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\"Navigating Life with Migraine and Other Headaches focuses on the many myths that exist around headaches and dispels common misperceptions by providing simple explanations on how headaches occur, and, most importantly, how to treat them. The authors give real, practical advice: when and how to manage your headaches, when to seek treatment, and when to be concerned. From vitamins to prescription meds; from when to go to the emergency department to optimizing doctor visits; options for managing headaches are presented in this accessible and easy-to-read resource. The more you know about headache, including the mechanisms that cause pain, the better you and your family can manage this common and chronic condition. Through the use of patient stories, a glossary of terms for easy reference, and key points for quick retention, this book is a high-quality resource for people looking for empowerment and a sense of control\"--Provided by publisher.

In adults with migraine and previous preventive treatment failures, a single infusion of a monoclonal antibody to pituitary adenylate cyclase–activating polypeptide led to fewer migraine days per month than placebo over the next 4 weeks.

Increasing evidence points towards the role of mitochondrial functioning, energy metabolism, and oxidative stress in migraine. However not all previous research has been conclusive and some mitochondrial function/oxidative stress markers have not yet been examined. To this end, alpha-lipoic acid (ALA), total thiols, total plasma antioxidant capacity (TAC), lipid peroxide (PerOx), oxidised LDL (oxLDL), HbA1c and lactate were determined in the serum of 32 higher frequency episodic migraineurs (5–14 migraine days/ months, 19 with aura, 28 females) in this cross-sectional study. The majority of patients had abnormally low ALA and lactate levels (87.5% and 78.1%, respectively). 46.9% of the patients had abnormally high PerOx values, while for thiols and TAC over one third of patients had abnormally low values (31.2% and 37.5%, respectively). 21.9% of patients had abnormally low HbA1c and none had an HbA1c level above 5.6%. oxLDL was normal in all but one patient. This study provides further evidence for a role of oxidative stress and altered metabolism in migraine pathophysiology, which might represent a suitable therapeutic target. ALA, being too low in almost 90% of patients, might represent a potential biomarker for migraine. Further research is needed to replicate these results, in particular a comparison with a control group. This study is part of the trial registration: ClinicalTrials.gov: NCT03132233, registered on 27.04.2017, https://clinicaltrials.gov/ct2/show/NCT03132233 .

Background Migraine is a highly prevalent neurological disorder related to severe, unilateral headache and symptoms such as vomiting, nausea, and photophobia. Growing evidence implicates oxidative stress and inflammation as key contributors to migraine pathophysiology, exacerbating symptoms and related mental health conditions. Mixodin is a novel bioactive formulation derived from natural compounds, including curcumin, piperine, and gingerol, which are well-established for their anti-inflammatory and antioxidant properties. While each component has shown potential in alleviating migraine-related symptoms, the combined therapeutic efficacy remains unclear. This study investigates whether the combined natural compounds in mixodin provide synergistic benefits in migraine management by targeting multiple underlying mechanisms. This study aims to examine the effects of mixodin supplementation on clinical symptoms, mental health, quality of life (QOL), inflammatory, and oxidative stress factors in patients with migraine. Methods This study is a randomized, double-blind, placebo-controlled clinical trial involving 60 patients diagnosed with migraine by a neurologist according to the ICHD-3 criteria. Eligible participants, aged 20 to 60 years, will be randomly assigned to one of two groups. The intervention group ( n  = 30) will receive two mixodin capsules daily for 8 weeks, each containing 300 mg of curcumin, 7.5 mg of gingerol, and 3.75 mg of piperine. The control group ( n  = 30) will receive two placebo capsules daily for the same duration. The primary outcome will be the clinical symptoms of migraine, including the frequency, severity, and duration of migraine attacks reported by patients. Secondary outcomes will include serum levels of high-sensitivity C-reactive protein (hs-CRP), calcitonin gene-related peptide (CGRP), total antioxidant capacity (TAC), total oxidant status (TOS), malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO), and assessments of mental health status and QOL. Discussion This clinical trial aims to evaluate the effects of mixodin supplementation on inflammatory markers, oxidative stress, migraine-related symptoms, mental health, and QOL in patients with migraine. The results may suggestion insights into underlying mechanisms and support the development of evidence-based clinical guidelines that incorporate anti-inflammatory and antioxidant strategies to enhance therapeutic outcomes in migraine management. Trial registration Iranian Registry of Clinical Trials ( www.irct.ir ) (ID: IRCT20241009063312N1). Registration date: 2024–12–15. Trial status The protocol is Version 2.0, March 01, 2025. Recruitment began November 11, 2024, and is anticipated to be completed by June 22, 2025.

Rimegepant is a calcitonin gene-related peptide receptor antagonist that has shown efficacy and safety in the acute treatment of migraine. We aimed to compare the efficacy of rimegepant with placebo for preventive treatment of migraine. We did a multicentre, phase 2/3, randomised, double-blind, placebo-controlled trial at 92 sites in the USA. Adults with at least a 1-year history of migraine were recruited. After a 4-week observation period, eligible participants were randomised using an interactive web response system to oral rimegepant 75 mg or matching placebo every other day for 12 weeks (double-blind treatment phase). The primary efficacy endpoint was change from the 4-week observation period in the mean number of migraine days per month in the last 4 weeks of the double-blind treatment phase (weeks 9–12). Participants who received at least one dose of their assigned study medication and who had 14 days or more of data in the observation period and 14 days or more of data for at least one 4-week interval during the double-blind treatment phase were analysed for efficacy. Those who received at least one dose of study medication were analysed for safety. This study is registered with ClinicalTrials.gov, NCT03732638. Between Nov 14, 2018, and Aug 30, 2019, 1591 participants were recruited and assessed for eligibility, of whom 747 were randomly allocated either rimegepant (n=373) or placebo (n=374). 695 participants were included in the analysis for efficacy, of whom 348 were assigned rimegepant and 347 were allocated placebo. Rimegepant was superior to placebo on the primary endpoint of change in the mean number of migraine days per month during weeks 9–12. The change from the observation period in mean number of migraine days per month during weeks 9–12 was −4·3 days (95% CI –4·8 to –3·9) with rimegepant and −3·5 days (–4·0 to –3·0) with placebo (least squares mean difference −0·8 days, 95% CI −1·46 to −0·20; p=0·0099). 741 participants received study medication and were included in the safety analysis. 133 (36%) of 370 patients who received rimegepant reported an adverse event, compared with 133 (36%) of 371 who received placebo. Seven (2%) participants who received rimegepant and four (1%) who received placebo discontinued the study due to an adverse event; no patients died. Taken every other day, rimegepant was effective for preventive treatment of migraine. Tolerability was similar to that of placebo, and no unexpected or serious safety issues were noted. Biohaven Pharmaceuticals.

The trigeminal nerve and its projections to the intracranial vasculature — the trigeminovascular system — are at the nexus of migraine. Identification of the mechanisms that trigger signals in this system have led to targeted treatments and preventive therapies for migraine.

A higher percentage of participants who received the calcitonin gene–related peptide receptor antagonist ubrogepant had freedom from migraine pain and absence of the most bothersome migraine-associated symptom at 2 hours than participants who received placebo.

Treatment with the oral calcitonin gene–related peptide receptor antagonist rimegepant resulted in freedom from migraine pain 2 hours after the dose in 20% of patients; 12% of the patients who received placebo were pain-free. Freedom from the most bothersome migraine symptom aside from pain 2 hours after the dose was reported in 38% of patients who received rimegepant and 25% who received placebo.

Background The aim of this study was to evaluate the changes in the cognitive performance of migraine patients using a comprehensive series of cognitive/behavioral and electrophysiological tests. Method A randomized, cross-sectional, within subject approach was used to compare neuropsychological and electrophysiological evaluations from migrane-affected and healthy subjects. Results Thirty-four patients with migraine (6 males, 28 females, average 36 years old) were included. Migraineurs performed worse in the majority of the Montreal Cognitive Assessment (MoCA) ( p  = 0.007) compared to the healthy subjects, significantly in language ( p  = 0.005), memory ( p  = 0.006), executive functions ( p  = 0.042), calculation ( p  = 0.018) and orientation ( p  = 0.012). Migraineurs had a lower score on the memory trial of the Rey–Osterrieth complex figure test (ROCF) ( p  = 0.012). The P3 latency in Fz, Cz, Pz was prolonged in migraineurs compared with the normal control group ( P  < 0.001). In addition, we analyzed significant correlations between MoCA score and the duration of migraine. We also observed that a decrease in the MoCA-executive functions and calculation score and in the ROCF-recall score were both correlated to the frequency of migraine. Migraineurs were more anxious than healthy subjects ( p  = 0.001), which is independent of cognitive testing. Differences were unrelated to age, gender and literacy. Conclusions Cognitive performance decreases during migraine, and cognitive dysfunction can be related to the duration and frequency of a migraine attack.

The current study was performed to evaluate the effects of alpha-lipoic acid (ALA) supplementation on lactate, nitric oxide (NO), vascular cell adhesion molecule-1 (VCAM-1) levels, and clinical symptoms in women with episodic migraines. Considering the inclusion and exclusion criteria , ninety-two women with episodic migraines participated in this randomized, double-blind, placebo-controlled, parallel-design trial. The participants were randomly assigned to receive either 300 mg/day ALA or placebo, twice per day for 12 weeks. The primary outcomes included headache severity, headache frequency per month, and duration of attacks and the secondary outcomes included lactate (a marker of mitochondrial function), NO, and VCAM-1 serum levels were measured at baseline and the end of the intervention. At the end of the study, there was a significant decrease in lactate serum levels (− 6.45 ± 0.82 mg/dl vs − 2.27 ± 1.17 mg/dl; P  = 0.039) and VCAM-1 (− 2.02 ± 0.30 ng/ml vs − 1.21 ± 0.36 ng/ml; P  = 0.025) in the ALA as compared to the placebo group. In addition, the severity (P < 0.001), frequency (P = 0.001), headache impact test (HIT-6) (P < 0.001), headache dairy results (HDR) (P = 0.003), and migraine headache index score (MHIS) (P < 0.001) had significantly decreased in the intervention as compared to the control group. No significant changes were observed for NO levels and duration of migraine pains. ALA supplementation can be considered a potential adjunct treatment in patients with migraine due to its improving mitochondrial and endothelial functions and clinical symptoms.