic and episodic migraine participants (6 trials, N = 2004, P = 0.30, low-quality evidence). For the population of both chronic and episodic migraine participants a reduction in severity of migraine rated during clinical visits, on a 10 cm visual analogue scale (VAS) of 3.3 cm (95% CI -4.2 to -2.5, very low-quality evidence) in favour of botulinum toxin treatment came from four small trials (N = 209); better reporting of this outcome measure from the additional eight trials that recorded it may have improved our confidence in the pooled estimate. Global assessment and quality-of-life measures were poorly reported and it was not possible to carry out statistical analysis of these outcome measures. Analysis of adverse events showed an increase in the risk ratio with treatment with botulinum toxin over placebo 30% (RR 1.28, 95% CI 1.12 to 1.47, moderate-quality evidence). For every 100 participants 60 experienced an adverse event in the botulinum toxin group compared with 47 in the placebo group.Botulinum toxin versus other prophylactic agentThree trials studied comparisons with alternative oral prophylactic medications. Meta-analyses were not possible for number of migraine days, number of headache days or number of migraine attacks due to insufficient data, but individually trials reported no differences between groups for a variety of efficacy measures in the population of both chronic and episodic migraine participants. The global impression of disease measured using Migraine Disability Assessment (MIDAS) scores were reported from two trials that showed no difference between groups. Compared with oral treatments, botulinum toxin showed no between-group difference in the risk of adverse events (2 trials, N = 114, very low-quality evidence). The relative risk reduction (RRR) for withdrawing from botulinum toxin due to adverse events compared with the alternative prophylactic agent was 72% (P = 0.02, 2 trials, N = 119).Dosing trialsThere were insufficient data available for the comparison of different doses.Quality of the evidenceThe quality of the evidence assessed using GRADE methods was varied but mostly very low; the quality of the evidence for the placebo and active control comparisons was low and very low, respectively for the primary outcome measure. Small trial size, high risk of bias and unexplained heterogeneity were common reasons for downgrading the quality of the evidence. AUTHORS' CONCLUSIONS: In chronic migraine, botulinum toxin type A may reduce the number of migraine days per month by 2 days compared with placebo treatment. Non-serious adverse events were probably experienced by 60/100 participants in the treated group compared with 47/100 in the placebo group. For people with episodic migraine, we remain uncertain whether or not this treatment is effective because the quality of this limited evidence is very low. Better reporting of outcome measures in published trials would provide a more complete evidence base on which to draw conclusions.

13 Review Non-Pharmacological Approaches for Migraine. 2018

Puledda, Francesca / Shields, Kevin. ·Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. francesca.puledda@kcl.ac.uk. · Headache Service, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. ·Neurotherapeutics · Pubmed #29616493.

ABSTRACT: Migraine is one of the most common and debilitating neurological disorders. However, the efficacy of pharmacological therapies may have unsatisfactory efficacy and can be poorly tolerated. There is a strong need in clinical practice for alternative approaches for both acute and preventive treatment. Occasionally, this need might arise in the context of low-frequency migraneurs who are not keen to use medication or fear the potential side effects. At the opposite end of the spectrum, clinicians might be faced with patients who have proven refractory to numerous medications. These patients may benefit from invasive treatment strategies. In recent years, promising strategies for migraine therapy have emerged alongside a progressively better understanding of the complex pathophysiology underlying this disease. This review discusses the most recent and evidence-based advances in non-pharmacological therapeutic approaches for migraine, offering alternatives to drug treatment for both the commonly encountered episodic cases as well as the more complex migraine phenotypes, which are capable of challenging even the headache specialist.

14 Review Targeted CGRP Small Molecule Antagonists for Acute Migraine Therapy. 2018

Holland, Philip R / Goadsby, Peter J. ·Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 125 Coldharbour Lane, London, UK. philip.holland@kcl.ac.uk. · NIHR-Wellcome Trust, King's Clinical Research Facility, King's College Hospital, London, UK. ·Neurotherapeutics · Pubmed #29556965.

ABSTRACT: Migraine is a highly prevalent, severe, and disabling neurological condition with a significant unmet need for effective acute therapies. Patients (~50%) are dissatisfied with their currently available therapies. Calcitonin gene-related peptide (CGRP) has emerged as a key neuropeptide involved in the pathophysiology of migraines. As reviewed in this manuscript, a number of small molecule antagonists of the CGRP receptor have been developed for migraine therapy. Incredibly, the majority of the clinical trials conducted have proven positive, demonstrating the importance of this signalling pathway in migraine. Unfortunately, a number of these molecules raised liver toxicity concerns when used daily for as little as 7 days resulting in their discontinuation. Despite the clear safety concerns, clinical trial data suggests that their intermittent use remains a viable and safe alternative, with 2 molecules remaining in clinical development (ubrogepant and rimegepant). Further, these proofs of principle studies identifying CGRP as a viable clinical target have led to the development of several CGRP or CGRP receptor-targeted monoclonal antibodies that continue to show good clinical efficacy.

15 Review Targeted Acid-Sensing Ion Channel Therapies for Migraine. 2018

Karsan, Nazia / Gonzales, Eric B / Dussor, Gregory. ·Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Denmark Hill, London, SE5 9PJ, UK. · TCU and UNTHSC School of Medicine (applicant for LCME accreditation), Department of Medical Education, 3500 Camp Bowie Blvd., Fort Worth, TX, 76107, USA. · School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, BSB-14, Richardson, TX, 75080, USA. Gregory.dussor1@utdallas.edu. ·Neurotherapeutics · Pubmed #29549622.

ABSTRACT: Acid-sensing ion channels (ASICs) are a family of ion channels, consisting of four members; ASIC1 to 4. These channels are sensitive to changes in pH and are expressed throughout the central and peripheral nervous systems-including brain, spinal cord, and sensory ganglia. They have been implicated in a number of neurological conditions such as stroke and cerebral ischemia, traumatic brain injury, and epilepsy, and more recently in migraine. Their expression within areas of interest in the brain in migraine, such as the hypothalamus and PAG, their demonstrated involvement in preclinical models of meningeal afferent signaling, and their role in cortical spreading depression (the electrophysiological correlate of migraine aura), has enhanced research interest into these channels as potential therapeutic targets in migraine. Migraine is a disorder with a paucity of both acute and preventive therapies available, in which at best 50% of patients respond to available medications, and these medications often have intolerable side effects. There is therefore a great need for therapeutic development for this disabling condition. This review will summarize the understanding of the structure and CNS expression of ASICs, the mechanisms for their potential role in nociception, recent work in migraine, and areas for future research and drug development.

16 Review Targeted 5-HT 2018

Vila-Pueyo, Marta. ·Department of Basic & Clinical Neuroscience, Headache Group, James Black Center, King's College London, 125 Coldharbour Lane, London, SE5 9NU, UK. marta.vila@kcl.ac.uk. ·Neurotherapeutics · Pubmed #29488143.

ABSTRACT: Migraine is a common neurological disease characterised by the presence of attacks of unilateral, severe head pain accompanied by other symptoms. Although it has been classified as the sixth most disabling disorder, the available therapeutic options to treat this condition have not progressed accordingly. The advance in the development of 5-HT

17 Review Abdominal migraine. 2018

Angus-Leppan, Heather / Saatci, Defne / Sutcliffe, Alastair / Guiloff, Roberto J. ·Clinical Neurosciences, Royal Free London NHS Foundation Trust, London NW3 2QG, UK heather.angus-leppan@nhs.net. · Institute of Neurology, University College London. · Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK. · University College London and Great Ormond Street Institute of Child Health, University College London. · Imperial College London. · Faculty of Medicine, University of Chile, Santiago, Chile. ·BMJ · Pubmed #29459383.

ABSTRACT: -- No abstract --

18 Review Targeted Orexin and Hypothalamic Neuropeptides for Migraine. 2018

Strother, Lauren C / Srikiatkhachorn, Anan / Supronsinchai, Weera. ·Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. lauren.strother@kcl.ac.uk. · International Medical College, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand. · Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand. weera.su@chula.ac.th. ·Neurotherapeutics · Pubmed #29442286.

ABSTRACT: The hypothalamus is involved in the regulation of homeostatic mechanisms and migraine-related trigeminal nociception and as such has been hypothesized to play a central role in the migraine syndrome from the earliest stages of the attack. The hypothalamus hosts many key neuropeptide systems that have been postulated to play a role in this pathophysiology. Such neuropeptides include but are not exclusive too orexins, oxytocin, neuropeptide Y, and pituitary adenylate cyclase activating protein, which will be the focus of this review. Each of these peptides has its own unique physiological role and as such many preclinical studies have been conducted targeting these peptide systems with evidence supporting their role in migraine pathophysiology. Preclinical studies have also begun to explore potential therapeutic compounds targeting these systems with some success in all cases. Clinical efficacy of dual orexin receptor antagonists and intranasal oxytocin have been tested; however, both have yet to demonstrate clinical effect. Despite this, there were limitations in these cases and strong arguments can be made for the further development of intranasal oxytocin for migraine prophylaxis. Regarding neuropeptide Y, work has yet to begun in a clinical setting, and clinical trials for pituitary adenylate cyclase activating protein are just beginning to be established with much optimism. Regardless, it is becoming increasingly clear the prominent role that the hypothalamus and its peptide systems have in migraine pathophysiology. Much work is required to better understand this system and the early stages of the attack to develop more targeted and effective therapies aimed at reducing attack susceptibility with the potential to prevent the attack all together.

19 Review Central and peripheral processes in headache. 2018

Varma, Adithya / Jain, Saurabh / Majid, Arshad / De Felice, Milena. ·Department of Neuroscience, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK. ·Curr Opin Support Palliat Care · Pubmed #29438129.

ABSTRACT: PURPOSE OF REVIEW: Migraine is an extremely incapacitating collection of neurological symptoms that usually includes a severe, throbbing, recurring pain on one side of the head. The World Health Organization ranks migraine as the third most prevalent disease and the seventh commonest primary pain condition in the world. Trigeminovascular-mediated central sensitization has been implicated in the development of migraine symptoms including pain following light touch. This review explores the activation and sensitization of the brain systems that have emerged from recent studies and that contribute to migraine. RECENT FINDINGS: A number of pathophysiological mechanisms have been implicated in the development of migraine and other primary headache disorders. Neuroimaging techniques used to identify both structural and functional features of the brain in migraineurs have helped identify brain regions that are active during or in between migraine attacks, with particular emphasis on those areas relevant to pain pathways, including the hypothalamus and periaqueductal grey. SUMMARY: Several key studies have helped address the long-standing debate over whether migraine originates from vascular or neuronal dysfunction and now support that migraine is a neurological disorder. However, a complete understanding of the central nervous system dysfunction underlying this condition has yet to be elucidated.

20 Review Recent Advances in Pharmacotherapy for Migraine Prevention: From Pathophysiology to New Drugs. 2018

Ong, Jonathan Jia Yuan / Wei, Diana Yi-Ting / Goadsby, Peter J. ·Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. · NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, Wellcome Foundation Building, London, SE5 9PJ, UK. · Division of Neurology, Department of Medicine, National University Health System, University Medicine Cluster, Singapore, Singapore. · Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. peter.goadsby@kcl.ac.uk. · NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, Wellcome Foundation Building, London, SE5 9PJ, UK. peter.goadsby@kcl.ac.uk. ·Drugs · Pubmed #29396834.

ABSTRACT: Migraine is a common and disabling neurological disorder, with a significant socioeconomic burden. Its pathophysiology involves abnormalities in complex neuronal networks, interacting at different levels of the central and peripheral nervous system, resulting in the constellation of symptoms characteristic of a migraine attack. Management of migraine is individualised and often necessitates the commencement of preventive medication. Recent advancements in the understanding of the neurobiology of migraine have begun to account for some parts of the symptomatology, which has led to the development of novel target-based therapies that may revolutionise how migraine is treated in the future. This review will explore recent advances in the understanding of migraine pathophysiology, and pharmacotherapeutic developments for migraine prevention, with particular emphasis on novel treatments targeted at the calcitonin gene-related peptide (CGRP) pathway.

21 Review Migraine Treatment: Current Acute Medications and Their Potential Mechanisms of Action. 2018

Ong, Jonathan Jia Yuan / De Felice, Milena. ·Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK. jonathan_ong@nuhs.edu.sg. · NIHR-Wellcome Trust King's Clinical Research Facility, Kings College Hospital, London, UK. jonathan_ong@nuhs.edu.sg. · Department of Medicine, Division of Neurology, National University Health System, University Medicine Cluster, Singapore, Singapore. jonathan_ong@nuhs.edu.sg. · School of Clinical Dentistry, The University of Sheffield, Sheffield, UK. ·Neurotherapeutics · Pubmed #29235068.

ABSTRACT: Migraine is a common and disabling primary headache disorder with a significant socioeconomic burden. The management of migraine is multifaceted and is generally dichotomized into acute and preventive strategies, with several treatment modalities. The aims of acute pharmacological treatment are to rapidly restore function with minimal recurrence, with the avoidance of side effects. The choice of pharmacological treatment is individualized, and is based on the consideration of the characteristics of the migraine attack, the patient's concomitant medical problems, and treatment preferences. Notwithstanding, a good understanding of the pharmacodynamic and pharmacokinetic properties of the various drug options is essential to guide therapy. The current approach and concepts relevant to the acute pharmacological treatment of migraine will be explored in this review.

22 Review Chronic post-traumatic headache in children and adolescents: systematic review of prevalence and headache features. 2018

Shaw, Lauren / Morozova, Maria / Abu-Arafeh, Ishaq. ·Department of Paediatrics, Forth Valley Royal Hospital, Larbert, FK5 4WR, UK. · Paediatric Neurosciences Unit, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK. ·Pain Manag · Pubmed #29192541.

ABSTRACT: The aim of this systematic review is to determine the prevalence and clinical features of chronic post-traumatic headache (CPTH) in children and adolescents. Literature search of PubMed, Embase, Cochrane databases and Google Scholar was carried out for all studies reporting on CPTH in children and young people under the age of 18 years between January 1980 and November 2016. Search command included post-traumatic headache, postconcussion syndrome, child and adolescent. Demographic data, diagnostic criteria of headache disorders, occurrence of headache after head injury and headache phenotypes were collected. The prevalence of nonspecific 'chronic headache' after head injury in children was 39% and prevalence of CPTH, as defined by the International Classification of Headache Disorders (2004), was 7.6% (95% CI: 5.9-9.7). Migraine-like headache was the most common presentation followed by tension-type headache. Other children had either mixed or unclassified headache disorders.

23 Review Migraine in Systemic Autoimmune Diseases. 2018

Cavestro, Cinzia / Ferrero, Marcella. ·Headache Centre, Department of Neurology, "S.Lazzaro", ASL CN2, Alba, Italy. · Forensic and Conservation Genetics, University of Central Lancashire, Preston, United Kingdom. ·Endocr Metab Immune Disord Drug Targets · Pubmed #29173190.

ABSTRACT: BACKGROUND AND OBJECTIVE: Migraine and systemic autoimmune diseases are 2-3-fold more common in women and various studies have reported an association between the two pathologies. METHODS: This review takes into account epidemiological studies involving migraine and systemic lupus erythematosus, antiphospholipid syndrome, Sjogren's syndrome, and other diffuse connective tissue diseases. This scientific literature analysis consists of the main articles found in Medline with a search up to April 2017. RESULTS: Many epidemiological studies were carried out on patients suffering from systemic lupus erythematosus. Results showed that headache and migraine are more prevalent in systemic lupus erythematosus patients compared to controls, especially migraine with aura. Patients with Lupus and migraine show a higher lupus activity and association with Raynaud and/or antiphospholipids in these populations are contradictory. There are not enough data to establish an association between antiphospholipid syndrome and migraine. However, data are more consistent between antiphospholipid carrier condition and migraine. Systemic sclerosis is a rare disease, for this reason the amount of available data on this disorder are scanty. However, some studies reported an association between headache, migraine and systemic sclerosis, especially where gliotic brain lesions and Raynaud are coexisting. Finally, large propensity cohort population based studies suggested that systemic autoimmune diseases are more frequent in patients suffering from migraine. CONCLUSION: An attempt at explaining the possible link between these disorders and migraine is discussed at the end of the review. Several autoimmune alterations are shared by most autoimmune diseases and headache types. Endothelial dysfunction is the only alteration that is common among all these disorders.

24 Review Migraine with prolonged aura: phenotype and treatment. 2018

Viana, Michele / Afridi, Shazia. ·Headache Science Center, C. Mondino National Neurological Institute, Via Mondino 2, 27100, Pavia, Italy. michele.viana@ymail.com. · Department of Neurology, Guy's and St Thomas' NHS Trust, London, UK. ·Naunyn Schmiedebergs Arch Pharmacol · Pubmed #29143861.

ABSTRACT: We review the published literature on migraine with prolonged aura (PA), specifically with regards to the phenotype and treatment options. PA is not uncommon. A recent study found that about 17% of migraine auras are prolonged and that 26% of patients with migraine with aura have experienced at least one PA. The characteristics of PA are similar to most typical auras with the exception of a higher number of aura symptoms (in particular sensory and/or dysphasic). There are no well-established treatments at present which target the aura component of migraine. Other than case reports, there have been open-label studies of lamotrigine and greater occipital nerve blocks. The only randomised, blinded, controlled trial to date has been of nasal ketamine showing some reduction in aura severity but not duration. A small open-labelled pilot study of amiloride was also promising. Larger randomised, controlled trials are needed to establish whether any of the existing or novel compounds mentioned are significantly effective and safe.

25 Review Migraine, menopause and hormone replacement therapy. 2018

MacGregor, E Anne. ·Barts Sexual Health Centre, London, UK. ·Post Reprod Health · Pubmed #28994639.

ABSTRACT: Perimenopause marks a period of increased migraine prevalence in women and many women also report troublesome vasomotor symptoms. Migraine is affected by fluctuating estrogen levels with evidence to support estrogen 'withdrawal' as a trigger of menstrual attacks of migraine without aura, while high estrogen levels can trigger migraine aura. Maintaining a stable estrogen environment with estrogen replacement can benefit estrogen-withdrawal migraine particularly in women who would also benefit from relief of vasomotor symptoms. In contrast to contraceptive doses of ethinylestradiol, migraine aura does not contraindicate use of physiological doses of natural estrogen. In women with migraine with or without aura, using only the lowest doses of transdermal estrogen necessary to control vasomotor symptoms minimizes the risk of unwanted side effects. Cyclical progestogens can have an adverse effect on migraine so continuous progestogens, as provided by the levonorgestrel intrauterine system or in continuous combined transdermal preparation, are preferred. There are no data on the effect of micronized progesterone on migraine, either cyclical or continuous. Non-hormonal options for both conditions are limited but there is evidence of efficacy for escitalopram and venflaxine.