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See detailEstrogen-dependent effects of 5-hydroxytryptophan on cortical spreading depression in rat: Modelling the serotonin-ovarian hormone interaction in migraine aura.
Chauvel, Virginie; Multon, Sylvie ULg; Schoenen, Jean ULg

in Cephalalgia : An International Journal of Headache (2017)

Background: Cortical spreading depression (CSD) is the likely culprit of the migraine aura. Migraine is sexually dimorphic and thought to be a ‘‘low 5-HT’’ condition. We sought to decipher the ... [more ▼]

Background: Cortical spreading depression (CSD) is the likely culprit of the migraine aura. Migraine is sexually dimorphic and thought to be a ‘‘low 5-HT’’ condition. We sought to decipher the interrelation between serotonin, ovarian hormones and cortical excitability in a model of migraine aura. Methods: Occipital KCl-induced CSDs were recorded for one hour at parieto-occipital and frontal levels in adult male (n 1⁄4 16) and female rats (n 1⁄4 64) one hour after intraperitoneal (i.p.) injection of 5-hydroxytryptophan (5-HTP) or NaCl. Sixty-five oophorectomized females were treated with estradiol- (E2) or cholesterol- (Chol) filled capsules. Two weeks later we recorded CSDs after 5-HTP/NaCl injections before or 20 hours after capsule removal. Results: 5-HTP had no effect in males, but decreased CSD frequency in cycling females, significantly so during estrus, at parieto-occipital (􏰀3.5CSD/h, p<0.001) and frontal levels (􏰀2.5CSD/h, p1⁄40.014). In oophorectomized rats, CSD susceptibility increased during E2 treatment at both recording sites (þ5CSD/h, p1⁄40.001 and þ3CSD/h, p<0.01), but decreased promptly after E2 withdrawal (􏰀4.7CSD/h, p < 0.001 and 􏰀1.7CSD/h, p 1⁄4 0.094). The CSD inhibitory effect of 5-HTP was significant only in E2-treated rats (􏰀3.4CSD/h, p 1⁄4 0.006 and 􏰀1.8CSD/h, p 1⁄4 0.029). Neither the estrous cycle phase, nor E2 or 5-HTP treatments significantly modified CSD propagation velocity. Conclusion: 5-HTP decreases CSD occurrence in the presence of ovarian hormones, suggesting its potential efficacy in migraine with aura prophylaxis in females. Elevated E2 levels increase CSD susceptibility, while estrogen withdrawal decreases CSD. In a translational perspective, these findings may explain why migraine auras can appear during pregnancy and why menstrual-related migraine attacks are rarely associated with an aura. [less ▲]

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See detailFamilial history of migraine influences habituation of visual evoked potentials
Lisicki Martinez, Marco ULg; Ruiz-Romagnoli, Emiliano; D'Ostilio, Kevin ULg et al

in Cephalalgia : An International Journal of Headache (2017)

Background: Lack of habituation of visual evoked potentials (VEP) is a common finding in migraine patients between attacks. Previous studies have suggested an electrophysiological familial aggregation ... [more ▼]

Background: Lack of habituation of visual evoked potentials (VEP) is a common finding in migraine patients between attacks. Previous studies have suggested an electrophysiological familial aggregation pattern associated with migraine. The aim of this study was to evaluate the influence of a positive familial history of migraine on VEP amplitude and habituation. Methods: We recorded six blocks of 100 VEP during continuous pattern-reversal stimulation in 30 patients with migraine between attacks (MO) and in 30 healthy volunteers, of whom 15 had a first-degree relative suffering from migraine (HVm) and 15 had not (HV). Results: Both MO and HVm had a significant deficit of VEP habituation and similarly reduced N1-P1 first block amplitudes, compared to HV (habituation slope: MO ¼ 0.033, HVm ¼ 0.021, HV ¼ 0.025, HV vs. MO p ¼ 0.002, HV vs. HVm p ¼ 0.036; mean N1-P1 amplitude in the first block: MO ¼ 9.08 mV, HVm ¼ 9.29 mV, HV ¼ 12.19 mV. HV vs. MO p ¼ 0.041, HV vs. HVm p ¼ 0.076). The first block N1-P1 amplitude was negatively correlated with the habituation slope for both MO (r ¼ .44, p ¼ 0.015) and HVm (r ¼ .56, p ¼ 0.031) while no significant correlation was found in HV (r ¼ .17, p ¼ 0.53). There were no differences in VEP latencies between the groups. Conclusions: Our study suggests that lack of habituation of visual evoked potentials is probably a genetically determined endophenotypic trait that is associated with both migraine and migraine susceptibility. We hypothesize that genetic diversity of populations could account for some of the discrepancies between electrophysiological studies performed in migraine and for interindividual variations among the subgroups. [less ▲]

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See detailScreening for the metabolic syndrome in subjects with migraine
Streel, Sylvie ULg; Donneau, Anne-Françoise ULg; Dardenne, Nadia ULg et al

in Cephalalgia : An International Journal of Headache (2016)

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See detailVisual and auditory cortical evoked potentials in interictal episodic migraine: An audit on 624 patients from three centres.
Ambrosini, Anna; Kisialou, A; Coppola, Gianluca et al

in Cephalalgia : An International Journal of Headache (2016)

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See detailCerebral metabolism before and after external trigeminal nerve stimulation in episodic migraine
MAGIS, Delphine ULg; D'Ostilio, Kevin ULg; Thibaut, Aurore ULg et al

in Cephalalgia : An International Journal of Headache (2016)

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See detailNoninvasive neurostimulation methods for migraine therapy: The available evidence
SCHOENEN, Jean ULg; Baschi, Roberta; MAGIS, Delphine ULg et al

in Cephalalgia : An International Journal of Headache (2016)

Abstract Background: Migraine is one of the most disabling neurological disorders. The current pharmacological armamentarium is not satisfying for a large proportion of patients because the responder rate ... [more ▼]

Abstract Background: Migraine is one of the most disabling neurological disorders. The current pharmacological armamentarium is not satisfying for a large proportion of patients because the responder rate does not exceed 50% on average and the most effective drugs often induce intolerable side effects. During recent years, noninvasive central and peripheral neuromodulation methods have been explored for migraine treatment. Overview: A review of the available evidence suggests that noninvasive neuromodulation techniques could be beneficial for migraine patients. The transcranial stimulation methods allow modulating selectively cortical activity and can thus be curtailed to the patient’s pathophysiological profile, while transcutaneous stimulation of pericranial nerves likely modulates central pain control centers. Occipital single-pulse transcranial magnetic stimulation and transcutaneous supraorbital stimulation have the strongest evidence respectively for acute and preventive treatment. Transcranial direct current stimulation and repetitive magnetic stimulation are promising in pilot studies, but large sham-controlled trials are not yet available. Conclusions: The noninvasive neurostimulation methods are promising for migraine treatment and devoid of serious adverse effects allowing their combination with drug therapies. Their application in clinical practice will depend on the industry’s capacity to develop portable and user-friendly devices, and on the scientists’ capacity to prove their efficacy in randomized sham-controlled trials. [less ▲]

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See detailTRANSCUTANEOUS OCCIPITAL NERVE STIMULATION AND TRANSCRANIAL DIRECT CURRENT STIMULATION IN CHRONIC MIGRAINE: A PILOT COMPARISON OF THERAPEUTIC AND ELECTROPHYSIOLOGICAL EFFECTS
MAGIS, Delphine ULg; D'Ostilio, Kevin ULg; Baschi et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 31

Background: Management of chronic migraine (CM) is often challenging. There is a need for more effective and better-tolerated preventive therapies. Among non-invasive neurostimulation procedures ... [more ▼]

Background: Management of chronic migraine (CM) is often challenging. There is a need for more effective and better-tolerated preventive therapies. Among non-invasive neurostimulation procedures, transcutaneous occipital nerve stimulation (tONS) would act via central pain modulation, while transcranial direct current stimulation (tDCS) would modify cortical excitability that is abnormal in CM. Objectives: In this pilot trial we compared the clinical effects of tDCS and tONS in refractory CM and their ability to modify nociception and cortical responsiveness. Methods: Forty-three CM patients (17 with history of drug overuse) applied either 2mA tDCS during 2 months (N¼20, cathode over visual cortex, anode over left DLPFC), or tONS during 3 months (N¼23, Cefaly Kit ArnoldTM), both in daily 20 min-sessions. Visual evoked potentials (VEP), nociceptive blink reflexes (nBR) and quantitative sensory testing were recorded before and after treatment. Results: During the last stimulation month, total headache days decreased in both groups ( 16.4% for tDCS, 17% for tONS, p<0.05). Migraine days were reduced by 21.4% (p¼0.06) and 22% (p<0.05) respectively, while 30% responder rates were 47% and 42%. Medication intake was significantly reduced after tONS ( 43%). There was no significant change of nBR in either group. VEP habituation reversed to an episodic migraine pattern, i.e. a deficit, after tONS but not after tDCS. Conclusion: tONS and inhibitory tDCS of the visual cortex are interesting non-invasive options for the treatment of CM, but these results have to be confirmed in a randomized controlled trial. tONS was able to induce recordable changes in visual cortex responsiveness [less ▲]

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See detailA MACHINE-LEARNING CLASSIFIER FOR EPISODIC MIGRAINE BASED ON VISUAL EVOKED GAMMA BAND ACTIVITY
D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg; SCHOENEN, Jean ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 56

Introduction: Objective and reliable biomarkers of migraine may be of interest for diagnosis and research purposes. Neuroimaging-based machine-learning classifiers are promising but hampered by ... [more ▼]

Introduction: Objective and reliable biomarkers of migraine may be of interest for diagnosis and research purposes. Neuroimaging-based machine-learning classifiers are promising but hampered by availability and cost issues. Conversely, evoked potential are of easy access and affordable. They have provided increasing evidence that sensory information processing is impaired in migraine. We have used gamma band oscillations (GBOs) of visual evoked potentials (VEPs) to compute a machine-learning neural network classifier in episodic migraine. Materials and methods: We analyzed GBOs from VEPs (6x100 responses). Recordings were performed in two matched samples: a training sample composed of 43 migraine patients (EM) and 20 healthy volunteers (HV) and a validating sample of 18 EM and 10 HV. A logistic regression model of the training sample was performed to evaluate the relevance of the predictor variables. Ten neural networks were automatically generated based on late component frequency, n3-p4 and p4-n4 slopes, 1st block n1-p2 amplitude and age. Results: The logistic regression model of the training sample reached a significant classification rate of 79% (EM: 88%; HV: 60%, p¼0.002). The best neural network was able to classify the groups with an accuracy of 73% in the training phase and 89% in the subsequent validation (success rate HV: 90%; EM: 88%). The mean global accuracy within the training and validating samples were 69% (63–78%) and 84% (82–89%). Conclusions: This machine-learning neural network classifier based on visual GBOs provides an accurate and costefficient tool for objective migraine diagnosis. Further training and validation studies with new cohorts are warranted [less ▲]

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See detailNON-INVASIVE CERVICAL VAGUS NERVE STIMULATION: IS THERE ELECTROPHYSIOLOGICAL EVIDENCE FOR GENUINE VAGAL AFFERENTS ACTIVATION?
NONIS, Romain ULg; D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 56

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See detailDOES NON-INVASIVE VAGUS NERVE STIMULATION NORMALIZE HABITUATION OF EVOKED POTENTIALS IN PATIENTS WITH EPISODIC MIGRAINE
NONIS, Romain ULg; D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 58

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See detailMETABOLIC CHANGES IN THE MIGRAINE BRAIN IN RELATION TO AGEING AND DISEASE LOAD
D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg; NONIS, Romain ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 59

Introduction: Migraine prevalence tends to decrease with advancing age. Morphological and functional brain changes occuring in migraine could be secondary to repeated attacks and/or to abnormal sensory ... [more ▼]

Introduction: Migraine prevalence tends to decrease with advancing age. Morphological and functional brain changes occuring in migraine could be secondary to repeated attacks and/or to abnormal sensory processing. In normal ageing, brain modifications could traduce a progressive refinement to cope with the environment, associated with a reduction in the complexity of brain connections. We hypothesized that metabolism in various brain regions might be differentially modified by age in migraine patients. Materials and methods: Forty-one subjects underwent a FDG-PET scan: 21 patients with interictal episodic migraine without aura (MO, age range: 20–63 years, 5M) and 20 healthy controls (HV, 21–59 years, 5 M). Results: In MO vs. HV, the overall FDG uptake was reduced in the left visual cortex, left medial frontal gyrus and bilaterally in the insula, somatosensory and motor cortices. Metabolisms of the posterior thalamus, brainstem including the periaqueductal gray (PAG), visual cortex, and (para)hippocampus, strongly increased with age in MO patients but not in HV. Disease duration positively correlated with PAG, (para)hippocampus and rostral anterior cingulate cortex (rACC) metabolisms in MO. Conclusion: Migraine patients, compared to HV, have a decreased resting metabolism in several areas belonging to the ‘‘pain/salience matrix’’, which is in line with previous neuroimaging studies. Metabolism of the rACC is specifically related to disease load whereas metabolism of other sensory processing regions is more affected by age. Whether these functional changes are due to repeated stereotyped attack-related stimulations and to a learning process with complexity reduction of neuronal connections and/or compensatory age-related hyperactivity, remains to be demonstrated [less ▲]

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See detailMETABOLIC CORRELATES OF VISUAL EVOKED POTENTIALS HABITUATION IN MIGRAINEURS AND CONTROLS
D'Ostilio, Kevin ULg; Lisicki Martinez, Marco ULg; SCHOENEN, Jean ULg et al

in Cephalalgia : An International Journal of Headache (2016), 36(1S), 60

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See detailNon-invasive vagus nerve stimulation for PREVention and Acute treatment of chronic cluster headache (PREVA): A randomised controlled study.
Gaul, Charly; Diener, Hans-Christoph; Silver, Nicholas et al

in Cephalalgia : An International Journal of Headache (2015)

Background: Chronic cluster headache (CH) is a debilitating disorder for which few well-controlled studies demonstrate effectiveness of available therapies. Non-invasive vagus nerve stimulation (nVNS) was ... [more ▼]

Background: Chronic cluster headache (CH) is a debilitating disorder for which few well-controlled studies demonstrate effectiveness of available therapies. Non-invasive vagus nerve stimulation (nVNS) was examined as adjunctive prophylactic treatment of chronic CH. Methods: PREVA was a prospective, open-label, randomised study that compared adjunctive prophylactic nVNS (n=48) with standard of care (SoC) alone (control (n=49)). A two-week baseline phase was followed by a four-week randomised phase (SoC plus nVNS vs control) and a four-week extension phase (SoC plus nVNS). The primary end point was the reduction in the mean number of CH attacks per week. Response rate, abortive medication use and safety tolerability were also assessed. Results: During the randomised phase, individuals in the intent-to-treat population treated with SoC plus nVNS (n=45) had a significantly greater reduction in the number of attacks per week vs controls (n=48) (-5.9 vs -2.1, respectively) for a mean therapeutic gain of 3.9 fewer attacks per week (95% CI: 0.5, 7.2; p=0.02). Higher #50% response rates were also observed with SoC plus nVNS (40% (18/45)) vs controls (8.3% (4/48); p<0.001). No serious treatment-related adverse events occurred. Conclusion: Adjunctive prophylactic nVNS is a well-tolerated novel treatment for chronic CH, offering clinical benefits beyond those with SoC. [less ▲]

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See detailOne-year Prevalence of Migraine Using a Validated Extended French Version of the ID MigraineTM: a Belgian Population-Based Study
Schoenen, Jean ULg; Streel, Sylvie ULg; Donneau, Anne-Françoise ULg et al

in Cephalalgia : An International Journal of Headache (2015, May), 35(6), 155-156

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See detailTargeting pericranial nerve branches to treat migraine: Current approaches and perspectives.
Ambrosini, Armin; D'Alessio, Costantino; MAGIS, Delphine ULg et al

in Cephalalgia : An International Journal of Headache (2015)

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See detailValidation of an extended French version of ID MigraineTM as a migraine-screening tool
Streel, Sylvie ULg; Donneau, Anne-Françoise ULg; Dardenne, Nadia ULg et al

in Cephalalgia : An International Journal of Headache (2015), 35(5), 437-442

Introduction: Migraine has a considerable social, economic, physical and emotional burden but remains underdiagnosed and undertreated. A specific migraine screening tool could help remove barriers to ... [more ▼]

Introduction: Migraine has a considerable social, economic, physical and emotional burden but remains underdiagnosed and undertreated. A specific migraine screening tool could help remove barriers to health care and be an attractive instrument for epidemiological studies. The objective of this work was to assess the validity of an extended French version of ID MigraineTM as a migraine-screening tool. Methods: Sixty-seven subjects from the NESCaV study (2010–2012) completed the migraine screen and were diagnosed by a neurologist specializing in headache medicine using the International Classification of Headache Disorders, 2nd edition criteria (gold standard). Agreement between the two diagnoses was evaluated by Cohen kappa coefficient (k). Sensitivity, specificity and predictive values of the migraine screen were calculated. Results: Migraine was diagnosed in 21 (31.3%) of the 67 subjects according to the screening tool and in 24 (35.8%) by the neurologist (k¼0.90). The prevalence of migraine was unrelated to age, gender, education and perception of financial resources. Sensitivity and specificity of the screen were 87.5% and 100%, respectively. The screen prevalence of migraine with aura was 10.4% (sensitivity and specificity: 83.3% and 96.7%, respectively). Conclusion: The extended French version of ID MigraineTM (ef-ID Migraine) is a validated tool to screen migraine in French-speaking countries. [less ▲]

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See detailSphenopalatine ganglion neuromodulation in migraine: What is the rationale?
SCHOENEN, Jean ULg; Khan, S; Ashina, M

in Cephalalgia : An International Journal of Headache (2014), 34(5), 382-391

This article examines the pathophysiological facets of migraine that would made the disorder amenable by sphenopalatine ganglion neurostimulation.

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See detailMigraine and serotonin: The quest for the Holy Grail goes on.
SCHOENEN, Jean ULg

in Cephalalgia : An International Journal of Headache (2014), 34(3), 163-164

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