Exploring the effects of extracranial injections of botulinum toxin type A on prolonged intracranial meningeal nociceptors responses to cortical spreading depression in female rats
Agustin Melo-Carrillo,Agustin Melo-Carrillo,Andrew M. Strassman,Andrew M. Strassman,Aaron J. Schain,Aaron J. Schain,Rodrigo Noseda,Rodrigo Noseda,Sait Ashina,Sait Ashina,Aubrey Manack Adams,Mitchell F. Brin,Rami Burstein,Rami Burstein +13 more
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TLDR
The findings suggest that the mechanism of action by which botulinum neurotoxin type A prevents migraine differ from the one by which calcitonin gene-related peptide monoclonal antibodies prevent migraine and that even when the origin of migraine is central, a peripherally acting drug can intercept/prevent the headache.Abstract:
BackgroundBotulinum neurotoxin type A, an FDA-approved prophylactic drug for chronic migraine, is thought to achieve its therapeutic effect through blocking activation of unmyelinated meningeal noc...read more
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Dual Therapy With Anti-CGRP Monoclonal Antibodies and Botulinum Toxin for Migraine Prevention: Is There a Rationale?
TL;DR: The pathophysiological rationale of dual therapy with anti‐calcitonin gene‐related peptide monoclonal antibodies and botulinum toxin type A in treatment‐resistant chronic migraine prevention is narratively reviewed.
Journal ArticleDOI
Real-World Evidence for Control of Chronic Migraine Patients Receiving CGRP Monoclonal Antibody Therapy Added to OnabotulinumtoxinA: A Retrospective Chart Review.
Andrew M. Blumenfeld,Benjamin M. Frishberg,Jack Schim,Ashley Iannone,Gary Schneider,Larisa Yedigarova,Aubrey Manack Adams +6 more
TL;DR: Combination use of onabotulinumtoxinA and calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) has the potential to be more effective than either therapy alone for migraine prevention as discussed by the authors.
Journal ArticleDOI
Low-dose interleukin-2 reverses behavioral sensitization in multiple mouse models of headache disorders.
Jintao Zhang,Katherine Czerpaniak,Liang Huang,Xuemei Liu,Megan E. Cloud,Jacqueline Unsinger,Richard S. Hotchkiss,Daizong Li,Yu-Qing Cao +8 more
TL;DR: Ld-IL2 is identified as a promising prophylactic for multiple headache disorders with a mechanism distinct from the existing treatment options and completely reversed the cutaneous hyper-sensitivity induced by repeated administration of sumatriptan.
Journal ArticleDOI
Combined onabotulinumtoxinA/atogepant treatment blocks activation/sensitization of high-threshold and wide-dynamic range neurons:
Agustin Melo-Carrillo,Andrew M. Strassman,Andrew M. Strassman,Aaron J. Schain,Aaron J. Schain,Aubrey Manack Adams,Mitchell F. Brin,Rami Burstein,Rami Burstein +8 more
TL;DR: Combination therapy that inhibits meningeal C-fibers and prevents calcitonin gene‒receptor peptide from activating its receptors on Aδ-meningeal nociceptors may be more effective than a monotherapy in reducing migraine days per month in patients with chronic migraine.
Journal ArticleDOI
Real-World Evidence for the Safety and Efficacy of CGRP Monoclonal Antibody Therapy Added to OnabotulinumtoxinA Treatment for Migraine Prevention in Adult Patients With Chronic Migraine
Laszlo Mechtler,Nicolas Saikali,Jennifer McVige,Olivia K. Hughes,Alexander Traut,Aubrey Manack Adams +5 more
TL;DR: In this real-world study, onabotulinumtoxinA was effective at reducing MHD and the addition of a CGRP mAb was safe, well-tolerated and associated with incremental and clinically meaningful reductions in MHD for those who stayed on the combination treatment.
References
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Journal ArticleDOI
OnabotulinumtoxinA for treatment of chronic migraine: Results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial
Hans-Christoph Diener,David W. Dodick,Sheena K. Aurora,Catherine C. Turkel,Ronald E. DeGryse,Richard B. Lipton,Stephen D. Silberstein,MF Brin,MF Brin +8 more
TL;DR: Significant reductions from baseline were observed for onabotulinumtoxinA for headache and migraine days, cumulative hours of headache on headache days and frequency of moderate/severe headache days, which in turn reduced the burden of illness in adults with disabling chronic migraine.
Journal ArticleDOI
Migraine: multiple processes, complex pathophysiology.
TL;DR: Attempts to understand the headache pain itself point to activation of the trigeminovascular pathway as a prerequisite for explaining why the pain is restricted to the head, often affecting the periorbital area and the eye, and intensifies when intracranial pressure increases.
Journal ArticleDOI
Activation of Meningeal Nociceptors by Cortical Spreading Depression: Implications for Migraine with Aura
TL;DR: The findings demonstrates for the first time that induction of CSD by focal stimulation of the rat visual cortex can lead to long-lasting activation of nociceptors that innervate the meninges.
Journal ArticleDOI
Chaos and commotion in the wake of cortical spreading depression and spreading depolarizations
TL;DR: The once-held view that spreading depolarizations may not exist in the human brain has changed, largely because of the discovery of migraine genes that confer cortical spreading depression susceptibility, the application of sophisticated imaging tools and efforts to interrogate their impact in the acutely injured human brain.
Journal ArticleDOI
C nociceptor activity in human nerve during painful and non painful skin stimulation.
J Van Hees,Jan Gybels +1 more
TL;DR: It is concluded that nociceptive C input provoked by thermal or chemical stimuli correlates well with pain sensation, however, similar C input provided by mechanical stimulation, which activates also A beta mechanoreceptors, did not necessarily produce pain sensation.