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Migraine Research Making Headway

Investigators are looking for and finding new approaches to diagnosis, treatment, and prevention. Here: highlights of some of the latest findings.

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Migraine researchers continue to look for and find new approaches to diagnosis, treatment, and prevention of this challenging disorder and its comorbidities. Some of the latest study findings and recommendations are summarized in this brief slideshow.

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Migraine linked with dry eye disease. The chances of having dry eye disease are at least 20% greater in patients who have a diagnosis of migraines than in those who do not. In a retrospective case-control study, the odds of having dry eye disease in patients with a migraine diagnosis were 1.72 times higher and after accounting for multiple confounding factors 1.42 times higher. The association may not reflect cause and effect, but patients with migraine may be at risk for having this comorbid diagnosis.

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Migraine, C-reactive protein, and insomnia. In a recent study of patients with headache, high sensitivity C-reactive protein (hs-CRP) was more likely to be elevated in those who had migraine, especially those who had migraine with aura. No association was found between elevated hs-CRP and migraine without aura or non-migrainous headache. The association between hs-CRP and migraine was strongly dependent on insomnia status-it was evident only among those who had insomnia.

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Lose weight, lose migraine. In obese persons with migraine, weight loss is associated with significant reductions in headache frequency, pain intensity, disability, and attack duration. Improvement was similar with weight reduction achieved through bariatric surgery or behavioral intervention and in adults and children. Mechanisms that link obesity, weight loss, and migraine may include alterations in chronic inflammation, adipocytokines, obesity comorbidities, and behavioral and psychological risk factors.

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Pain catastrophizing is no child’s play. In an evaluation of pain catastrophizing in children and adolescents, no difference was detected in Total Pain Catastrophizing score between episodic and chronic migraine groups. The Pain Catastrophizing Scale was not correlated with migraine-related disability but was significantly correlated with general low quality of life, allodynia, pericranial tenderness, anxiety, and depression. The clinical profile would not be a feature of chronic migraine in childhood but could predict it.

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CGRP links brain and heart. Investigators reviewed the current evidence on the possible short- and long-term effect of calcitonin gene-related peptide (CGRP) blockade with monoclonal antibodies as a therapeutic target for patients with migraine. They concluded that CGRP plays an important role in migraine and in physiological and pathological cardiovascular conditions and found encouraging safety and tolerability data from clinical trials for the treatment of episodic and chronic migraine.

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Spinal manipulation may ease migraine pain. Researchers performed a systematic review and meta‐analysis to evaluate the evidence on spinal manipulation as an alternative or integrative therapy in reducing migraine pain and disability. Spinal manipulation reduced migraine days with an overall small effect size as well as migraine pain and intensity. The preliminary results suggested that spinal manipulation may be an effective therapeutic technique.

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