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Affatato O, Moulin TC, Pisanu C, Babasieva VS, Russo M, Aydinlar EI, Torelli P, Chubarev VN, Tarasov VV, Schiöth HB, Mwinyi J. High efficacy of onabotulinumtoxinA treatment in patients with comorbid migraine and depression: a meta-analysis. J Transl Med 2021; 19:133. [PMID: 33789668 PMCID: PMC8011097 DOI: 10.1186/s12967-021-02801-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/19/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Migraine and depression are highly prevalent and partly overlapping disorders that cause strong limitations in daily life. Patients tend to respond poorly to the therapies available for these diseases. OnabotulinumtoxinA has been proven to be an effective treatment for both migraine and depression. While many studies have addressed the effect of onabotulinumtoxinA in migraine or depression separately, a growing body of evidence suggests beneficial effects also for patients comorbid with migraine and depression. The current meta-analysis systematically investigates to what extent onabotulinumtoxinA is efficient in migraineurs with depression. METHODS A systematic literature search was performed based on PubMed, Scopus and Web of Science from the earliest date till October [Formula: see text], 2020. Mean, standard deviation (SD) and sample size have been used to evaluate improvement in depressive symptoms and migraine using random-effects empirical Bayes model. RESULTS Our search retrieved 259 studies, eight of which met the inclusion criteria. OnabotulinumtoxinA injections administered to patients with both chronic migraine and major depressive disorder led to mean reduction of [Formula: see text] points (CI [[Formula: see text]], [Formula: see text]) in the BDI scale, of [Formula: see text] points (CI [[Formula: see text]], [Formula: see text]) in the BDI-II scale and of [Formula: see text] points (CI [[Formula: see text]], [Formula: see text]) in the PHQ-9 scale, when evaluating depressive symptoms. In the case of the migraine-related symptoms, we found mean reductions of [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) points in the HIT6 scale, [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) in the MIDAS scale, [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) points in the VAS scale and of [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) migraine episodes per month. Comorbid patients showed slightly better improvements in BDI, HIT6 scores and migraine frequency compared to monomorbid patients. The latter group manifested better results in MIDAS and VAS scores. CONCLUSION Treatment with onabotulinumtoxinA leads to a significant reduction of disease severity of both chronic migraine and major depressive disorder in patients comorbid with both diseases. Comparative analyses suggest an equivalent strong effect in monomorbid and comorbid patients, with beneficial effects specifically seen for certain migraine features.
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Affiliation(s)
- Oreste Affatato
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.
| | - Thiago C Moulin
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
| | - Claudia Pisanu
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.,Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Victoria S Babasieva
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Marco Russo
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Elif I Aydinlar
- Department of Neurology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Paola Torelli
- Headache Centre, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Vladimir N Chubarev
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vadim V Tarasov
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.,Institute for Translational Medicine and Biothechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Helgi B Schiöth
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.,Institute for Translational Medicine and Biothechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jessica Mwinyi
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
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Elmaci I, Altinoz MA, Sari R, Syed HR, Aydinlar EI, Kahraman S, Jean WC. Shall elective neurosurgical patients be postponed during a pandemic? Lessons from the peak period of COVID-19 pandemic. J Neurosurg Sci 2020; 65:460-461. [PMID: 33320470 DOI: 10.23736/s0390-5616.20.05230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Ilhan Elmaci
- Department of Neurosurgery, Acibadem M.A.A. University, Acibadem Maslak Hospital, Istanbul, Turkey -
| | - Meric A Altinoz
- Department of Biochemistry, Acibadem M.A.A. University, Istanbul, Turkey
| | - Ramazan Sari
- Department of Neurosurgery, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Hasan R Syed
- Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA.,Global Brainsurgery Initiative, Washington DC, USA
| | - Elif I Aydinlar
- Department of Neurology, Acibadem M.A.A. University, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Sibel Kahraman
- Department of Anesthesiology, Acibadem M.A.A. University, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Walter C Jean
- Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA.,Department of Neurological Surgery, George Washington University, Washington DC, USA
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