Migraine Roundup: Addressing Stigma; Trigeminal Nerve Stimulation; Migraine, PTSD Link

Interview Highlights Stigma Associated With Migraine

In an interview with NeurologyLive^®, Valentina Popova, MD, a pediatric headache specialist at NYU Langone, outlined some of the misconceptions and stigma that migraineurs face. Migraine itself is an unpredictable disease, considering its headache attacks, nausea, and additional symptoms, and is thought to be genetic in cause.

But those who suffer from the condition may be labeled as attention-seeking or have their attacks downplayed as just a headache. When it comes to eliminating these stigmas, “a good place to start would be schools,” Popova said. People may say migraineurs “are just trying to get out of schoolwork or don’t want to do schoolwork,” she said.

Involving physicians with schools may be beneficial as they can outline exactly what the diagnosis is, “and come up with a plan where the child is not exempt from school…but a plan that helps to deal with their migraines as best as we can,” Popova explained.

Efficacy of Trigeminal Nerve Stimulation

In an additional article published on NeurologyLive^®, Deena Kuruvilla, MD, the medical director of the Westport Headache Institute, discussed her research on the potential of external trigeminal nerve stimulation (e-TNS) to treat migraine. Study findings were presented at the 2021 American Headache Society Annual Scientific Meeting.

Results showed e-TNS, carried out with the Cefaly device, was superior to a sham device in providing 2-hour pain freedom and sustained pain freedom after 24 hours.

“We know that this stimulator specifically targets the nerves in the forehead, called the supratrochlear nerve, and the supraorbital nerves, and then we know that it affects the pain pathway by directly stimulating these nerves,” Kuruvilla said.

The treatment offers an important nonpharmacological alternative for migraineurs.

Understanding the Link Between PTSD and Migraine

Study results published in Frontiers in Neuroscience revealed that genes may hold the answer to the challenging comorbidity of migraine and posttraumatic stress disorder (PTSD), Psychiatric Times^™ reports.

By observing 6 pairs of monozygotic (MZ) twins discordant for PTSD and 15 pairs of MZ twins discordant for migraine, researchers discovered common genes and pathways shared by the 2 conditions. “We identified DAPK2 and TM6SF2 as 2 of the top overlapping genes between the 2 disorders,” they wrote. “These findings suggest that epigenetic changes in response to different types of stress may ‘mediate’ stress phenotypes,” researchers added.

Because epigenetic changes can serve as a drug target, due to the fact they can often be reversed, findings offer the potential basis for new treatments.