CGRP and Migraine: What Have We Learned From Measuring CGRP in Migraine Patients So Far?

The multi-functional neuropeptide calcitonin gene-related peptide (CGRP) plays a major role in the pathophysiology of migraine. The detection of elevated CGRP levels during acute migraine headache was the first evidence of the importance of the peptide. Since then, elevated CGRP levels have been detected not only during spontaneous and experimentally induced migraine attacks but also interictally. However, the detection of CGRP in peripheral blood shows conflicting results. In this respect, alternative detection methods are needed and have been already proposed. This article summarizes what we have learned from studies investigating CGRP in jugular and peripheral blood and reviews the latest state of research concerning the detection of CGRP in saliva and tear fluid as well as their contribution to our understanding of migraine pathophysiology

Cluster Headache Impact Questionnaire (CHIQ) – a short measure of cluster headache related disability

Background Cluster headache (CH) is a severe, highly disabling primary headache disorder. However, there is little research on CH-related disability, and most of it is based on non CH-specific questionnaires. The aim of this study was to develop a short, CH-specific disability questionnaire. Methods The 8-item Cluster Headache Impact Questionnaire (CHIQ) was developed based on a literature review and patient and expert interviews. The questionnaire was tested in 254 CH patients (171 males; 47.5 ± 11.4 years; 111 chronic CH, 85 active episodic CH, 52 episodic CH in remission) from our tertiary headache center or from a German support group. Results Reliability and validity of the CHIQ was evaluated in active episodic and chronic CH patients ( n = 196). Internal consistency (Cronbach’s α = 0.88) and test-retest reliability (ICC 0.91, n = 41) were good. Factor analysis identified a single factor. Convergent validity was shown by significant correlations with the Headache Impact Test (HIT-6, r = 0.58, p < 0.001), subscales of the depression, anxiety and stress scales (DASS, r = 0.46–0.62; p < 0.001) and with CH attack frequency ( r = 0.41; p < 0.001). CHIQ scores significantly differentiated between chronic CH (25.8 ± 6.5), active episodic CH (23.3 ± 6.9) and episodic CH patients in remission (13.6 ± 11.9, p < 0.05 for all 3 comparisons). Conclusions The CHIQ is a short, reliable, valid, and easy to administer measure of CH-related disability, which makes it a useful tool for clinical use and research

„Duale Weiterbildung“: Duale Studienformate als Form der Hochschulweiterbildung?

Im Kontext der Hochschulweiterbildung spielen duale Studienformatebislang eine untergeordnete Rolle. Zwar wächstdas Angebot weiterbildender dualer Masterstudiengänge, dererstaunlich hohe Anteil beruflich Qualifizierter in dualenBachelorstudiengängen deutet allerdings darauf hin, dassdiese, wenngleich formal nicht als Weiterbildung verstandenund konzipiert, auch Potentiale für die hochschulischeWeiterbildung bieten können. Die dargestellten Befundeder Studie „Mobilisierung von Bildungspotenzialen für dieMINT-Fachkräftesicherung – der Beitrag des dualen Studiums“(Wolter et al. 2014) zeigen, dass sowohl Studierende alsauch Unternehmen duale Bachelorstudiengänge zur Höherqualifizierungnach einem beruflichen Abschluss nutzen unddass Unternehmensbindung und berufliche Sicherheit dabeieine zentrale Rolle spielen

The Real-World Experiences of Persons With Multiple Sclerosis During the First COVID-19 Lockdown: Application of Natural Language Processing

BACKGROUND The increasing availability of "real-world" data in the form of written text holds promise for deepening our understanding of societal and health-related challenges. Textual data constitute a rich source of information, allowing the capture of lived experiences through a broad range of different sources of information (eg, content and emotional tone). Interviews are the "gold standard" for gaining qualitative insights into individual experiences and perspectives. However, conducting interviews on a large scale is not always feasible, and standardized quantitative assessment suitable for large-scale application may miss important information. Surveys that include open-text assessments can combine the advantages of both methods and are well suited for the application of natural language processing (NLP) methods. While innovations in NLP have made large-scale text analysis more accessible, the analysis of real-world textual data is still complex and requires several consecutive steps. OBJECTIVE We developed and subsequently examined the utility and scientific value of an NLP pipeline for extracting real-world experiences from textual data to provide guidance for applied researchers. METHODS We applied the NLP pipeline to large-scale textual data collected by the Swiss Multiple Sclerosis (MS) registry. Such textual data constitute an ideal use case for the study of real-world text data. Specifically, we examined 639 text reports on the experienced impact of the first COVID-19 lockdown from the perspectives of persons with MS. The pipeline has been implemented in Python and complemented by analyses of the "Linguistic Inquiry and Word Count" software. It consists of the following 5 interconnected analysis steps: (1) text preprocessing; (2) sentiment analysis; (3) descriptive text analysis; (4) unsupervised learning-topic modeling; and (5) results interpretation and validation. RESULTS A topic modeling analysis identified the following 4 distinct groups based on the topics participants were mainly concerned with: "contacts/communication;" "social environment;" "work;" and "errands/daily routines." Notably, the sentiment analysis revealed that the "contacts/communication" group was characterized by a pronounced negative emotional tone underlying the text reports. This observed heterogeneity in emotional tonality underlying the reported experiences of the first COVID-19-related lockdown is likely to reflect differences in emotional burden, individual circumstances, and ways of coping with the pandemic, which is in line with previous research on this matter. CONCLUSIONS This study illustrates the timely and efficient applicability of an NLP pipeline and thereby serves as a precedent for applied researchers. Our study thereby contributes to both the dissemination of NLP techniques in applied health sciences and the identification of previously unknown experiences and burdens of persons with MS during the pandemic, which may be relevant for future treatment

Excellent Response to OnabotulinumtoxinA : Different Definitions, Different Predictors

The identification of patients who can benefit the most from the available preventive treatments is important in chronic migraine. We explored the rate of excellent responders to onabotulinumtoxinA in a multicenter European study and explored the predictors of such response, according to different definitions. A pooled analysis on chronic migraineurs treated with onabotulinumtoxinA and followed-up for, at least, 9 months was performed. Excellent responders were defined either as patients with a ≥75% decrease in monthly headache days (percent-based excellent responders) or as patients with <4 monthly headache days (frequency-based excellent responders). The characteristics of excellent responders at the baseline were compared with the ones of patients with a <30% decrease in monthly headache days. Percent-based excellent responders represented about 10% of the sample, whilst frequency-based excellent responders were about 5% of the sample. Compared with non-responders, percent-based excellent responders had a higher prevalence of medication overuse and a higher excellent response rate even after the 1st and the 2nd injection. Females were less like to be frequency-based excellent responders. Chronic migraine sufferers without medication overuse and of female sex may find fewer benefits with onabotulinumtoxinA. Additionally, the excellent response status is identifiable after the first cycle

„Duale Weiterbildung“. Duale Studienformate als Form der Hochschulweiterbildung?

Im Kontext der Hochschulweiterbildung spielen duale Studienformate bislang eine untergeordnete Rolle. Zwar wächst das Angebot weiterbildender dualer Masterstudiengänge, der erstaunlich hohe Anteil beruflich Qualifizierter in dualen Bachelorstudiengängen deutet allerdings darauf hin, dass diese, wenngleich formal nicht als Weiterbildung verstanden und konzipiert, auch Potentiale für die hochschulische Weiterbildung bieten können. Die dargestellten Befunde der Studie „Mobilisierung von Bildungspotenzialen für die MINT-Fachkräftesicherung – der Beitrag des dualen Studiums“ (Wolter et al. 2014) zeigen, dass sowohl Studierende als auch Unternehmen duale Bachelorstudiengänge zur Höherqualifizierung nach einem beruflichen Abschluss nutzen und dass Unternehmensbindung und berufliche Sicherheit dabei eine zentrale Rolle spielen. (DIPF/Orig.