Recent Advances in Craniofacial Pain and Headaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Neurobiology and Clinical Neuroscience".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 12556

Special Issue Editors


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Guest Editor
1. CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
2. Unidad de Fisioterapia, Hospital Universitario La Paz-Carlos III, IdiPAZ (Hospital La Paz Institute for Health Research), 28029 Madrid, Spain
Interests: neurosciences; pain; physiotherapy; headaches; temporomandibular disorders
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
Interests: neurosciences; pain; physiotherapy; headaches; temporomandibular disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pain is the most prevalent symptom of all and also accounts for up to 80% of the causes of access to our healthcare facilities through the emergency department. From this perspective, the field of pain should be one of the greatest challenges for healthcare providers. Among the different types of pain, craniofacial pain and headaches have proven to be highly disabling and involve very high healthcare costs.

In recent decades, the approach to both pain assessment and treatment has undergone significant changes and advances. Key to these advances has been the development of new neurophysiological models that aim to explain how pain works and how it impacts from a biopsychosocial point of view.

Specifically, this Special Issue aims to bring together new research in the field of craniofacial pain and headaches. This Special Issue welcomes original articles and reviews focused on the pathophysiological (or physiological, or neurophysiological) mechanisms of Craniofacial Pain and Headaches.

Dr. Alfonso Gil-Martínez
Dr. Ignacio Elizagaray-García
Guest Editors

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Keywords

  • craniofacial pain
  • headache
  • migraine
  • painful temporomandibular disorders
  • orofacial pain
  • biomedical advances
  • treatment
  • assessment
  • innovation

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Published Papers (7 papers)

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Research

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15 pages, 547 KiB  
Article
Hyperalgesia, Increased Temporal Summation and Impaired Inhibitory Mechanisms in Episodic and Chronic Cluster Headache: An Observational Study
by Gabriele Bertotti, Juan Ignacio Elizagaray-García, Jaime Rodríguez-Vico and Alfonso Gil-Martínez
Biomedicines 2024, 12(2), 374; https://doi.org/10.3390/biomedicines12020374 - 06 Feb 2024
Viewed by 798
Abstract
Cluster Headache (CH) is a primary headache that causes severe pain. Some evidence suggests that central mechanisms might be involved. The objective of this study was (1) to compare hyperalgesia signs, temporal summation and conditioned pain modulation among episodic (ECH) and chronic CH [...] Read more.
Cluster Headache (CH) is a primary headache that causes severe pain. Some evidence suggests that central mechanisms might be involved. The objective of this study was (1) to compare hyperalgesia signs, temporal summation and conditioned pain modulation among episodic (ECH) and chronic CH (CCH) patients and controls, (2) to compare these factors between sides in the patient groups and (3) to compare the psychophysical variables between the groups. This cross-sectional study included 71 subjects divided into three groups (ECH, CCH and controls). Pressure pain thresholds, temporal summation, conditioned pain modulation and other psychosocial variables were measured. The ANOVA showed differences for all physical outcome measures (p < 0.05). Bonferroni post hoc analyses showed differences when comparing the patient groups with the healthy subjects (p < 0.05), with large effect sizes (d > 0.8). No differences between the patient groups were found for almost all the variables (p > 0.05). Significant differences for all the variables were detected when comparing the symptomatic and non-symptomatic sides in both the ECH and CCH groups (p < 0.05). The ECH and CCH groups showed mechanical hyperalgesia, increased temporal summation and impaired inhibitory mechanisms compared to the controls. Side-to-side differences were also detected within the patient groups. Patients with CCH had poorer sleep quality and quality of life than the controls. Full article
(This article belongs to the Special Issue Recent Advances in Craniofacial Pain and Headaches)
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14 pages, 1731 KiB  
Article
Intranasal Lidocaine Administration via Mucosal Atomization Device: A Simple and Successful Treatment for Postdural Puncture Headache in Obstetric Patients
by Benedikt Hermann Siegler, Rui Pedro dos Santos Pereira, Jens Keßler, Stephanie Wallwiener, Markus Wallwiener, Jan Larmann, Susanne Picardi, Richard Carr, Markus Alexander Weigand and Beatrice Oehler
Biomedicines 2023, 11(12), 3296; https://doi.org/10.3390/biomedicines11123296 - 13 Dec 2023
Cited by 1 | Viewed by 958
Abstract
(1) Background: Postdural puncture headache (PDPH) remains a serious complication in obstetric patients. While the epidural blood patch represents the current gold standard in therapy, a growing number of alternative measures are thought to be beneficial for clinical management. The purpose of this [...] Read more.
(1) Background: Postdural puncture headache (PDPH) remains a serious complication in obstetric patients. While the epidural blood patch represents the current gold standard in therapy, a growing number of alternative measures are thought to be beneficial for clinical management. The purpose of this study was to retrospectively analyze the efficacy of intranasal lidocaine administration to treat PDPH in obstetrics at our university hospital; (2) Methods: A retrospective analysis of the medical records of patients with PDPH has been performed focusing on the techniques of administration, dosing, treatment duration, impact on pain intensity as well as side effects of intranasal lidocaine; (3) Results: During the study period, 5610 obstetric patients received neuraxial anesthesia, of whom 43 (0.77%) developed PDPH. About one third of the patients with PDPH after spinal anesthesia (n = 8), epidural anesthesia (n = 5) or both (n = 2) were treated with intranasal lidocaine. Lidocaine was administered either via gauze compresses (GC, n = 4), a mucosal atomization device (MAD, n = 8) or with a second-line mucosal atomization device due to low gauze compress efficacy (n = 3). All patients treated with lidocaine refused the epidural blood patch. Nebulization of lidocaine resulted in a significant reduction in pain intensity after the first dose (p = 0.008). No relevant side effects developed except sporadic temporal pharyngeal numbness. The utilization of the mucosal atomization device averted the necessity for an epidural blood patch, whether employed as the primary or secondary approach; (4) Conclusions: Our data imply that the mucosal atomization device enhances the efficacy of intranasal lidocaine administration in obstetric patients suffering from PDPH. Full article
(This article belongs to the Special Issue Recent Advances in Craniofacial Pain and Headaches)
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11 pages, 406 KiB  
Article
Headache Prevalence and Its Associated Factors in Makkah, Saudi Arabia
by Maram H. Alshareef and Bayan Hashim Alsharif
Biomedicines 2023, 11(10), 2853; https://doi.org/10.3390/biomedicines11102853 - 20 Oct 2023
Cited by 1 | Viewed by 1248
Abstract
Primary headaches are more prevalent and associated with several risk factors, such as chronic diseases, unhealthy lifestyles, smoking, caffeine intake, work, and stress. However, these factors are not associated with specific headache disorders. We investigated the prevalence of primary headache disorders and the [...] Read more.
Primary headaches are more prevalent and associated with several risk factors, such as chronic diseases, unhealthy lifestyles, smoking, caffeine intake, work, and stress. However, these factors are not associated with specific headache disorders. We investigated the prevalence of primary headache disorders and the associated risk factors in Makkah. This cross-sectional study, conducted over a 6-month period, used an anonymous survey disseminated through online platforms. The questionnaire was a modified version of a validated questionnaire used to assess headaches in relation to modifiable and non-modifiable risk factors. In total, 1177 participants aged 18–65 (mean, 31.5 ± 12.6) years were included. Headaches were diagnosed among 44.2% of participants aged 20–59 years, with a high prevalence among young adults; additionally, 71.5% of participants with headaches reported experiencing headaches for <15 days per month. Chronic headaches were found in 28.5% of participants. Age, chronic diseases, work, caffeine consumption, and smoking were associated with having a significant effect on headache prevalence. The prevalence of headaches in Makkah has increased in comparison to that reported in previous studies. Certain modifiable and non-modifiable risk factors have been associated with headaches. Headaches impact all life aspects of individuals and communities. An educational program for professionals and patients can improve patient outcomes. Full article
(This article belongs to the Special Issue Recent Advances in Craniofacial Pain and Headaches)
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9 pages, 605 KiB  
Article
Potentially Inappropriate Use of Opioids in the Management of Migraine in Colombia
by Manuel E. Machado-Duque, Maria Fernanda Echeverry-Gutiérrez, Andrés Gaviria-Mendoza, Luis F. Valladales-Restrepo and Jorge E. Machado-Alba
Biomedicines 2023, 11(9), 2385; https://doi.org/10.3390/biomedicines11092385 - 25 Aug 2023
Cited by 1 | Viewed by 1428
Abstract
Research objective: To identify the frequency of opioid use in a group of patients diagnosed with migraine in Colombia. Methods: Study of a retrospective cohort of patients with a diagnosis of migraine and a first prescription of antimigraine drugs from emergency services and [...] Read more.
Research objective: To identify the frequency of opioid use in a group of patients diagnosed with migraine in Colombia. Methods: Study of a retrospective cohort of patients with a diagnosis of migraine and a first prescription of antimigraine drugs from emergency services and a priority outpatient clinic. Sociodemographic, clinical, and pharmacological variables were identified; a 12-month follow-up was carried out to identify the use of a new opioid. Results: A total of 6309 patients with a diagnosis of migraine were identified, with a mean age of 35.5 ± 12.3 years, of which 81.3% were women. Nonsteroidal anti-inflammatory drugs (51.1%) were the most frequently prescribed medications, followed by ergotamine + caffeine (31.3%), acetaminophen (15.05%), and acetaminophen + codeine (14.4%). At the time of the index, 1300 (20.6%) patients received some opioid. During the follow-up, a total of 1437 (22.8%) patients received a new opioid, of which 31.8% belonged to the group that received an initial opioid and 20.4% to the group that did not receive one, which was statistically significant (OR:1.81; 95%CI:1.58–2.07; p < 0.001). Conclusions: The frequent use of opioids in the management of migraines is potentially inappropriate and can lead to problems of tolerance, abuse and dependence. This combined with the low prescription of triptans, offers an opportunity for improvements in medical practice. Full article
(This article belongs to the Special Issue Recent Advances in Craniofacial Pain and Headaches)
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Review

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32 pages, 405 KiB  
Review
Neuromodulation for Craniofacial Pain and Headaches
by Ray J. Pak, Jun B. Ku and Alaa Abd-Elsayed
Biomedicines 2023, 11(12), 3328; https://doi.org/10.3390/biomedicines11123328 - 16 Dec 2023
Viewed by 957
Abstract
Headaches and facial pain are highly prevalent diseases but are often difficult to treat. Though there have been significant advances in medical management, many continue to suffer from refractory pain. Neuromodulation has been gaining interest for its therapeutic purposes in many chronic pain [...] Read more.
Headaches and facial pain are highly prevalent diseases but are often difficult to treat. Though there have been significant advances in medical management, many continue to suffer from refractory pain. Neuromodulation has been gaining interest for its therapeutic purposes in many chronic pain conditions, including headaches and facial pain. There are many potential targets of neuromodulation for headache and facial pain, and some have more robust evidence in favor of their use than others. Despite the need for more high-quality research, the available evidence for the use of neuromodulation in treating headaches and facial pain is promising. Considering the suffering that afflicts patients with intractable headache, neuromodulation may be an appropriate tool to improve not only pain but also disability and quality of life. Full article
(This article belongs to the Special Issue Recent Advances in Craniofacial Pain and Headaches)
27 pages, 3722 KiB  
Review
Unveiling the Role of Contingent Negative Variation (CNV) in Migraine: A Review of Electrophysiological Studies in Adults and Children
by María E. de Lahoz, Paloma Barjola, Irene Peláez, David Ferrera, Roberto Fernandes-Magalhaes and Francisco Mercado
Biomedicines 2023, 11(11), 3030; https://doi.org/10.3390/biomedicines11113030 - 11 Nov 2023
Viewed by 930
Abstract
Migraine has been considered a chronic neuronal-based pain disorder characterized by the presence of cortical hyperexcitability. The Contingent Negative Variation (CNV) is the most explored electrophysiological index in migraine. However, the findings show inconsistencies regarding its functional significance. To address this, we conducted [...] Read more.
Migraine has been considered a chronic neuronal-based pain disorder characterized by the presence of cortical hyperexcitability. The Contingent Negative Variation (CNV) is the most explored electrophysiological index in migraine. However, the findings show inconsistencies regarding its functional significance. To address this, we conducted a review in both adults and children with migraine without aura to gain a deeper understanding of it and to derive clinical implications. The literature search was conducted in the PubMed, SCOPUS and PsycINFO databases until September 2022m and 34 articles were retrieved and considered relevant for further analysis. The main results in adults showed higher CNV amplitudes (with no habituation) in migraine patients. Electrophysiological abnormalities, particularly focused on the early CNV subcomponent (eCNV), were especially prominent a few days before the onset of a migraine attack, normalizing during and after the attack. We also explored various modulatory factors, including pharmacological treatments—CNV amplitude was lower after the intake of drugs targeting neural hyperexcitability—and other factors such as psychological, hormonal or genetic/familial influences on CNV. Although similar patterns were found in children, the evidence is particularly scarce and less consistent, likely due to the brain’s maturation process during childhood. As the first review exploring the relationship between CNV and migraine, this study supports the role of the CNV as a potential neural marker for migraine pathophysiology and the prediction of pain attacks. The importance of further exploring the relationship between this neurophysiological index and childhood migraine is critical for identifying potential therapeutic targets for managing migraine symptoms during its development. Full article
(This article belongs to the Special Issue Recent Advances in Craniofacial Pain and Headaches)
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12 pages, 744 KiB  
Review
Novel Therapeutic Targets for Migraine
by Areeba Nisar, Zubair Ahmed and Hsiangkuo Yuan
Biomedicines 2023, 11(2), 569; https://doi.org/10.3390/biomedicines11020569 - 15 Feb 2023
Cited by 6 | Viewed by 5342
Abstract
Migraine, a primary headache disorder involving a dysfunctional trigeminal vascular system, remains a major debilitating neurological condition impacting many patients’ quality of life. Despite the success of multiple new migraine therapies, not all patients achieve significant clinical benefits. The success of CGRP pathway-targeted [...] Read more.
Migraine, a primary headache disorder involving a dysfunctional trigeminal vascular system, remains a major debilitating neurological condition impacting many patients’ quality of life. Despite the success of multiple new migraine therapies, not all patients achieve significant clinical benefits. The success of CGRP pathway-targeted therapy highlights the importance of translating the mechanistic understanding toward effective therapy. Ongoing research has identified multiple potential mechanisms in migraine signaling and nociception. In this narrative review, we discuss several potential emerging therapeutic targets, including pituitary adenylate cyclase-activating polypeptide (PACAP), adenosine, δ-opioid receptor (DOR), potassium channels, transient receptor potential ion channels (TRP), and acid-sensing ion channels (ASIC). A better understanding of these mechanisms facilitates the discovery of novel therapeutic targets and provides more treatment options for improved clinical care. Full article
(This article belongs to the Special Issue Recent Advances in Craniofacial Pain and Headaches)
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