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Rosignoli C, Ornello R, Onofri A, Caponnetto V, Grazzi L, Raggi A, Leonardi M, Sacco S. Applying a biopsychosocial model to migraine: rationale and clinical implications. J Headache Pain 2022; 23:100. [PMID: 35953769 PMCID: PMC9367111 DOI: 10.1186/s10194-022-01471-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/02/2022] [Indexed: 12/23/2022] Open
Abstract
Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.
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Affiliation(s)
- Chiara Rosignoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Ornello
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Agnese Onofri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Caponnetto
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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Dell’Isola GB, Tulli E, Sica R, Vinti V, Mencaroni E, Di Cara G, Striano P, Verrotti A. The Vitamin D Role in Preventing Primary Headache in Adult and Pediatric Population. J Clin Med 2021; 10:jcm10245983. [PMID: 34945279 PMCID: PMC8709239 DOI: 10.3390/jcm10245983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022] Open
Abstract
Headache is among the main neurological disorders with a great impact on both adults and children. The diagnosis of primary headache and proper management is often delayed with a great impact on work productivity and overall quality of life. Chronic headache often requires prophylactic therapy to reduce the frequency and severity of the attacks and the use of abortive medications. Besides the use of several classes of drugs, another treatment modality is the use of Nutraceuticals. Some studies have suggested a possible role of vitamin D in headache prophylaxis. Indeed, vitamin D is involved in several pathways of brain development, neuroprotection and neurotransmission. Moreover, there is data suggesting a close relationship between primary headache and vitamin D deficiency, both in children and in adults. To date, a few studies have evaluated the effect of vitamin D on headaches. The aim of this review is to summarize the data collected on headache prophylaxis with vitamin D comparing the effects of vitamin D in pediatric and adult populations.
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Affiliation(s)
- Giovanni Battista Dell’Isola
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy; (E.T.); (R.S.); (V.V.); (E.M.); (G.D.C.); (A.V.)
- Correspondence:
| | - Eleonora Tulli
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy; (E.T.); (R.S.); (V.V.); (E.M.); (G.D.C.); (A.V.)
| | - Rossella Sica
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy; (E.T.); (R.S.); (V.V.); (E.M.); (G.D.C.); (A.V.)
| | - Valerio Vinti
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy; (E.T.); (R.S.); (V.V.); (E.M.); (G.D.C.); (A.V.)
| | - Elisabetta Mencaroni
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy; (E.T.); (R.S.); (V.V.); (E.M.); (G.D.C.); (A.V.)
| | - Giuseppe Di Cara
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy; (E.T.); (R.S.); (V.V.); (E.M.); (G.D.C.); (A.V.)
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, IRCCS “G. Gaslini” Institute, Gerolamo Gaslini Street, 5, 16147 Genoa, Italy;
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Paolo Daneo Square, 3, 16132 Genoa, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy; (E.T.); (R.S.); (V.V.); (E.M.); (G.D.C.); (A.V.)
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