Erenumab is the first human monoclonal antibody to be approved as a selective therapy for migraine prophylaxis in adults. This study assessed, in a real-world setting, the efficacy of erenumab and its impact on the quality of life (QoL) of Cypriot migraine patients who had failed several treatments in the past. Erenumab was prescribed as a stand-alone or as an add-on therapy to 16 patients with chronic migraine. The first component of the study examined migraine parameters before and after erenumab therapy and included an interim 3-month subjective assessment. In the second component, the patients were asked to complete the validated Migraine-Specific Quality-of-Life Questionnaire—Version 2.1 (MSQ V2.1) during the last month of their individual treatment as a measure of the QoL. The results showed a statistically significant improvement in almost all migraine parameters following erenumab treatment. In the 3-month-interval assessment, 81.3% of the patients reported an improvement in their mental well-being, anxiety, and depression levels, with more than 80% of the patients reporting an improvement in almost all assessed migraine parameters. MSQ V2.1 indicated a good health status in all three domains (mean values > 60 on a scale 0–100), with the “role function preventative” domain having the highest health scores (85). Over a period of 6 months, erenumab was safe, well-tolerated, and effective in preventing migraine symptoms and improving HR-QoL. We conclude that this novel medication, which is not yet part of the national formulary in Cyprus, may be a cost-effective solution in reducing the disease burden of chronic migraine.

Charcot-Marie-Tooth disease is one of the most common inherited neurological disorders affecting the peripheral nervous system. The common clinical manifestations of the disease are distal muscle weakness and atrophy, often associated with a characteristic steppage gait and foot deformities. Transient acute and recurrent or chronic central nervous system manifestations, predominantly, dysarthria, dysphagia, motor weakness, and ataxia, have been recognized as a feature of the X-linked type 1 of CMT (CMTX1). The CNS symptoms occur typically in young age and often precede the clinical manifestation of the polyneuropathy. Several predisposing factors such as exercise, fever, and returning from areas of high altitude have been described as triggers of the CNS symptoms; however, in many cases, a substantial cause remains undetermined. In this report, we describe a patient with three attacks of transient CNS deficits at the ages of 11, 21, and 38 years, respectively, which were also accompanied by transient white matter abnormalities on MRI. Two of the attacks occurred after prolonged exposure to sunlight. In our knowledge, this is the first documented case with such long latency periods between CNS attacks as well as the only report describing intense sun exposure as a possible provoking factor.

The Human Central Nervous System (CNS) is governed by electrochemical networks forming a delicate interplay between the different regions of the brain. The objective of the present experiment is to investigate the phylogenetic background of this electrochemical network by creating a comparable binary and ternary interplay of interactions between different neurotransmitters (noradrenaline, histamine, serotonin, acetylcholine, glutamate, and dopamine) in the unicellular eukaryote Tetrahymena pyriformis. Tetrahymena – as a protozoon – has no nervous system; however, it has been shown that it has not only the ability to store, synthesize and secrete biogenic amines but it also bears binding sites for the corresponding receptors of some of these molecules. The chemotactic responsiveness elicited by the neurotransmitters was examined in Tetrahymena cells, using a modified version of Leick’s two-chamber capillary chemotaxis assay with 20-minute incubation times. The concentration course of each neurotransmitter was determined and the concentration eliciting the strongest effect was further used to examine the chemotactic response of the neurotransmitters when used in pairs and in groups of three. Adequate cellular responses (chemoattractant and chemorepellent) were detected in both cases when the neurotransmitters were used alone and in combinations. A pattern detected in these responses was related to the neurotransmitters’ physicochemical characteristics (XlogP, TPSA). These provide evidence that the chief regulatory molecules of the CNS can be identified even in lower, eukaryotic unicellular levels of phylogeny and possibly alter the basic functions of these organisms. In summary, our results support the theory that any evolved nervous system-like interplay could stem from a common origin. Therefore, identifying the “ancient” function of a molecule or its receptor effect can open new windows in the advancement of therapeutic interventions.

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