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Exploring Recent Advancements in Migraine Treatment: Insights from Clinical Neurology
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Exploring Recent Advancements in Migraine Treatment: Insights from Clinical Neurology

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 26 January 2025 | Viewed by 3289

Special Issue Editors

Dr. Pablo Irimia

E-Mail Website
Guest Editor
Departamento de Neurología, Clínica Universitaria de Navarra, 31008 Pamplona, Spain
Interests: headache; migraine; pathophysiology; chronic migraine, treatment
Dr. Dimos-Dimitrios Mitsikostas

E-Mail Website
Guest Editor
First Neurology Department, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, 157 72 Athens, Greece
Interests: headache; migraine; pathophysiology; chronic migraine, treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The treatment landscape for migraine has witnessed significant advancements in recent years. Migraine, a complex, prevalent, and highly disabling neurological disorder, is often underdiagnosed and undertreated. In recent years, there have been important advances in the pathophysiology of the disease that have facilitated the development of new drugs for both the symptomatic and preventive treatments. These novel therapies not only expand the range of available treatments but also offer substantial advantages due to their specificity for migraine treatment, increased effectiveness, and improved tolerability.

Presently, clinicians have a more extensive therapeutic arsenal for managing migraine and must carefully select the optimal treatment for each patient from the diverse options available. This thematic Special Issue aims to explore the challenges contributing to the undertreatment of migraine, emphasizing recent therapeutic breakthroughs and underscoring the importance of initiating symptomatic and preventive treatment in the early phases. By providing a practical perspective, it enables clinicians to familiarize themselves with innovative treatments and gain insights into the underlying pathophysiological foundations of therapies currently in development.

Dr. Pablo Irimia
Dr. Dimos-Dimitrios Mitsikostas
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • migraine
  • chronic migraine
  • treatment
  • progression
  • stigma

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Published Papers (3 papers)

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Research

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37 pages, 3801 KiB  
Article
Migraine Genetic Susceptibility Does Not Strongly Influence Migraine Characteristics and Outcomes in a Treated, Real-World, Community Cohort
by Bruce A. Chase, Roberta Frigerio, Susan Rubin, Irene Semenov, Steven Meyers, Angela Mark, Thomas Freedom, Revital Marcus, Rima Dafer, Jun Wei, Siqun L. Zheng, Jianfeng Xu, Ashley J. Mulford, Alan R. Sanders, Anna Pham, Alexander Epshteyn, Demetrius Maraganore and Katerina Markopoulou
J. Clin. Med. 2025, 14(2), 536; https://doi.org/10.3390/jcm14020536 (registering DOI) - 16 Jan 2025
Abstract
Background/Objectives: Migraine is a common neurological disorder with highly variable characteristics. While genome-wide association studies have identified genetic risk factors that implicate underlying pathways, the influence of genetic susceptibility on disease characteristics or treatment response is incompletely understood. We examined the relationships [...] Read more.
Background/Objectives: Migraine is a common neurological disorder with highly variable characteristics. While genome-wide association studies have identified genetic risk factors that implicate underlying pathways, the influence of genetic susceptibility on disease characteristics or treatment response is incompletely understood. We examined the relationships between a previously developed standardized integrative migraine polygenic genetic risk score (PRS) and migraine characteristics in a real-world, treated patient cohort. Methods: This retrospective cohort study used covariate-adjusted regression to comprehensively evaluate associations between the PRS and clinical characteristics in 1653 treated migraine cases with European ancestry at baseline and, in 800 cases, after one year. Cases were deeply phenotyped by neurologists during extensive interviews, using structured clinical documentation tools to record ~200 discrete data elements. Results: In treated patients, higher standardized PRS showed associations with two common migraine symptoms: photophobia (odds ratio [confidence interval]: 1.33 [1.13–1.56], p = 0.001) and stabbing pain (1.21 [1.08–1.36], p = 0.001]; both retained significance at Q = 0.05. Associations with phonophobia, nausea, emesis, and unilateral headache had similar effect sizes but did not survive correction for multiple tests. In this population, the PRS was not associated with other symptoms of migraine attacks, objective measures of migraine disability, frequency, severity, average duration, time-to-peak intensity of migraine attacks, chronification, emergency department visits, triptan responsiveness, or changes at follow-up. Conclusions: In treated patients, genetic risk was associated with common migraine symptoms but not with the severity of migraine characteristics or treatment outcomes. This suggests that in treated patients, other genetic and non-genetic factors influence migraine symptom severity and disease course more strongly than genetic susceptibility. Full article
(This article belongs to the Special Issue Exploring Recent Advancements in Migraine Treatment: Insights from Clinical Neurology)
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16 pages, 3987 KiB  
Article
An Integrative Migraine Polygenic Risk Score Is Associated with Age at Onset But Not Chronification
by Bruce A. Chase, Roberta Frigerio, Susan Rubin, Tiffani Franada, Irene Semenov, Steven Meyers, Stuart Bergman-Bock, Angela Mark, Thomas Freedom, Revital Marcus, Rima Dafer, Jun Wei, Siqun L. Zheng, Jianfeng Xu, Ashley J. Mulford, Alan R. Sanders, Anna Pham, Alexander Epshteyn, Demetrius Maraganore and Katerina Markopoulou
J. Clin. Med. 2024, 13(21), 6483; https://doi.org/10.3390/jcm13216483 - 29 Oct 2024
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Abstract
Background/Objective: Genome-wide association studies (GWASs) demonstrate a complex genetic landscape for migraine risk. Migraine polygenic risk scores (PRSs) developed from GWAS data may have utility for predicting disease course. We analyzed the strength of association between an integrative migraine PRS and age [...] Read more.
Background/Objective: Genome-wide association studies (GWASs) demonstrate a complex genetic landscape for migraine risk. Migraine polygenic risk scores (PRSs) developed from GWAS data may have utility for predicting disease course. We analyzed the strength of association between an integrative migraine PRS and age at onset and chronification. Methods: In this retrospective clinical/genetic case–control study, PGS004799 was calculated for adults with European ancestry from two real-world community cohorts. In the DodoNA cohort, 1653 treated, deeply phenotyped migraine cases, diagnosed using International Classification of Headache Disorders 3rd edition criteria, were followed for a mean (range) of 2.3 (1–10) years and compared to 3460 controls (without migraine diagnosis). In the GHI cohort, 2443 cases were identified using the first migraine ICD code as a proxy for migraine onset and compared to 8576 controls (without migraine ICD codes). PRS associations with age at onset (DodoNA) or first migraine ICD code (GHI) and chronification (DodoNA) were evaluated. Results: In both cohorts, PRS was higher in cases (DodoNA mean (range) cases: 0.82 (0.07–1.76), controls: 0.78 (0.04–1.56); t (5111) = −6.1, p = 1.4 × 10−9, GHI: cases: 0.79 (0.003–1.68), controls: 0.75 (−0.06–1.53); t (11,017) = −7.69, p = 1.6 × 10−14), and a higher PRS was associated with earlier onset in females (HR [95% CI] DodoNA: 2.1 [1.6–2.6, p < 0.001; GHI: 1.8 [1.4–2.1], p < 0.001) and in males (DodoNA: 2.5 [1.3–4.7], p = 0.005; GHI: 1.6 [1.1–2.6], p = 0.027). PRS was not different in cases with or without chronification (t (1651) = −1.67, p = 0.094) and was not associated with earlier chronification (1.2 [0.8–1.6], p = 0.424). Conclusions: Higher genetic risk was associated with earlier onset and increased risk of migraine well into adulthood, but not with chronification. This suggests that the PRS quantifies genetic susceptibility that is distinct from factors influencing disease course. Full article
(This article belongs to the Special Issue Exploring Recent Advancements in Migraine Treatment: Insights from Clinical Neurology)
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Review

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19 pages, 380 KiB  
Review
Unravelling Migraine Stigma: A Comprehensive Review of Its Impact and Strategies for Change
by Javier Casas-Limón, Sonia Quintas, Alba López-Bravo, Alicia Alpuente, Alberto Andrés-López, María Victoria Castro-Sánchez, Javier Amós Membrilla, Cristian Morales-Hernández, Nuria González-García and Pablo Irimia
J. Clin. Med. 2024, 13(17), 5222; https://doi.org/10.3390/jcm13175222 - 3 Sep 2024
Viewed by 1921
Abstract
Migraine-related stigma is a pervasive issue impacting nearly half of chronic migraine patients, with significant consequences for their quality of life, disability and mental health. Despite its profound effects, migraine stigma remains under-recognised in both clinical practice and research. This narrative review explores [...] Read more.
Migraine-related stigma is a pervasive issue impacting nearly half of chronic migraine patients, with significant consequences for their quality of life, disability and mental health. Despite its profound effects, migraine stigma remains under-recognised in both clinical practice and research. This narrative review explores the three primary types of stigmas affecting migraine patients: public, structural and internalised. Public stigma involves negative societal attitudes and stereotypes that trivialise the condition. Structural stigma is reflected in policies that restrict access to necessary care and resources. Internalised stigma occurs when patients absorb these negative views, leading to self-blame and diminished self-worth. Addressing these different types of stigmas is crucial for improving the understanding, diagnosis and treatment of migraine. Educational efforts, advocacy and policy reform are essential strategies in this context. A deep understanding of stigma is vital for developing effective interventions that enhance clinical management and patient quality of life. Ultimately, reducing stigma can lead to better health outcomes and a more comprehensive approach to migraine care. Full article
(This article belongs to the Special Issue Exploring Recent Advancements in Migraine Treatment: Insights from Clinical Neurology)
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