@article {909, title = {Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study}, journal = {Scientific Reports}, volume = {11}, year = {2021}, pages = {3846}, abstract = {
To date, two randomized, controlled studies support the use of candesartan for migraine prophylaxis but with limited external validity. We aim to evaluate the effectiveness and tolerability of candesartan in clinical practice and to explore predictors of patient response. Retrospective cohort study including all patients with migraine who received candesartan between April 2008-February 2019. The primary endpoint was the number of monthly headache days during weeks 8{\textendash}12 of treatment compared to baseline. Additionally, we evaluated the frequency during weeks 20{\textendash}24. We analysed the percentage of patients with 50\% and 75\% response rates and the retention rates after three and 6\ months of treatment. 120/4121 patients were eligible, aged 45.9 [11.5]; 100 (83.3\%) female. Eighty-four patients (70\%) had chronic migraine and 53 (42.7\%) had medication-overuse headache. The median number of prior prophylactics was 3 (Inter-quartile range 2{\textendash}5). At baseline, patients had 20.5 {\textpm} 8.5 headache days per month, decreasing 4.3 {\textpm} 8.4\ days by 3\ months (weeks 12{\textendash}16) and by 4.7 {\textpm} 8.7\ days by 6\ months (paired Student{\textquoteright}s t-test, p \< 0.001). The percentage of patients with a 50\% response was 32.5\% at 3\ months and 31.7\% at 6\ months, while the retention rate was 85.0\% and 58.3\%. The number of prior treatments (Odds ratio 0.79, 95\% CI 0.64{\textendash}0.97) and the presence of daily headache (Odds ratio 0.39, 95\% CI 0.16{\textendash}0.97) were associated with a lower probability of response. Candesartan showed beneficial effects in the preventive treatment of migraine in clinical practice, including patients with chronic migraine, medication-overuse headache and resistance to prior prophylactics.
}, issn = {2045-2322}, doi = {10.1038/s41598-021-83508-2}, url = {https://doi.org/10.1038/s41598-021-83508-2}, author = {S{\'a}nchez-Rodr{\'\i}guez, Carmen and Sierra, {\'A}lvaro and {\'A}lvaro Planchuelo-G{\'o}mez and Mart{\'\i}nez-P{\'\i}as, Enrique and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David} } @conference {939, title = {Resting-state functional alterations in patients with persistent headache after COVID-19 infection: an exploratory study}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {Objective: To evaluate resting-state functional alterations in patients with persistent headache after COVID-19 resolution.
Methods: Exploratory case-control study. Highresolution brain resting-state functional Magnetic Resonance Imaging data were acquired in patients with
persistent headache after COVID-19 infection and healthy controls (HC). CONN toolbox (version 17) was employed to assess the resting-state functional connectivity between 84 cortical and subcortical gray matter regions of interest. Significant results were considered with p \< 0.05 (Family Discovery Rate and seed-level corrected).
Results: Ten patients with persistent headache after COVID-19 (mean age: 53.8 +- 7.8 years; nine women) and 10 HC balanced for age and sex (mean age: 51.9 +- 6.6 years; nine women) were included in the study. Statistically significant higher functional connectivity was observed in the patients with persistent headache compared to HC in 10 connections. These connections were composed of an occipital region and another region that included the isthmus cingulate gyrus, a frontal or a parietal area. In the patients, significant lower functional connectivity was found in 12 connections between the cingulate and hippocampal gyri, parietal, temporal and frontal regions.
Conclusions: Patients with persistent headache after COVID-19 infection present strengthened functional connectivity with occipital regions and weakened functional connectivity between frontal, temporal and parietal regions.