Journal ArticleDOI
Interictal increase of CGRP levels in peripheral blood as a biomarker for chronic migraine
Eva Cernuda-Morollón,Davinia Larrosa,César Ramón,Juan de la Vega,Pablo Martínez-Camblor,Julio Pascual +5 more
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TLDR
Increased CGRP level measured in peripheral blood outside migraine attacks and in the absence of symptomatic medication could be a biomarker helping in the diagnosis of chronic migraine (CM).Abstract:
Objective: To determine calcitonin gene-related peptide (CGRP) levels outside migraine attacks in peripheral blood as a potential biomarker for chronic migraine (CM). Methods: Women older than 17 years and diagnosed with CM were recruited. Matched healthy women with no headache history and women with episodic migraine (EM) served as control groups, together with a series of patients with episodic cluster headache in a pain-free period. CGRP levels were determined in blood samples obtained from the right antecubital vein by ELISA outside a migraine attack and having taken no symptomatic medication the day before. For ethical reasons, preventatives were not stopped. Results: We assessed plasma samples from 103 women with CM, 31 matched healthy women, 43 matched women with EM, and 14 patients with episodic cluster headache matched for age. CGRP levels were significantly increased in CM (74.90 pg/mL) as compared with control healthy women (33.74 pg/mL), women with EM (46.37 pg/mL), and patients with episodic cluster headache (45.87 pg/mL). Thresholds of 43.45 and 58.22 pg/mL optimize the sensitivity and specificity to differentiate CM from healthy controls and EM, respectively. In the CM group, CGRP levels were significantly increased in women with a history of migraine with aura vs those only experiencing migraine without aura. Variables such as age, analgesic overuse, depression, fibromyalgia, vascular risk factors, history of triptan consumption, or kind of preventative treatment did not significantly influence CGRP levels. Conclusion: Increased CGRP level measured in peripheral blood outside migraine attacks and in the absence of symptomatic medication could be a biomarker helping in the diagnosis of CM.read more
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Journal ArticleDOI
Calcitonin Gene-Related Peptide: Physiology and Pathophysiology
TL;DR: It is concluded that CGRP is an important peptide in mammalian biology, but it is too early at present to know if new medicines for disease treatment will emerge from knowledge concerning this molecule.
Journal ArticleDOI
Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial
Stewart J. Tepper,Messoud Ashina,Uwe Reuter,Jan Lewis Brandes,David Doležil,Stephen D. Silberstein,Paul Winner,Dean Leonardi,Daniel D. Mikol,Robert A. Lenz +9 more
TL;DR: In patients with chronic migraine, erenumab 70 mg and 140 mg reduced the number of monthly migraine days with a safety profile similar to placebo, providing evidence that erenUMab could be a potential therapy for migraine prevention.
Journal ArticleDOI
Chronic migraine: risk factors, mechanisms and treatment.
Arne May,Laura H. Schulte +1 more
TL;DR: The pathophysiology of migraine chronification can be understood as a threshold problem: certain predisposing factors, combined with frequent headache pain, lower the threshold of migraine attacks, thereby increasing the risk of chronic migraine.
Journal ArticleDOI
The role of calcitonin gene-related peptide in peripheral and central pain mechanisms including migraine.
TL;DR: The role of CGRP in primary afferents, the dorsal root ganglion, and in the trigeminal system as well as its role in peripheral and central sensitization and its potential contribution to pain processing and to migraine are reviewed.
Journal ArticleDOI
The pathophysiology of migraine: implications for clinical management.
TL;DR: The identification of new migraine-associated genes, the visualisation of brain regions that are activated at the earliest stages of a migraine attack, and the recognition of the crucial role for neuropeptides are among the advances that have led to novel targets for migraine therapy.
References
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Journal ArticleDOI
Vasoactive peptide release in the extracerebral circulation of humans during migraine headache
TL;DR: A substantial elevation of the calcitonin gene‐related peptide level in the external jugular but not the cubital fossa blood was seen in both classic and common migraine, and may have importance in the pathophysiology of migraine.
Journal ArticleDOI
Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model
TL;DR: This work establishes a link between migraine aura and headache by demonstrating that cortical spreading depression activates trigeminovascular afferents and evokes a series of cortical meningeal and brainstem events consistent with the development of headache.
Journal ArticleDOI
Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine.
Jes Olesen,Hans-Christoph Diener,Ingo W. Husstedt,Peter J. Goadsby,David E. Hall,Ulrich Meier,Stephane Pollentier,Lynna M. Lesko +7 more
TL;DR: The CGRP antagonist BIBN 4096 BS was effective in treating acute attacks of migraine and showed significant superiority over placebo with respect to most secondary end points.
Journal ArticleDOI
The trigeminovascular system and migraine: Studies characterizing cerebrovascular and neuropeptide changes seen in humans and cats
Peter J. Goadsby,Lars Edvinsson +1 more
TL;DR: These data characterize some aspects of the cerebrovascular physiology of the trigeminovascular system and demonstrate important interactions between this system and the effective antimigraine agents sumatriptan and dihydroergotamine and that such interactions can be represented in animal models.
Journal ArticleDOI
New Appendix Criteria Open for a Broader Concept of Chronic Migraine
Jes Olesen,Marie-Germaine Bousser,Hans-Christoph Diener,David W. Dodick,M. First,Peter J. Goadsby,H. Gobel,Miguel J. A. Láinez,James W. Lance,Richard B. Lipton,G. Nappi,F Sakai,Jean Schoenen,Stephen D. Silberstein,Timothy J. Steiner +14 more
TL;DR: The International Headache Classification Committee has worked out the more inclusive criteria for CM and MOH and it is now recommended that the MOH diagnosis should no longer request improvement after discontinuation of medication overuse but should be given to patients if they have a primary headache plus ongoing medication over use.
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