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New Trends and Advances in Treatment Headache Disorders

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 16177

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Special Issue Editor

Dr. Anna P. Andreou

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Guest Editor

Kings College London, Headache Research, London, UK
Interests: headache disorders; chronic migraine; primary headaches; migraine research; neurology

Special Issue Information

Dear Colleagues,

Primary headache disorders are among the most prevalent, painful, and disabling neurological conditions. After many years of lack of innovative discoveries on disease pathophysiology and specific therapies, the field has seen a burst of new discoveries on both headache mechanisms and treatments. These novel treatments are mainly available for the acute and preventive treatment of migraine, and to a lesser degree for the treatment of cluster headache. This significant progress on the development of new treatments arises from early preclinical studies on the role of different molecules in the pathophysiology of these conditions.

This Special Issue of the Journal of Clinical Medicine will contain original and review papers concerning novel concepts on headache pathophysiology and origin and focus on current and future targets in headache treatments. Researchers involved in the field are invited to contribute with their significant expertise; additionally, the issue will include invited contributions from world-leading experts, who will contribute on how to best manage headache patients and offer their view on the missing links in disease biology and whether, given the availability of new and effective treatments for migraine, further investigations on novel targets and novel treatments are still needed.

Dr. Anna P. Andreou
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

headache
migraine
cluster headache
CGRP
PACAP
gepants
neurology
trigeminal
brain
neurobiology

Published Papers (5 papers)

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Research

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10 pages, 2330 KiB

Open AccessArticle

Interaction between Pain, Disability, Mechanosensitivity and Cranio-Cervical Angle in Subjects with Cervicogenic Headache: A Cross-Sectional Study

by Patricia Martínez-Merinero, Fernando Aneiros Tarancón, Javier Montañez-Aguilera, Susana Nuñez-Nagy, Daniel Pecos-Martín, Rubén Fernández-Matías, Alexander Achalandabaso-Ochoa, Samuel Fernández-Carnero and Tomás Gallego-Izquierdo

J. Clin. Med. 2021, 10(1), 159; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10010159 - 05 Jan 2021

Cited by 4 | Viewed by 4128

Abstract

The relationship between the forward head posture and mechanosensitivity in subjects with a cervicogenic headache (CGH) remains uncertain. The aim of the study was to evaluate if there was a relationship between the tissue mechanosensitivity and cranio-cervical angle (CCA) that was moderated by pain intensity and/or disability in subjects with CGH. A convenience sample of 102 subjects was recruited. The CCA was measured with photographs, using a postural assessment software. The pain intensity was measured with a visual analogue scale (VAS), and the disability was measured with the Northwick Park Questionnaire. The pressure pain threshold (PPT) was measured at the spinous process of C2, the upper trapezius and splenius capitis muscles, and the median nerve. Simple moderation multiple regression analyses were constructed. There was a positive relationship between PPT at C2 and CCA, but a nonsignificant relationship for the PPT measured at the muscles and median nerve. The effect of PPT at C2 over CCA was moderated by pain intensity (R² = 0.17; R² change = 0.06; p < 0.05) but not disability. The Johnson–Neyman analysis revealed a cut-off point for the statistical significance of 4.66 cm in VAS. There seems to be a positive relationship between PPT at C2 and CCA, which is positively moderated by pain intensity in subjects with CGH. Full article

(This article belongs to the Special Issue New Trends and Advances in Treatment Headache Disorders)

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11 pages, 560 KiB

Open AccessArticle

Open Label Prospective Experience of Supplementation with a Fixed Combination of Magnesium, Vitamin B2, Feverfew, Andrographis Paniculata and Coenzyme Q10 for Episodic Migraine Prophylaxis

by Michail Vikelis, Emmanouil V. Dermitzakis, George S. Vlachos, Panagiotis Soldatos, Konstantinos C. Spingos, Pantelis Litsardopoulos, Evangelia Kararizou and Andreas A. Argyriou

J. Clin. Med. 2021, 10(1), 67; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10010067 - 27 Dec 2020

Cited by 6 | Viewed by 3229

Abstract

Background: To investigate the efficacy and safety of supplementation with a fixed combination of magnesium, vitamin B2, feverfew, andrographis paniculata and coenzyme Q10 in episodic migraine (EM) prevention. Methods: A pilot, single-arm, open-label study was conducted. After a one-month baseline period, the above-described supplementation was introduced in 113 EM Greek patients, who were prospectively followed-up for three months. The primary endpoint was the change in monthly migraine days between baseline period (BSL) and the third month of supplementation (T3). Secondary endpoints included changes in mean intensity of migraine and in days with use of acute migraine medications. Changes in scores of Migraine Disability Assessment questionnaire (MIDAS), Headache Impact Test-6 (HIT-6), Migraine Therapy Assessment questionnaire (MTAQ), Migraine-Specific Quality-of-life questionnaire (MSQ-QOL), Hospital Anxiety and Depression Scale (HADS) were also evaluated. Those with ≥50% reduction in monthly migraine days at T3, compared to BSL were considered supplementation-responders. Results: The mean number of migraine days was significantly decreased between BSL and T3 (9.4 ± 3.7 vs. 6.1 ± 3.5; p < 0.001). Likewise, days with peak headache intensity of >4/10 (5.7 ± 3.4 vs. 4.9 ± 3.1; p < 0.001) as well as days using acute headache medications per month (8.9 ± 3.6 vs. 5.7 ± 3.4; p < 0.001) were significantly reduced. At T3, 64 patients (56.6%) were classified as responders. The beneficial effect of supplementation was also associated with significant changes in HIT-6, MIDAS, MTAQ and MSQ-QOL scores. There were no safety concerns. Conclusions: The supplementation we have tested appears to be an effective and well-tolerated preventive approach against EM. A randomized, placebo-controlled study is needed to confirm our results. Full article

(This article belongs to the Special Issue New Trends and Advances in Treatment Headache Disorders)

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11 pages, 480 KiB

Open AccessArticle

Orthostatic Headache in Children Including Postural Tachycardia Syndrome and Orthostatic Hypotension: A Near-Infrared Spectroscopy Study

by Soken Go, Gaku Yamanaka, Akiko Kasuga, Kanako Kanou, Tomoko Takamatsu, Mika Takeshita, Natsumi Morishita, Shinichiro Morichi, Yu Ishida, Shingo Oana, Yasuyo Kashiwagi, Takashi Mitsufuji, Nobuo Araki and Hisashi Kawashima

J. Clin. Med. 2020, 9(12), 4125; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9124125 - 21 Dec 2020

Cited by 2 | Viewed by 2794

Abstract

Background and aim: Although head and/or neck pain attributed to orthostatic hypotension is included in international guidelines, its mechanisms and relevance remain unknown. This study examined the term’s relevance and aimed to elucidate the associated clinical features. Methods: An active stand test was performed to evaluate fluctuations in systemic and cerebral circulation in children and adolescents reporting complaints in the absence of a confirmed organic disorder. The subjects were categorized based on orthostatic headache presence/absence, and their characteristics and test results were compared. Results: Postural tachycardia syndrome was observed in 50.0% of children with, and 55.1% without, orthostatic headache. For orthostatic hypotension, the respective values were 31.3% and 30.6%. A history of migraine was more prevalent in children with orthostatic headaches (64.1% vs. 28.6%; p < 0.01). The observed decrease in the cerebral oxygenated hemoglobin level was larger in children with orthostatic headaches (Left: 6.3 (3.2–9.4) vs. 4.1 (0.8–6.1); p < 0.01, Right: 5.3 (3.1–8.6) vs. 4.0 (0.8–5.9); p < 0.01). Conclusion: Fluctuations in cerebral blood flow were associated with orthostatic headaches in children, suggesting that the headaches are due to impaired intracranial homeostasis. As orthostatic headache can have multiple causes, the term “head and/or neck pain attributed to orthostatic (postural) hypotension” should be replaced with a more inclusive term. Full article

(This article belongs to the Special Issue New Trends and Advances in Treatment Headache Disorders)

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Review

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17 pages, 283 KiB

Open AccessReview

CGRP Receptor Antagonists and 5-HT1F Receptor Agonist in the Treatment of Migraine

by Matilde Capi, Valerio De Angelis, Donatella De Bernardini, Ottavia De Luca, Fabiola Cipolla, Luana Lionetto, Maurizio Simmaco and Paolo Martelletti

J. Clin. Med. 2021, 10(7), 1429; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10071429 - 01 Apr 2021

Cited by 19 | Viewed by 2805

Abstract

Discovering that calcitonin-related peptide (CGRP) plays a key role in the complex pathophysiology of migraine has allowed us to make great strides in the development of new approaches for acute and preventive treatment. This evidence has led to the development of small molecules antagonist molecules of the CGRP receptor (“gepants”) and of a new class of medications called “Ditans”. This review presents the data from clinical trials reporting the efficacy, safety, and tolerability of the new drugs used in the treatment of migraines. Evidences show that therapeutic approaches targeted to CGRP have the potential to transform the clinical management of migraine, even though its appropriate place has yet to be determined with accuracy. Full article

(This article belongs to the Special Issue New Trends and Advances in Treatment Headache Disorders)

16 pages, 546 KiB

Open AccessReview

An Evaluation of Medication Prescribing Patterns for Acute Migraine in the Emergency Department: A Scoping Review

by Jun Hua Lim, Leila Karimi and Tissa Wijeratne

J. Clin. Med. 2021, 10(6), 1191; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10061191 - 12 Mar 2021

Cited by 6 | Viewed by 2571

Abstract

Migraine is one of the leading causes of disability worldwide and patients with acute migraine frequently present to emergency departments (ED). The current literature suggests that ED treatment of migraine headache varies across institutions. Considering this, we conducted a scoping review to summarize trends in medication prescribing patterns for acute migraine treatment in the ED setting. Trends were evaluated for factors influencing treatment choices, with particular attention placed on opioids and migraine specific therapy. This scoping review was based on the Arksey and O’Malley methodological framework and included studies published between 1 January 2000 and 31 May 2020. 14 publications met the inclusion criteria. The most common classes of medication prescribed were anti-emetics or Non-steroidal anti-inflammatory drugs (NSAID), but rates varied between studies. There was a concerning trend towards an underutilization of triptans and overutilization of opiates. The use of specific clinical treatment goals (e.g., two-hour pain free freedom response) was also not evident. Additionally, 88% (n = 8) of the nine studies commenting on adherence to hospital or evidence-based guidelines stated that practices were non-adherent. Overall, the reviewed literature reveals treatment practices for acute migraine in the ED are heterogeneous and deviate from established international recommendations. Full article

(This article belongs to the Special Issue New Trends and Advances in Treatment Headache Disorders)

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