Cognitive deficits are gender based, opioids complicate prophylactic treatment, patients with migraine seen by ophthalmologists-find concise summaries of these and other findings here.
Cognitive deficits in migraineurs heightened by gender effect, nonpersistence and opioids are primary prophylactic treatment issues, why ophthalmologists are seeing patients with migraine-these are some of the latest developments in migraine research. Find concise summaries in this brief slideshow.
Migraineurs in a recent study had more emotional and visual cognitive processing abnormalities, including higher levels of anxiety and reduced P3 amplitude, than healthy controls. Females with migraine were more anxious than males and might experience more severe abnormalities in visual neurocognitive processing. Researchers concluded that psychiatric comorbidities could lead to increased burdens affecting clinical outcomes for patients with migraine, particularly women.
In a retrospective study, nonpersistence to treatment was observed in 90% of patients with migraine who were initiating prophylactic medication. Treatment was switched in 39% of patients, restarted in 30%, and discontinued in 31%. Medication use over the follow-up included opioids, 77.4% of patients; NSAIDs, 66.6%; triptans, 59.9%; and ergotamines, 2.6%. The risk of GI-related adverse events and opioid abuse increased with long-term use of opioids.
Many patients with a primary headache disorder present for neuro-ophthalmic evaluation because the disorder causes ophthalmic symptoms, a literature review found. Migraine patients often experience visual disturbances, such as aura, and more complex perceptual abnormalities, such as Alice in Wonderland syndrome, and migraine may be linked with photophobia, eye pain, dry eye, autonomic features, and anisocoria. An understanding of typical ophthalmic features may help providers help patients find appropriate treatment.
A population-based bidirectional association was found between onset of fibromyalgia and onset of migraine in patients who had migraine and in those who had fibromyalgia, respectively, with a greater risk of migraine than of fibromyalgia. The incidence rates of fibromyalgia in the migraine cohort and migraine in the fibromyalgia cohort increased with age in both directions. The authors noted that hypothalamic neuroendocrine dysfunction has been proposed as a brain mechanism common to the conditions.
In a cross-sectional study, US adolescents who had migraine reported significantly shorter sleep duration and earlier wakeup time than those who did not have headache. There were significantly more sleep disturbances in adolescents who had any headache, particularly migraine, than in those who did not. Youth who had migraine with aura reported more difficulty maintaining sleep, early morning awakening, daytime fatigue, and persistent insomnia symptoms than those who had migraine without aura.
In a Canadian study, the prevalence of ever attempting suicide was much higher in persons who had migraine than in those who did not in both men and women (men: 7.5% vs 1.9%; women: 9.3% vs 2.7%). The odds of suicide attempts among migraineurs were higher among poorer respondents; those experiencing chronic pain; and those who had a history of childhood adversities, substance dependence, or mental illness. The authors recommended targeted outreach to reduce suicidality in migraineurs.
Migraine was positively associated with Parkinson disease (PD) in a series of cross-sectional case-control analyses performed to systematically describe the PD phenome. The association remained significant after correcting for head injury, angina, and chest pain during exercise. The authors suggested that because the average age of onset for migraine typically is much earlier than for PD, migraine may be a novel PD risk factor. Restless leg syndrome and epilepsy are other neurological disorders linked with PD.