16th European Headache Congress

Chair

What to know and what to consider

Prof. Dr

Invited speaker

Invited lecture

The interictal state of headache

Prof.

Lessons from MRI and EEG in migraine and persistent post-COVID headache

Prof. Dr.

Decreased plasma RANTES/CCL5 concentration in headache-free episodic migraine patients

Migraine

Abstract text (incl. figure legends and references) Introduction: The regulated on activation and normal T-cell expressed and secreted (RANTES/CCL5) is a chemotactic protein that beyond to chemoattraction is involved in nociception and trigeminal pain. Previous study demonstrated an increased serum RANTES/CCL5 concentration in migraineurs during migraine attack. Additionally, higher RANTES/CCL5 concentration distinguish migraine patients compared to tension-type headache patients. However, the RANTES/CCL5 concentration in headache-free period of migraineurs is contradictory in the literature. Methods: Blood samples were collected in two independent time-points to measure plasma RANTES/CCL5 concentration of 21 females with episodic migraine without aura and 22 healthy control females The difference in plasma RANTES/CCL5 between migraine and control group was calculated with Mann-Whitney U-test using SPSS27. Results: RANTES/CCL5 concentration were decreased in migraine patients compared[K1] to healthy controls in both blood samplings (1.BS: U=329, p=0.017; 2.BS: U=312, p=0.049). Conclusion: Previous studies reported that lower RANTES/CCL5 concentration was associated with higher flow-mediated dilation in vessels. Thus, the decreased serum RANTES/CCL5 concentration replicated in two independent measures may be the sign of vascular hypersensitivity in migraine patients between attacks. The decreased RANTES/CCL5 concentration in interictal period may be a predisposing factor for migraine attack, while the increased RANTES/CCL5 concentration might be associated with migraine pain in ictal period. These findings suggest that RANTES/CCL5 might play a complex role in migraine pathophysiology through its pro-inflammatory, nociceptive and vascular effects that should be further explored. Funding:EFOP-3.6.3-VEKOP-16-2017-00009; 2017-1.2.1-NKP-2017-00002, KTIA_13_NAPA-II/14, KTIA_NAP_13-1-2013- 0001, KTIA_NAP_13-2- 2015-0001; 2020-4.1.1.-TKP2020; TKP2021-EGA-25; 2019-2.1.7-ERA-NET-2020-00005.

Abstract lecture

Functional connectivity changes in patients with complex migraine aura: beyond the visual network

Neuroimigang in headache disorders

Abstract text (incl. figure legends and references) Background and purpose: Although the majority of migraine with aura (MwA) patients experience simple visual aura, a discrete percentage also report somatosensory, dysphasic or motor symptoms (the so-called complex auras). The wide aura clinical spectrum led to an investigation of whether the heterogeneity of the aura phenomenon could be produced by different neural correlates, suggesting an increased visual cortical excitability in complex MwA. The aim was to explore whether complex MwA patients are characterized by more pronounced connectivity changes of the visual network and whether functional abnormalities may extend beyond the visual network encompassing also the sensorimotor network in complex MwA patients compared to simple visual MwA patients. Methods: By using a resting-state functional magnetic resonance imaging approach, the resting-state functional connectivity (RS-Fc) of both visual and sensorimotor networks in 20 complex MwA patients was compared with 20 simple visual MwA patients and 20 migraine without aura patients. Results: Complex MwA patients showed a significantly higher RS-Fc of the left lingual gyrus, within the visual network, and of the right anterior insula, within the sensorimotor network, compared to both simple visual MwA and migraine without aura patients (p &lt; 0.001). The abnormal right anterior insula RS-Fc was able to discriminate complex MwA patients from simple aura MwA patients as demonstrated by logistic regression analysis (area under the curve 0.83). Conclusion: Our findings suggest that higher extrastriate RS-Fc might promote cortical spreading depression onset representing the neural correlate of simple visual aura that can propagate to sensorimotor regions if an increased insula RS-Fc coexists, leading to complex aura phenotypes.

Professor

DNA methylation changes associated with treatment response in chronic migraine

Genetics genomics | RNA

Medication overuse headache

Abstract text (incl. figure legends and references) Objective: The mechanisms behind the transformation of episodic migraine to chronic migraine and vice versa have not yet been elucidated. Epigenetic changes are implicated in this process. If treatment results in conversion back to episodic migraine these epigenetic processes might also be reverted. We aimed to identify DNA methylation changes associated with treatment response in chronic migraine patients with medication overuse. Methods: A longitudinal epigenome-wide association study was performed as part of the Chronification and Reversibility of Migraine (CHARM) study. Blood was taken from chronic migraine patients (n = 98) at baseline and after a 12-week withdrawal period. Treatment responders, patients with ≥ 50% reduction in monthly headache days (MHD), were compared with non-responders to identify methylation changes associated with treatment response. Similarly, ≥ 50% versus &lt; 50% reduction in monthly migraine days (MMD) was compared. Sex-specific analyses were performed. Finally, it was evaluated whether DNA methylation status at baseline was predictive of treatment response after t = 12 weeks. Results: At the genome-wide level, a change in DNA methylation at one CpG site within an intron of the HDAC4 gene was associated with MHD response (p = 9.42×10–8) (Fig 1A). Sex-specific analyses revealed two CpG sites associated with MHD response, proximal to DLGAP2 for women (p = 1.11x10-7) and STS5/AKIP1 for men (p = 8.67x10-8). Five CpG sites were associated with MMD response in men: ZAN (p = 2.41x10-8), ZNF248 (p = 2.52x10-8), H4C2 (p = 2.87x10-8), between RIT2/SYT4 (p = 4.29x10-8), and between NRXN1/ASB3 (p = 6.44x10-8). Baseline methylation at one CpG within MARK3 was predictive of MMD response at 12 weeks. Conclusion: Global and sex-specific DNA methylation changes are associated with treatment response in chronic migraine. Moreover, DNA methylation status at baseline might be predictive of treatment response.

On Demand

Strauss 1

SciSe 9

Scientific session

SciSe 9
The interictal state of headache

Appointment

Chair

Programme

SciSe 9The interictal state of headache

Appointment

Chair

Programme

SciSe 9
The interictal state of headache