Sex Hormones and Calcitonin Gene–Related Peptide in Women With Migraine

Raffaelli, Bianca; Storch, Elisabeth; Overeem, Lucas Hendrik; Terhart, Maria; Fitzek, Mira Pauline; Lange, Kristin Sophie; Reuter, Uwe

doi:10.1212/wnl.0000000000207114

Cited by 29 publications

(32 citation statements)

References 50 publications

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“…29 Given the high rate of migraine type HA after TBI, 4,6,30,31 the risk elevation for female individuals could be explained by their known migraine-type HA propensity, 32 with a potential mechanism of unmasking a genetic predisposition 33 and/or hormonally mediated increases in calcitonin gene-related peptide levels. 34 We found that in addition to females, individuals of Black race and lower education level were also at greater risk for chronic HA after moderate to severe TBI. Socioeconomic factors are known to influence outcomes across a broad range of health conditions.…”

Section: Discussionmentioning

confidence: 62%

“…Penetrating-type TBI is also associated with other long-term complications after TBI, including seizures and poorer overall functional status 29. Given the high rate of migraine type HA after TBI,4,6,30,31 the risk elevation for female individuals could be explained by their known migraine-type HA propensity,32 with a potential mechanism of unmasking a genetic predisposition33 and/or hormonally mediated increases in calcitonin gene–related peptide levels 34…”

Section: Discussionmentioning

confidence: 99%

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What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

Walker,

Perera,

Hammond

et al. 2023

Journal of Head Trauma Rehabilitation

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Objective: Although headache (HA) is a common sequela of traumatic brain injury (TBI), early predictors of chronic HA after moderate to severe TBI are not well established, and the relationship chronic HA has with psychosocial functioning is understudied. Thus, we sought to (1) determine demographic and injury predictors of chronic HA 1 or more years after moderate to severe TBI and (2) examine associations between chronic HA and psychosocial outcomes. Setting: Community. Participants: Participants in the TBI Model System (TBIMS) with moderate to severe TBI who consented for additional chronic pain questionnaires at the time of TBIMS follow-up. Design: Multisite, observational cohort study using LASSO (least absolute shrinkage and selection operator) regression for prediction modeling and independent t tests for psychosocial associations. Main Outcome Measure(s): Chronic HA after TBI at year 1 or 2 postinjury and more remotely (5 or more years). Results: The LASSO model for chronic HA at 1 to 2 years achieved acceptable predictability (cross-validated area under the curve [AUC] = 0.70). At 5 or more years, predictability was nearly acceptable (cross-validated AUC = 0.68), but much more complex, with more than twice as many variables contributing. Injury characteristics had stronger predictive value at postinjury years 1 to 2 versus 5 or more years, especially sustained intracranial pressure elevation (odds ratio [OR] = 3.8) and skull fragments on head computed tomography (CT) (OR = 2.5). Additional TBI(s) was a risk factor at both time frames, as were multiple socioeconomic characteristics, including lower education level, younger age, female gender, and Black race. Lower education level was a particularly strong predictor at 5 or more years (OR up to 3.5). Emotional and participation outcomes were broadly poorer among persons with chronic HA after moderate to severe TBI. Conclusions: Among people with moderate to severe TBI, chronic HA is associated with significant psychosocial burden. The identified risk factors will enable targeted clinical screening and monitoring strategies to enhance clinical care pathways that could lead to better outcomes. They may also be useful as stratification or covariates in future clinical trial research on treatments.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

Walker,

Perera,

Hammond

et al. 2023

Journal of Head Trauma Rehabilitation

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“…The fall in serum estradiol levels which occurs in the perimenstrual period is considered a potent and predictable trigger for migraine, possibly triggering migraine by lowering the trigeminal activation threshold 2,5,8,14 . A recent study examined the levels of CGRP in plasma and tear fluid of women over their menstrual cycles, and suggested that women with episodic migraine have hormone‐dependent changes in plasma and tear CGRP levels 22 . These changes in CGRP levels were not seen in women who did not have migraine, or who had episodic migraine and were taking hormonal contraceptives.…”

Section: Discussionmentioning

confidence: 99%

Effect of galcanezumab in women with episodic migraine meeting criteria for menstrually related migraine: A post hoc analysis of EVOLVE‐1 and EVOLVE‐2

MacGregor,

Okonkwo,

Detke

et al. 2023

Headache

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BackgroundWe evaluated galcanezumab for migraine prevention in patients who met International Classification of Headache Disorders, 3rd edition criteria for menstrually related migraine (MRM).MethodsPatients were identified post hoc from three double‐blind, randomized, phase 3 clinical trials in patients with episodic migraine. Patients completed a 1‐month prospective baseline period and up to 6 months (EVOLVE‐1 and ‐2, studies pooled) of double‐blind treatment with galcanezumab (120 mg/month) or placebo. Menses and headache information were recorded by electronic daily diary. Patients with a migraine attack starting during the 5‐day perimenstrual interval (first day of bleeding ± 2 days) for ≥2 of their first three diary‐recorded menstrual cycles were categorized as having MRM. The primary efficacy measure was mean change in monthly migraine headache days from baseline, averaged over Months 4 through 6. Response rates, change in monthly perimenstrual migraine headache days, monthly non‐perimenstrual migraine headache days, and quality of life were also assessed.ResultsPost hoc MRM analysis criteria were met by 462/1133 women (41%). Mean (standard deviation) baseline monthly migraine headache days were 9.7 (±3.1; n = 146) for galcanezumab‐treated patients and 9.6 (±2.8; n = 316) for placebo‐treated patients. The mean change (standard error [SE]) in migraine headache days over Months 4 through 6 was −5.1 days (±0.39) for galcanezumab versus −3.2 (±0.35) for placebo (p < 0.001). The mean change (SE) in perimenstrual migraine headache days over Months 4 through 6 was −0.75 days (±0.08) for galcanezumab versus −0.49 (±0.07) for placebo (p = 0.004). For migraine headache days outside the perimenstrual period, the mean change in migraine headache days was −4.6 (±0.38) for galcanezumab and −2.8 (±0.33) for placebo (p < 0.001). Improvements in response rates and the Migraine‐Specific Quality of Life Questionnaire were also observed over Months 4 through 6.ConclusionGalcanezumab was effective for migraine prevention in women with MRM.

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“…Eine Studie der Charité Berlin konnte zeigen, dass die CGRP-Konzentrationen (Plasma und Tränenflüssigkeit) während der Menstruation bei Patientinnen mit Migräne deutlich höher waren als bei gesunden Kontrollprobandinnen. Darüber hinaus waren die CGRP-Konzentrationen während der Menstruation höher als bei Einnahme einer hormonellen Kontrazeption, dies erscheint passend zur genannten Hypothese [26].…”

Section: Migräne Und Hormoneunclassified

Migräne und weibliche Geschlechtshormone

Evers¹,

Israel-Willner²,

Raffaelli³

2023

Nervenheilkunde

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ZUSAMMENFASSUNGIn einer Gruppe aus Expertinnen und Experten aus dem Bereich der Gynäkologie und der Kopfschmerzmedizin wurden die verschiedenen Aspekte des Zusammenhangs zwischen weiblichen Geschlechtshormonen und Kopfschmerzen, insbesondere Migräne, diskutiert. Auf Grundlage einer systematischen aktuellen Literaturrecherche wurde dann ein gemeinsames Konsensuspapier erarbeitet, das diese verschiedenen Aspekte in klinischer und therapeutischer Hinsicht umfasst. Insbesondere werden Informationen und Empfehlungen zur Einnahme der oralen hormonalen Kontrazeption bei Frauen mit Migräne, zur menstruellen Migräne, zur Situation in der Schwangerschaft und Stillzeit, zu postmenopausalen Kopfschmerzen und zu anderen hormonellen Situationen gegeben. Es handelt sich ausdrücklich nicht um eine Leitlinie, sondern um eine selbst initiierte Konsensusfindung.

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Sex Hormones and Calcitonin Gene–Related Peptide in Women With Migraine

Cited by 29 publications

References 50 publications

What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

Effect of galcanezumab in women with episodic migraine meeting criteria for menstrually related migraine: A post hoc analysis of EVOLVE‐1 and EVOLVE‐2

Migräne und weibliche Geschlechtshormone

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