The journal of headache and pain
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The purpose of this review is to provide a comprehensive overview of the findings of clinical electrophysiology studies aimed to investigate changes in information processing of migraine with aura patients. ⋯ Since most of the electrophysiological abnormalities mentioned above were more frequently present and had a greater amplitude in migraine with aura than in migraine without aura, neurophysiological techniques have been shown to be of great help in the search for the pathophysiological basis of migraine aura.
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Review
A narrative review on the burden of migraine: when the burden is the impact on people's life.
The burden of headache disorders, and of migraine in particular, is multifaceted and fragmented. The aim of this narrative review is to provide a description the main topics underlying the concepts of burden and impact of migraine disorders. ⋯ The results of this narrative review show that the meaning of a sentence like "migraine is a burdensome condition" is not univocal: rather, it may refer to different concepts and meanings. In our opinion, future research should focus on understanding and facing the impact of migraine on work-related activities and on everyday life activities, as these aspects are highly connected to some tangible (i.e. cost) and less tangible (i.e. interictal burden and reduced quality of life) facets of migraine burden. Disease-specific measures have been implemented and should be exploited to enhance our understanding of migraine burden. This approach would allow to better understand the real impact on people's life of such a burdensome disease.
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In the past decade, migraine research has identified novel drug targets. In this review, we discuss recent data on emerging anti-migraine therapies. ⋯ Collectively, novel migraine therapies represent a major progress in migraine treatment and will undoubtedly transform headache medicine.
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Primary headaches are one of the most prevalent neurological disorders and can occur during a wide range of lifespan. Primary headaches, especially migraine, are cyclic disorders with a complex sequence of symptoms within every headache attack. ⋯ The age-dependent differences in the clinical presentation are less distinct in cluster headache and, especially, in tension-type headache. The differences in the clinical presentation are in agreement with the idea that the connectivity of hypothalamic areas with different brainstem areas, especially the central parasympathetic areas, is important for the clinical manifestation of migraine, as well as, the change during lifespan.
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While migraine headaches can be provoked, or predicted by the presence of an aura or premonitory symptoms, the prediction or elicitation of the aura itself is more problematic. Therefore, imaging studies directly examining the aura phenomenon are sparse. ⋯ Whether asymptomatic CSD also happens in some migraine without aura is still under debate. In addition, new evidence points to glial activation in MWA, indicating the involvement of astrocytes in the neuroinflammatory cascade that follows CSD, as well as dural macrophages, supporting the involvement of the trigeminovascular system in migraine pain.