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Migraine Disorders: HELP
Articles from Milan
Based on 226 articles published since 2009

These are the 226 published articles about Migraine Disorders that originated from Milan during 2009-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10
1 Editorial The evolution of migraine therapy: a new concept of care. 2018

Frediani, Fabio. ·Headache Center, Neurological and Stroke Unit, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, Via Pio II, 3, 20153, Milan, Italy. fabio.frediani@asst-santipaolocarlo.it. ·Neurol Sci · Pubmed #29904880.

ABSTRACT: -- No abstract --

2 Review Clinical neurophysiology of migraine with aura. 2019

Coppola, Gianluca / Di Lorenzo, Cherubino / Parisi, Vincenzo / Lisicki, Marco / Serrao, Mariano / Pierelli, Francesco. ·Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica, 79-04100, Latina, Italy. · IRCCS - Don Gnocchi, Piazzale Morandi, 6-20121, Milan, Italy. · IRCCS - Fondazione Bietti, via livenza, 3-00198, Rome, Italy. vmp_g@outlook.it. · Headache Research Unit, University of Liège, Department of Neurology-Citadelle Hospital, Boulevard du Douzième de Ligne, 1-400, Liège, Belgium. · IRCCS - Neuromed, Via Atinense, 18-86077, Pozzilli, (IS), Italy. ·J Headache Pain · Pubmed #31035929.

ABSTRACT: BACKGROUND: The purpose of this review is to provide a comprehensive overview of the findings of clinical electrophysiology studies aimed to investigate changes in information processing of migraine with aura patients. MAIN BODY: Abnormalities in alpha rhythm power and symmetry, the presence of slowing, and increased information flow in a wide range of frequency bands often characterize the spontaneous EEG activity of MA. Higher grand-average cortical response amplitudes, an increased interhemispheric response asymmetry, and lack of amplitude habituation were less consistently demonstrated in response to any kind of sensory stimulation in MA patients. Studies with single-pulse and repetitive transcranial magnetic stimulation (TMS) have reported abnormal cortical responsivity manifesting as greater motor evoked potential (MEP) amplitude, lower threshold for phosphenes production, and paradoxical effects in response to both depressing or enhancing repetitive TMS methodologies. Studies of the trigeminal system in MA are sparse and the few available showed lack of blink reflex habituation and abnormal findings on SFEMG reflecting subclinical, probably inherited, dysfunctions of neuromuscular transmission. The limited studies that were able to investigate patients during the aura revealed suppression of evoked potentials, desynchronization in extrastriate areas and in the temporal lobe, and large variations in direct current potentials with magnetoelectroencephalography. Contrary to what has been observed in the most common forms of migraine, patients with familial hemiplegic migraine show greater habituation in response to visual and trigeminal stimuli, as well as a higher motor threshold and a lower MEP amplitude than healthy subjects. CONCLUSION: Since most of the electrophysiological abnormalities mentioned above were more frequently present and had a greater amplitude in migraine with aura than in migraine without aura, neurophysiological techniques have been shown to be of great help in the search for the pathophysiological basis of migraine aura.

3 Review A narrative review on the burden of migraine: when the burden is the impact on people's life. 2019

Leonardi, Matilde / Raggi, Alberto. ·Neurology, Public Health and Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. matilde.leonardi@istituto-besta.it. · Neurology, Public Health and Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. ·J Headache Pain · Pubmed #31023226.

ABSTRACT: BACKGROUND: The burden of headache disorders, and of migraine in particular, is multifaceted and fragmented. The aim of this narrative review is to provide a description the main topics underlying the concepts of burden and impact of migraine disorders. MAIN RESULTS: MedLine has been searched for publications covering the period 1990-2018 dealing with the terms burden or impact of migraine, including both episodic and chronic migraine. The main results and themes are reported in a descriptive way, and were grouped by similarity of content into overarching categories. A total of 49 papers, published over 25 years (1994-2018), were retained for the qualitative analysis. Six main themes were identified: prevalence of migraine disorders, overall impact of migraine disorders, impact on work or school activities, family impact, interictal burden, and disease costs. Majority of included studies concluded that patients with migraine reported an higher burden or impact in one or more of the six main themes herein identified, compared to non-headache patients or to patients with tension-type headache, with a tendency towards worse outcomes consistently with higher headache frequency. CONCLUSIONS: The results of this narrative review show that the meaning of a sentence like "migraine is a burdensome condition" is not univocal: rather, it may refer to different concepts and meanings. In our opinion, future research should focus on understanding and facing the impact of migraine on work-related activities and on everyday life activities, as these aspects are highly connected to some tangible (i.e. cost) and less tangible (i.e. interictal burden and reduced quality of life) facets of migraine burden. Disease-specific measures have been implemented and should be exploited to enhance our understanding of migraine burden. This approach would allow to better understand the real impact on people's life of such a burdensome disease.

4 Review When does the brain choose pain? 2019

Frediani, Fabio / Bussone, Gennaro. ·Headache Centre - Neurological Department, "S. Carlo Borromeo" Hospital, ASST Santi Paolo e Carlo, Milan, Italy. fabio.frediani@asst-santipaolocarlo.it. · Primary Emeritus of the C. Besta Neurological Institute IRCCS Foundation, Milan, Italy. ·Neurol Sci · Pubmed #30919200.

ABSTRACT: Why does the brain choose pain? Why does an organ that is able to mask pain, even when intense as in fractures or in fighting wounds, decide to let pain pass and begin conscious, such as that of migraine, when there is no noxa patogena and there is no threat to the integrity of the organism, failing in the main function of pain, that of protection? In this brief review, we retrace the journey that led to the identification of the first complex mechanism of regulation of painful input, the spinal gate control system, through the identification of the predominantly thalamocortical supraspinal centers of the neuromatrix, up to the recognition of a pain matrix extremely articulate and sophisticated that integrates elementary sensations with much more complex functions, related to memory, affectivity, emotion, autonomic self-regulation, and homeostasis systems and so on. Why does the protection system lose its fundamental function in migraine in a behavioral harakiri that periodically damages only itself? This is the challenge facing those dealing with primary headaches in the next future: why migraine? The great strides made in the last decades that have led to the understanding of complex pathogenetic mechanisms risk remaining orphans if we fail to identify the primum movens at the base of one of the most common pathologies in the human race.

5 Review Imaging the migrainous brain: the present and the future. 2019

Colombo, Bruno / Messina, Roberta / Rocca, Maria Assunta / Filippi, Massimo. ·Department of Neurology, IRCCS Ospedale San Raffaele, Vita-salute University, Via Olgettina 48, 20100, Milan, Italy. colombo.bruno@hsr.it. · Department of Neurology, IRCCS Ospedale San Raffaele, Vita-salute University, Via Olgettina 48, 20100, Milan, Italy. ·Neurol Sci · Pubmed #30906964.

ABSTRACT: In the last 20 years, we observed significant improvements in the use of magnetic resonance imaging (MRI) for the evaluation of patients affected by migraine. Before these technological advances, knowledge of the pathogenesis of migraine was particularly based on clinical assessment. Complementary to clinical evaluation, conventional MRI provides both specific information for differential diagnosis (particularly if cortical or subcortical lesions are detected in the migrainous brain) and unsurpassable opportunities in migraine research. However, the correlations between brain structural and functional alterations and both the clinical manifestation of the disease and the individual history of the patient remains uncertain. Both quantitative and functional MR-based techniques have a great potential to better provide insights into human brain structures and possible links between brain areas and complex brain networks that could be involved in the pathophysiology of migraine. Morphometric and functional MRI approaches are contributing to better elucidate the mechanisms that underlie the pain mechanisms and functional adaptation in migraine patients. All these information support the view of migraine as a complex brain disorder involving different cortical and subcortical areas.

6 Review Sleep disorder-related headaches. 2019

Ferini-Strambi, Luigi / Galbiati, Andrea / Combi, Romina. ·IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology-Sleep Disorders Centre, Milan, Italy. ferinistrambi.luigi@hsr.it. · "Vita-Salute" San Raffaele University, Milan, Italy. ferinistrambi.luigi@hsr.it. · IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology-Sleep Disorders Centre, Milan, Italy. · "Vita-Salute" San Raffaele University, Milan, Italy. · School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy. ·Neurol Sci · Pubmed #30906963.

ABSTRACT: Migraine with and without aura, cluster headache, hypnic headache, and paroxysmal hemicranias are each reported as intrinsically related to sleep. Chronic migraine, chronic tension-type headache, and medication overuse headache may cause sleep disturbance. Otherwise, both headache and sleep disorder may be manifestations of a same systemic dysfunction. There is a vicious cycle linking sleep disorders and migraine. The poor quality or poor duration of sleep could be a trigger of migraine attack and migraineurs with poor sleep reported a higher headache frequency. Moreover, coping behaviors of migraineurs (e.g., going to sleep early to relieve migraine attacks) can be factors precipitating and perpetuating sleep disturbances themselves. During cluster headache, patients report a poor quality of sleep correlated with the amount of daylight. In particular, it was demonstrated that melatonin levels have influences on cluster headache attacks. Concerning the pathophysiology of hypnic headache, it has been hypothesized a possible role of obstructive sleep apnea in triggering nocturnal attacks: an increased number of apnea episodes has been reported in hypnic headache patients, but a lack of a temporal correlation of headache attacks with the drop of oxygen saturation has been observed. Tension-type headache is the most common headache with sleep dysregulation (lack of sleep or oversleeping) frequently reported as a triggering factor for acute attacks: management of sleep disturbances seems crucial in this form of headache.

7 Review CGRP and migraine from a cardiovascular point of view: what do we expect from blocking CGRP? 2019

Favoni, Valentina / Giani, Luca / Al-Hassany, Linda / Asioli, Gian Maria / Butera, Calogera / de Boer, Irene / Guglielmetti, Martina / Koniari, Chrysoula / Mavridis, Theodoros / Vaikjärv, Marge / Verhagen, Iris / Verzina, Angela / Zick, Bart / Martelletti, Paolo / Sacco, Simona / Anonymous781479. ·Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. valentina.favoni2@unibo.it. · IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3 Pad. G, 40139, Bologna, Italy. valentina.favoni2@unibo.it. · Ricovero Ferdinando Uboldi, Paderno Dugnano, Italy. · Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands. · Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. · IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3 Pad. G, 40139, Bologna, Italy. · Dipartimento Neurologico e INSPE, IRCCS Ospedale San Raffaele, Milan, Italy. · Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. · Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. · Regional Referral Headache Center, Sant'Andrea Hospital, Rome, Italy. · Department of Clinical Pathology, University of Sassari, Sassari, Italy. · 1st Neurology Department, Aeginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. · Faculty of Medicine, University of Tartu, Tartu, Estonia. · Neurology Clinic, University of Perugia, Perugia, Italy. · S. Maria della Misericordia Hospital, Perugia, Italy. · UOC Neurologia e Stroke Unit, Ospedale SS Filippo e Nicola, Avezzano, Italy. · Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy. ·J Headache Pain · Pubmed #30866804.

ABSTRACT: Calcitonin gene-related peptide (CGRP) is a neuropeptide with a pivotal role in the pathophysiology of migraine. Blockade of CGRP is a new therapeutic target for patients with migraine. CGRP and its receptors are distributed not only in the central and peripheral nervous system but also in the cardiovascular system, both in blood vessels and in the heart. We reviewed the current evidence on the role of CGRP in the cardiovascular system in order to understand the possible short- and long-term effect of CGRP blockade with monoclonal antibodies in migraineurs.In physiological conditions, CGRP has important vasodilating effects and is thought to protect organs from ischemia. Despite the aforementioned cardiovascular implication, preventive treatment with CGRP antibodies has shown no relevant cardiovascular side effects. Results from long-term trials and from real life are now needed.

8 Review Prevention, education and counselling: the worldwide role of the community pharmacist as an epidemiological sentinel of headaches. 2019

Baratta, Francesca / Allais, Gianni / Rolando, Sara / Manzoni, Gian Camillo / Bussone, Gennaro / Benedetto, Chiara / Scarinzi, Cecilia / Gnavi, Roberto / Spadea, Teresa / Costa, Giuseppe / Parente, Marco / Mana, Massimo / Giaccone, Mario / Mandelli, Andrea / Brusa, Paola. ·Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, 10125, Turin, Italy. francesca.baratta@unito.it. · Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy. · FI.CEF. onlus, Italian Headache Foundation, via Celoria 11, 20133, Milan, Italy. · Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy. · Federfarma Torino, Via Sant'Anselmo, 14, 10125, Turin, Italy. · Federfarma Piemonte, Via Sant'Anselmo, 14, 10125, Turin, Italy. · Order of Pharmacists of Turin, Via Sant'Anselmo, 14, 10125, Turin, Italy. · FOFI, Federation of the Orders of Italian Pharmacists, Via Palestro 75, 00185, Rome, Italy. · Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, 10125, Turin, Italy. ·Neurol Sci · Pubmed #30854588.

ABSTRACT: Headache disorders are the third among the worldwide causes of disability, measured in years of life lost to disability. Given the pharmacies' importance in general in headache patient and, in particular in migraine patient management, various studies have been carried out in recent years dealing with this issue. Indeed, in 2014, our research group first analysed publications on a number of studies conducted worldwide. As five years have passed since our first analysis of the literature and having carried out a number of specific studies in Italy since 2014, we wish to analyse once again the studies carried out globally on this topic to evaluate how the situation has evolved in the meantime. The key words used for the bibliographic search were "community pharmacy" and "headache"; we considered articles published between 2014 and 2018. The selected studies regarded Sweden USA, Belgium, Ireland, Jordan and Ethiopia. From the analysis of the international research papers, it is evident that, despite the time that has passed since the previous analyses and the general agreement that pharmacists find themselves in an ideal position to offer adequate levels of counselling to headache patients, the knowledge of pharmacists is not yet sufficient. Clearly, there is a strong need to develop training programmes specifically focused on this subject. Regarding Italy, a national study, commenced in 2016, was designed as a cross-sectional survey employing face-to-face interviews between pharmacist and patient using a questionnaire drawn up by experts in compliance with best practice from scientific literature. Six hundred ten pharmacists followed a specific training course; 4425 questionnaires were correctly completed. The use of pharmacies as epidemiological sentinels, given their capillarity and daily contact with the local population in Italy, enabled us to obtain an epidemiological snapshot closer to the real-life situation compared to specialist headache centres. Over the course of this study, data on headaches were gathered in Italian pharmacies with the highest levels of numerosity in the world.

9 Review The neurosurgical treatment of craniofacial pain syndromes: current surgical indications and techniques. 2019

Franzini, Andrea / Moosa, Shayan / D'Ammando, Antonio / Bono, Beatrice / Scheitler-Ring, Kristen / Ferroli, Paolo / Messina, Giuseppe / Prada, Francesco / Franzini, Angelo. ·Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy. andrea.franzini1@hotmail.it. · Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, VA, USA. andrea.franzini1@hotmail.it. · Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, VA, USA. · Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy. · Department of Neurosurgery, Humanitas Research Hospital, Milan, Italy. · University of Missouri School of medicine, Columbia, MO, USA. · Focused Ultrasound Foundation, Charlottesville, VA, USA. ·Neurol Sci · Pubmed #30835002.

ABSTRACT: Craniofacial pain syndromes are comprised of multiple pathological entities resulting in pain referred to the scalp, face, or deeper cranial structures. In a small subset of patients affected by those syndromes, pharmacological and physical therapies fail in alleviating pain. In some of those refractory patients surgical procedures aimed at relieving pain are indicated and have been adopted with variable results and safety profiles. In this review, the authors describe craniofacial pain syndromes that most commonly fail to respond to pharmacological therapies and may be amenable to tailored surgical procedures. In particular, trigeminal, glossopharyngeal, and occipital neuralgias are considered, as well as some primary headache syndromes such as cluster headache, short unilateral neuralgiform headache with conjunctival injection and tearing/short unilateral neuralgiform headache with autonomic symptoms, and migraine. Surgical techniques, including the implantation of deep brain or peripheral nerve electrodes with subsequent chronic stimulation, microvascular decompression of neurovascular conflicts, and percutaneous lesioning of neural structures are described. Finally, surgical indications, outcomes, and safety of these procedures are presented.

10 Review Progression in migraine: Role of mast cells and pro-inflammatory and anti-inflammatory cytokines. 2019

Conti, Pio / D'Ovidio, Cristian / Conti, Chiara / Gallenga, Carla Enrica / Lauritano, Dorina / Caraffa, Alessandro / Kritas, Spiros K / Ronconi, Gianpaolo. ·Immunology Division, Postgraduate Medical School, University of Chieti-Pescara, Chieti, Italy. Electronic address: pconti@unich.it. · Section of Legal Medicine, Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy. Electronic address: cridov@yahoo.it. · Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy. Electronic address: cconti@unich.it. · Department of Biomedical Sciences and Specialist Surgery, Section of Ophthalmology, University of Ferrara, Italy. Electronic address: gllcln@unife.it. · University of Milan-Bicocca, Medicine and Surgery Department, Centre of Neuroscience of Milan, Italy. Electronic address: dorina.lauritano@unimib.it. · Department of Pharmacology, University of Perugia, Perugia, Italy. Electronic address: auro.caraffa@libero.it. · Department of Microbiology and Infectious Diseases, Aristotle University of Thessaloniki, Macedonia, Greece. Electronic address: skritas@vet.auth.gr. · UOS Clinica dei Pazienti del Territorio, Policlinico Gemelli, Rome, Italy. Electronic address: gianpaolo.ronconi@policlinicogemelli.it. ·Eur J Pharmacol · Pubmed #30529470.

ABSTRACT: Migraine is a common painful neurovascular disorder usually associated with several symptoms, such as photophobia, phonophobia, nausea, vomiting and inflammation, and involves immune cells. Mast cells (MCs) are immune cells derived from hematopoietic pluripotent stem cells which migrate and mature close to epithelial, blood vessels, and nerves. In almost all vascularized tissues there are MCs that produce, contain and release biologically active products including cytokines, arachidonic acid compounds, and proteases. In addition, MCs participate in innate and adaptive immune responses. Innate responses in the central nervous system (CNS) occur during neuroinflammatory phenomena, including migraine. Antigens found in the environment have a crucial role in inflammatory response, causing a broad range of diseases including migraine. They can be recognized by several innate immune cells, such as macrophages, microglia, dendritic cells and MCs, which can be activated trough Toll-like receptor (TLR) signaling. MCs reside close to primary nociceptive neurons, associate with nerves, and are capable of triggering local inflammation. MCs are involved in the pathophysiology of various tissues and organs, especially where there is an increase of angiogenesis. Activated MCs release preformed mediators include histamine, heparin, proteases (tryptase, chimase), hydrolases, cathepsin, carboxypeptidases, and peroxidase, and they also generate pro-inflammatory cytokines/chemokines. In addition, activated macrophages, microglia and MCs in the CNS release pro-inflammatory cytokines which provoke an increase of arachidonic acid product levels and lead to migraine and other neurological manifestations including fatigue, nausea, headaches and brain fog. Innate immunity and pro-inflammatory interleukin (IL)-1 cytokine family members can be inhibited by IL-37, a relatively new member of the IL-1 family. In this article, we report that some pro-inflammatory cytokines inducing migraine may be inhibited by IL-37, a natural suppressor of inflammation, and innate and acquired immunity.

11 Review Pharmacotherapy for acute migraines in children and adolescents. 2019

Barbanti, P / Grazzi, L / Egeo, G. ·a Headache and Pain Unit, Department of Neurological , Motor and Sensorial Sciences; IRCCS San Raffaele Pisana , Rome , Italy. · b San Raffaele University , Rome , Italy. · c Neuroalgology Unit , Headache Center Fondazione IRCCS Istituto Neurologico "Carlo Besta" , Milan , Italy. ·Expert Opin Pharmacother · Pubmed #30526161.

ABSTRACT: INTRODUCTION: Migraine is increasingly recognized as an extremely burdensome and disabling disorder in both children and adolescents. A proper treatment plan is needed to improve the quality of life of both children and families as well as to minimize the risk of disease progression. AREAS COVERED: This review focuses on the current pharmacotherapy for acute migraine in pediatric populations, taking into account specific considerations for those drugs tested in randomized, placebo-controlled trials (RCTs). EXPERT OPINION: A large number of RCTs have documented the efficacy, tolerability, and safety of different compounds. Triptans appears more effective than placebo but results are variable and inconsistent. Almotriptan and rizatriptan are effective as oral formulations, as well as sumatriptan and zolmitriptan as both oral and nasal spray formulations. Adding non-steroidal anti-inflammatory drugs (NSAIDs) reinforces triptan's effectiveness. Furthermore, small RCTs have documented both the efficacy of ibuprofen and the ineffectiveness of acetaminophen. Naproxen, ketoprofen, diclofenac, and indomethacin - NSAIDs effective in acute migraines in adults - should be tested also in pediatric subjects. Furthermore, the authors suggest that dopamine receptor antagonists should be considered in cases of severe migraines. Lastly, better designed RCTs are needed to fine-tune current therapeutic resources.

12 Review Can we now say that commonalities between restless leg syndrome and migraine exist? 2019

Raggi, Alberto. ·Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milano, Italy. alberto.raggi@istituto-besta.it. ·Neurol Sci · Pubmed #30280360.

ABSTRACT: The recent manuscript by Xinglong Yang and colleagues provided the first relatively reliable estimate of restless leg syndrome (RLS) prevalence among migraine sufferers, which was estimated at 19% (95% CI 14-24%). The implications of the association between the two conditions are wide, and call for further action aimed to address common disease mechanism-associated conditions such as sleep-related ones and associated burden.

13 Review Is Medication Overuse Drug Specific or Not? Data from a Review of Published Literature and from an Original Study on Italian MOH Patients. 2018

Grazzi, Licia / Grignani, Eleonora / D'Amico, Domenico / Sansone, Emanuela / Raggi, Alberto. ·Division of Neuroalgology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. licia.grazzi@istituto-besta.it. · Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. · Division of Neuroalgology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. ·Curr Pain Headache Rep · Pubmed #30151604.

ABSTRACT: PURPOSE OF REVIEW: The aim is twofold. First, to give an insight on the role exerted by different classes of drugs in favouring migraine chronification. Second, to explore the relationship between type and amount of overused medications and history of previous withdrawal treatment and of frequent relapses. RECENT FINDINGS: All drug classes were found to favour migraine chronification. No data are available for the association with relapses into CM-MOH. Our clinical study shows that patients who underwent previous withdrawal treatments were more likely to be overusers of multiple drug classes and overuse higher amounts of symptomatic medications, particularly, indomethacin, eletriptan and tramadol. Frequent relapsers were more likely to be overusers of opioids or ergotamine and caffeine derivates or of multiple classes, particularly acetylsalicylic acid and ergotamine/caffeine derivates. The joint results our review and clinical study do not seem to support the idea that MOH is drug-specific: rather, it points out that all drug classes may induce migraine chronification. Those drugs which are at higher risk of overuse are among those preferred by the "worst" patients, i.e. those who needed one or more withdrawal treatments for MOH. Our results reinforce the clinical impression that patients with CM and MOH, and particularly the most difficult to treat for their poor response to withdrawal treatments, are characterised by a particular drive towards the consumption of "whatever is likely to be perceived to provide some relief", despite these drugs that are perceived as "more powerful", are often indicated as second- or third-line medications.

14 Review Pediatric sporadic hemiplegic migraine (ATP1A2 gene): a case report and brief literature review. 2018

Schwarz, Ghil / Anzalone, Nicoletta / Baldoli, Cristina / Impellizzeri, Matteo / Minicucci, Fabio / Comi, Giancarlo / Colombo, Bruno. ·Department of Neurology and Neurophysiology, San Raffaele Scientific Institute, Milan, Italy. · Department of Neuroradiology, San Raffaele Scientific Institute, Milan, Italy. · Department of Neurology, Division of Neurosciences, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, via Olgettina 58, 20122, Milan, Italy. · Department of Neurology and Neurophysiology, San Raffaele Scientific Institute, Milan, Italy. colombo.bruno@hsr.it. · Department of Neurology, Division of Neurosciences, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, via Olgettina 58, 20122, Milan, Italy. colombo.bruno@hsr.it. ·Neurol Sci · Pubmed #29904856.

ABSTRACT: -- No abstract --

15 Review Migraine and cerebrovascular disease: still a dangerous connection? 2018

Agostoni, Elio Clemente / Longoni, Marco. ·Neurology and Stroke Unit, Department of Neurosciences, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy. · Neurology and Stroke Unit, Department of Neurosciences, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy. marco.longoni@ospedaleniguarda.it. ·Neurol Sci · Pubmed #29904830.

ABSTRACT: Migraine is a common type of headache in young adults, with an estimated prevalence of 4% before puberty and as high as 25% in women by their mid to late 30s. About one third of migraineurs experience transient neurological symptoms known as auras, which characterize a variant known as migraine with aura. Many evidences have shown an increased risk of vascular events in patients affected by migraine, particularly among women and among migraine patients with aura. Potential underlying mechanisms include endothelial dysfunction, hypercoagulability, platelet aggregation, vasospasm, cardiovascular risk factors, paradoxical embolism, spreading depolarization, shared genetic risk, use of non-steroidal anti-inflammatory drugs, and immobilization. The risk of vascular events in migraine patients is also linked by concomitant oral contraception; moreover, the common finding of increased incidence of right to left cardiac shunt in migraine patients might have a pathogenetic role. Finally, many MRI studies in migraine patients, particularly in migraine with aura, have shown subcortical lesions particularly in the cerebellum as a common finding. In this review, we analyzed the more recent findings regarding the topic of migraine as a risk factor in stroke.

16 Review Optimizing the long-term management of chronic migraine with onabotulinumtoxinA in real life. 2018

Tassorelli, Cristina / Tedeschi, Gioacchino / Sarchielli, P / Pini, Luigi Alberto / Grazzi, Licia / Geppetti, Pierangelo / De Tommaso, Marina / Aguggia, Marco / Cortelli, P / Martelletti, Paolo. ·a Headache Science Center , National Neurological Institute C. Mondino , Pavia , Italy. · b Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy. · c Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy. · d Neurology Clinic , University Hospital of Perugia , Perugia , Italy. · e Center for Neuroscience and Neurotechnology, Polyclinic Hospital , University of Modena and Reggio Emilia , Modena , Italy. · f Headache and Neuroalgology Unit , Neurological Institute "C. Besta" IRCCS Foundation , Milan , Italy. · g Headache Center, Department of Health Sciences , University of Florence , Florence , Italy. · h Applied Neurophysiology and Pain Unit, SMBNOS Department, Polyclinic General Hospital , Bari Aldo Moro University , Bari , Italy. · i Headache Center, Neurology Department , Asti Hospital , Asti , Italy. · j Department of Biomedical and Neuromotor Sciences , University of Bologna , Bologna , Italy. · k IRCCS Institute of Neurological Sciences of Bologna , Bellaria Hospital , Bologna , Italy. · l Department of Clinical and Molecular Medicine, Sapienza University of Rome and Regional Referral Headache Center , Sant'Andrea Hospital , Rome , Italy. ·Expert Rev Neurother · Pubmed #29280408.

ABSTRACT: INTRODUCTION: Management of chronic migraine is challenging. OnabotulinumtoxinA (OBT-A) is the only medication licensed for prevention of chronic migraine, and has been widely adopted in clinical practice. Limited data is available on its long-term use. Areas covered: Data from controlled trials are combined with available data on the long-term use of OBT-A in real-life studies, with information obtained in a recent survey among Italian headache centers, and the clinical experience of the authors. Six areas were identified as relevant to patients with chronic migraine: 1) definition of responders to OBT-A; 2) management of responders to OBT-A; 3) optimal timing of prophylaxis with OBT-A; 4) position of OBT-A in prevention of chronic migraine; 5) management of medication overuse, and 6) patient education. Expert commentary: This review provides an update on the latest evidence regarding the long-term use of OBT-A in chronic migraine and analyzes the critical issues in the decision-making process that emerge from the analysis of the literature and routine practice. A treatment algorithm is proposed for the adoption in the daily practice.

17 Review Vestibular migraine: who is the patient? 2017

Colombo, Bruno / Teggi, Roberto / Anonymous1520907. ·Headache Unit, Department of Neurology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy. colombo.bruno@hsr.it. · ENT Department, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy. ·Neurol Sci · Pubmed #28527080.

ABSTRACT: Vestibular migraine has been classified as a specific entity in which vestibular symptomatology is defined as part of the migrainous disorder. New and appropriate diagnostic criteria have been proposed by the Barany and International Headache Societies. The diagnosis of vestibular migraine mainly depends on the patient history. The NIVE project is a prospectic multicentric study on vestibular migraine. The aim of this project is to evaluate demographics, epidemiology, clinical manifestations of migraine and vertigo in a large cohort of Caucasian patients affected by vestibular migraine.

18 Review The role of visual system in migraine. 2017

Marzoli, Stefania Bianchi / Criscuoli, Alessandra. ·Neuro-ophthalmology Service and Ocular Electrophysiology Laboratory, Scientific Institute Capitanio Hospital, IRCCS Istituto Auxologico Italiano, via Mercalli, 28, 20122, Milan, Italy. s.bianchimarzoli@auxologico.it. · Neuro-ophthalmology Service and Ocular Electrophysiology Laboratory, Scientific Institute Capitanio Hospital, IRCCS Istituto Auxologico Italiano, via Mercalli, 28, 20122, Milan, Italy. ·Neurol Sci · Pubmed #28527076.

ABSTRACT: The visual system is involved in different ways in migraine. Visual auras are the most common form of migraine aura. It may consist of positive or negative visual symptoms and cortical spreading depression is felt to be the phenomenon that underlies it. Even in migraine without aura, vision it is not totally excluded given that one of the major criteria for the diagnosis of migraine is photophobia. In persistent visual aura, patients refer symptoms defined as visual snow and television static. In retinal migraine unilateral decreased vision or complete visual loss occurs. Ophthalmoplegic migraine is characterized by palsy of one among the three ocular motor nerves. Migraine visual aura, particularly when occurring without headache, is a diagnosis of exclusion. Imaging studies and laboratory tests should exclude neurologic disease, included seizures and central nervous system tumor, ocular pathologies, carotid or cardiac disease, thrombosis and connective tissue disease.

19 Review Usefulness of nutraceuticals in migraine prophylaxis. 2017

D'Onofrio, Florindo / Raimo, Simona / Spitaleri, Daniele / Casucci, Gerardo / Bussone, Gennaro. ·Institute of Neurology San G. Moscati Hospital, Avellino, Italy. · Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy. simonaraimo.sun@gmail.com. · San Francesco Hospital, Telese Terme, Benevento, Italy. · C. Besta Neurological Institute and Foundation, Milan, Italy. ·Neurol Sci · Pubmed #28527067.

ABSTRACT: Several studies have supported the efficacy of complementary and alternative medicine approaches (physical, behavioral and nutraceutical therapies) in the treatment of headache disorders. Nutraceutical treatment consists of taking vitamins, supplements (magnesium, riboflavin, coenzyme Q10, and alpha lipoic acid) and herbal preparations (feverfew and butterbur), and its usage is frequently determined by dissatisfaction with conventional medical therapies. There is a growing body of research on nutraceutical use for migraine prophylaxis. This brief overview provides information about the potential efficacy and side effects of various nutraceutical products summarizing randomized controlled trials of some of the most commonly used non-pharmacological treatments for the prophylaxis and treatment of migraine, including magnesium, coenzyme Q10, riboflavin (vitamin B

20 Review Action mechanisms of Onabotulinum toxin-A: hints for selection of eligible patients. 2017

Lovati, Carlo / Giani, Luca. ·Neurology Unit, Headache Center, Osp. L.Sacco, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy. carlo.lovati@asst-fbf-sacco.it. · Neurology Unit, Headache Center, Osp. L.Sacco, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy. ·Neurol Sci · Pubmed #28527052.

ABSTRACT: In the past few decades, the so-feared botulinum toxin has conversely acquired the role of a ever more versatile therapeutic substance, used in an increasing number of pathological situations, including chronic headache and more precisely in the prophylaxis of chronic migraine. The medical use of botulinum toxin allowed to better understand its multiple mechanisms of action. Investigations about the pathophysiology of primary and secondary headaches has shown a series of common biological elements that frequently are also targets of the action of botulinum toxin. These increasing evidences allowed to identify some biochemical, neurophysiological and radiological markers that may be useful in the individuation of patients which probably will respond to the treatment with Onabotulinum toxin-A among chronic migraineurs. These predictors include CGRP plasmatic levels, specific laser-evoked potential responses, peculiar brain MRI and fMRI and characteristic clinical manifestations. Unfortunately, at now, these predictors are still not available for the clinical practice. Furthermore, the better knowledge about biology of headaches and regarding botulinum toxin activities may also help in directing investigations on the possible use of Onabotulinum toxin-A in other headaches different from migraine. This review tries to show in detail these biological mechanisms and their implication in selecting patients eligible for the treatment with Onabotulinum toxin-A.

21 Review The link between obesity and migraine in childhood: a systematic review. 2017

Farello, G / Ferrara, P / Antenucci, A / Basti, C / Verrotti, A. ·Department of Pediatrics, University of L'Aquila, Via Vetoio 1, Coppito, 67100, L'Aquila, Italy. giovanni.farello@cc.univaq.it. · Department of Pediatrics, Catholic University, A. Gemelli Hospital, Rome, Italy. · Department of Pediatrics, University of L'Aquila, Via Vetoio 1, Coppito, 67100, L'Aquila, Italy. ·Ital J Pediatr · Pubmed #28270183.

ABSTRACT: Obesity and headache are two highly prevalent diseases both in adults and children and they are associated with a strong personal and social impact. Many studies suggest that obesity is comorbid with headache in general, and migraine in particular and obesity seems to be a risk factor for migraine progression and for migraine frequency both in adults and in children. Research shows that there are multiple areas of overlap between migraine pathophysiology and the central and peripheral pathways regulating feeding: inflammatory mediators such as the calcitonin gene-related protein (CGRP), neurotransmitters such as serotonin, peptides such as orexin and adipocytokines such as adiponectin (ADP) and leptin could explain the common pathogenesis. In this paper we discussed the association between obesity and migraine through the analysis of the most recent studies in children and we reviewed data from literature in order to assess the association between obesity and headache and to clarify the possible common pathogenic mechanisms.

22 Review Brain plasticity and migraine transformation: fMRI evidences. 2016

Lovati, Carlo / Giani, Luca / Mele, Francesco / Sinelli, Alessandro / Tien, Thien Trung / Preziosa, Giulia / Mariani, Claudio. ·a Neurology Unit, Luigi Sacco Hospital , University of Milan , Milan , Italy. · b University of Milan , Milan , Italy. ·Expert Rev Neurother · Pubmed #27388277.

ABSTRACT: INTRODUCTION: Chronification transforms episodic migraine into the pathologic chronic form. Biological characteristics of the migrainous brain progressively change, in predisposed subjects, under the repetition of external and internal stimuli. Modifications involve neurons, synapses, neurotransmitters, receptors, connectivity and pain control. f-MRI is a promising way to explore the still unclear biology of this progression. Areas covered: Data included were obtained from the most relevant and updated works available on PubMed about this topic. We summarized the pathophysiology of migraine chronification and of brain plasticity, and we described the different fMRI techniques and their main evidences about migraine transformation. Expert commentary: Functional-MRI has revealed many aspects regarding the peculiarity of the migrainous brain and its tendency toward chronicity but a series of questions are still open: What are the hallmarks of the predisposition to chronification? Which elements are the cause and which the consequence of this process?

23 Review A review of recent literature on functional MRI and personal experience in two cases of definite vestibular migraine. 2016

Teggi, Roberto / Colombo, B / Rocca, M A / Bondi, S / Messina, R / Comi, G / Filippi, M. ·ENT Department, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy. teggi.roberto@hsr.it. · Department of Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. · Neuroimaging Research Unit, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. · ENT Department, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy. ·Neurol Sci · Pubmed #27225278.

ABSTRACT: The pathophysiology of vestibular migraine (VM) is at present poorly understood. Functional magnetic resonance imaging (fMRI), a technique that measures brain activity by detecting changes associated with blood flow oxygenation, has been used to study neural pathways involved in VM pathophysiology. In this study, we summarize results of previous fMRI studies in VM patients, both during and between vertigo attacks. Moreover, we report our experience in two patients with definite VM, who underwent fMRI during a visual stimulation in a vertigo-free period. Compared with 15 matched healthy controls, fMRI demonstrated activation of brain areas related to integration of visual and vestibular cues (increased activation of the paracentral lobule and bilateral inferior parietal lobule and decreased activation of the left superior frontal gyrus, head of the caudate nucleus, left superior temporal gyrus, left parahippocampal gyrus, and right lingual gyrus). Our results partially confirm those of other authors, reporting increased activation of multimodal association brain areas (BA 40, BA 31/5) and decreased activation of occipital regions In addition, we also found a decreased activation of fronto-temporal areas, such as the parahippocampal region, functionally involved in space memory and navigation.

24 Review SMART (stroke-like migraine attack after radiation therapy) syndrome: a case report with review of the literature. 2016

Rigamonti, Andrea / Lauria, Giuseppe / Mantero, Vittorio / Filizzolo, Marco / Salmaggi, Andrea. ·Department of Neurology, "Alessandro Manzoni" General Hospital, Via Dell'Eremo 9/11, 23900, Lecco, Italy. rig74@libero.it. · Neuroalgology and Headache Unit, National Neurological Institute C. Besta, Via Celoria 11, 20133, Milan, Italy. · Department of Neurology, "Alessandro Manzoni" General Hospital, Via Dell'Eremo 9/11, 23900, Lecco, Italy. · Neuroradiology, A.O Manzoni, Via Dell'Eremo 9/11, 23900, Lecco, Italy. ·Neurol Sci · Pubmed #26466588.

ABSTRACT: -- No abstract --

25 Review Nimodipine in otolaryngology: from past evidence to clinical perspectives. 2015

Monzani, D / Genovese, E / Pini, L A / Di Berardino, F / Alicandri Ciufelli, M / Galeazzi, G M / Presutti, L. ·Unità Operativa Complessa di Otorinolaringoiatria. Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy; · Cattedra di Farmacologia Clinica, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy; · Unità Operativa Complessa di Audiologia, Fondazione "IRCCS Ca' Granda", Ospedale Maggiore Policlinico di Milano, Italy; · Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università degli Studi di Modena e Reggio Emilia. ·Acta Otorhinolaryngol Ital · Pubmed #26246657.

ABSTRACT: As L-type voltage-gated calcium channels (VGCCs) control Ca(2+) influx and depolarisation of cardiac and vascular smooth muscle, they represent a specific therapeutic target for calcium channel blockers (CCBs), which are approved and widely used to treat hypertension, myocardial ischaemia and arrhythmias. L-type currents also play a role in calcium entry in the sensory cells of the inner ear. In hair cells of both cochlea and labyrinth, calcium cytoplasmic influx is the first physiological process that activates complex intracellular enzymatic reactions resulting in neurotransmitter release. Excessive calcium ion entry into sensory cells, as a consequence of L-VGCCs malfunction is responsible for over-activation of phospholipase A2 and C, protein kinase II and C, nitric oxide synthase and both endonucleases and depolymerases, which can cause membrane damage and cellular death if the cytoplasmic buffering capacity is overcome. Nimodipine, a highly lipophilic 1-4 dihydropyridine that easily crosses the brain-blood barrier, is generally used to reduce the severity of neurological deficits resulting from vasospasm in patients with subarachnoid haemorrhage. Moreover, due to its selective blocking activity on L-channel calcium currents, nimodipine is also suggested to be an effective countermeasure for cochlear and vestibular dysfunctions known as channelopathies. Indeed, experimental data in amphibians and mammalians indicate that nimodipine has a stronger efficacy than other CCBs (aminopyridine, nifedipine) on voltage-dependent whole-cell currents within hair cells at rest and it is the only agent that is also effective during their mechanically induced depolarisation. In humans, the efficacy of nimodipine is documented in the medical management of peripheral vestibular vertigo, sensorineural hearing loss and tinnitus, even in a pathology as complex as Ménière's disease. Nimodipine is also considered useful in the prophylaxis of damage to the facial and cochlear nerves caused by ablative surgery of cerebellopontine tumours; it has been recently hypothesised to accelerate functional recovery of recurrent nerve lesions during thyroid cancer surgery. Further trials with adequate study design are needed to test the efficacy of nimodipine in the treatment of vertigo due to cerebrovascular disease and vestibular migraine.