The profile of refractory chronic cluster headache.

Introduction: Chronic cluster headache (CCH) is a relatively rare primary headache disorder whose management is often challenging. The prevalence of refractory CCH (rCCH) is unknown. Our aim is to describe the frequency of rCCH within a population of CCH, define the clinical profile of the refractory patients and the treatments they underwent.

Clinical predictors of therapeutic failure of occipital nerve stimulation in refractory chronic cluster headache.

Background: Occipital nerve stimulation (ONS) is a treatment with evidence in refractory chronic cluster headache (CCH). However, the variable response rate and cost make it necessary to investigate predictors of response.

Methods: This is a cross-sectional study conducted through the review of medical records of CCH patients from six hospitals in Madrid.

CandeSpartan Study: Candesartan Spanish Response-prediction and Tolerability study in migraine.

Introduction: Effectiveness of candesartan in migraine prevention is supported by two randomized controlled trials. We aimed to assess the effectiveness, tolerability, and response predictors of candesartan in the preventive treatment of migraine.

Methods: Observational, multicenter, prospective cohort study.

Evaluation of the concomitant use of prophylactic treatments in patients with migraine under anti-calcitonin gene-related peptide therapies: The PREVENAC study.

Background And Purpose: Anti-calcitonin gene-related peptide (CGRP) therapies are recent preventive therapies approved for both episodic and chronic migraine. One of the measures of effectiveness is the withdrawal of other preventive treatments. The objective of this study is to quantify the impact of anti-CGRP drugs in concomitant preventive treatment in patients with migraine.

RE-START: Exploring the effectiveness of anti-calcitonin gene-related peptide resumption after discontinuation in migraine.

Background And Purpose: According to the latest European guidelines, discontinuation of monoclonal antibodies against calcitonin gene-related peptide (anti-CGRP MAb) may be considered after 12-18 months of treatment. However, some patients may worsen after discontinuation. In this study, we assessed the response following treatment resumption.

Potential Predictors of Response to CGRP Monoclonal Antibodies in Chronic Migraine: Real-World Data.

Purpose Of Review: Real-world data (RWD) has identified potential predictors of response to anti-CGRP therapies in patients with chronic migraine (CM). This review aims to synthesize the most remarkable findings published to date regarding this topic.

Recent Findings: Migraine features such as unilateral pain and positive triptan response and chronic features such as daily headache or medication overuse (MO) emerge as predictors of positive outcomes, potentially linked to elevated baseline serum anti-calcitonin gene-related peptide (anti-CGRP) levels.

Effectiveness, tolerability, and response predictors of preventive anti-CGRP mAbs for migraine in patients over 65 years old: a multicenter real-world case-control study.

Objective: To evaluate clinical characteristics, effectiveness, and tolerability of preventive anti- calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) in the elderly. Anti-CGRP mAbs have demonstrated efficacy and safety in patients with migraine although there is limited information regarding the elderly.

Design: We performed a multicenter case-control study of cases (patients over 65 years old) and controls (sex-matched patients under 55 years old) with migraine receiving anti-CGRP mAbs.

Headache in patients with inflammatory bowel disease: Migraine prevalence according to the Migraine Screening-Questionnaire (MS-Q) and headache characteristics.

Background: The gut-brain axis describes a complex bidirectional association between neurological and gastrointestinal (GI) disorders. In patients with migraine, GI comorbidities are common. We aimed to evaluate the presence of migraine among patients with inflammatory bowel disease (IBD) according to Migraine Screen-Questionnaire (MS-Q) and describe the headache characteristics compared to a control group.

Headache attributed to SARS-CoV-2 infection, vaccination and the impact on primary headache disorders of the COVID-19 pandemic: A comprehensive review.

Objective: The objective is to summarize the knowledge on the epidemiology, pathophysiology and management of secondary headache attributed to SARS-CoV-2 infection and vaccination; as well as to delineate their impact on primary headache disorders.

Methods: This is a narrative review of the literature regarding primary and secondary headache disorders in the setting of COVID-19 pandemic. We conducted a literature search in 2022 on PubMed, with the keywords "COVID 19" or "vaccine" and "headache" to assess the appropriateness of all published articles for their inclusion in the review.

DNA Methylation Description of Hippocampus, Cortex, Amygdala, and Blood of Drug-Resistant Temporal Lobe Epilepsy.

Epigenetic changes such as DNA methylation were observed in drug-resistant temporal lobe epilepsy (DR-TLE), a disease that affects 25-30% of epilepsy patients. The main objective is to simultaneously describe DNA methylation patterns associated with DR-TLE in hippocampus, amygdala, surrounding cortex to the epileptogenic zone (SCEZ), and peripheral blood. An Illumina Infinium MethylationEPIC BeadChip array was performed in 19 DR-TLE patients and 10 postmortem non-epileptic controls.

Amitriptyline for post-COVID headache: effectiveness, tolerability, and response predictors.

Background: Headache is one of the most frequently reported symptoms in post-COVID patients. The clinical phenotype of COVID-19 headache combines phenotypic features of both tension-type headache (TTH) and migraine. We aimed to assess the effectiveness, side effects and predictors of amitriptyline (AMT) response in a real-world study setting.

Machine-learning-based approach for predicting response to anti-calcitonin gene-related peptide (CGRP) receptor or ligand antibody treatment in patients with migraine: A multicenter Spanish study.

Background And Purpose: Several variables have been reported to be associated with anti-calcitonin gene-related peptide (CGRP) receptor or ligand antibody response, but with differing results. Our objective was to determine whether machine-learning (ML)-based models can predict 6-, 9- and 12-month responses to anti-CGRP receptor or ligand therapies among migraine patients.

Methods: We performed a multicenter analysis of prospectively collected data from patients with migraine receiving anti-CGRP therapies.

Treatment of migraine with monoclonal antibodies.

Introduction: In the few last years, a new family of drugs, anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs), has been developed for migraine therapy. Anti-CGRP mAbs are highly effective, but the current limited experience with their use and their high-cost warrant establishing certain rules of use.

Areas Covered: The present review provides an overview of the management of migraine patients, especially those who are undergoing treatment with anti-CGRP mAbs.

"The Triptan's Hangover": A Multicentric Cross-sectional Observational Study of the Adverse Events of Triptans in Patients With Migraine.

The emergence of triptans represented a breakthrough in the treatment of migraine, but in clinical practice, patients describe symptoms that resemble those of a hangover after taking them. We propose the use of the Hangover Symptoms Scale (HSS) to evaluate this syndrome in patients that take triptans, which may help identify patients at higher risk of presenting these adverse effects that may interfere with therapeutic compliance.A cross-sectional observational pilot study with prospective data collection through a clinical-demographic questionnaire and the HSS was carried out on patients with migraine treated in headache units in 3 tertiary hospitals in Madrid.

Clinical characteristics and perfusion-computed tomography alterations in a series of patients with migraine with aura attended as stroke code.

Objective: The aim of the current study was to determine the clinical characteristics of migraine with aura (MA) as well as the frequency and patterns of perfusion-computed tomography (PCT) alterations, in a series of patients with MA mimicking acute ischemic stroke.

Background: MA is one of the most frequent stroke mimics, following seizures and psychiatric disorders. Previous case reports and short series have reported abnormal PCT patterns in patients with MA.

Cluster-Then-Classify Methodology for the Identification of Pain Episodes in Chronic Diseases.

Chronic diseases benefit of the advances on personalize medicine coming out of the integrative convergence of significant developments in systems biology, the Internet of Things and Artificial Intelligence. 70% to 80% of all healthcare costs in the EU and US are currently spent on chronic diseases, leading to estimated costs of C=700 billion and $3.5 trillion respectively.

Are doctors accurate when diagnosing themselves with migraine? A study on migraine prevalence among doctors in a tertiary care hospital.

Migraine is considered an underdiagnosed disease in general population. Different studies show a higher prevalence in neurologists. However, there are few studies about its prevalence in doctors of other specialties, where it could also be superior than in general population.

Headache History-Taking in an Emergency Department: Impact Evaluation of a Training Session.

Introduction: Headache represents about 25% of the total neurological consultations at the emergency department (ED). Up to 80% of these consultations are represented by primary headaches, in which an accurate and directed history-taking may help reach the specific diagnosis avoiding unnecessary complementary tests and reducing diagnostic latencies.

Methods: We carried out a training session on headache management at the ED, focusing on history-taking and primary headaches' diagnoses and management.

Effects of the onabotulinumtoxinA follow-up delay in migraine course during the COVID-19 lockdown.

Background: Face-to-face procedures have been postponed during COVID-19 pandemic. We aim to evaluate the impact of onabotulinumtoxinA follow-up delay in migraine during COVID-19 pandemic.

Methods: Subjective worsening, intensity of migraine attacks, and frequency of headache and migraine were retrospectively compared between patients with unmodified and interrupted onabotulinumtoxinA follow-up in Headache Units.

Evaluation of the Impact of the COVID-19 Lockdown in the Clinical Course of Migraine.

Objective: Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine.

Design: Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020.

Headache during SARS-CoV-2 infection as an early symptom associated with a more benign course of disease: a case-control study.

Background And Purpose: Headache is an important manifestation during SARS-CoV-2 infection. In this study, the aim was to identify factors associated with headache in COVID-19 and headache characteristics.

Methods: This case-control study includes COVID-19 hospitalized patients with pneumonia during March 2020.