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Article ; Online: Pathophysiology of Migraine.

Recober, Ana

Continuum (Minneapolis, Minn.)

2021 Volume 27, Issue 3, Page(s) 586–596

Abstract: Purpose of review: This article summarizes the current understanding of the pathophysiology of migraine, including some controversial aspects of the underlying mechanisms of the disorder.: Recent findings: Recent functional neuroimaging studies ... ...

Abstract	Purpose of review: This article summarizes the current understanding of the pathophysiology of migraine, including some controversial aspects of the underlying mechanisms of the disorder. Recent findings: Recent functional neuroimaging studies focusing on the nonpainful symptoms of migraine have identified key areas of the central nervous system implicated in the early phases of a migraine attack. Clinical studies of spontaneous and provoked migraine attacks, together with preclinical studies using translational animal models, have led to a better understanding of the disease and the development of disease-specific and targeted therapies. Summary: Our knowledge of the pathophysiology of migraine has advanced significantly in the past decades. Current evidence supports our understanding of migraine as a complex cyclical brain disorder that likely results from dysfunctional sensory processing and dysregulation of homeostatic mechanisms. This article reviews the underlying mechanisms of the clinical manifestations of each phase of the migraine cycle.
MeSH term(s)	Animals ; Brain/diagnostic imaging ; Central Nervous System ; Cognition ; Humans ; Migraine Disorders/diagnosis
Language	English
Publishing date	2021-11-25
Publishing country	United States
Document type	Journal Article ; Review
ISSN	1538-6899
ISSN (online)	1538-6899
DOI	10.1212/CON.0000000000000983
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Article: Migraine and obesity: moving beyond BMI.

Recober, Ana / Peterlin, B Lee

Future neurology

2014 Volume 9, Issue 1, Page(s) 37–40

Language	English
Publishing date	2014-03-20
Publishing country	England
Document type	Journal Article
ISSN	1479-6708
ISSN	1479-6708
DOI	10.2217/fnl.13.65
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Article ; Online: Photophobia in primary headaches.

Rossi, Heather L / Recober, Ana

Headache

2015 Volume 55, Issue 4, Page(s) 600–604

Abstract: Background: Photophobia is a debilitating feature of many headache disorders.: Overview: Clinical and preclinical research has identified several potential pathways involved in enhanced light sensitivity. Some of these structures include trigeminal ... ...

Abstract	Background: Photophobia is a debilitating feature of many headache disorders. Overview: Clinical and preclinical research has identified several potential pathways involved in enhanced light sensitivity. Some of these structures include trigeminal afferents in the eye, second-order neurons in the trigeminal nucleus caudalis, third-order neurons in the posterior thalamus, modulatory neurons in the hypothalamus, and fourth-order neurons in the visual and somatosensory cortices. It is unclear to what degree each site plays a role in establishing the different temporal patterns of photophobia across different disorders. Peptides such as calcitonin gene-related peptide and pituitary adenylate cyclase-activating polypeptide may play a role in photophobia at multiple levels of the visual and trigeminal pathways. Conclusion: While our understanding of photophobia has greatly improved in the last decade, there are still unanswered questions. These answers will help us develop new therapies to provide relief to patients with primary headache disorders.
MeSH term(s)	Headache Disorders, Primary/diagnosis ; Headache Disorders, Primary/epidemiology ; Humans ; Photophobia/diagnosis ; Photophobia/epidemiology ; Trigeminal Nerve/pathology ; Visual Pathways/pathology
Language	English
Publishing date	2015-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	410130-3
ISSN	1526-4610 ; 0017-8748
ISSN (online)	1526-4610
ISSN	0017-8748
DOI	10.1111/head.12532
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Article ; Online: Unanswered questions in headache: so what is photophobia, anyway?

Russo, Andrew F / Recober, Ana

Headache

2013 Volume 53, Issue 10, Page(s) 1677–1678

MeSH term(s)	Calcitonin Gene-Related Peptide/physiology ; Headache/blood ; Headache/diagnosis ; Humans ; Light/adverse effects ; Pain Perception/physiology ; Photophobia/blood ; Photophobia/diagnosis
Chemical Substances	Calcitonin Gene-Related Peptide (JHB2QIZ69Z)
Language	English
Publishing date	2013-09-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	410130-3
ISSN	1526-4610 ; 0017-8748
ISSN (online)	1526-4610
ISSN	0017-8748
DOI	10.1111/head.12231
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Article ; Online: Benefits of an on-line migraine education video for patients with co-occurring migraine and depression.

Thakur, Elyse / Recober, Ana / Turvey, Carolyn / Dindo, Lilian N

Journal of psychosomatic research

2018 Volume 112, Page(s) 47–52

Abstract: Objective: To evaluate effects of an online, hour-long migraine education and management education program on health outcomes in people with migraine experiencing significant depressive symptoms.: Methods: Eligible individuals in the community with ... ...

Abstract	Objective: To evaluate effects of an online, hour-long migraine education and management education program on health outcomes in people with migraine experiencing significant depressive symptoms. Methods: Eligible individuals in the community with comorbid migraine and depressive symptoms (n = 95) participated in the 12-week study. Participants completed self-report questionnaires examining general functioning, headache-specific disability, migraine frequency, pain, and depressive symptoms, before, and at 2, 6, and 12 weeks following the migraine education and management program. Primary analyses evaluated change over time in each outcome, using individual linear growth curve models. Results: After watching the migraine education and management video, there were significant effects of time (across all time points) for average pain level in the past 30 days (b = -0.20, p < .001), most intense pain level in the past 30 days (b = -0.33, p < .001) depression (Patient Health Questionnaire-8; b = -0.28, p = .002), and headache-specific disability (Headache Disability Inventory; b = -1.32, p < .001), such that each of these outcomes improved linearly over time. Conclusions: A brief, online educational video is practical and effective and can lead to enhanced migraine knowledge and self-management skills and lessen the burden of migraine and concurrent depressive symptoms.
MeSH term(s)	Adult ; Depression/epidemiology ; Education, Distance ; Female ; Humans ; Male ; Migraine Disorders/epidemiology ; Surveys and Questionnaires ; Video Recording/methods
Language	English
Publishing date	2018-06-26
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80166-5
ISSN	1879-1360 ; 0022-3999
ISSN (online)	1879-1360
ISSN	0022-3999
DOI	10.1016/j.jpsychores.2018.06.012
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Article ; Online: Migraine and triggers: post hoc ergo propter hoc?

Hoffmann, Jan / Recober, Ana

Current pain and headache reports

2013 Volume 17, Issue 10, Page(s) 370

Abstract: The influence of environmental factors on the clinical manifestation of migraine has been a matter of extensive debate over the past decades. Migraineurs commonly report foods, alcohol, meteorologic or atmospheric changes, exposure to light, sounds, or ... ...

Abstract	The influence of environmental factors on the clinical manifestation of migraine has been a matter of extensive debate over the past decades. Migraineurs commonly report foods, alcohol, meteorologic or atmospheric changes, exposure to light, sounds, or odors, as factors that trigger or aggravate their migraine attacks. In the same way, physicians frequently follow this belief in their recommendations in how migraineurs may reduce their attack frequency, especially with regard to the consumption of certain food components. Interestingly, despite being such a common belief, most of the clinical studies have shown conflicting results. The aim of the review is to critically analyze clinical and pathophysiological facts that support or refute a correlation between certain environmental stimuli and the occurrence of migraine attacks. Given the substantial discrepancy between patients' reports and objective clinical data, the methodological difficulties of investigating the link between environmental factors and migraine are highlighted.
MeSH term(s)	Humans ; Migraine Disorders/etiology ; Migraine Disorders/physiopathology ; Precipitating Factors
Language	English
Publishing date	2013-08-31
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2055062-5
ISSN	1534-3081 ; 1531-3433
ISSN (online)	1534-3081
ISSN	1531-3433
DOI	10.1007/s11916-013-0370-7
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Zs.A 5477: Show issues

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Article ; Online: Female sex and obesity increase photophobic behavior in mice.

Rossi, Heather L / Lara, Orlando / Recober, Ana

Neuroscience

2016 Volume 331, Page(s) 99–108

Abstract: Migraine affects predominantly women. Furthermore, epidemiological studies suggest that obesity is a risk factor for migraine and this association is influenced by sex. However, the biological basis for this bias is unclear. To address this issue, we ... ...

Abstract	Migraine affects predominantly women. Furthermore, epidemiological studies suggest that obesity is a risk factor for migraine and this association is influenced by sex. However, the biological basis for this bias is unclear. To address this issue, we assessed light avoidant behavior, a surrogate of photophobia, in female C57BL/6J mice fed regular diet (RD) or high-fat diet (HFD, 60% kcal from fat). We first assessed sex differences in basal photophobia in 20-25-week-old mice and found that both obese and lean females spent significantly less time in light than their male counterparts. Next, we assessed photophobia evoked by trigeminal stimulation with intradermal capsaicin. Females at 20-25weeks of age did not display capsaicin-evoked photophobic behavior unless they had diet-induced obesity. When we tested 8-11-week-old females to determine if the diet alone could be responsible for this effect, we found that both HFD and RD 8-11-week-old females exhibit capsaicin-evoked photophobic behavior. This is in contrast to what we have previously shown in males and indicates a sex difference in the photophobic behavior of mice. Comparison of 20-25-week-old RD mice with 8-11-week-old RD mice suggests that age or age-related weight gain may contribute to capsaicin-evoked photophobic behavior in males, but not in females. These findings suggest that obesity exacerbates photophobia in both sexes, but additional work is needed to understand the sex- and age-specific mechanisms that may contribute to photophobia and trigeminal pain.
MeSH term(s)	Aging/physiology ; Aging/psychology ; Analysis of Variance ; Animals ; Avoidance Learning ; Capsaicin ; Cohort Studies ; Diet, High-Fat ; Disease Models, Animal ; Female ; Male ; Mice, Inbred C57BL ; Migraine Disorders/physiopathology ; Motor Activity/physiology ; Obesity/complications ; Obesity/physiopathology ; Photic Stimulation ; Photophobia/etiology ; Photophobia/physiopathology ; Random Allocation ; Sex Characteristics ; Time Factors
Chemical Substances	Capsaicin (S07O44R1ZM)
Language	English
Publishing date	2016-09-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	196739-3
ISSN	1873-7544 ; 0306-4522
ISSN (online)	1873-7544
ISSN	0306-4522
DOI	10.1016/j.neuroscience.2016.06.022
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Zs.A 1215: Show issues

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Article ; Online: Patients With Vestibular Migraine are More Likely to Have Occipital Headaches than those With Migraine Without Vestibular Symptoms.

Wattiez, Anne-Sophie / O'Shea, Sarah A / Ten Eyck, Patrick / Sowers, Levi P / Recober, Ana / Russo, Andrew F / Fattal, Deema

Headache

2020 Volume 60, Issue 8, Page(s) 1581–1591

Abstract: Objective: To determine whether patients with vestibular migraine are more likely to suffer from an occipital headache than patients with migraine without vestibular symptoms.: Background: Vestibular migraine is an underdiagnosed disorder in which ... ...

Abstract	Objective: To determine whether patients with vestibular migraine are more likely to suffer from an occipital headache than patients with migraine without vestibular symptoms. Background: Vestibular migraine is an underdiagnosed disorder in which migraine is associated with vestibular symptoms. Anatomical evidence and symptomatology hint at the involvement of brain structures in the posterior fossa (back of the head location). We hypothesized that vestibular migraine patients are more likely than migraineurs without vestibular symptoms to experience headaches located in the back of the head, that is, occipital headaches. Methods: A retrospective cross-sectional study was conducted at the University of Iowa Hospital and Clinics. Chart analysis of 169 patients was performed. The primary outcome was the location of the headache in vestibular migraine patients and migraineurs without vestibular symptoms. The secondary outcomes included the association of vestibular migraine with gender, age at onset of headache, age at onset of vestibular symptoms (such as vertigo, head motion-induced dizziness), aura, motion sickness, other associated symptoms, family history of headaches, and family history of motion sickness. Results: In vestibular migraine group, 45/103 (44%) had occipital location for their headaches vs 12/66 (18%) in migraine patients without vestibular symptoms, for an odd's ratio of 3.5 (95% CI = 1.7-7.2, P < .001). Additionally, the age at onset of headache was greater in the vestibular migraine group (28 ± 12 vs 18 ± 9 years, P < .001) and motion sickness was more common (41/98 (42%) in the vestibular migraine group, 1/64 (2%) in the migraine without vestibular symptoms group, P < .001). Conclusions: This study suggests that patients with vestibular migraine are more likely to have occipital headaches than patients with migraine without vestibular symptoms. Our data support the initiation of a prospective study to determine whether a patient presenting with occipital headaches, with late onset of age of headache, and with a history of motion sickness is at an increased risk for the possible development of vestibular migraine.
MeSH term(s)	Adult ; Age of Onset ; Cross-Sectional Studies ; Dizziness/physiopathology ; Female ; Headache/physiopathology ; Humans ; Male ; Migraine Disorders/physiopathology ; Motion Sickness/physiopathology ; Retrospective Studies ; Vertigo/physiopathology ; Vestibular Diseases/physiopathology
Language	English
Publishing date	2020-07-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	410130-3
ISSN	1526-4610 ; 0017-8748
ISSN (online)	1526-4610
ISSN	0017-8748
DOI	10.1111/head.13898
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Article ; Online: Comorbidity of Migraine, Major Depressive Disorder, and Generalized Anxiety Disorder in Adolescents and Young Adults.

Dindo, Lilian N / Recober, Ana / Haddad, Rita / Calarge, Chadi A

International journal of behavioral medicine

2016 Volume 24, Issue 4, Page(s) 528–534

Abstract: Purpose: Depression and anxiety are highly comorbid psychiatric conditions and both are common in adult patients with migraine. This study aims to examine the unique associations between major depressive disorder (MDD) and generalized anxiety disorder ( ... ...

Abstract	Purpose: Depression and anxiety are highly comorbid psychiatric conditions and both are common in adult patients with migraine. This study aims to examine the unique associations between major depressive disorder (MDD) and generalized anxiety disorder (GAD) in a well-characterized group of older adolescents and college-age individuals with migraine. Method: Participants (N = 227), between 15 and 20 years old, who were unmedicated or within 1 month of beginning antidepressant treatment underwent a comprehensive psychiatric assessment to establish the presence of MDD and GAD, according to the Diagnostic and Statistical Manual, Fourth Edition, Text Revision, and to rate their symptom severity using the Longitudinal Interval Follow-up Evaluation for Adolescents (A-LIFE). They then completed the ID-Migraine. The Student's t test and chi-square test were used to compare continuous and categorical variables, respectively, across participants with vs. without migraine. Logistic regression analysis examined the association between the presence of migraine and psychopathology. Results: A diagnosis of MDD was associated with significantly increased risk of having migraine. Moreover, more severe and persistent ratings of depression were associated with an even higher likelihood of having migraine. A diagnosis of GAD was also significantly associated with the presence of migraine. The prevalence of comorbid MDD and GAD was significantly higher in participants with migraine than those without migraine (55 vs. 22%, p < 0.0001). When examined concurrently, GAD remained significantly associated with migraine, with a statistical trend for MDD to be associated with it. Conclusion: The comorbidity of migraine, MDD, and GAD has important clinical and research implications. Patients who suffer from any of these problems should be screened for all three in order to receive comprehensive care. Shared psychological and biological vulnerabilities may be involved in the three conditions. Greater understanding of the shared vulnerabilities can lead to unified treatments.
MeSH term(s)	Adolescent ; Anxiety Disorders/psychology ; Comorbidity ; Depressive Disorder, Major/psychology ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Male ; Migraine Disorders/psychology ; Prevalence ; Young Adult
Language	English
Publishing date	2016-12-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1187972-5
ISSN	1532-7558 ; 1070-5503
ISSN (online)	1532-7558
ISSN	1070-5503
DOI	10.1007/s12529-016-9620-5
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Zs.A 5090: Show issues

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Article: Calcitonin gene-related peptide: A molecular link between obesity and migraine?

Recober, Ana / Goadsby, Peter J

Drug news & perspectives

2010 Volume 23, Issue 2, Page(s) 112–117

Abstract: Epidemiological studies have begun to suggest obesity is a risk factor for chronic migraine, although no causal relationship has been established and risk factors for progression from episodic to chronic migraine remain unknown. The neuropeptide ... ...

Abstract	Epidemiological studies have begun to suggest obesity is a risk factor for chronic migraine, although no causal relationship has been established and risk factors for progression from episodic to chronic migraine remain unknown. The neuropeptide calcitonin gene-related peptide (CGRP) plays a important role in the pathophysiology of migraine. Here, the potential role of CGRP as a molecular link between obesity and migraine is reviewed. A mechanistic association is supported by several lines of evidence: 1) common markers are elevated in obesity and migraine, 2) adipose tissue secretes proinflammatory cytokines and adipocytokines that have been implicated in migraine pathophysiology and 3) elevated levels of CGRP have been found in plasma of obese individuals. We propose that CGRP released from trigeminal neurons may represent a biological link between obesity and migraine. Enhanced trigeminal CGRP production in obese susceptible individuals may lower the threshold necessary to trigger migraine attacks, leading to more frequent episodes and eventually to chronic migraine.
MeSH term(s)	Adipokines/metabolism ; Adipose Tissue/metabolism ; Animals ; Calcitonin Gene-Related Peptide/metabolism ; Cytokines/metabolism ; Humans ; Migraine Disorders/physiopathology ; Obesity/physiopathology ; Trigeminal Nerve/metabolism
Chemical Substances	Adipokines ; Cytokines ; Calcitonin Gene-Related Peptide (JHB2QIZ69Z)
Language	English
Publishing date	2010-03-30
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	885125-6
ISSN	2013-0139 ; 0214-0934
ISSN (online)	2013-0139
ISSN	0214-0934
DOI	10.1358/dnp.2010.23.2.1475909
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