Volume of the hypothalamus and its subunits in patients with episodic migraine without aura during interictal periods.

Background: The hypothalamus is thought to play a crucial role in the recurrence of migraine attacks, exhibiting activity prior to the onset of a migraine attack. Nonetheless, our comprehension of the roles of its subunits, especially during the interictal phase, remains limited. This study investigated hypothalamic volumetric differences between individuals with episodic migraine and healthy controls, with scans conducted during the interictal phase, free from the effects of preventative medications.

Hallmarks of primary headache: part 2- Tension-type headache.

Background And Aim: Tension-type headache is the most prevalent primary headache disorder. While the episodic subtype is more common, chronic tension-type headache significantly impacts health-related quality of life and contribute to increased healthcare utilization and disability. Despite considerable advances in the understanding of tension-type headache, critical gaps persist.

Assessment of hypothalamic macrostructure in episodic cluster headache: a volumetric segmentation MRI study.

Purpose: The functional involvement of the hypothalamus in the pathophysiology of episodic cluster headache (eCH) is well known, but its macrostructural involvement remains unclear. In this study, we investigated differences in the volumetry of the entire hypothalamus and its subunits in patients with in-bout eCH during headache-free periods.

Material And Methods: We examined hypothalamic volumes in 26 eCH patients (scanned during bout periods but outside of active attacks and off prophylactic medications) and 20 age- and sex-matched healthy controls (HCs).

Cortical thickness studies in migraine: Current evidence and future directions.

BackgroundStructural imaging offers insight into migraine pathogenesis. Magnetic resonance imaging (MRI) morphometry plays a crucial role in identifying these alterations, yet the clinical significance remains debated. While gray matter volume and cortical curvature are commonly analyzed, cortical thickness offers a more direct measure of cytoarchitectural differences and neuroplastic changes in migraine.

The role of community pharmacists in managing common headache disorders, and their integration within structured headache services: position statement on behalf of the European Headache Federation (EHF) and Lifting The Burden (LTB: the Global Campaign against Headache), with the formal endorsement of the International Pharmaceutical Federation.

In the sustainable development goals (SDG) context of seeking universal health coverage, the expanding gap between the supply of specialized and primary health-care providers of headache-related health care and the care needs of the very large number of people affected by headache is a formidable but not insoluble public-health challenge. Structured headache services provide a cost-effective framework wherein controlled patient flows enable the care needs of people with headache to be met at appropriate levels, but these services may still be overwhelmed by inappropriate demand.Community pharmacists are an underutilized resource, potentially well able to provide the solution.

Evidence-based guidelines for the pharmacological treatment of migraine, summary version.

We here present evidence-based guidelines for the pharmacological treatment of migraine. These guidelines, created by the Italian Society for the Study of Headache and the International Headache Society, aim to offer clear, actionable recommendations to healthcare professionals. They incorporate evidence-based recommendations from randomized controlled trials and expert-based opinions.

Evidence-based guidelines for the pharmacological treatment of migraine.

We here present evidence-based guidelines for the pharmacological treatment of migraine. These guidelines, created by the Italian Society for the Study of Headache and the International Headache Society, aim to offer clear, actionable recommendations to healthcare professionals. They incorporate evidence-based recommendations from randomized controlled trials and expert-based opinions.

Artificial neural networks applied to somatosensory evoked potentials for migraine classification.

Background: Finding a biomarker to diagnose migraine remains a significant challenge in the headache field. Migraine patients exhibit dynamic and recurrent alterations in the brainstem-thalamo-cortical loop, including reduced thalamocortical activity and abnormal habituation during the interictal phase. Although these insights into migraine pathophysiology have been valuable, they are not currently used in clinical practice.

Consensus Recommendations to Establish Reporting Standards in fMRI of Migraine: A Delphi Study.

Background And Objectives: Migraine is a multifaceted primary headache disorder. In neuroimaging of migraine, fMRI has been used to elucidate pathophysiology or monitor treatment effects. The current literature, however, is highly heterogeneous regarding reported variables and methodologies.

The epidemiology and unmet need of migraine in five european countries: results from the national health and wellness survey.

Background: Despite the high global prevalence, burden, and direct and indicated costs, migraines are often under-diagnosed and undertreated. Understanding the prevalence of migraine and unmet needs is crucial for improving diagnosis and treatment across Europe (EU) countries; however, real-world studies are limited.

Methods: This retrospective cross-sectional survey utilized weighted patient-reported data from the 2020 National Health and Wellness Survey (NHWS) in five EU (5EU) countries (France, Germany, United Kingdom [UK], Italy, and Spain).

MRI-based analysis of the microstructure of the thalamus and hypothalamus and functional connectivity between cortical networks in episodic cluster headache.

Background: Neuroimaging studies have shown that hypothalamic/thalamic nuclei and other distant brain regions belonging to complex cerebral networks are involved in cluster headache (CH). However, the exact relationship between these areas, which may be dependent or independent, remains to be understood. We investigated differences in resting-state functional connectivity (FC) between brain networks and its relationship with the microstructure of the hypothalamus and thalamus in patients with episodic CH outside attacks and healthy controls (HCs).

Local Dynamic Stability of Trunk During Gait Can Detect Dynamic Imbalance in Subjects with Episodic Migraine.

Background/hypothesis: Motion sensitivity symptoms, such as dizziness or unsteadiness, are frequently reported as non-headache symptoms of migraine. Postural imbalance has been observed in subjects with vestibular migraine, chronic migraine, and aura. We aimed to assess the ability of largest Lyapunov's exponent for a short time series (sLLE), which reflects the ability to cope with internal perturbations during gait, to detect differences in local dynamic stability between individuals with migraine without aura (MO) with an episodic pattern between attacks and healthy subjects (HS).

Neurophysiological Effects of Withdrawal from Acute Overused Medications in Chronic Migraine with Medication-Overuse Headache.

: Chronic migraine with medication-overuse headache (CM-MOH) is neurophysiologically characterized by increased cortical excitability with sensitization at both the thalamocortical and the cortical levels. It is unclear whether the increased cortical excitability could be reverted by medication withdrawal (i.e.

A 1-month ketogenic diet in patients with migraine gives a clinical beneficial effect associated with increased latency of somatosensory thalamo-cortical activity.

Objective: Since the habituation deficit of evoked potentials could be related to abnormal thalamocortical drive, we searched for a modulatory effect of ketogenic diet (KD) on somatosensory-evoked thalamo-cortical activity. KD is effective in preventing migraine. Previous studies showed that KD normalises habituation of somatosensory and visual cortical evoked responses in parallel with a decrease in of migraine attack frequency.

Machine learning classification meets migraine: recommendations for study evaluation.

The integration of machine learning (ML) classification techniques into migraine research has offered new insights into the pathophysiology and classification of migraine types and subtypes. However, inconsistencies in study design, lack of methodological transparency, and the absence of external validation limit the impact and reproducibility of such studies. This paper presents a framework of six essential recommendations for evaluating ML-based classification in migraine research: (1) group homogenization by clinical phenotype, attack frequency, comorbidity, therapy, and demographics; (2) defining adequate sample size; (3) quality control of collected and preprocessed data; (4) transparent training, testing, and performance evaluation of ML models, including strategies for data splitting, overfitting control, and feature selection; (5) interpretability of results with clinical relevance; and (6) open data and code sharing to facilitate reproducibility.

The incremental burden and healthcare resource utilization among people with migraine in Europe: Insights from the 2020 European National Health and Wellness Survey.

Background: Despite the high prevalence of migraine in Europe, there is limited research on the burden among people with migraine.

Methods: This cross-sectional survey used patient-reported data from the 2020 European National Health and Wellness Survey in France, Germany, Italy, Spain, and the United Kingdom. The study assessed the sociodemographic characteristics, health-related quality of life, depression, work productivity and activity impairment, and healthcare resource utilization among matched samples of people with diagnosed migraine (n = 3985) and compared to a matched cohort without migraine (n = 7970).

Altered brainstem-cortex activation and interaction in migraine patients: somatosensory evoked EEG responses with machine learning.

Background: To gain a comprehensive understanding of the altered sensory processing in patients with migraine, in this study, we developed an electroencephalography (EEG) protocol for examining brainstem and cortical responses to sensory stimulation. Furthermore, machine learning techniques were employed to identify neural signatures from evoked brainstem-cortex activation and their interactions, facilitating the identification of the presence and subtype of migraine.

Methods: This study analysed 1,000-epoch-averaged somatosensory evoked responses from 342 participants, comprising 113 healthy controls (HCs), 106 patients with chronic migraine (CM), and 123 patients with episodic migraine (EM).

Decoding Visual Responses: Insights into Chronic Migraine and Medication Overuse Headache with Electrophysiological Analysis.

: Habituation and sensitization are opposite phenomena that play a role in the pathophysiology of episodic migraine and its progression to chronic migraine (CM). There have been just a few studies that have investigated these phenomena in patients with medication overuse headache (MOH) in comparison to those with chronic migraine (CM) and healthy controls (HCs), and the findings have been inconsistent. : We measured and examined visual evoked potentials (VEPs) in 81 patients with MOH and 24 patients with CM, as well as 24 HCs.

Subsegmentation of the hippocampus in subgroups of migraine with aura patients: advanced structural neuroimaging study.

Background: This study investigated for a possible contributing role of hippocampus in the different clinical phenotypic manifestations of migraine aura.

Methods: Herein, patients were categorized as those with pure visual aura (MwAv), those who reported additional somatosensory and dysphasic symptoms (MwAvsd), and healthy controls (HCs). Neuroimaging data obtained using FreeSurfer-based segmentation of hippocampal subfields were compared between HCs and patients with migraine with aura, as well as between HCs and those with MwAv and MwAvsd.

Quantification Approaches in Non-Target LC/ESI/HRMS Analysis: An Interlaboratory Comparison.

Nontargeted screening (NTS) utilizing liquid chromatography electrospray ionization high-resolution mass spectrometry (LC/ESI/HRMS) is increasingly used to identify environmental contaminants. Major differences in the ionization efficiency of compounds in ESI/HRMS result in widely varying responses and complicate quantitative analysis. Despite an increasing number of methods for quantification without authentic standards in NTS, the approaches are evaluated on limited and diverse data sets with varying chemical coverage collected on different instruments, complicating an unbiased comparison.

Lack of a direct link between macular cones function and photophobia in interictal migraine.

Background: It is still debatable whether the mechanisms underlying photophobia are related to altered visual cortex excitability or specific abnormalities of colour-related focal macular retino-thalamic information processing.

Methods: This cross-sectional study examined Ganzfeld blue-red (B-R) and blue-yellow (B-Y) focal macular cone flash ERG (ffERG) and focal-flash visual evoked potentials (ffVEPs) simultaneously in a group of migraine patients with (n = 18) and without (n = 19) aura during the interictal phase, in comparison to a group of healthy volunteers (HVs) (n = 20). We correlate the resulting retinal and cortical electrophysiological responses with subjective discomfort from exposure to bright light verified on a numerical scale.

Salivary Testosterone Levels and Pain Perception Exhibit Sex-Specific Association in Healthy Adults But Not in Patients With Migraine.

This study investigated the sex-specific associations between pain perception and testosterone levels in healthy controls (HCs) and patients with migraine. Male and female HCs and migraine patients were recruited. A series of questionnaires were completed by the participants to evaluate their psychosocial profiles, which included data on mood, stress, and sleep quality.