Cluster headache management and beyond

Martelletti, Paolo

doi:10.1517/14656566.2015.1052741

Cited by 13 publications

(13 citation statements)

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“…One common treatment method for these attacks is the inhalation of pure oxygen [155]. Decreased oxygen supply has been associated with an increase in adenosine levels [156,157].…”

Section: The Role Of Adenosine In Common Forms Of Headachementioning

confidence: 99%

The Role of Adenosine Signaling in Headache: A Review

2017

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Migraine is the third most prevalent disease on the planet, yet our understanding of its mechanisms and pathophysiology is surprisingly incomplete. Recent studies have built upon decades of evidence that adenosine, a purine nucleoside that can act as a neuromodulator, is involved in pain transmission and sensitization. Clinical evidence and rodent studies have suggested that adenosine signaling also plays a critical role in migraine headache. This is further supported by the widespread use of caffeine, an adenosine receptor antagonist, in several headache treatments. In this review, we highlight evidence that supports the involvement of adenosine signaling in different forms of headache, headache triggers, and basic headache physiology. This evidence supports adenosine A2A receptors as a critical adenosine receptor subtype involved in headache pain. Adenosine A2A receptor signaling may contribute to headache via the modulation of intracellular Cyclic adenosine monophosphate (cAMP) production or 5' AMP-activated protein kinase (AMPK) activity in neurons and glia to affect glutamatergic synaptic transmission within the brainstem. This evidence supports the further study of adenosine signaling in headache and potentially illuminates it as a novel therapeutic target for migraine.

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“…One common treatment method for these attacks is the inhalation of pure oxygen [155]. Decreased oxygen supply has been associated with an increase in adenosine levels [156,157].…”

Section: The Role Of Adenosine In Common Forms Of Headachementioning

confidence: 99%

The Role of Adenosine Signaling in Headache: A Review

2017

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“…The designation highlights its typical pattern, in which each attack (a single episode of headache) occurs in clusters or bouts of variable duration, with a circadian and circannual rhythmicity [1, 2]. …”

Section: Introductionmentioning

confidence: 99%

“…This side-switching is mostly verified between clusters, is extremely rare within a single bout, and never occurs within the same attack [1, 2]. …”

Section: Introductionmentioning

confidence: 99%

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Chronic Cluster Headache with an Atypical Presentation and Treatment Response

Santos

Morais

2016

Case Reports in Neurological Medicine

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The management of cluster headache (CH) may be challenging. We report a 50-year-old male with recurrent attacks of dull and severe unilateral periorbital pain, lasting 30–45 minutes, twice a day, exclusively during sleep, and accompanied by ipsilateral rhinorrhea and lacrimation. The pain switched sides within every attack. CH treatment was initiated but the patient maintained recurrence rates compatible with chronic CH, even after increasing verapamil to 460 mg/day. Afterwards we decided to add lithium (800 mg/day). With this treatment the severity and recurrence of CH substantially decreased, despite the patient's autonomous decision to take lithium only during the acute phase of the cluster. The exclusively alternating location and the excellent response to short cycles of lithium represent two unique features of CH.

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“…П о в ы ш е н и е о с в е д о м л е н н о с т и п а ц и е н т о в о п р о ф и л а к т и к е Г Б и о б р а з е ж и з н и По мнению P. Martelletti [43], лечение ГБ требует не только фармакотерапии, но и изменения образа жизни, ги-гиены сны и полной информированности пациента о забо-левании в доступной для него форме. Поэтому важное зна-чение приобретает образование пациентов с ГБ.…”

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