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- Dahlöf, Carl, 1947, et al.
(författare)
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The course of frequent episodic migraine in a large headache clinic population: a 12-year retrospective follow-up study.
- 2009
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 49:8, s. 1144-52
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite its high prevalence, little is known about the clinical course of migraine. Presented here are the findings of a 12-year follow-up study involving patients diagnosed at baseline with frequent episodic migraine. OBJECTIVE: The main objectives were to determine the long-term outcome of patients with frequent episodic migraine and to identify factors predictive of a favorable vs less favorable prognosis. METHODS: A total of 374 subjects (200 women, 174 men) were selected randomly from a total population of 2812 patients initially diagnosed before December 31, 1996, with episodic migraine and at baseline experiencing 1 to 6 attacks per month. Their subsequent migraine course was evaluated via telephone interviews conducted between 2005 and 2006. RESULTS: Migraine attacks had ceased in 110 (29%) of the 374 patients (57 women and 53 men). The remaining 264 subjects continued to experience migraine attacks at follow-up, and a change in attack frequency was reported by 80% (of whom 80% reported fewer attacks). Sixty-six percent reported a change in pain intensity over time, and of these 83% reported milder pain. Only 6 subjects (6/374 = 1.6%) had developed chronic migraine. CONCLUSION: These data from a headache clinic population suggest that migraine has a favorable prognosis in most patients. Whether the findings reflect the natural history of the disorder or interval improvements in headache management remains conjectural.
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- Edvinsson, Lars
(författare)
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Neuronal signal substances as biomarkers of migraine
- 2006
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 46:7, s. 1088-1094
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Tidskriftsartikel (refereegranskat)abstract
- Of the sensory nervous system associated signal substances it is only calcitonin generelated peptide (CGRP) that is reliably associated with the degree of pain in the acute attacks of primary headaches. The treatment with triptans alleviates both the pain and the associated CGRP release, putatively via a presynaptic effect on the sensory nerves. The studies of opoids and other sensory neuropeptides are inconsistent and require further analysis. Initial positive data on endothelin and its receptors have turned out negative. Nitric oxide mechanisms are still debated both in terms of initiation of attacks and for the treatment.
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- Edvinsson, Lars
(författare)
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The CGRP Pathway in Migraine as a Viable Target for Therapies
- 2018
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Ingår i: Headache. - : Wiley. - 0017-8748. ; 58, s. 33-47
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Tidskriftsartikel (refereegranskat)abstract
- The neuropeptide calcitonin gene-related peptide is well established as a key player in the pathogenesis of migraine. Clinical studies show calcitonin gene-related peptide levels correlate with migraine attacks, and decreases in this neuropeptide can indicate antimigraine therapy effectiveness. Research has revealed a wide distribution of expression sites for calcitonin gene-related peptide in the central and peripheral nervous system. Of these, the calcitonin gene-related peptide receptor, which binds calcitonin gene-related peptide with high affinity, has attracted growing interest as a viable target for antimigraine therapies. An incentive to pursue such research is the continuing unmet medical need of patients. Triptans have offered some clinical benefit, but many patients do not respond and these drugs have important safety considerations. Initial calcitonin gene-related peptide-focused research led to development of the “gepant” small-molecule calcitonin gene-related peptide receptor blockers. Positive efficacy reports concerning the gepants have been tempered by safety findings which led to the discontinuation of some of these agents. Currently, there is considerable excitement regarding monoclonal antibodies against calcitonin gene-related peptide (eptinezumab, galcanezumab, fremanezumab) and the calcitonin gene-related peptide receptor (erenumab). To date, these monoclonal antibodies have shown promising efficacy in clinical trials, with no major safety concerns. If ongoing long-term studies show that their efficacy can be maintained, this may herald a new era for effective antimigraine therapies.
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- Edvinsson, Lars
(författare)
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The Journey to Establish CGRP as a Migraine Target: A Retrospective View.
- 2015
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 55:9, s. 1249-1255
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Tidskriftsartikel (refereegranskat)abstract
- In this retrospective, Dr. Lars Edvinsson recounts early steps and milestones in our understanding of the neuropeptide calcitonin gene-related peptide (CGRP) in the trigeminovascular system and its role in migraine. The discovery of the presence and function of CGRP and other neuropeptides in the cerebral vasculature and its sensory innervation is described. He relates the seminal finding that CGRP is uniquely released during migraine and the journey to develop blockers of CGRP effects. Now, over 30 years since its discovery, CGRP has become the target for a number of promising novel treatments for migraine patients.
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- Edvinsson, Lars
(författare)
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The Trigeminovascular Pathway : Role of CGRP and CGRP Receptors in Migraine
- 2017
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Ingår i: Headache. - : Wiley. - 0017-8748. ; 57, s. 47-55
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Forskningsöversikt (refereegranskat)abstract
- The trigeminal ganglion plays a key role in primary headache pathophysiology. Calcitonin gene-related peptide (CGRP) and CGRP receptors are expressed in trigeminal neurons that form C-fibers and A-fibers, respectively. In acute migraine and cluster headache attacks, there is release of CGRP into the cranial venous outflow. In addition, intravenous CGRP can induce migraine-like symptoms in migraine patients. These findings led to the development of anti-migraine therapies that inhibit CGRP action. Currently, CGRP receptor antagonists, the gepants, and monoclonal antibodies towards CGRP and the CGRP receptor are all showing positive relief of acute and chronic migraine in clinical trials. However, there is still much to learn about the role of CGRP and CGRP receptors in headache pathophysiology, the critical anatomical sites, peripheral or central, of anti-CGRP agents, and the potential involvement of CGRP-related peptides and receptors. This review provides a brief history of the discovery of the role of CGRP in migraine and highlights current progress in understanding the complexity of the trigeminovascular pathway and its peptide transmitters.
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- Ekbom, K, et al.
(författare)
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Cluster headache and aura
- 2009
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 49:5, s. 786-787
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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