Can vestibular rehab help vestibular migraine? A new review suggests that it may ease dizziness and improve daily functioning. Molly O'Brien breaks down the information in this Migraine Minute News Update.

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Script: A new review published in Headache, The Journal of Head and Face Pain, looked at whether or not vestibular rehabilitation could be effective for vestibular migraine. Researchers looked at seven studies involving more than 400 people with VM. The studies focused on how dizziness affects daily life, using a standardized questionnaire called the Dizziness Handicap Inventory.

Overall, people who did vestibular rehab saw improvements in dizziness and quality of life. Results differed from study to study, so additional research is needed to confirm the benefits and figure out which exercises are most helpful.

Migraine preventive treatment benefits may go beyond fewer headache days. A new study links erenumab to improved symptoms of anxiety, depression, and poor sleep quality in some people with migraine. Molly O'Brien has the details in this Migraine Minute News Update.

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Script: A new study suggests that one migraine treatment may offer benefits beyond less headache days. Researchers found that the CGRP monoclonal antibody erenumab, sold under the brand name Aimovig, not only reduces migraine frequency… but may improve symptoms of anxiety, depression, and poor sleep quality in some adults with migraine.

Participants took 140MG of erenumab monthly. Over the course of the 24 weeks those who had at least a 50 percent drop in monthly migraine days ALSO saw improved anxiety, depression, and sleep quality. The authors say improvements are likely driven by better migraine control rather than a direct effect of the medication. Researchers also say this study highlights how good migraine prevention may improve overall well-being and quality of life.

In a study published in Headache, researchers identified 36 symptoms that can appear hours before a migraine attack. In this MM news update, Molly O'Brien highlights the most common symptoms, when they occur, and how recognizing these early signs can help people better treat their migraine attacks.

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Transcript:

A new study published in Headache is among the first to explore the migraine prodrome from the patient's perspective.

Researchers held in-depth interviews with 20 people who have migraine, all to better understand what happens before the headache phase begins and how bothersome those symptoms are.

The study identified 36 prodrome symptoms…. with nausea, fatigue, sensitivity to light and sound, neck pain/stiffness, irritability, dizziness or vertigo, sensitivity to temperature, brain fog, and trouble concentrating being the most commonly reported. On average, each participant experienced about 13 prodrome symptoms.

And, 72% of prodrome symptoms occurred one to six hours before the onset of head pain.

The study authors say understanding these early signs may help determine a treatment window…. And if patients can use treatment before severe pain begins, there is potential to reduce migraine burden.

That's your MM news update. I'm Molly O'Brien.

Our recent survey shows some people aren't aware migraine can progress—and many fear their attacks can get worse. Molly O'Brien breaks down the survey results in this MM news update. Do you worry about pain and symptoms getting worse? Let us know in the comments.

Learn more: https://www.migrainedisorders.org/migraine-disorders/migraine-treatments/

Transcript:

Did you know that migraine can be a progressive disease? For some people, attacks can become more frequent, and symptoms or pain may worsen over time. People may even transition from episodic to chronic migraine. The Association of Migraine Disorders held a survey to see how much the migraine community knows about the potential for progression.

Among 459 respondents, 18% did not know that migraine could worsen over time. 50% were aware but hadn't always realized it could progress or become more severe.

68% said they were moderately to extremely worried that their migraine frequency or severity might increase.

While migraine doesn't get worse for everyone, proper treatment can help prevent progression.

If you're nervous about your attacks getting worse, be sure to talk to your healthcare provider and visit AMD's treatments page to learn more.

That's your MM news update, I'm Molly O'Brien.

Treating migraine in pregnancy can be challenging since many drugs carry risks. The good news is that the FDA updated precautions on a drug-free wearable device. Molly O'Brien has the story in this Migraine Minute News Update.

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The FDA recently updated its precautionary language on the Nerivio neuromodulation device… removing the note that it has not been studied for use during pregnancy.

Based on a 2023 study published in Headache, the FDA changed the precaution to: "Users should consult their healthcare provider if they are pregnant or intend to get pregnant prior to using the device."

As we previously reported in an August 2023 Migraine Minute News update, the study's results suggest that the Nerivio device is a safe treatment for migraine during pregnancy, does not increase the risk for adverse pregnancy outcomes, and may offer a drug-free treatment option for migraine during pregnancy.

First-of-its-kind study: A new study suggests that a combination of THC + CBD works better than placebo, THC alone, or CBD alone for reducing migraine pain and symptoms. Molly O'Brien breaks it down in this Migraine Minute News Update.

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Script: For the first time, researchers tested cannabis in a placebo-controlled trial for migraine… and results suggest it could be effective.

A recent study found that when treating migraine attacks, a vaporized combination of THC and CBD worked better than THC alone, CBD alone, or a placebo. THC alone helped with pain, but not other symptoms, while CBD alone did not show any benefit.

Study participants who used the THC/CBD combination also saw improvements in light and sound sensitivity, but not nausea or vomiting.

No serious adverse events were reported.

In an interview with MedScape, one researcher noted that people experienced benefits without using higher, recreational doses of cannabis.

A new real-world study shows atogepant (sold under brand name Qulipta) may quickly reduce migraine days—even for those who haven't responded to other treatments. Molly O'Brien has more in this Migraine Minute News Update!

Read more: http://bit.ly/3UcEuJN CC License: https://creativecommons.org/licenses/by-nc-nd/4.0/ Script: The GIANT study, published inThe Journal of Headache and Pain, offers real-world evidence that atogepant is a safe, well-tolerated, and effective for migraine prevention—among those whose prior treatments didn't work.

Researchers looked at the impact of 60 mg of atogepant, taken once daily in people with either high-frequency episodic or chronic migraine. Many of the participants had already tried at least three other preventive treatments… including CGRP monoclonal antibodies.

Results? At 12 weeks, on average, participants saw a decrease of 6 migraine days and 11 headache days per month. In fact, nearly 60% of experienced at least a 50 percent drop in migraine days. Pain intensity, disability, and use of acute drugs also dropped.

Some saw improvement in migraine frequency within the first week.

Can diabetes and weight loss drugs help with migraine relief? A new study suggests GLP-1 medications may significantly reduce migraine days. @ Molly O'Brien has more in this Migraine Minute News Update.

Read More: http://bit.ly/4kGN4eO

Image and license to use: Headache. 2025; 00: 1-8. http://bit.ly/47imNQO

Script: GLP-1s….a drug class widely used for diabetes and weight loss treatment, may also help migraine.

A small study published in Headache looked at liraglutide as an add-on treatment for unresponsive migraine in people with obesity who have tried at least two preventive migraine treatments. The study tracked 31 adults with high-frequency episodic or chronic migraine.

After taking a daily dose of the drug for three months, on average, they saw monthly headache days drop from about 20 to just under 11—a significant improvement. What may be surprising… is that the benefit came with insignificant weight loss.

A major study found that oral triptans work better for the acute treatment of migraine, than newer drugs. Molly O'Brien breaks it all down in this Migraine Minute News Update.

Read more: https://bit.ly/3Wu6ZnP

Images and License to use: BMJ 2024;386:e080107http://bit.ly/4ljgU9x

Script: A major international study published in the British Medical Journal found triptans to be the most effective acute treatment for migraine.

Researchers analyzed 137 clinical trials involving nearly 90,000 adults… comparing 17 oral treatments. They looked at how many people were pain-free two hours post-dose and how many were still pain-free at 24 hours, as well as the safety and tolerability of the treatments.

They looked at how many people were pain-free at 2 hours and 24 hours, as well as the safety and tolerability of the treatments.

The top performer? Eletriptan — it was shown to be the most effective for both rapid and sustained pain relief. Other high performers included rizatriptan, sumatriptan, and zolmitriptan. Those four triptans consistently outperformed newer acute treatment options like lasmiditan, ubrogepant, and rimegepant.

These newer acute treatments worked about as well as acetaminophen and most non-steroidal anti-inflammatory drugs. Also, results showed that not all NSAIDs work the same for migraine.

A study in the Journal of Psychopharmacology found a surprising connection between psychedelic use and frequent bad headaches. Could psilocybin play a role in headache treatment? Molly O'Brien explains in this Migraine Minute News Update. Read more: http://bit.ly/40k21Mu

Script:

A new study in the Journal of Psychopharmacology shows that people who've used psychedelics like LSD or psilocybin may be less likely to experience frequent bad headaches.

Researchers analyzed data from a large group of people in the UK and found that those who reported a lifetime use of classic psychedelics were 25% less likely to report frequent bad headaches compared to those who had never used them.

So why might that be? One thought is that both psychedelics and conventional migraine drugs (like triptans) work on serotonin receptors in the brain.

While the study doesn't prove that psychedelics directly prevent headaches, It DOES add to growing evidence that psychedelics may be a helpful tool to treat headache disorders. And a quick note, psychedelics are illegal on a federal level in the US. That's your migraine minute news update, I'm Molly O'Brien.

Images: Sage Journals. The Journal of Psychopharmacology. doi: 10.1177/02698811251324

License to use: https://creativecommons.org/licenses/by/4.0/