Publications by authors named "Caronna E"
Purpose: Headache is a prevalent and highly disabling neurological disorder. There are no data on its prevalence in and impact on hospitalized patients. The objective of this study was to describe the prevalence of headache in hospitalized patients, triggers associated with headaches in this population, and compliance with documentation in the electronic medical record system (EMRS).
View Article and Find Full Text PDFArticle Synopsis
- Time plays a critical role in diagnosing headache disorders and understanding their underlying mechanisms, highlighting the need for effective timing analysis in headache research.
- A review of studies covering primary headache types—migraine, tension-type headache, and cluster headache—reveals distinct timing patterns, such as circadian rhythms in migraines and night-time occurrences in cluster headaches.
- Understanding these time patterns can improve the phenotyping, management, and treatment of headache disorders, pointing towards new, personalized approaches in headache care.
Article Synopsis
- The prodrome phase of a migraine attack occurs 24-48 hours before the headache and involves symptoms that can be mistaken for triggers.
- This review analyzes existing studies to clarify the distinction between prodromal symptoms and migraine triggers, using clinical and neurophysiological data.
- Understanding the interaction between brain activity during the prodromal phase and potential triggers is essential for improving migraine management and exploring their underlying mechanisms.
Background: Monoclonal antibodies targeting calcitonin gene-related peptide (CGRP-mAbs) are approved for adult migraine prevention but pose safety concerns in pregnancy. We assess the safety of CGRP-mAbs in the periconceptional period through a case series and literature review.
Methods: Six migraine-diagnosed women received CGRP-mAbs; treatment ceased upon pregnancy.
Article Synopsis
- Chronic migraine (CM) significantly impacts adolescents, and a study aimed to evaluate the safety and effectiveness of onabotulinumtoxinA (BTX-A) in treating these cases while reviewing existing pediatric literature.
- The study included 20 patients under 18, revealing that 55% of participants saw a significant reduction in monthly headache days after 6 months, and 57.1% continued to show improvement at the 12-month mark.
- No adverse effects were reported, suggesting that BTX-A is a safe and effective treatment for adolescents with CM who do not respond to traditional oral medications.
Article Synopsis
- Anti-CGRP monoclonal antibodies are effective treatments for preventing migraines, but patients show varied responses, influenced by specific clinical factors.
- A study involving over 5,800 patients identified key predictors of treatment response at 6 months, including older age, unilateral pain, absence of depression, fewer monthly migraine days, and lower disability levels.
- The findings highlight that higher migraine frequency and greater baseline disability negatively impact treatment effectiveness, which can inform future patient management and reimbursement policies.
Background: Migraine is a complex neurological disorder with significant heterogeneity in its clinical presentation and molecular mechanisms. Calcitonin gene-related peptide (CGRP) has emerged as a key player in migraine pathophysiology, but challenges remain in its utilization as a biomarker. This study aimed to investigate salivary CGRP levels during migraine attacks across the frequency spectrum and explore associations with clinical variables.
View Article and Find Full Text PDFPurpose Of Review: This review aims to explore the use of patient-reported outcome measures (PROMs) in migraine. Traditionally assessed through specific features, recent adoption of PROMs allows for a more objective and quantifiable evaluation. PROMs, which are standardized questionnaires collecting health information directly from a patients' perspective, cover various aspects, including migraine specific aspects.
View Article and Find Full Text PDFBackground: To date, a number of studies on migraine have cross-sectionally evaluated sensory sensitivity with aversion thresholds/scores along the migraine cycle, reporting a decreased tolerance to sensory stimuli in different sensory modalities. Our hypothesis was that patients with migraine would exhibit heightened sensitivity to sound, light, touch and smell on days where they reported greater headache intensity.
Methods: This is an exploratory, longitudinal study, carried out over the course of 27 days.
Background And Purpose: The aim was to provide insights to the characteristics of headache in the context of COVID-19 on behalf of the Headache Scientific Panel and the Neuro-COVID-19 Task Force of the European Academy of Neurology (EAN) and the European Headache Federation (EHF).
Methods: Following the Delphi method the Task Force identified six relevant questions and then conducted a systematic literature review to provide evidence-based answers and suggest specific diagnostic criteria.
Results: No data for facial pain were identified in the literature search.
Background: Migraine is one of the main causes of disability worldwide. Anti-CGRP monoclonal antibodies (MAbs) have proven to be safe and efficacious as preventive migraine treatments. However, their use is restricted in many countries due to their apparently high cost.
View Article and Find Full Text PDFArticle Synopsis
- Migraine is a common and debilitating neurological condition with historically limited preventive treatment options due to a lack of effective therapies.
- Recent research has identified calcitonin gene-related peptide (CGRP), a crucial player in migraine, leading to the development of targeted treatments such as anti-CGRP monoclonal antibodies and gepants.
- Four monoclonal antibodies (erenumab, galcanezumab, fremanezumab, and eptinezumab) and two gepants (rimegepant and atogepant) have been approved, showing promising results for preventing both episodic and chronic migraines.
Background: The present study aimed to describe the prevalence and evolution of depressive symptoms in a cohort of migraine patients treated with anti-CGRP monoclonal antibodies.
Methods: This is an exploratory, prospective, unicentric, one-year longitudinal study. We included migraine patients who started treatment with anti-CGRP monoclonal antibodies.
Background And Purpose: In clinical practice patients may report migraine worsening as a consequence of COVID-19 (either infection or vaccines), however, data in this area are lacking. We aimed to investigate the link between COVID-19 and COVID-19 vaccination with migraine worsening and its associated factors.
Methods: An online survey was sent to migraine patients followed up in a Spanish Headache Clinic, collecting demographic data, and information regarding SARS-CoV-2 infection and vaccination.
Targeting CGRP has proved to be efficacious, tolerable, and safe to treat migraine; however, many patients with migraine do not benefit from drugs that antagonize the CGRPergic system. Therefore, this review focuses on summarizing the general pharmacology of the different types of treatments currently available, which target directly or indirectly the CGRP receptor or its ligand. Moreover, the latest evidence regarding the selectivity and site of action of CGRP small molecule antagonists (gepants) and monoclonal antibodies is critically discussed.
View Article and Find Full Text PDFHeadache in COVID-19 and Long COVID: to Know Facts for Clinical Practice.
Curr Neurol Neurosci Rep
October 2023
Article Synopsis
- Headaches are a common symptom during and after COVID-19, but their mechanisms and treatments are not fully understood.
- Specific characteristics of headaches associated with COVID-19 variants, like Omicron, are still being researched, particularly for patients with existing headache disorders.
- Despite increasing research, findings are inconsistent and primarily reflect early pandemic data, highlighting the need for further studies on COVID-19-related headaches.
Background And Purpose: An impaired neurovascular coupling has been described as a possible player in neurodegeneration and cognitive decline. Migraine is a recurrent and incapacitating disorder that starts early in life and has shown neurovascular coupling abnormalities. Despite its high prevalence, the physiology and underlying mechanisms are poorly understood.
View Article and Find Full Text PDFBackground: Clinical trials on anti-calcitonin gene-related peptide monoclonal antibodies poorly investigated their impact on migraine accompanying symptoms.
Objective: To evaluate the impact of basal accompanying symptoms on anti-CGRP monoclonal antibodies treatment response and their evolution after six months of treatment in migraine patients.
Methods: Patients with migraine diagnosis seen in the Headache Clinic and treated with erenumab, galcanezumab or fremanezumab were prospectively recruited.
Background: Migraine is a cyclic, neurosensory disorder characterized by recurrent headaches and altered sensory processing. The latter is manifested in hypersensitivity to visual stimuli, measured with questionnaires and sensory thresholds, as well as in abnormal cortical excitability and a lack of habituation, assessed with visual evoked potentials elicited by pattern-reversal stimulation. Here, the goal was to determine whether factors such as age and/or disease severity may exert a modulatory influence on sensory sensitivity, cortical excitability, and habituation.
View Article and Find Full Text PDFBackground: Anti-CGRP monoclonal antibodies have shown notable effectiveness and tolerability in migraine patients; however, data on their use in elderly patients is still lacking, as clinical trials have implicit age restrictions and real-world evidence is scarce. In this study, we aimed to describe the safety and effectiveness of erenumab, galcanezumab and fremanezumab in migraine patients over 65 years old in real-life.
Methods: In this observational real-life study, a retrospective analysis of prospectively collected data from 18 different headache units in Spain was performed.
Background And Purpose: The response pattern to monoclonal antibodies against calcitonin gene-related peptide (anti-CGRP MAbs) shown in migraine prevention clinical trials is not always reproducible at an individual level. This study was undertaken to describe patterns of start and consistency of the response to anti-CGRP MAbs during the first 6 months of treatment and the association with baseline clinical characteristics.
Methods: This is a prospective clinical cohort observational study.
Background: Several studies have described potential microRNA (miRNA) biomarkers associated with migraine, but studies are scarcely reproducible primarily due to the heterogeneous variability of participants. Increasing evidence shows that disease-related intrinsic factors together with lifestyle (environmental factors), influence epigenetic mechanisms and in turn, diseases. Hence, the main objective of this exploratory study was to find differentially expressed miRNAs (DE miRNA) in peripheral blood mononuclear cells (PBMC) of patients with migraine compared to healthy controls in a well-controlled homogeneous cohort of non-menopausal women.
View Article and Find Full Text PDFObjective: 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.