Background: A significant proportion of people with migraine do not achieve sufficient relief of their acute migraine symptoms with the currently available medications. A previous study showed that intranasal evaporative cooling reduced headache and migraine-associated symptoms when given in an outpatient clinic setting. This study aimed to evaluate the feasibility of self-administering the same intervention for acute migraine in an at-home setting. The findings of this study were intended to inform the design and implementation of a planned full-scale randomized controlled trial (RCT).
Methods: We conducted a prospective single-group clinical feasibility trial in southern Sweden. Participants meeting the criteria for episodic migraine, with or without aura, were recruited through local advertisements. After a screening period, during which two migraine attacks were registered and evaluated under usual care, participants treated their next three migraine attacks at home with 10 minutes of intranasal cooling (RhinoChill®, BrainCool AB, Lund, Sweden). The primary outcome was a reduction in headache, nausea, photophobia, and phonophobia immediately after treatment. The secondary outcome was tolerability, and treatment effects within 24 hours.
Results: Six out of 15 participants completed the study, using the cooling treatment for three consecutive migraine attacks. The main reasons for drop-out were pain/discomfort from treatment and lack of effect. A total of 23 treatments were registered by 10 participants. Small effects on pain and other migraine symptoms were observed immediately after treatment. The treatment was considered very unpleasant (Visual Analogue Scale 7.3/10) and not superior to usual care.
Conclusions: The RhinoChill® intranasal cooling treatment at home was found to be non-feasible due to pain and discomfort, resulting in a high drop-out rate. Additionally, it had only minor effects on migraine pain and symptoms. The findings of this study led to the cancellation of a planned full-scale RCT.
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http://dx.doi.org/10.7759/cureus.72911 | DOI Listing |
Br J Pharmacol
January 2025
Center for Clinical Pharmacology, Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Background And Purpose: Pituitary adenylate cyclase activating polypeptide (PACAP) is a human migraine trigger that is being targeted for migraine. The δ-opioid receptor (δ-receptor) is a novel target for the treatment of migraine, but its mechanism remains unclear. The goals of this study were to develop a mouse PACAP-headache model using clinically significant doses of PACAP; determine the effects of δ-receptor activation in this model; and investigate the co-expression of δ-receptors, PACAP and PACAP-PAC1 receptor.
View Article and Find Full Text PDFJ Headache Pain
January 2025
School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia.
Background: Migraine is the most common complex neurological disorder, affecting over a billion people worldwide. Neurogenic inflammation has long been recognized as a key factor in the pathophysiology of migraine though little research has been directed to investigating whether inflammation is greatest in migraine with aura or without, and whether inflammation is a permanent state in migraine or whether is an event related transitory state. Thus, the primary aim of this single-centre, retrospective study was to explore the potential clinical utility of the Serial Systemic Immune-Inflammatory Indices (SSIIi) as a comparative measure of duration and severity of inflammation derived from routine blood cell counts in migraine patients with aura and no-aura both within an acute inpatient setting and as outpatients.
View Article and Find Full Text PDFCureus
December 2024
Department of Ophthalmology, Unidade Local de Saúde de São João, Porto, PRT.
Migraine, a neurological disorder often accompanied by symptoms such as visual disturbances, nausea, and photophobia, involves complex interactions between genetic and environmental factors, while vascular factors are also implicated, influenced by both genetic predisposition and environmental triggers. This case report discusses a 41-year-old male with a history of migraine with visual aura, presenting with sudden left-eye visual loss. Comprehensive ophthalmologic examination revealed a central scotoma, while multimodal imaging, including spectral-domain optical coherence tomography (SD-OCT), showed focal alterations in the outer plexiform layer.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
January 2025
Department of Pediatric Radiology and Neuroradiology (C.D., F.A., C.P., A.R.), Children's Hospital V. Buzzi, Milan, Italy.
Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is an uncommon condition represented by an infantile-onset disorder, frequently arising from heterozygous mutations in the gene. Individuals with GLUT1-DS may present with early-onset seizures (typically manifesting before 4 years of age), developmental delay, and complex movement disorders. In fewer cases, stroke-like events or hemiplegic migraine-like symptoms are also reported, defined by unilateral paresis affecting 1 side of the body and/or one-half of the face, occasionally accompanied by speech impairment.
View Article and Find Full Text PDFJAMA
January 2025
Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington.
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