Migraine: From Pathogenesis to Treatment

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (15 April 2024) | Viewed by 1013

Special Issue Editor


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Guest Editor
IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
Interests: headache; migraine; pharmacological treatments

Special Issue Information

Dear Colleagues,

Awareness about the burden of migraine and its disability has grown. These factors have been increasingly recognized by migraine patients and researchers alike. In recent years, we have witnessed the development of new therapeutic options, but also an increase in the complexity of patients, with significantly more fragile and aged migraine patients, as well as patients with comorbidities and polydrug therapeutic regimens.

The new challenge in migraine research is to move towards better tailoring the available therapies and developing new safe treatments that could be implemented as stand-alone and add-on options. In order to achieve this, new statistical and machine learning models could be trained to differentiate among migraine subtypes and to predict responders by combining different data from different sources to better understand the mechanisms and outcomes associated. In parallel, a better classification of patients and responders to treatment could also help in developing newer and safer treatments targeted at specific patient subtypes in order to increase the chances of success and reduce the number of adverse events.

This Special Issue is focused on understanding and treating migraines, and aims to advance the current knowledge on migraine mechanisms to aid in the development of new therapeutic options: through pharmacological research; investigations on feasibility, tolerability, and efficacy, with a focus on host–drug mechanisms; and in combination with other technologies.

Dr. Alessandro Viganò
Guest Editor

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Keywords

  • migraine
  • tension type headache
  • TDCS
  • TMS
  • RCT

Published Papers (1 paper)

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Research

13 pages, 1364 KiB  
Article
Exploring the Therapeutic Potential of Quadripulse rTMS over the Visual Cortex: A Proof-of-Concept Study in Healthy Volunteers and Chronic Migraine Patients with Medication Overuse Headache
by Alessandro Viganò, Tullia Sasso D’Elia, Simona Liliana Sava, Alfredo Colosimo, Vittorio Di Piero, Delphine Magis and Jean Schoenen
Biomedicines 2024, 12(2), 288; https://doi.org/10.3390/biomedicines12020288 - 26 Jan 2024
Viewed by 794
Abstract
In chronic migraine with medication overuse (CM-MOH), sensitization of visual cortices is reflected by (i) increased amplitude of stimulus-evoked responses and (ii) habituation deficit during repetitive stimulation. Both abnormalities might be mitigated by inhibitory transcranial neurostimulation. Here, we tested an inhibitory quadripulse repetitive [...] Read more.
In chronic migraine with medication overuse (CM-MOH), sensitization of visual cortices is reflected by (i) increased amplitude of stimulus-evoked responses and (ii) habituation deficit during repetitive stimulation. Both abnormalities might be mitigated by inhibitory transcranial neurostimulation. Here, we tested an inhibitory quadripulse repetitive transcranial magnetic stimulation (rTMS-QPI) protocol to decrease durably visual cortex excitability in healthy subjects (HS) and explored its therapeutic potential in CM-MOH patients. Pattern-reversal visual evoked potentials (VEP) were used as biomarkers of effect and recorded before (T1), immediately after (T2), and 3 h after stimulation (T3). In HS, rTMS-QPI durably decreased the VEP 1st block amplitude (p < 0.05) and its habituation (p < 0.05). These changes were more pronounced for the P1N2 component that was modified already at T2 up to T3, while for N1P1 they were significant only at T3. An excitatory stimulation protocol (rTMS-QPE) tended to have an opposite effect, restricted to P1N2. In 12 CM-MOH patients, during a four-week treatment (2 sessions/week), rTMS-QPI significantly reduced monthly headache days (p < 0.01). In patients reversing from CM-MOH to episodic migraine (n = 6), VEP habituation significantly improved after treatment (p = 0.005). rTMS-QPI durably decreases visual cortex responsivity in healthy subjects. In a proof-of-concept study of CM-MOH patients, rTMS-QPI also has beneficial clinical and electrophysiological effects, but sham-controlled trials are needed. Full article
(This article belongs to the Special Issue Migraine: From Pathogenesis to Treatment)
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