Current Problems and New Horizons in Headache Clinical Practice

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 16180

Special Issue Editors


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Guest Editor
Physical Education and Health Center, Nagaoka University of Technology, Nagaoka, Niigata, Japan
Interests: headache; migraine
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Neurology, Saitama Neuropsychiatric Institute, Saitama, Saitama, Japan
Interests: headache; migraine
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Canon Marketing Japan Inc., Research & Business Development Center, Minato-ku, Tokyo, Japan
2. Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
Interests: hypersensitivity and environment in migraine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Headache is one of the most harmful diseases to healthy life expectancy in the world. Opportunity and economic losses due to headaches are beginning to be recognized. A paradigm shift is occurring as new drugs are being introduced one after another, and headaches, especially migraine, have become a treatable disease. On the other hand, some patients have become headache refugees or suffer from medication-overuse headaches due to a lack of access to appropriate headache care and correct information.

This special issue solicits manuscripts on a wide range of headache-related treatment and prevention topics. Particular attention will be paid to papers with content related to new drugs, awareness-raising, and epidemiological studies to expand appropriate headache treatment and other topics that will lead to more people being able to enjoy headache medical care. In addition, papers using the latest technologies, such as artificial intelligence and smartphone applications, are also welcome.

We look forward to papers that will help make headache treatment accessible to as many people as possible and that will help bring about social change.

Dr. Masahito Katsuki
Dr. Tomokazu Shimazu
Prof. Dr. Muneto Tatsumoto
Guest Editors

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Published Papers (6 papers)

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Research

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15 pages, 2680 KiB  
Article
Treatment Patterns for and Characteristics of Headache in Children and Adolescents Aged 6–17 Years in Japan: A Retrospective Cross-Sectional and Longitudinal Analysis of Health Insurance Claims Data
by Masahito Katsuki, Yasuhiko Matsumori, Taisuke Ichihara, Yuya Yamada, Shin Kawamura, Kenta Kashiwagi, Akihito Koh, Tetsuya Goto, Kazuma Kaneko, Naomichi Wada and Fuminori Yamagishi
Life 2024, 14(1), 96; https://doi.org/10.3390/life14010096 - 8 Jan 2024
Cited by 2 | Viewed by 2315
Abstract
Objective: To investigate the prescription patterns for patients aged 6–17 years with headaches in the REZULT database. Methods: We cross-sectionally investigated (Study 1) the pattern of prescription and the proportion of triptan overprescription (≥30 tablets/90 d of triptans) among patients diagnosed with headaches [...] Read more.
Objective: To investigate the prescription patterns for patients aged 6–17 years with headaches in the REZULT database. Methods: We cross-sectionally investigated (Study 1) the pattern of prescription and the proportion of triptan overprescription (≥30 tablets/90 d of triptans) among patients diagnosed with headaches in 2020. Next, we longitudinally studied patients (Study 2) for more than two years from the initial headache diagnosis (July 2010 to April 2022). The number of prescribed tablets was counted every 90 days. Results: In Study 1, headache diagnoses were assigned to 62,568 of 543,628 (11.51%) patients, and 1524 of 62,568 (2.44%) patients received acute medication. Single nonsteroidal anti-inflammatory drugs and triptans were prescribed to 620/624 (99.36%) and 5/624 (0.80%) of patients aged 6–11 years, respectively, and 827/900 (91.89%) and 91/900 (10.11%) of patients aged 12–17 years, respectively. Triptan overprescription was observed in 11/96 (11.46%) patients, and 5/11 (45.45%) of those patients received prophylactic medication. In Study 2, 80,756/845,470 (9.55%) patients aged 6–17 years were diagnosed with headaches that persisted for at least two years. Over two years, 44/80,756 (0.05%) patients were overprescribed triptans, and 3408/80,756 (4.22%) patients were prescribed prophylaxis on at least one occasion. Conclusions: Based on real-world data, the appropriate use of prophylactic treatment is still problematic. Overprescription of triptans was observed, although the number of patients was small. Full article
(This article belongs to the Special Issue Current Problems and New Horizons in Headache Clinical Practice)
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12 pages, 3120 KiB  
Article
Cervical Impairments in Subjects with Chronic Migraine: An Observational Study
by José Angel del-Blanco-Muñiz, Daniel Martín-Vera, Maria Dolores Sosa-Reina, Alfonso Trinidad-Morales, Marta de-la-Plaza-San-Frutos and Alberto Sánchez-Sierra
Life 2023, 13(8), 1773; https://doi.org/10.3390/life13081773 - 18 Aug 2023
Cited by 2 | Viewed by 1719
Abstract
Objective: The aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine and healthy control subjects. Methods: An observational study was carried [...] Read more.
Objective: The aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine and healthy control subjects. Methods: An observational study was carried out in accordance with the STROBE statements. The flexor longus colli and multifidus, two neck-stabilizing muscles, were measured using B-mode ultrasound imaging. The upper trapezius, masseter, temporalis, anterior tibialis, and median nerve all underwent bilateral pressure-pain threshold (PPT) assessments. The statistical program SPSS 29.0 was used to implement the Mann–Whitney U test and Chi-squared test. Spearman Rho was utilized to establish the correlations between the variables. Results: Sixty participants were enrolled in the study. The subjects, who were matched in terms of age, gender, and body mass index (BMI), were equally divided into migraine and control groups. No significant differences between the groups were found in the multifidus CSA regarding both sides at rest (right: p = 0.625; left: p = 0.203). However, in contraction, the multifidus CSA showed a significant decrease on the left side in the patients with migraine compared to the controls (p = 0.032), but no significant differences were found in the right multifidus CSA in contraction between the two groups (p = 0.270). In comparison to the healthy volunteers, the migraine sufferers showed a substantial reduction in CSA in the longus colli muscle on both the left side (p = 0.001) and the right side at rest (p = 0.003), as well as in the CSA of the left longus colli in contraction (p < 0.001). Furthermore, the migraine patients showed significantly lower PPT compared to the healthy subjects in local and widespread areas bilaterally. All the parameters revealed higher sensitization in the migraine group in the following areas: the right and left temporal regions (p < 0.001), the right and left upper trapezius (p < 0.001 and p < 0.01, respectively), the right and left masseter muscles (p < 0.01), the right and left median nerves (p < 0.001 and p < 0.01, respectively), and the right and left anterior tibialis muscles (p < 0.001). In terms of the craniocervical flexion test (CCFT), the migraine patients demonstrated significantly lower values than the healthy subjects (p < 0.001). A moderate positive correlation was noted between the PPT in the right temporalis muscle and that in the left longus colli and the right multifidus in contraction. The PPT in the right temporalis muscle also exhibited a positive correlation with the CCFT, although this correlation was low. Between the PPT values, the upper trapezius on both sides showed a moderate positive correlation with the median nerve bilaterally. Conclusions: This research suggests that individuals with migraine may experience local and widespread pain sensitization. A decrease in functionality due to the low muscle endurance of the deep cervical muscles is also accompanied by low values of muscle thickness in contraction. These findings may help to select more accurate treatment approaches for patients with migraine. Full article
(This article belongs to the Special Issue Current Problems and New Horizons in Headache Clinical Practice)
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Review

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9 pages, 783 KiB  
Review
Medication-Overuse Headache: Update on Management
by Prut Koonalintip, Katherine Phillips and Benjamin R. Wakerley
Life 2024, 14(9), 1146; https://doi.org/10.3390/life14091146 - 11 Sep 2024
Cited by 1 | Viewed by 2993
Abstract
Long-term frequent use of acute pain medication for the treatment of headaches has paradoxically been shown to increase the frequency of headaches. So-called medication-overuse headache (MOH) is particularly problematic in patients with migraine who overuse triptans and opioids. Prevention through education remains the [...] Read more.
Long-term frequent use of acute pain medication for the treatment of headaches has paradoxically been shown to increase the frequency of headaches. So-called medication-overuse headache (MOH) is particularly problematic in patients with migraine who overuse triptans and opioids. Prevention through education remains the most important management strategy. Once established, MOH can be difficult to treat. Although complete or near-complete withdrawal of acute pain medication for 8–12 weeks has been shown to benefit most patients, this can be hard to achieve. The use of OnabotulinumtoxinA and drugs that target the calcitonin gene-related peptide system for the prevention of migraines have been shown to benefit patients with MOH. Furthermore, the use of novel acute pain medication for migraines, including Gepants and Ditans, which do not cause MOH, are likely to improve patient outcomes. In this review article we examine the following: the burden of MOH; who develops MOH; the pathophysiological mechanisms; and the treatment strategies. Full article
(This article belongs to the Special Issue Current Problems and New Horizons in Headache Clinical Practice)
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13 pages, 259 KiB  
Review
Neuromodulation Techniques for Headache Management
by Noora Reffat, Carolina Pusec, Scott Price, Mayank Gupta, Philippe Mavrocordatos and Alaa Abd-Elsayed
Life 2024, 14(2), 173; https://doi.org/10.3390/life14020173 - 24 Jan 2024
Cited by 3 | Viewed by 3259
Abstract
This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. A search was conducted in PubMed in August of 2023 to survey the [...] Read more.
This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. A search was conducted in PubMed in August of 2023 to survey the current literature on neuromodulation for the treatment of headache. In total, the search yielded 1989 results, which were further filtered to include only systematic reviews published between 2022 to 2023 to capture the most up-to-date and comprehensive research on this topic. The citation lists of these articles were reviewed to find additional research on neuromodulation and supplement the results presented in this paper with primary literature. Research on the use of neuromodulation for the treatment of headache has predominantly focused on four neuromodulation techniques: peripheral nerve stimulation (PNS), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and spinal cord stimulation (SCS). Outcome measures reported in this article include impact on migraine and headache frequency and/or pain intensity, adverse effects of the neuromodulation technique, and associated costs, when available. We found that neuromodulation has developed utility as an alternative treatment for both chronic cluster headaches and migraines, with a reduction in frequency and intensity of headache most elucidated from the articles mentioned in this review. Full article
(This article belongs to the Special Issue Current Problems and New Horizons in Headache Clinical Practice)

Other

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8 pages, 228 KiB  
Opinion
Migraine and Pregnancy
by Katherine Phillips, Prut Koonalintip and Benjamin R. Wakerley
Life 2024, 14(10), 1224; https://doi.org/10.3390/life14101224 - 25 Sep 2024
Cited by 1 | Viewed by 2201
Abstract
Migraine affects almost one in five women of reproductive age. Therefore, understanding its impact on pregnancy outcomes and how to manage migraine safely in pregnancy are of particular importance. This review will summarise the clinical course of migraine during pregnancy, the management of [...] Read more.
Migraine affects almost one in five women of reproductive age. Therefore, understanding its impact on pregnancy outcomes and how to manage migraine safely in pregnancy are of particular importance. This review will summarise the clinical course of migraine during pregnancy, the management of women presenting with headaches during pregnancy, the management of migraine during pregnancy and summarise what is known about how migraine and migraine medications impact pregnancy outcomes. Full article
(This article belongs to the Special Issue Current Problems and New Horizons in Headache Clinical Practice)
8 pages, 1856 KiB  
Case Report
Spontaneous Intracranial Hypotension and Subdural Hematomas Treatment Management Using MMA Embolization and Target Blood Patch: A Case Report
by Luigi Cirillo, Francesca Verna, Ciro Princiotta, Massimo Dall’Olio, Arianna Rustici, Carlo Bortolotti, Filippo Badaloni, Davide Mascarella, Pietro Cortelli and Sabina Cevoli
Life 2024, 14(2), 250; https://doi.org/10.3390/life14020250 - 13 Feb 2024
Cited by 1 | Viewed by 2142
Abstract
We report a patient suffering from spontaneous intracranial hypotension (SIH) who, following a non-selective lumbar blood patch, returned to his healthcare provider with severe symptoms of neurological deficits. It was subsequently discovered that the aforementioned deficits were due to a bilateral subdural hematoma, [...] Read more.
We report a patient suffering from spontaneous intracranial hypotension (SIH) who, following a non-selective lumbar blood patch, returned to his healthcare provider with severe symptoms of neurological deficits. It was subsequently discovered that the aforementioned deficits were due to a bilateral subdural hematoma, and an emergency surgical drainage of the hematoma has been performed. However, the hematoma reformed and potential cerebrospinal fluid leakage was consequently investigated through myelography. Following the diagnostic finding of a venous diverticulum, a selective blood patch was executed in the affected area, and in order to stabilize the hematoma, an embolization of the middle meningeal arteries was performed. The combination of such operations allowed for the resorption of the hematoma and the improvement of neurological symptoms. Full article
(This article belongs to the Special Issue Current Problems and New Horizons in Headache Clinical Practice)
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