Meta-analytical evidence of functional and structural abnormalities associated with pain processing in migraine patients: An activation likelihood estimation

Qawasmeh, Majdi Al; Ahmed, Yaman B.; Al-Bzour, Ayah N.; Al-Majali, Ghayda’a N.; Alzghoul, Saja M.; Al-Khalili, Anas A.; Ibrahim, Ruaa B.; Hamza, Ammar I.; Al-Mannai, Ramaz S.; Refaie, Haneen; Alhayek, Kefah; Kofahi, Raed; Leffler, Alexandra; Salem, Khalid El

doi:10.1097/md.0000000000031206

Cited by 3 publications

(3 citation statements)

References 51 publications

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“…In our cases, only two of six patients experienced the fremanezumab's efficacy. The older age of the patients may suffer from the longer duration of migraine, together with CM and MOH, leading to changes in the brain's structure [ 18 , 19 ] and making it more difficult for the CGRP-mABs to be effective. In such cases, erenumab, which has been suggested to have the potential to improve the functional structure of the brain [ 20 ], maybe a better choice.…”

Section: Discussionmentioning

confidence: 99%

Fremanezumab for Migraine Prevention in Japanese Elderly Aged Over 70 Years Old

Katsuki¹,

Kashiwagi²,

Kawamura³

et al. 2023

Cureus

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BackgroundElderly migraine is a public health problem with prolonged life expectancy, and effective prophylactic treatment is needed. There were no reports on fremanezumab for the elderly. We described the real-world data of fremanezumab, calcitonin gene-related peptide-related monoclonal antibody (CGRP-mAB), for migraine in elderly over 70 years old. MethodsWe retrospectively investigated six elderly migraine patients over 70 years old treated with fremanezumab. Headache impact test-6 (HIT-6), monthly headache days (MHD), and monthly acute medication intake days (AMD) before one and three months after starting fremanezumab treatment were evaluated. ResultsThree women and three men (median age 78; range: 71-99) were included. One was chronic migraine (CM), three were CM and medication-overuse headache, and two were episodic migraine and tension-type headache. All six patients received monthly fremanezumab. The median MHD before, during one, and three months after treatment were 30 (4-30), 30 (4-30), and 29 (15-30, n=4). Those of AMD were 17 (0-30), 9.5 (0-30), and 1 (0-28). Those about HIT-6 were 64 (56-72), 59.5 (52-70), and 55. 5 (48-64). Two (33.3%) of the six patients experienced therapeutic effectiveness. There were no side effects. ConclusionWe described the six elderly migraine patients aged over 70 years old treated with fremanezumab. Two (33.3%) of the six patients experienced therapeutic effectiveness. This is the first report of fremanezumab for elderly migraine patients aged over 70 years old. Further evidence accumulation is needed about CGRP-mABs for the elderly.

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Section: Discussionmentioning

confidence: 99%

Fremanezumab for Migraine Prevention in Japanese Elderly Aged Over 70 Years Old

Katsuki¹,

Kashiwagi²,

Kawamura³

et al. 2023

Cureus

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“…Interictally, migraine without aura patients showed significantly lower gray matter density in the right inferior parietal lobule, right temporal inferior gyrus, right superior temporal gyrus, and left temporal pole compared to healthy volunteers. Ictally, gray matter density increased in the left temporal pole, bilateral insula, and right lenticular nuclei, with no areas showing decreased gray matter density Al Qawasmeh et al [46] Meta-analysis Migraine without aura patients showed a grey matter volume reduction in the insula and anterior cingulate, whereas migraine with aura patients showed a grey matter volume reduction in the cerebellum, cingulate gyrus, and insula.…”

Section: Coppola Et Al [45] Cohortmentioning

confidence: 99%

“…Research has indicated that migraine alters the activity of brain structures involved in memory processing and consolidation, including the insula [ 43 , 45 ]. Al Qawasmeh et al found that patients with migraine without aura exhibited a reduction in grey matter volume in the insula and anterior cingulate, while those with migraine with aura showed grey matter volume reduction in the cerebellum, cingulate gyrus, and insula [ 46 ]. Insular changes in chronic pain, particularly in patients with trigeminal neuralgia, involve modifications in gray matter volume.…”

Section: Reviewmentioning

confidence: 99%

The Role of the Insula in Chronic Pain and Associated Structural Changes: An Integrative Review

McBenedict,

Petrus,

Pires

et al. 2024

Cureus

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Chronic pain affects a substantial portion of the global population, significantly impacting quality of life and well-being. This condition involves complex mechanisms, including dysfunction of the autonomic nervous system, which plays a crucial role in pain perception. The insula, a key brain region involved in pain processing, plays a critical role in pain perception and modulation. Lesions in the insula can result in pain asymbolia, where pain perception remains intact but emotional responses are inappropriate. The insula is anatomically and functionally divided into anterior and posterior regions, with the posterior insula processing nociceptive input based on intensity and location before relaying it to the anterior insula for emotional mediation. Understanding the insula's intricate role in pain processing is crucial, as it is involved in encoding prediction errors and mediating emotional dimensions of pain perception. The focus of this review was on synthesizing existing literature on the role of the insula in chronic pain and associated structural changes. The goal was to integrate findings from various sources to provide a comprehensive overview of the topic. The search strategy included a combination of Medical Subject Headings (MeSH) and relevant keywords related to insula and chronic pain. The following databases were surveyed: PubMed, Embase, Scopus, and Web of Science. We identified a total of 2515 articles, and after following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline based on eligibility criteria, 46 articles were used to synthesize this review. Our study highlights the pivotal role of the insula in chronic pain processing and associated structural changes, integrating findings from diverse studies and neuroimaging investigations. Beyond mere pain sensation, the insula contributes to emotional awareness, attention, and salience detection within the pain network. Various chronic pain conditions reveal alterations in insular activity and connectivity, accompanied by changes in gray matter volume and neurochemical profiles. Interventions targeting the insula show promise in alleviating chronic pain symptoms. However, further research is needed to understand underlying mechanisms, which can aid in developing more effective therapeutic interventions for pain.

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Mind the Metabolic Gap: Bridging Migraine and Alzheimer's disease through Brain Insulin Resistance

Moro,

Pirovano,

Rota

2024

Aging and disease

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Brain insulin resistance has recently been described as a metabolic abnormality of brain glucose homeostasis that has been proven to downregulate insulin receptors, both in astrocytes and neurons, triggering a reduction in glucose uptake and glycogen synthesis. This condition may generate a mismatch between brain’s energy reserve and expenditure, ??mainly during high metabolic demand, which could be involved in the chronification of migraine and, in the long run, at least in certain subsets of patients, in the prodromic phase of Alzheimer’s disease, along a putative metabolic physiopathological continuum. Indeed, the persistent disruption of glucose homeostasis and energy supply to neurons may eventually impair protein folding, an energy-requiring process, promoting pathological changes in Alzheimer's disease, such as amyloid-β deposition and tau hyperphosphorylation. Hopefully, the “neuroenergetic hypothesis” presented herein will provide further insight on there being a conceivable metabolic bridge between chronic migraine and Alzheimer’s disease, elucidating novel potential targets for the prophylactic treatment of both diseases.

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Meta-analytical evidence of functional and structural abnormalities associated with pain processing in migraine patients: An activation likelihood estimation

Cited by 3 publications

References 51 publications

Fremanezumab for Migraine Prevention in Japanese Elderly Aged Over 70 Years Old

Fremanezumab for Migraine Prevention in Japanese Elderly Aged Over 70 Years Old

The Role of the Insula in Chronic Pain and Associated Structural Changes: An Integrative Review

Mind the Metabolic Gap: Bridging Migraine and Alzheimer's disease through Brain Insulin Resistance

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