Putative mechanisms of the relationship between obesity and migraine progression

Bigal, Marcelo E.; Lipton, Richard B.

doi:10.1007/s11916-008-0036-z

Cited by 34 publications

(16 citation statements)

References 44 publications

(45 reference statements)

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“…Modifiable factors include attack frequency [17], obesity [20], medication overuse [21], caffeine use/misuse [10, 22, 23], sleep disorders (e.g., snoring, obstructive sleep apnea, insomnia, hypersomnia) [24, 25], stressful life events [26, 27], specific psychological patterns (e.g., depression, anxiety, and personality disorders) [28, 29], behavioral issues [30, 31], and family history of mood disorders and substance use disorders (alcohol, drugs) [32]. …”

Section: Roads To Migraine Chronicizationmentioning

confidence: 99%

Chronic migraine plus medication overuse headache: two entities or not?

Negro

Martelletti

2011

J Headache Pain

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Chronic migraine (CM) represents migraine natural evolution from its episodic form. It is realized through a chronicization phase that may require months or years and varies from patient to patient. The transition to more frequent attacks pattern is influenced by lifestyle, life events, comorbid conditions and personal genetic terrain, and it often leads to acute drugs overuse. Medication overuse headache (MOH) may complicate every type of headache and all the drugs employed for headache treatment can cause MOH. The first step in the management of CM complicated by medication overuse must be the withdrawal of the overused drugs and a detoxification treatment. The goal is not only to detoxify the patient and stop the chronic headache but also to improve responsiveness to acute or prophylactic drugs. Different methods have been suggested: gradual or abrupt withdrawal; home treatment, hospitalization, or a day-hospital setting; re-prophylaxes performed immediately or at the end of the wash-out period. Up to now, only topiramate and local injection of onabotulinumtoxinA have shown efficacy as therapeutic agents for re-prophylaxis after detoxification in patients with CM with and without medication overuse. Although the two treatments showed similar efficacy, onabotulinumtoxinA is associated with a better adverse events profile. Recently, the Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program proved that patients with CM, even those with MOH, are the ones most likely to benefit from onabotulinumtoxinA treatment. Furthermore, it provided an injection paradigm that can be used as a guide for a correct administration of onabotulinumtoxinA.

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Section: Roads To Migraine Chronicizationmentioning

confidence: 99%

Chronic migraine plus medication overuse headache: two entities or not?

Negro

Martelletti

2011

J Headache Pain

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“…Among the putative mechanisms to explain the obesity/CVD relationship, metabolic syndrome (or the syndrome of insulin resistance) has been suggested. 47 Metabolic syndrome has been associated with chronic pain overall. Women with fibromyalgia are five times more likely than healthy controls to have metabolic syndrome.…”

mentioning

confidence: 99%

Migraine and cardiovascular disease

Bigal¹,

Kurth

Hu³

et al. 2009

Neurology

170

135

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Migraine, especially migraine with aura (MA), is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication, and cardiovascular mortality. The mechanisms which link migraine to ischemic vascular disease remain uncertain and are likely to be complex. Cortical spreading depression, the presumed substrate of aura, may directly predispose to brain lesions and that would explain why MA is consistently demonstrated as a risk factor for cerebral ischemia, while for migraine without aura (MO), the evidence is less consistent. Additionally, individuals with migraine have a higher prevalence of risk factors known to be associated with cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. The increased prevalence of CVD risk factors is also higher for MA than for MO. Since the evidence linking migraine and CVD is getting robust, neurologists should be aware of this association. Individuals with MO seem to be at little increased risk of CVD. MA is associated with an increased risk of ischemic stroke and likely also for other ischemic CVD events. Accordingly, heightened vigilance is recommended for modifiable cardiovascular risk factors in migraineurs, especially with MA. Ultimately, it will be important to determine whether MA is a modifiable risk factor for CVD and if preventive medications for migraine or antiplatelet therapy might reduce the risk of CVD in patients with MA. Neurology ® 2009;72:1864-1871 GLOSSARY BMI ϭ body mass index; CDH ϭ chronic daily headache; CI ϭ confidence interval; CSD ϭ cortical spreading depression; CVD ϭ cardiovascular disease; EPC ϭ endothelial progenitor cells; HR ϭ hazard ratio; MA ϭ migraine with aura; MMP ϭ matrix metalloproteinase; MO ϭ migraine without aura; MTHFR ϭ methyltetrahydrofolate reductase; RR ϭ relative risk.

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“…In migraineurs, obesity has been associated with more frequent and severe headache attacks and with new onset of chronic migraine [40][41][42] but it is unrelated to migraine aura 43 . Among the putative mechanisms to explain the obesity/migraine relationship, metabolic syndrome (or the syndrome of insulin resistance) has been suggested 44 . Metabolic syndrome has been associated with chronic pain overall.…”

Section: Mechanisms Of Association Putative Mechanisms Commentsmentioning

confidence: 99%

Migraine and cardiovascular disease

Bigal

2011

Arq. Neuro-Psiquiatr.

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Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis. Key words: migraine, cardiovascular disease, stroke. Migrânea e doenças cardiovasculares RESUMOA migrânea, especialmente a migrânea com aura, é fator de risco para lesões cerebrais. Evidência recente sugere que migrânea com e sem aura é associada com outras doenças cardiovasculares isquêmicas, incluindo a angina, o infarto do miocárdio, revascularização coronária, claudicação e morte súbita. Iniciamos discutindo o diagnóstico da migrânea e seus mecanismos fisiopatológicos. Após sumarizar a evidência, discutimos resultados de meta-análise recente. Por fim, ressaltamos resultados de um grande estudo populacional sobre o assunto. Palavras-chave: migrânea, doença cardiovascular, acidente vascular cerebral.

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Putative mechanisms of the relationship between obesity and migraine progression

Cited by 34 publications

References 44 publications

Chronic migraine plus medication overuse headache: two entities or not?

Chronic migraine plus medication overuse headache: two entities or not?

Migraine and cardiovascular disease

Migraine and cardiovascular disease

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