migraine Tag

13 Oct

Posted at 19:26h in Author Interviews, JAMA, Neurology, OBGYNE

MedicalResearch.com Interview with:

Professor Anick Bérard PhD FCAHS FISPE

Canada Research Chair Tier 1 on Medications and Pregnancy

Faculty of Medicine, Université Paris Cité, France

Faculty of Pharmacy, University of Montreal

Adjunct Professor, Faculty of Pharmacy, Université Claude Bernard Lyon 1, France

Principal Investigator: Canadian Mother-Child Initiative on Drug Safety in Pregnancy (CAMCCO – Research, Training, Knowledge-Dissemination); CONCEPTION study – COVID-19 and Pregnancy; AMerican PREGNANcy-Mother-Child CohorT (AM-PREGNANT)

Director, Research Unit on Medications and Pregnancy, Research Center – CHU Sainte-Justine

Editor in Chief, Frontiers in Pharmacology – Pharmacoepidemiology

Medication and Pregnancy Notice: Migraine preventive medications, including anti-CGRP therapies and propranolol, should only be prescribed and monitored by your healthcare provider. If you are pregnant, planning a pregnancy, or think you may be pregnant, do not stop, start, or change any medication on your own. Talk with your healthcare provider about the risks and benefits for your individual situation.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:

  • Migraine is very prevalent in pregnancy – 20%.
  • It usually improves in the 2nd/3rd trimester – especially for migraine without aura.
  • Anti-CGRPs are effective therapies for the prevention of migraine but their safety in pregnancy is unknown. Guidelines do not recommend use during pregnancy except in very few cases. Women with chronic migraine are usually switched to safer alternatives 5-6 months before pregnancy (because of the 30-day half-life – 5 times the half-life). But inadvertent exposures occur.
  • Our study is the first large scale study looking at the safety of anti-CGRP during pregnancy for the prevention of chronic migraine. Using data from US pregnant women with chronic migraine, anti-CGRP use increased the risk of spontaneous abortion by 42% (baseline risk of clinically detected spontaneous abortions is 6-8%; the absolute risk on anti-CGRP becomes 8-11%); but propranolol use did not. Our findings are in line with the current guidelines on migraine preventive therapies which recommend discontinuation of anti-CGRP at least 5 months before conception and switch to established migraine preventive therapies such as propranolol.

29 Mar

Posted at 14:13h in Author Interviews, Brigham & Women's - Harvard, Neurology, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_58952" align="alignleft" width="200"]William R. Renthal, MD, PhD Director of Research, John R. Graham Headache Center Department of Neurology Brigham and Women's Hospital Assistant Professor of Neurology, Harvard Medical School Dr. Renthal[/caption] William R. Renthal, MD, PhD Director of Research, John R. Graham Headache Center Department of Neurology Brigham and Women's Hospital Assistant Professor of Neurology, Harvard Medical School MedicalResearch.com:  What is the background for this study?  Response: We know that a nervous system structure called the trigeminal ganglion plays a critical role in migraine headache, but the cell types that exist in this structure are poorly understood. We have used cutting-edge, single-cell genomic technologies to profile the genes expressed within each trigeminal ganglion cell type in both human and mouse with the goal of identifying molecular features that could allow us to inhibit head pain selectively without affecting other cell types.

18 Aug

Posted at 21:19h in Author Interviews, NEJM, Neurology, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_57964" align="alignleft" width="200"]Jessica Ailani M.D. FAHS FAAN FANA Director Medstar Georgetown Headache Center Vice Co-Chair of Strategic Planning for MedStar Neurology Professor of Clinical Neurology MedStar Georgetown University Hospital Dr. Ailani[/caption] Jessica Ailani M.D. FAHS FAAN FANA Director Medstar Georgetown Headache Center Vice Co-Chair of Strategic Planning for MedStar Neurology Professor of Clinical Neurology MedStar Georgetown University Hospital MedicalResearch.com: What is the background for this study? Response: Migraine is a common neurological disease that causes disabling attacks that can be frequent. Preventive treatments can help reduce the frequency of attacks and improve patient function, reducing disease burden.

22 May

Posted at 13:42h in Author Interviews, Brigham & Women's - Harvard, Clots - Coagulation, Hematology, Neurological Disorders, Pain Research
MedicalResearch.com Interview with: Daniel Chasman, PhD Pamela Rist, ScD, Yanjun Guo, MD, PhD Division of Preventative Medicine Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been speculation in the field about relationships between coagulation and migraine susceptibility for some time, but previous research has been largely inconclusive. In this study, we leveraged Mendelian randomization, a mode of genetic analysis that can support or refute potential causal effects on a health outcome, to examine whether hemostatic factors may contribute to risk of MA.

11 Jun

Posted at 22:11h in Author Interviews, JAMA, Pain Research
MedicalResearch.com Interview with: Tobias Kurth, MD, ScD (Pronouns: he/him) Professor of Public Health and Epidemiology Director, Institute of Public Health Charité – Universitätsmedizin Berlin  MedicalResearch.com: What is the background for this study? Response: Migraine (with aura) has been associated with increased risk of cardiovascular disease but its absolute contribution in relation to other major vascular risk factors was not unclear.

11 May

Posted at 15:45h in Author Interviews, Neurological Disorders, Neurology, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_54158" align="alignleft" width="160"]Holly Yancy, DO Headache medicine specialist Phoenix, AZ Dr. Yancy[/caption] Holly Yancy, DO Headache medicine specialist Banner – University Medicine Neuroscience Institute Phoenix, AZ Dr. Yancy comments on the recent Neurology journal article on the potential impact of yoga on migraine.  MedicalResearch.com: What is the background for this study? How might yoga reduce migraine intensity or frequency?  Response: The authors of this trial have studied the benefits of yoga when added to medical management of episodic migraine. They expand on prior, smaller reports of the potential benefit of yoga and mindfulness to migraine patients with a well-designed study that shows yoga, as an adjunct to preventive medication, can lower the intensity, frequency and impact of migraines. Participants even used less abortive medication. The authors propose multiple potential mechanisms of action, including an increase in parasympathetic / decrease in sympathetic nervous system activity, decreased muscle tension, and stress management.

12 Feb

Posted at 19:00h in Author Interviews, Neurology, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_53142" align="alignleft" width="200"]Chun Yuen Fong Post-doc research fellow Center for Cognitive and Evolutionary Science University of Tokyo Dr. Fong[/caption] Chun Yuen Fong Post-doc research fellow Center for Cognitive and Evolutionary Science University of Tokyo  MedicalResearch.com: What is the background for this study? Response: Migraine is one of the most prevalent neurological disorders worldwide. However, what exactly trigger a migraine episode is not entirely clear despite years of research. Moreover, migraine sufferers often report having excessive sensitivity to light and certain patterns during the headache-free period. Some researchers suggested that such abnormal sensations were associated with the enhanced cortical hyperexcitability of the migraine sufferers. In our study, we aimed to build on this theory by comparing the neurophysiological activities between regular migraine sufferers and control using electroencephalography (EEG). Using the same research method, we also compared the neural activities between healthy participants who reported having more abnormal visual sensations to those with less.

27 Nov

Posted at 00:26h in Author Interviews, JAMA, Neurology, Ophthalmology, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_52310" align="alignleft" width="133"]Priv.-Doz. Dr. med. Christoph Schankin Consultant Head University Headache Clinic Department of Neurology Inselspital, Bern University Hospital University of Bern Dr. Schankin[/caption] Priv.-Doz. Dr. med. Christoph Schankin Consultant Head University Headache Clinic Department of Neurology Inselspital, Bern University Hospital University of Bern MedicalResearch.com: What is the background for this study? Response: Visual snow syndrome is a debilitating disorder with a continuous TV snow-like visual disturbance that persists over years. Patients have additional visual problems, such as severe afterimages, floaters or photophobia. The syndrome is associated with migraine and migraine aura, but the interaction between the two remains unclear.

17 Dec

Posted at 23:47h in Author Interviews, Diabetes, JAMA, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_46571" align="alignleft" width="200"]Guy Fagherazzi, MSc, PhD, HDR Senior Research Scientist in Digital & Diabetes Epidemiology Center of Research in Epidemiology and Population Health  Inserm, Paris-South Paris-Saclay University Dr. Guy Fagherazzi[/caption] Guy Fagherazzi, MSc, PhD, HDR Senior Research Scientist in Digital & Diabetes Epidemiology Center of Research in Epidemiology and Population Health Inserm, Paris-South Paris-Saclay University MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Migraine has further been associated with increased risk of overall and specific cardiovascular disease events. Because migraine has also been associated with factors related with insulin resistance and type 2 diabetes, an association between migraine and diabetes has been hypothesized. We observed a lower risk of type 2 diabetes in women with active migraine. We also show a linear decrease of migraine prevalence long before and a plateau long after type 2 diabetes diagnosis. 

17 Jul

Posted at 14:27h in Author Interviews, ENT, JAMA, Neurology, Pain Research

MedicalResearch.com Interview with: Jen-Tsung Lai, MD Department of Otolaryngology Kuang-Tien General Hospital Shalu, Taichung, Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cochlear Migraine( CM ) is a new proposed diagnosis in 2018. CM could present as fluctuating hearing loss or sudden hearing loss that provoked the tinnitus. Furthermore , CM with...

04 Jun

Posted at 21:37h in Author Interviews, Pain Research, Pharmaceutical Companies
MedicalResearch.com Interview with: Zosano Pharma Dr. Peter Schmidt, MD, MSc Senior Director, medical Affairs and Clinical Development Zosano Pharma   MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a post-hoc analysis of Zosano’s pivotal efficacy trial using its adhesive dermally-applied microarray (ADAM) zolmitriptan formulation, M207. The trial found that M207 was effective versus placebo for the co-primary endpoints of pain freedom and most bothersome symptom (MBS) freedom, both at two hours. The MBS endpoint was just ratified as a new endpoint in the FDA’s February 2018 guidance for acute migraine trials. The stated aim of this new endpoint is “…to better align the study outcome with the symptom(s) of primary importance to patients…” This is logical, as a given migraine patient may not experience all four previous symptom endpoints (pain, photophobia, phonophobia, nausea).

07 May

Posted at 11:14h in Author Interviews, Brigham & Women's - Harvard, Emergency Care, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_41533" align="alignleft" width="200"]Paul B. Rizzoli, M.D., FAAN, FAHS Department of Neurology Brigham and Women’s Hospital Clinical and Fellowship Director, John R Graham Headache Center Brigham and Women’s Faulkner Hospital Assistant Professor of Neurology Harvard Medical School Dr. Rizzoli[/caption] Paul B. Rizzoli, M.D., FAAN, FAHS Department of Neurology Brigham and Women’s Hospital Clinical and Fellowship Director, John R Graham Headache Center Brigham and Women’s Faulkner Hospital Assistant Professor of Neurology Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Migraine and other recurrent headache disorders disproportionately affect otherwise healthy, middle-aged people, particularly women, and are a leading cause of suffering and disability. Accurate epidemiologic information is vital for providers, researchers and policy makers. In this paper we surveyed the most recent data from population-based studies in the United States to assess the burden and impact of these conditions. Our search included such sources as the National Health Interview Study (NHIS), the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Ambulatory Medical Care Survey (NAMCS). We found that the prevalence and burden of self-reported migraine and other severe headache has remained stable but high in the past 19 years, affecting roughly 1 out of every 6 Americans (15.3%) and 1 in 5 women (20.7%) over a 3-month period. Among other findings was that headache is proportionately more burdensome those in middle age (elderly also), those who are unemployed and those who are disabled or who have low family income. Headache represents roughly 3% of all annual emergency department visits. 

04 Apr

Posted at 11:18h in Author Interviews, BMJ, Heart Disease, Pain Research, Stroke
MedicalResearch.com Interview with: [caption id="attachment_40974" align="alignleft" width="133"]Islam Elgendy MD Division of Cardiovascular Medicine University of Florida   Dr. Elgendy[/caption] Islam Elgendy MD Division of Cardiovascular Medicine University of Florida   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Migraine headache is a prevalent medical condition, often being chronic and debilitating to many. Previous studies have shown that migraine, particularly migraine with aura, is associated with an increased risk of cardiovascular events. Recently, a number of these studies have reported long-term follow up data. To better understand the long-term morbidity that is associated with migraines, we performed a systematic evaluation to study the link between migraine and risk of cardiovascular and cerebrovascular events. This study demonstrated that migraine is associated with an increased risk of major adverse cardiovascular and cerebrovascular events, which was driven by an increased long-term risk of myocardial infarction and stroke. This effect was predominantly observed in migraineurs who have aura. 

01 Feb

Posted at 12:19h in Author Interviews, BMJ, Heart Disease, Pain Research, Stroke
MedicalResearch.com Interview with: “Headache.” by Avenue G is licensed under CC BY 2.0Kasper Adelborg, MD, PhD Postdoctoral Fellow Department of Clinical Epidemiology Aarhus University Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Around one billion people worldwide are affected by migraine. Migraine has considerable impact on quality of life and imposes a substantial burden on society. Migraine is primarily a headache disorder, but previous studies have suggested a link between migraine and stroke and myocardial infarction, particularly among women, while the link between migraine and other heart problems are less well known. In this large register-based Danish study published in the BMJ, we confirmed that migraine is associated with increased risks of stroke and myocardial infarction, but we also found that migraine was associated with increased risks of other cardiovascular diseases (specifically, venous thromboembolism and atrial fibrillation). Migraine was not associated with increased risks of heart failure or peripheral artery disease. In contrast to most previous studies, our study had a very large sample size and an age- and sex- matched comparison cohort from the general population, which allowed us to put migraine in a population context and to perform several subgroup analyses. Here, we found several interesting findings.
  • In general, the associations were strongest in the first year after diagnosis but persisted in the long term (up to 19 years after diagnosis).
  • Most associations applied to both migraine patients with aura (warning signs before a migraine, such as seeing flashing lights) and in those without aura, and in both women and in men. 

05 Jan

Posted at 00:48h in Author Interviews, Pain Research, Surgical Research
MedicalResearch.com Interview with: “Migraine” by makelessnoise is licensed under CC BY 2.0Lisa Gfrerer, MD PhD Clinical Fellow in Surgery Brigham and Women's Hospital William Gerald Austen MD Chief, Plastic and Reconstructive Surgery Chief, Division of Burn Surgery Massachusetts General Hospital  MedicalResearch.com: What are the main findings? Response: Migraine surgery patients at our institution are chronic pain patients who have failed conservative therapy and are severely disabled by their disease. We initiated this study to understand two important points. First, it was previously unclear how to categorize these patients in terms of pain intensity and disability on the spectrum of better known pain conditions such as chronic back pain/ nerve pain/ carpal tunnel.  This is very important to appreciate the extent of this disease. Second, instead of collecting migraine characteristic such as decrease in migraine days/ duration/ pain, we wanted to understand how functionally disabled these patients are in their daily lives and how much better they get after surgery. This is ultimately what matters to patients. We therefore decided to evaluate our outcomes by using the Pain Self Efficacy Questionnaires (PSEQ). This validated pain questionnaire has been used to describe pain intensity/disability in patients with different acute and chronic pain conditions.

08 Mar

Posted at 13:02h in Author Interviews, JAMA, Pain Research, Stroke
MedicalResearch.com Interview with: Alessandro Pezzini, MD, FESO Professore Associato di Neurologia Dipartimento di Scienze Cliniche e Sperimentali Clinica Neurologica Università degli Studi di Brescia Italia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scarce reports have suggested that a relation might exist between migraine and cervical artery dissection (CEAD), the most frequent cause of ischemic stroke in young adults in Western countries. However, data available so far were obtained from few studies conducted on small cohorts of patients, which limits the generalizability of their findings. In our study we analysed the data from the Italian Project on Stroke in Young Adults (IPSYS) project, one of the largest registries of young ischemic stroke patients, and observed that migraine, especially the subtype without aura was strongly and independently associated to CEAD. This seems particularly true for men and for people younger than 39 years.

13 Jan

Posted at 14:28h in Author Interviews, BMJ, Brigham & Women's - Harvard, Pain Research, Stroke
MedicalResearch.com Interview with: [caption id="attachment_31109" align="alignleft" width="135"]Dr. Matthias Eikermann, MD, PhD Associate Professor of Anaesthesia, Harvard Medical School Clinical Director, Critical Care Division Dr. Matthias Eikermann[/caption] Dr. Matthias Eikermann, MD, PhD Associate Professor of Anaesthesia Harvard Medical School Clinical Director, Critical Care Division  MedicalResearch.com: What is the background for this study? Response: Up to one fifth of the general population have migraine, a primary, chronic-intermittent headache disorder affecting the neuronal and vascular systems and characterized by severe headache accompanied by nausea and/or sensory hypersensitivities such as photophobia and phonophobia. In approximately 20-30% of patients, the headache phase is preceded or accompanied by transient focal neurological disturbances presenting as visual symptoms but also sensory, aphasic, or motor symptoms known as migraine aura. Stroke is responsible for approximately 6.2 million deaths a year and is a leading global cause of long term disability. Considering that more than 50 million patients in hospital and 53 million ambulatory patients undergo surgical procedures in the United States every year. We found that patients with migraine, particularly migraine with aura, undergoing a surgical procedure are at increased risk of perioperative ischemic stroke and readmission to hospital within 30 days after discharge.

06 Nov

Posted at 13:11h in Author Interviews, Dermatology, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_21019" align="alignleft" width="200"]Alexander Egeberg, MD PhD National Allergy Research Centre, Departments of Dermato-Allergology and Cardiology Herlev and Gentofte University Hospital, University of Copenhagen Hellerup, Denmark Dr. Alexander Egeberg[/caption] Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Hellerup Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with rosacea frequently report symptoms of migraine, and this link has been discussed for many years. However, very little research has actually been performed in this area, and the prevalence varies greatly between studies. We examined the prevalence of migraine in patients with rosacea, nationwide, as well as the risk of new-onset migraine in patients with manifest rosacea. We found a markedly increased prevalence of migraine among patients with rosacea. The risk of new-onset migraine was also higher among patients with rosacea, but only among women. Perhaps most notably was the observation that risk of new-onset migraine was highest among patients older than 50 years. This was surprising, since new-onset migraine in older individuals is often considered a "red flag".

13 Jun

Posted at 15:54h in Author Interviews, Biomarkers, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_24979" align="alignleft" width="142"]Dr. Gretchen Tietjen MD Professor and Chair of Neurology Director of UTMC Headache Treatment and Research Program Director of the UTMC Stroke Program Dr. Gretchen Tietjen[/caption] Dr. Gretchen Tietjen MD Professor and Chair of Neurology Director of UTMC Headache Treatment and Research Program Director of the UTMC Stroke Program MedicalResearch.com: What is the background for this study? Dr. Tietjen : C-reactive protein (CRP) is a well-established biomarker of inflammation. Elevated levels of CRP predict future cardiovascular events, such as myocardial infarction (heart attack) and stroke. Evidence linking higher CRP levels with migraine is limited and results from large population-based studies are conflicting. The National Health and Nutrition Examination Survey (NHANES) data for children and adolescents linked elevated CRP to headache, particularly in girls, and the Women’s Health Study showed an association of CRP with migraine in women over 45 years of age. In the Reykjavik study, CRP levels in persons with migraine were similar to levels in those without migraine. The aim of our study was to examine the relationship of CRP and migraine in a large population-based sample of over 9,000 young adults (24 to 32 years old) from The National Longitudinal Study of Adolescent to Adult Health (Add Health).

01 Jun

Posted at 11:44h in Author Interviews, BMJ, Brigham & Women's - Harvard, Heart Disease, Neurological Disorders, Women's Heart Health

MedicalResearch.com Interview with: [caption id="attachment_24756" align="alignleft" width="200"] Dr. Tobias Kurth[/caption] Prof. Dr. Dr. Tobias Kurth Professor of Public Health and Epidemiology and Director of the Institut of Public Health, Charité – Universitätsmedizin Berlin, Germany. Co-director, Centre Virchow-Villermé, for Public Health Paris – Berlin, Campus Berlin. Adjunct Associate Epidemiologist, Division of Preventive Medicine, Brigham and Women’s...

17 Feb

Posted at 22:04h in Author Interviews, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_21710" align="alignleft" width="159"]Souvik Sen, MD, MS, MPH, FAHA Professor and Chair, Neurology Department, South Carolina Smart State Endowed Stroke Chair University of South Carolina School of Medicine Dr. Souvik Sen[/caption] Souvik Sen, MD, MS, MPH, FAHA Professor and Chair,  Neurology Department, South Carolina Smart State Endowed Stroke Chair University of South Carolina School of Medicine  Medical Research: What was the catalyst for conducting this study examining the association between migraine with aura and ischemic stroke subtypes? Dr. Souvik Sen: South Carolina, North Carolina, and Georgia are located in the “buckle” of the stroke belt, with one of the highest stroke related death rates in the country. An unfortunate trend is that younger patients are having strokes leading to death and disability. As a part of the workup for young stroke we are interested in migraine with aura and the type of stroke associated with this condition. Medical Research: What did you conclude as a result of the findings and how did they compare with your expectations at the beginning of the study?

18 Sep

Posted at 20:27h in Author Interviews, Dermatology, Pain Research
psoriasis foundationMedicalResearch.com Interview with: Alexander Egeberg, MD Department of Cardiology Herlev and Gentofte Hospital Hellerup, Denmark Medical Research: What is the background for this study? What are the main findings? Dr. Egeberg: Psoriasis is a common chronic skin disease, with a strong inflammatory component. Within the last decade, our understanding of psoriasis have advanced significantly, and psoriasis is now widely regarded as a systemic disease, where the skin is a direct marker of disease activity. The inflammatory pathways in psoriasis have also been implicated in several central nervous system diseases such as depression, uveitis, and multiple sclerosis. Moreover, pain generation and sensitization can occur as a result of the pro-inflammatory mediators which are upregulated in psoriasis. In the present study, we investigated the association between psoriasis and psoriatic arthritis, and the risk of new-onset migraine. The main finding was a psoriasis-severity dependent increased risk of new-onset migraine, and patients with severe skin psoriasis, and psoriatic arthritis appeared to have the highest risk.

02 Jul

Posted at 18:54h in Author Interviews, Pain Research, Surgical Research

MedicalResearch.com Interview with: Dr. Bahman Guyuron MD Cleveland and Lyndhurst, Ohio From the Department of Plastic Surgery, University Hospital Case Medical Center; and the American Migraine Center Medical Research: What is the background for this study? Dr. Guyuron: Through several studies including retrospective, prospective pilot, prospective randomized, prospective randomized study with sham surgery, prospective...