Current Evidence on Potential Uses of MicroRNA Biomarkers for Migraine: From Diagnosis to Treatment

Gazerani, Parisa

doi:10.1007/s40291-019-00428-8

Cited by 35 publications

(35 citation statements)

References 146 publications

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“…An interictal study in premenopausal women with MWA showed that circulating levels of activated EMP were higher than in controls and that the EMP levels correlated with arterial stiffness as measured by finger tonometry 118 . Other biomarkers of endothelial activation in migraine, include endothelial microRNA that are known to be modulated in atherosclerosis and stroke, 119‐121 and claudin 5, a membrane protein regulating blood brain barrier permeability and endothelial cell integrity 115 . Biomarkers of endothelial regeneration and repair, including circulating endothelial progenitor cells (EPC) and EPC‐mobilizing stromal cell‐derived Factor‐1 alpha (SDF‐1 alpha), are both decreased in persons with MWA 122‐125 .…”

Section: Potential Mechanisms Of Migraine‐related Strokementioning

confidence: 99%

Migraine and Ischemic Stroke in Women. A Narrative Review

Tietjen

Maly

2020

Headache

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Objective/Background.-Migraine is associated with ischemic stroke. Women are 3-fold as likely as men to have migraine, and high estrogen states increase the risk of migraine with aura (MWA), venous thromboembolism (VTE), and of stroke. We review the epidemiological and mechanistic evidence of the migraine-stroke relationship and its risk factors, with a focus on women and conditions that exclusively or predominantly affect them.Methods.-We performed a search of MEDLINE/PubMed database, then a narrative review of the epidemiological evidence of the migraine-stroke relationship as well as the evidence for arterial, thrombophilic, and cardiac mechanisms to explain this connection. We examine the implications of this evidence for the diagnostic evaluation and treatment of MWA.Results.-MWA is associated with multiple stroke risk factors, such as hypertension, hyperlipidemia, diabetes mellitus, cigarette smoking, atrial fibrillation, and patent foramen ovale. In women, MWA is also associated with biomarkers of endothelial activation, hormonal contraceptive use, pregnancy, and VTE. This suggests that a subset of auras may be secondary, that is, induced by ischemia related to microemboli or in situ thrombosis. MWA-associated ischemic stroke is more common in young (<45 years old) women with high frequency of migraine attacks, hormonal contraception use, and with pregnancy and preeclampsia. There is increasing evidence that cardioembolism, often in conjunction with thrombophilia, plays a prominent role in MWA-associated cerebral infarction.Conclusion.-The commonality of factors associated with MWA and with MWA-associated stroke suggest that persons with secondary, ischemia-induced aura may be at elevated risk of stroke. Although further research is needed, we recommend consideration of a diagnostic evaluation of MWA that mirrors the evaluation of transient ischemic attack, given that prophylactic treatment targeting the ischemic origin of secondary aura may prevent migraine as well as stroke.

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Section: Potential Mechanisms Of Migraine‐related Strokementioning

confidence: 99%

Migraine and Ischemic Stroke in Women. A Narrative Review

Tietjen

Maly

2020

Headache

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“…Many studies consider that a 50% reduction in headache days is a clinically meaningful measure of the efficacy of prophylactic drugs. As most studies rely on sufferer-reported data, there is significant interest in developing biomarkers to more objectively monitor the efficacy of migraine pharmacotherapy; however, a reliable, commonly accepted biomarker for migraine treatment has not been identified (Gazerani, 2019). One promising approach is to combine genetic and brain imaging markers to identify the optimal migraine therapy (Nyholt et al, 2017).…”

Section: Sex-related Differences In Response To Pharmacotherapymentioning

confidence: 99%

“…Men with migraine have also been reported to have higher plasma levels of estrogen than men without migraine (Van Oosterhout et al, 2018). Other hormones, such as testosterone, progesterone, and prolactin, as well as genetic and epigenetic factors, may contribute to these sex-related differences in migraine (Gazerani and Vinterhøj, 2016;Delaruelle et al, 2018;Gazerani, 2019).…”

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confidence: 99%

Sex-Specific Pharmacotherapy for Migraine: A Narrative Review

Gazerani

Cairns

2020

Front. Neurosci.

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Migraine is a common neurological disorder characterized by recurrent headache episodes that accompany sensory-motor disturbances, such as higher sensitivity to touch and light, extremity heaviness or weakness, and speech or language disabilities. Worldwide, migraine is one of the top 10 causes of disability and hence poses a huge economic burden to society. On average, migraine occurs in 12% of population but its occurrence is sexually dimorphic, as it is two to three times more prevalent in women than in men. This female to male ratio of migraine prevalence is age-and sex hormone-dependent. Advancements in understanding migraine pathogenesis have also revealed an association with both genetics and epigenetics. The severity of migraine, in terms of its attack duration, headache intensity, frequency, and occurrence of migraineassociated symptoms, has generally been reported to be greater in women. Sex differences in migraine disability and comorbidities, such as psychiatric disorders, have also been noted in some population-based studies. However, research on sex-related differences in response to migraine treatments is relatively scarce. Although a general observation is that women consume more medication than men for migraine treatment, strategies for the use of abortive and preventive medications for migraine are generally similar in both sexes. This narrative review summarizes available findings on sexually distinct responses to abortive and prophylactic pharmacotherapy of migraine. Basic experimental data and clinical findings will be presented, and potential mechanisms underlying sex-based responses will be discussed to highlight the importance and value of sex-based treatment in migraine research and practice.

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“…This assumption has raised a question on the existence and potential benefits of an epigenetic diet for migraine [ 26 ]. This hypothesis has mainly been formed following recent advanced studies in the pathogenesis of migraine with a focus on epigenetics [ 35 , 36 ], where aberrant DNA methylation has been found to be associated with the occurrence of migraine [ 37 ]. In several genes, it has been reported that their methylation might be associated with migraine, including SH2D5 (SH2 domain containing 5) [ 38 ]; COMT (catechol-O-methyltransferase) [ 39 ]; ZNF234 (zinc finger protein 234) [ 39 ]; SOCS1 (suppressor of cytokine signaling 1) [ 39 ]; SLC2A9 , SLC38A4 , and SLC6A5 (solute carrier family 2, 38A, and 6A members 9, 4, and 5, respectively) [ 40 ]; DGKG (diacylglycerol kinase gamma) [ 40 ]; KIF26A (kinesin family member 26A) [ 40 ]; DOCK6 (dedicator of cytokinesis 6) [ 40 ]; CFD (complement factor D) [ 40 ]; RAMP1 (receptor activity modifying protein 1) [ 41 ]; and CGRP [ 42 ].…”

Section: Epigenetic Dietmentioning

confidence: 99%

Migraine and Diet

Gazerani

2020

Nutrients

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128

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Migraine is characterized by recurrent attacks of disabling headaches, often accompanied by sensory and motor disturbances. Clinical manifestations of migraine are influenced by dietary behaviors and dietary elements. Several dietary triggers for migraine have been identified, leading to the definition of strategies such as elimination diets, ketogenic diets, and comprehensive diets, mainly to help prevent migraine. Although inconsistency is present in the literature and no consensus exists, the available data are promising in supporting beneficial dietary interventions for some migraine patients. Several factors influence the net outcome, including age, sex, genetics, and environmental factors. Advancement in understanding the underlying mechanisms of migraine pathogenesis and how dietary factors can interfere with those mechanisms has encouraged investigators to consider diet as a disease-modifying agent, which may also interfere with the gut–brain axis or the epigenetics of migraine. Future work holds potential for phenotyping migraine patients and offering personalized recommendations in line with biopsychosocial models for the management of migraine. Diet, as an important element of lifestyle, is a modifiable aspect that needs further attention. Well-designed, systematic, and mechanism-driven dietary research is needed to provide evidence-based dietary recommendations specific to migraine. This narrative review aims to present the current status and future perspective on diet and migraine, in order to stimulate further research and awareness.

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Current Evidence on Potential Uses of MicroRNA Biomarkers for Migraine: From Diagnosis to Treatment

Cited by 35 publications

References 146 publications

Migraine and Ischemic Stroke in Women. A Narrative Review

Migraine and Ischemic Stroke in Women. A Narrative Review

Sex-Specific Pharmacotherapy for Migraine: A Narrative Review

Migraine and Diet

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