Journal ArticleDOI
Magnetic resonance angiography of intracranial and extracranial arteries in patients with spontaneous migraine without aura: a cross-sectional study
Faisal Mohammad Amin,Mohammad Sohail Asghar,Anders Hougaard,Adam E. Hansen,Vibeke Andrée Larsen,Patrick J.H. de Koning,Henrik Larsson,Jes Olesen,Messoud Ashina +8 more
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TLDR
Migraine pain was not accompanied by extracranial arterial dilatation, and by only slight intracranial dilated arteries, and future migraine research should focus on the peripheral and central pain pathways rather than simple arterial Dilatation.Abstract:
Summary Background Extracranial arterial dilatation has been hypothesised to be the cause of pain in patients who have migraine without aura. To test that hypothesis, we aimed to measure extracranial and intracranial arteries during attacks of migraine without aura. Methods In this cross-sectional study, we recruited patients aged 18–60 years from the Danish Headache Centre and via announcements on a Danish website. We did magnetic resonance angiography during spontaneous unilateral migraine attacks. Primary endpoints were difference in circumference of extracranial and intracranial arterial segments comparing attack and attack-free days and the pain and the non-pain side. The extracranial arterial segments measured were the external carotid (ECA), the superficial temporal (STA), the middle meningeal (MMA), and the cervical part of the internal carotid (ICA cervical ) arteries. The intracranial arterial segments were the cavernous (ICA cavernous ) and cerebral (ICA cerebral ) parts of the internal carotid, the middle cerebral (MCA), and the basilar (BA) arteries. This study is registered at Clinicaltrials.gov, number NCT01471314. Findings Between Oct 12, 2010, and Feb 8, 2012, we recruited 78 patients, of whom 19 women had a scan during migraine and were included in the final analysis. On migraine compared with non-migraine days, we detected no statistically significant dilatation of the extracranial arteries on the pain side (ECA, mean difference 1·2% [95% CI −5·7 to 8·2] p=0·985, STA 3·6% [–3·7 to 11·0] p=0·532, MMA 1·7% [–1·7 to 5·2] p=0·341, and ICA cervical 2·3% [–0·3 to 4·9] p=0·093); the intracranial arteries were more dilated during attacks (MCA, 13·0% [6·4 to 19·6] p=0·001, ICA cerebral 11·5% [5·6 to 17·3] p=0·0004, and ICA cavernous 11·4% [5·3 to 17·5] p=0·001), except for the BA (1·6% [–2·7 to 5·9] p=0·621). Compared with the non-pain side, during attacks we detected dilatation on the pain side of the intracranial arteries (MCA, mean difference 10·5% [0·7–20·3] p=0·044, ICA cerebral (14·4% [4·6–24·1] p=0·013), and ICA cavernous (9·1% [3·9–14·4] p=0·003) but not of the extracranial arteries (ECA, 2·1% [–3·8 to 9·2] p=0·238, STA, 3·6% [–3·7 to 10·8] p=0·525, MMA, 2·7% [–1·3 to 5·6] p=0·531, and ICA cervical , 5·0% [–0·5 to 10·4] p=0·119). Interpretation Migraine pain was not accompanied by extracranial arterial dilatation, and by only slight intracranial dilatation. Future migraine research should focus on the peripheral and central pain pathways rather than simple arterial dilatation. Funding University of Copenhagen, the Lundbeck Foundation, the Research Foundation of the Capital Region of Denmark, Danish Council for Independent Research-Medical Sciences, and the Novo Nordisk Foundation.read more
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Reference programme: Diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 2nd Edition, 2012
Lars Bendtsen,Steffen Birk,Helge Kasch,Karen Ægidius,Per Schmidt Sørensen,Lise Lykke Thomsen,Lars la Cour Poulsen,Mary-Jette Rasmussen,Christina Kruuse,Rigmor Jensen +9 more
TL;DR: The guideline first describes how to examine and diagnose the headache patient and how headache treatment is organised in Denmark, followed by individual sections on the characteristics, diagnosis, differential diagnosis and treatment of each of the major headache disorders and trigeminal neuralgia.
Journal ArticleDOI
Neuronal PAC1 receptors mediate delayed activation and sensitization of trigeminocervical neurons: Relevance to migraine
TL;DR: Evidence from rats that migraine is triggered by central effects on trigeminocervical neurons and a therapeutic target, PAC1 receptors is provided, suggesting that the endogenous mechanisms of migraine pathogenesis are located within the central nervous system and that the dural meninges and their primary afferent innervation are less likely to contribute to migraine initiation.
Journal ArticleDOI
Myofascial trigger points in migraine and tension-type headache
Thien Phu Do,Gerda Ferja Heldarskard,Lærke Tørring Kolding,Jeppe Hvedstrup,Henrik Winther Schytz +4 more
TL;DR: An overview of the current imaging modalities used for the detection of myofascial trigger points is presented and the role they play in the pathophysiology of each disorder and to which degree is unclarified is unClarified.
Journal ArticleDOI
An update on migraine: current understanding and future directions.
Francesca Puledda,Francesca Puledda,Roberta Messina,Roberta Messina,Peter J. Goadsby,Peter J. Goadsby +5 more
TL;DR: The present review will highlight the current aspects of migraine pathophysiology, covering an understanding of the complex workings of the migraine state and the brain regions responsible for them, and discuss the therapeutic agents which have appeared in the most recent years.
Journal ArticleDOI
Migraine induced by hypoxia: an MRI spectroscopy and angiography study.
Nanna Arngrim,Henrik Winther Schytz,Josefine Britze,Faisal Mohammad Amin,Mark B Vestergaard,Anders Hougaard,Frauke Wolfram,Patrick J.H. de Koning,Karsten Skovgaard Olsen,Niels H. Secher,Henrik Larsson,Jes Olesen,Messoud Ashina +12 more
TL;DR: Hypoxia induced migraine-like attacks with and without aura and dilated the cranial arteries in patients with migraine with aura, and hypoxia-induced attacks were not associated with altered concentration of glutamate or other metabolites.
References
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Journal ArticleDOI
The International Classification of Headache Disorders: 2nd edition
Journal ArticleDOI
Migraine prevalence, disease burden, and the need for preventive therapy
Richard B. Lipton,Marcelo E. Bigal,Merle L. Diamond,Frederick G. Freitag,Michael L. Reed,Walter F. Stewart +5 more
TL;DR: The epidemiologic profile of migraine has remained stable in the United States during the past 15 years and more than one in four migraineurs are candidates for preventive therapy, and a substantial proportion of those who might benefit from prevention do not receive it.
Journal ArticleDOI
Cost of disorders of the brain in Europe 2010
Anders Gustavsson,Mikael Svensson,Frank Jacobi,Christer Allgulander,Jordi Alonso,Ettore Beghi,R. Dodel,Mattias Ekman,Carlo Faravelli,Laura Fratiglioni,Brenda Gannon,David P.H. Jones,Poul Jennum,Albena Jordanova,Linus Jönsson,Korinna Karampampa,Martin Knapp,Martin Knapp,Gisela Kobelt,Tobias Kurth,Roselind Lieb,Mattias Linde,Christina Ljungcrantz,Andreas Maercker,Beatrice Melin,Massimo Moscarelli,Amir Musayev,Fiona Norwood,Martin Preisig,Maura Pugliatti,Juergen Rehm,Luis Salvador-Carulla,Brigitte Schlehofer,Roland Simon,Hans-Christoph Steinhausen,Lars Jacob Stovner,Jean-Michel Vallat,Peter Van den Bergh,Jim van Os,Jim van Os,Pieter E. Vos,Weili Xu,Hans-Ulrich Wittchen,Bengt Jönsson,Jes Olesen +44 more
TL;DR: The present report presents much improved cost estimates for the total cost of disorders of the brain in Europe in 2010, covering 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items.
Journal ArticleDOI
The economic cost of brain disorders in Europe
TL;DR: This new report presents updated, more accurate, and comprehensive 2010 estimates of annual costs for brain disorders in Europe for 30 European countries.
Journal ArticleDOI
Brain stem activation in spontaneous human migraine attacks.
Cornelius Weiller,Arne May,V. Limmroth,M Jüptner,H Kaube,R V Schayck,H H Coenen,Hans-Christoph Diener +7 more
TL;DR: Findings support the idea that the pathogenesis of migraine is related to an imbalance in activity between brain stem nuclei regulating antinociception and vascular control.
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