45(th) Annual Scientific Meeting of the American Headache Society June 19 -22, 2003, Chicago, IL, USA.
The 45(th) Annual Scientific Meeting of the American Headache Society focused on new areas of headache research: revised diagnostic criteria, increased the understanding of the pathogenesis of migraine and expansion of identified physiological changes in migraine beyond head pain to include cognitive, sleep and vestibular disturbances. A preview of the new International Headache Society criteria described changes in diagnostic categories, including special criteria for research. New definitions to categorise chronic daily headache, menstrual migraine and secondary headaches were the main highlights of the modified criteria. In addition, novel data on activation within trigeminovascular pathways expand the understanding of the pathogenesis of migraine. Identification of the ability of treatment to impact activation and sensitisation of peripheral and central neurons results in: an explanation for initial headache worsening and neck/chest tightness that commonly occur with triptans, a better understanding of the mechanisms of triptans, and a strong recommendation for early triptan intervention (within 20 min of headache onset). Application of matrix metalloproteinase models to migraine helps explain the ability of medications to cross the blood-brain barrier during a migraine episode, as well as describe possible ischaemia with repeated migraine (e.g., white matter abnormalities seen on magnetic resonance scanning). Improved classification of headache disorders, along with increased understanding of the physiology of migraine and mechanism of action of common treatments, should enhance future development and evaluation of effective headache therapy.
Marcus
Dawn A
DA
Pain Evaluation & Treatment Institute, 5750 Center Avenue, Pittsburgh, PA 15206, USA. MarcusD@anes.upmc.edu
D006801:Humans; D008881:Migraine Disorders / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D012955:Societies, Medical