Table Of ContentMigraine in
Medicine
A Machine-Generated
Overview of Current Research
Paolo Martelletti
Editor
123
Migraine in Medicine
Paolo Martelletti
Editor
Migraine in Medicine
A Machine-Generated Overview
of Current Research
Editor
Paolo Martelletti
Department of Clinical and Molecular Medicine
Sapienza University of Rome
Rome, Italy
ISBN 978-3-030-97358-2 ISBN 978-3-030-97359-9 (eBook)
https://doi.org/10.1007/978-3-030-97359-9
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2022
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Preface
Migraine is the most important chronic non-communicable disease among people
under the age of 50.
The wide epidemiological spread of migraine, about 1 billion people suffer from
it, the various comorbidities that aggravate its burden, the clinical complications
such as drug abuse that generate secondary pathologies, together with a low level of
education in this clinical and medical area make it a real challenge for our times.
We must also consider the healthcare costs implicit in a lifelong pathology
which, starting from a genetic basis, develops towards an irreversible chronicity of
pain. Recent basic pharmacological applications of the central role of calcitonin
gene-related peptide have led to the development of new classes of drugs acting on
this molecule or its receptor. These drugs act as a preventative or acute treatment of
the attack. Among the former we can include monoclonal antibodies to CGRP,
among the latter ditans and gepants.
There is still a real educational gap between the diagnostic needs, the treatment
of these patients, and the scarce multidisciplinary expertise available. In fact,
migraine can and should be treated first by the general practitioner, then by different
specialists such as neurologists, internists, clinical pharmacologists, emergency
physicians, and gynecologists.
The aim of this book on migraine is to fill the existing gap on the unmet needs of
this brain disorder by providing an agile but comprehensive tool on the management
of this important social disease. Generally, scientific books are the product of the
collaboration of several scientists in the construction of their architecture and con-
tents. In this particular case, this building process has been entrusted to Artificial
Intelligence.
Artificial intelligence is slowly entering our culture, overcoming the natural dis-
trust towards any innovation. When we are not aware of it or find it convenient not
to be, we make full use of it, satisfying our wishes and needs, declaring in our hearts
that its help saves time and is quietly efficient.
All forms of AI in medicine have long facilitated decision-making procedures in
diagnostics, robotic surgery, and are now emerging in education and training.
v
vi Preface
Interest in the new arises when the human mind sees the possibility of an
advancement in knowledge, a systematization of knowledge, and represents an
emotionally natural drive of the human being. Research, and especially medical
research, feeds on new discoveries, new scientific evidence, but does not carry out a
risk analysis of where innovation may or may not take us, often ending up by imple-
menting the scientific mainstream of a particular sector or theme in development.
This ends up being extremely unproductive in optimizing results within large
scientific projects, which are the ones that generate big data and are useful for medi-
cal progress. Fortunately, in recent decades there has been a shift from micro-fund-
ing of research aggregating scientific evidence in consequently jeopardized
macro-sectors, to the planning of research-oriented macro-areas where funding is
concentrated to try to fit together the various data streams useful for validating the
basic hypothesis.
This second planning has a higher level of guarantee for the use of complex sci-
entific evidence, which is unfortunately still numerically redundant. Today, too
much is published in medicine, with research lines that are often excessive or com-
pletely uncoordinated.
Even in the publication of books, today operating in a continuous flow as for
scientific journals, there are few master books, textbooks, handbooks, and reference
works, which survive to the attention of the reader after a decade from their
publication.
The conception, construction, and writing of a book according to traditional
planning are of course always influenced by the scientific imprinting of the vol-
ume’s editors, and by their cultural profile.
Artificial Intelligence, in this crucial phase of book construction, helps the Editor
to select articles guided by keywords widely shared by the scientific community,
analyzing and filtering the selection window through positive barriers such as pub-
lication frames (years taken into consideration), scientific impact (IF threshold
value), diffusion (download number threshold value), and social impact (Altmetrics
threshold value). All these filters can vary from chapter to chapter according to the
profile of the scientific journal that hosted the contents, either epidemiological or
clinical, biological, therapeutical, or others.
These are the procedures applied to this new way of creating a scientific book.
In the case of this specific editorial project, more appropriately defined as
Machine-Generated Literature Overview, for intellectual property reasons only arti-
cles published by Springer Nature were used; as the publisher has more than 2500
scientific journals in its portfolio, the risk analysis is really minimal.
The human intervention of a posteriori refinement minimizes the value of the
mathematical contribution of selection made by the Artificial Intelligence by limit-
ing itself to a second step of relocation in more pertinent chapters, the elimination
of redundant replicated evidence, and the definition of data grouping. The deploy-
ment within sections and chapters follows the historical flow of guidelines, expert
opinion, review, editorial, original, case report, varying the internal number of each
chapter, depending on how flourishing the research area was in the analyzed period.
Preface vii
The added value of a book with a structure like this is that the conclusions of
each chapter are the sole responsibility of readers and the opinion they have formed
for themselves without intermediaries, re-readings, and projections by the Publisher.
To sum up:
• Methodological transparency in the selection of papers
• Minimization of the risk of bias in the logic of selection and interpretation
• Common grids in the sequential presentation of articles in each chapter
• Grouping of sequential data to facilitate analysis/synthesis by readers
Finally, as usual for the closing of a Preface, I believe that this new journey in the
land of Migraine, here intentionally defined Migraine in Medicine as evidence of
the disciplinary transversality of this area of clinical medicine, can contribute verti-
cally to the training and updating of all actors to which this book is dedicated, from
the Academy to the Research Institutions, from Hospitals to Community Medicine
up to the pillar of Territorial General Medicine.
Rome, Italy Paolo Martelletti
Contents
1 Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
3 Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 453
4 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639
5 Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 883
ix
About the Editor
Paolo Martelletti is Professor of Internal Medicine,
Department of Clinical and Molecular Medicine, and
Chair of the Residency Program in Internal Medicine at
Sapienza University of Rome. He currently serves as
Chairman of Emergency Medicine, Sant’Andrea
University Hospital, Rome, Italy.He served as President,
European Headache Federation (2016–2018); Editor-
in- Chief (Founding), The Journal of Headache and
Pain, SpringerNature (2000–present); Editor-in-Chief,
SN Comprehensive Clinical Medicine, SpringerNature
(2018–present); Editor, Handbook of Headache, Springer Verlag (2011); Series
Editor, Headache Book Series, Springer Switzerland (2015–present); Chairman
(Co-Founder), Lifting The Burden, in Official Relations with WHO (2009–2016);
Project Team Member, WHO Atlas of Headache Disorders, WHO (2011); European
Expert, European Medicine Agency (2016–present); Director, School of Advanced
Studies of the European Headache Federation (2016–present).
xi
Chapter 1
Public Health
Introduction
The assertion that primary headaches are a social disease is now out of the question,
being established both by a high prevalence rate and by the impact they produce on
the person and society. The negative loop of these premises is overturned on the
vertical economic damage they cause, another solid evidence in the scientific litera-
ture. This expansion from personal to social damage, in terms of current expendi-
ture of the national health systems, requires as a natural consequence a more
efficient organization of the health services dedicated to control, education, reha-
bilitation, to achieve social care equity. Migraine represents the perfect paradigm of
this path.
Machine-Generated Summaries
1. Public Health
Machine generated keywords: child, tth, cost, migraine patient, adolescent,
headache service, gbd, score, brain, mmd, child adolescent, erenumab, costef-
fectiveness, preventive, udh.
1.1 Epidemiology
Machine generated keywords: tth, risk, china, child, brain, risk factor, cohort, paki-
stan, prevalence headache, sex, role, city, adolescent, udh, pmoh.
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 1
P. Martelletti (ed.), Migraine in Medicine,
https://doi.org/10.1007/978-3-030-97359-9_1
