Pharmacokinetics and safety of a new aspirin formulation for the acute treatment of primary headaches.

Introduction: For more than a century, aspirin has been used for the acute treatment of primary headaches. However, the many formulations available are characterized by differences in the pharmacokinetic profile that could affect therapy effectiveness.

Areas Covered: The formulations of aspirin affect the speed of absorption of the drug.

Refractory chronic migraine: a consensus statement on clinical definition from the European Headache Federation.

The debate on the clinical definition of refractory Chronic Migraine (rCM) is still far to be concluded. The importance to create a clinical framing of these rCM patients resides in the complete disability they show, in the high risk of serious adverse events from acute and preventative drugs and in the uncontrolled application of therapeutic techniques not yet validated.The European Headache Federation Expert Group on rCM presents hereby the updated definition criteria for this harmful subset of headache disorders.

Correlation between Migraine Severity and Cholesterol Levels.

Introduction: Several studies have documented increased cardiovascular risk factors, particularly hypercholesterolemia, in the migraine population with respect to controls. However, no studies have investigated the possible relationship between headache severity parameters and lipid serum levels.

Methods: This study evaluated the lipid asset in 52 migraine patients (17 with and 36 without aura) before and after treatment with drugs for migraine prophylaxis for 3 months.

Sodium channel antagonists for the treatment of migraine.

Introduction: Migraine has a strong social impact, influencing both quality of life and work productivity. Therapeutic approach of migraine consists of a multimodal program of pharmacotherapy and behavioral therapy in order to reduce the risk of chronification. Indications for the use of preventive therapy are three or more attacks per month, significant disability, attack duration that is > 90 min.

Treatment of menstrual migraine: utility of control of related mood disturbances.

Menstrual migraine (MM) has a prevalence in the general population of approximately 7%, although it seems to be much higher within the population of females with migraine. Episodes of MM have been reported to be longer, more intense, more disabling, less responsive to acute therapy and more prone to recurrence than those of other types of migraine. MM is demonstrated to have a bi-directional link to affective illnesses such as premenstrual dysphoric disorder and depression.

Sumatriptan in clinical practice: effectiveness in migraine and the problem of psychiatric comorbidity.

Migraine is a multifactorial and disabling syndrome often in comorbidity with psychiatric illnesses. Triptans are the first-line treatment in acute attacks and the most effective drugs in various types of migraine. Sumatriptan was the first medication of this group.

Improving quality in population surveys of headache prevalence, burden and cost: key methodological considerations.

Population-based studies of headache disorders are important. They inform needs assessment and underpin service policy for a set of disorders that are a public-health priority. On the one hand, our knowledge of the global burden of headache is incomplete, with major geographical gaps; on the other, methodological differences and variable quality are notable among published studies of headache prevalence, burden and cost.

Neuromodulation of chronic headaches: position statement from the European Headache Federation.

The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even medically intractable. When a definitive lack of responsiveness to conservative treatments is ascertained and medication overuse headache is excluded, neuromodulation options can be considered in selected cases. Here, the various invasive and non-invasive approaches, such as hypothalamic deep brain stimulation, occipital nerve stimulation, stimulation of sphenopalatine ganglion, cervical spinal cord stimulation, vagus nerve stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and transcutaneous electrical nerve stimulation are extensively published although proper RCT-based evidence is limited.

A six year retrospective review of occipital nerve stimulation practice--controversies and challenges of an emerging technique for treating refractory headache syndromes.

Background: A retrospective review of patients treated with Occipital Nerve Stimulation (ONS) at two large tertiary referral centres has been audited in order to optimise future treatment pathways.

Methods: Patient's medical records were retrospectively reviewed, and each patient was contacted by a trained headache expert to confirm clinical diagnosis and system efficacy. Results were compared to reported outcomes in current literature on ONS for primary headaches.

The omics in migraine.

The term omics consist of three main areas of molecular biology, such as genomics, proteomics and metabolomics. The omics synergism recognise migraine as an ideal study model, due to its multifactorial nature. In this review, the plainly research data featuring in this complex network are reported and analyzed, as single or multiple factor in pathophysiology of migraine.

Framing education on headache disorders into the Global Burden of Disease Study 2010. The European Headache Federation stands ready.

Framing education on headache disorders into the Global Burden of Disease Study 2010. The European Headache Federation stands ready.

Pharmacokinetic evaluation of almotriptan for the treatment of migraines.

Introduction: Migraine is a multifactorial neurovascular disorder characterized by recurrent episodes of disabling pain attacks, accompanied with gastrointestinal, neurological systems dysfunction. The pharmacologic treatment of migraine is classically divided in the management of the acute attack and preventive strategies. Triptans represent a powerful pharmacological tool in acute migraine treatment.

New insights into the cardiovascular risk of migraine and the role of white matter hyperintensities: is gold all that glitters?

The role of migraine as an independent risk factor for cardiovascular events has been debated for several years, while it is more established for ischemic stroke. Recently, new studies have examined the likelihood of migraine to determine cardiovascular events, supporting the hypothesis of a predominant role in patients with migraine with aura, the risk including both sexes. In the literature, multiple pathophysiological mechanisms are described to explain this association, and are here discussed.

Overattachment and perceived disability in chronic migraineurs.

Objectives: The aim of this cross-sectional study was to assess whether stagnation dimensions and depression were associated with perceived disability in chronic migraineurs.

Methods: Participants were 69 consecutive adult outpatients admitted to the Regional Referral Headache Centre of the Sant'Andrea Hospital in Rome, Italy. Patients were administered the Center for Epidemiologic Studies Depression Scale, the Stagnation Scale, and the Italian Perceived Disability Scale.

White matter hyperintensities and self-reported depression in a sample of patients with chronic headache.

White matter hyperintensities (WMH) have been associated with mood disorders in psychiatric patients. In the present study, we aimed to assess whether WMHs are associated with depressive symptoms and different sensitivity of the behavioral inhibition (BIS), and activation (BAS) systems in patients with chronic headache. Participants were 85 adult outpatients (16 men and 69 women) with a diagnosis of chronic headache.

Deciphering the task of N-acetyl aspartate in migraine.

Migraine is a common neurological disorder producing significant personal and societal burden. In the evaluated study, serum concentrations of N-acetyl aspartate (NAA), a biomarker of neuronal integrity, was found to be decreased in patients suffering from migraine with aura. These interesting results suggest a dual clinical readout.

Ictal epileptic headache: an old story with courses and appeals.

The term "ictal epileptic headache" has been recently proposed to classify the clinical picture in which headache is the isolated ictal symptom of a seizure. There is emerging evidence from both basic and clinical neurosciences that cortical spreading depression and an epileptic focus may facilitate each other, although with a different degree of efficiency. This review address the long history which lead to the 'migralepsy' concept to the new emerging pathophysiological aspects, and clinical and electroencephalography evidences of ictal epileptic headache.

Sumatriptan succinate : pharmacokinetics of different formulations in clinical practice.

Introduction: Migraine is a common neurovascular disorder characterized by recurrent episodes of disabling headache, autonomic nervous system dysfunction, and in some patients, neurological aura symptoms. Triptans are frequently prescribed drugs for the treatment of the acute migraine attack, considering their capability to provide wide efficacy and tolerability.

Areas Covered: This review discusses pharmacodynamics and pharmacokinetics of sumatriptan succinate, considering the clinical impact of new drug formulations in the treatment of acute migraine and cluster headache.

Emerging treatment for chronic migraine and refractory chronic migraine.

Introduction: Chronic migraine (CM), the suffering of 15 or more headache days with at least 8 of these migraine days, afflicts 1.3% - 5.1% of the global population.