Hallmarks of primary headache: part 1 - migraine.

Aura CGRP Calcitonin gene-related peptide Ditans Gepants Medication overuse headache Migraine Productivity loss Triptans

Journal

The journal of headache and pain
ISSN: 1129-2377
Titre abrégé: J Headache Pain
Pays: England
ID NLM: 100940562

Informations de publication

Date de publication:
31 Oct 2024
Historique:
received: 08 08 2024
accepted: 15 10 2024
medline: 1 11 2024
pubmed: 1 11 2024
entrez: 1 11 2024
Statut: epublish

Résumé

Migraine is a common disabling conditions which, globally, affects 15.2% of the population. It is the second cause of health loss in terms of years lived with disability, the first among women. Despite being so common, it is poorly recognised and too often undertreated. Specialty centres and neurologists with specific expertise on headache disorders have the knowledge to provide specific care: however, those who do not regularly treat patients with migraine will benefit from a synopsis on the most relevant and updated information about this condition. This paper presents a comprehensive view on the hallmarks of migraine, from genetics and diagnostic markers, up to treatments and societal impact, and reports the elements that identify migraine specific features. The most relevant hallmark of migraine is that it has common and individual features together. Besides the known clinical manifestations, migraine presentation is heterogeneous with regard to frequency of attacks, presence of aura, response to therapy, associated comorbidities or other symptoms, which likely reflect migraine heterogeneous genetic and molecular basis. The amount of therapies for acute and for prophylactic treatment is really wide, and one of the difficulties is with finding the best treatment for the single patient. In addition to this, patients carry out different daily life activities, and might show lifestyle habits which are not entirely adequate to manage migraine day by day. Education will be more and more important as a strategy of brain health promotion, because this will enable reducing the amount of subjects needing specialty care, thus leaving it to those who require it in reason of refractory condition or presence of comorbidities. Recognizing the hallmarks of migraine and the features of single patients enables prescribing specific pharmacological and non-pharmacological treatments. Medical research on headaches today particularly suffers from the syndrome of single-disease approach, but it is important to have a cross-sectional and joint vision with other close specialties, in order to treat our patients with a comprehensive approach that a heterogeneous condition like migraine requires.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
Migraine is a common disabling conditions which, globally, affects 15.2% of the population. It is the second cause of health loss in terms of years lived with disability, the first among women. Despite being so common, it is poorly recognised and too often undertreated. Specialty centres and neurologists with specific expertise on headache disorders have the knowledge to provide specific care: however, those who do not regularly treat patients with migraine will benefit from a synopsis on the most relevant and updated information about this condition. This paper presents a comprehensive view on the hallmarks of migraine, from genetics and diagnostic markers, up to treatments and societal impact, and reports the elements that identify migraine specific features.
MAIN RESULTS RESULTS
The most relevant hallmark of migraine is that it has common and individual features together. Besides the known clinical manifestations, migraine presentation is heterogeneous with regard to frequency of attacks, presence of aura, response to therapy, associated comorbidities or other symptoms, which likely reflect migraine heterogeneous genetic and molecular basis. The amount of therapies for acute and for prophylactic treatment is really wide, and one of the difficulties is with finding the best treatment for the single patient. In addition to this, patients carry out different daily life activities, and might show lifestyle habits which are not entirely adequate to manage migraine day by day. Education will be more and more important as a strategy of brain health promotion, because this will enable reducing the amount of subjects needing specialty care, thus leaving it to those who require it in reason of refractory condition or presence of comorbidities.
CONCLUSIONS CONCLUSIONS
Recognizing the hallmarks of migraine and the features of single patients enables prescribing specific pharmacological and non-pharmacological treatments. Medical research on headaches today particularly suffers from the syndrome of single-disease approach, but it is important to have a cross-sectional and joint vision with other close specialties, in order to treat our patients with a comprehensive approach that a heterogeneous condition like migraine requires.

Identifiants

pubmed: 39482575
doi: 10.1186/s10194-024-01889-x
pii: 10.1186/s10194-024-01889-x
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

189

Informations de copyright

© 2024. The Author(s).

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Auteurs

Alberto Raggi (A)

Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy. alberto.raggi@istituto-besta.it.

Matilde Leonardi (M)

Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy.

Marco Arruda (M)

Department of Neuroscience, Glia Institute, Ribeirão Preto, Brazil.

Valeria Caponnetto (V)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Matteo Castaldo (M)

Department of Health Science and Technology, Faculty of Medicine, CNAP, Center for Sensory-Motor Interaction (SMI), Aalborg University, Gistrup, Denmark.
Department of Medicine and Surgery, Clinical Psychophysiology and Clinical Neuropsychology Labs, Parma University, Parma, Italy.

Gianluca Coppola (G)

Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy.

Adriana Della Pietra (A)

Dept. Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.

Xiangning Fan (X)

Department of Medicine, University of Alberta, Edmonton, AB, Canada.

David Garcia-Azorin (D)

Department of Medicine, Toxicology and Dermatology, Faculty of Medicine, University of Valladolid, Valladolid, Spain.
Department of Neurology, Hospital Universitario Río Hortega, Valladolid, Spain.

Parisa Gazerani (P)

Department of Health Science and Technology, Faculty of Medicine, CNAP, Center for Sensory-Motor Interaction (SMI), Aalborg University, Gistrup, Denmark.
Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.

Lou Grangeon (L)

Neurology Department, CHU de Rouen, Rouen, France.

Licia Grazzi (L)

Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.

Fu-Jung Hsiao (FJ)

Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Keiko Ihara (K)

Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
Japanese Red Cross Ashikaga Hospital, Tochigi, Japan.

Alejandro Labastida-Ramirez (A)

Division of Neuroscience, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK.

Kristin Sophie Lange (KS)

Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.

Marco Lisicki (M)

Instituto de Investigación Médica Mercedes y Martín Ferreyra (INIMEC), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Córdoba, Córdoba, Argentina.

Alessia Marcassoli (A)

Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy.

Danilo Antonio Montisano (DA)

Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.

Dilara Onan (D)

Department of Physiotherapy and Rehabilitation, Faculty of Heath Sciences, Yozgat Bozok University, Yozgat, Turkey.

Agnese Onofri (A)

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Lanfranco Pellesi (L)

Department of Public Health Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark.

Mario Peres (M)

Hospital Israelita Albert Einstein, São Paulo, Brazil.
Instituto de Psiquiatria; Hospital das Clínicas da Faculdade de Medicina da USP, Sao Paulo, Brazil.

Igor Petrušić (I)

Laboratory for Advanced Analysis of Neuroimages, Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia.

Bianca Raffaelli (B)

Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.

Eloisa Rubio-Beltran (E)

Headache Group, Wolfson SPaRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Andreas Straube (A)

Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany.

Sebastian Straube (S)

Department of Medicine, University of Alberta, Edmonton, AB, Canada.
School of Public Health, University of Alberta, Edmonton, AB, Canada.

Tsubasa Takizawa (T)

Department of Neurology, Keio University School of Medicine, Tokyo, Japan.

Claudio Tana (C)

Center of Excellence On Headache and Geriatrics Clinic, SS Annunziata Hospital of Chieti, Chieti, Italy.

Michela Tinelli (M)

Care Policy Evaluation Centre (CPEC), London School of Economics and Political Science, London, UK.

Massimiliano Valeriani (M)

Systems Medicine Department, University of Tor Vergata, Rome, Italy.
Developmental Neurology Unit, IRCSS Ospedale Pediatrico Bambino Gesù, Rome, Italy.

Simone Vigneri (S)

Neurology and Neurophysiology Service - Pain Medicine Unit, Santa Maria Maddalena Hospital, Occhiobello, Italy.

Doga Vuralli (D)

Department of Neurology and Algology, Neuropsychiatry Center, Neuroscience and Neurotechnology Center of Excellence (NÖROM), Gazi University Faculty of Medicine, Ankara, Türkiye.

Marta Waliszewska-Prosół (M)

Division of Neurology, Wroclaw Medical University, Wroclaw, Poland.

Wei Wang (W)

Department of Neurology, Headache Center, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Yonggang Wang (Y)

Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China.

William Wells-Gatnik (W)

Unitelma Sapienza University of Rome, Rome, Italy.

Tissa Wijeratne (T)

Department of Neurology, Sunshine Hospital, St Albans, VIC, Australia.
Australian Institute of Migraine, Pascoe Vale South, VIC, Australia.

Paolo Martelletti (P)

Unitelma Sapienza University of Rome, Rome, Italy.

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