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Scientists search for a safe, non-addictive pain killer

Scientists working to find a safe, non-addictive pain killer to help fight the current opioid crisis in this country.

With the support of the National Institute on Drug Abuse, scientists at Wake Forest School of Medicine have been working to find a safe, non-addictive pain killer to help fight the current opioid crisis in this country. And they may have done just that, though in an animal model. Known as AT-121, the new chemical compound has dual therapeutic action that suppressed the addictive effects of opioids and produced morphine-like analgesic effects in non-human primates.

“In our study, we found AT-121 to be safe and non-addictive, as well as an effective pain medication,” said Mei-Chuan Ko, Ph.D., professor of physiology and pharmacology at the School of Medicine, part of Wake Forest Baptist Medical Center. “In addition, this compound also was effective at blocking abuse potential of prescription opioids, much like buprenorphine does for heroin, so we hope it could be used to treat pain and opioid abuse.”

The findings are published in the Aug. 29 issue of the journal Science Translational Medicine. The main objective of this study was to design and test a chemical compound that would work on both the mu opioid receptor, the main component in the most effective prescription pain killers, and the nociceptin receptor, which opposes or blocks the abuse and dependence-related side effects of mu-targeted opioids. Current opioid pain drugs, such as fentanyl and oxycodone, work only on the mu opioid receptor, which also produces unwanted side effects — respiratory depression, abuse potential, increased sensitivity to pain and physical dependence.

“We developed AT-121 that combines both activities in an appropriate balance in one single molecule, which we think is a better pharmaceutical strategy than to have two drugs to be used in combination,” Ko said. In the study, the researchers observed that AT-121 showed the same level of pain relief as an opioid, but at a 100-times lower dose than morphine. At that dose, it also blunted the addictive effects of oxycodone, a commonly abused prescription drug. The bifunctional profile of AT-121 not only gave effective pain relief without abuse potential, it also lacked other opioid side-effects that patients typically struggle with, such as itch, respiratory depression, tolerance and dependence.

“Our data shows that targeting the nociceptin opioid receptor not only dialed down the addictive and other side-effects, it provided effective pain relief,” Ko said. “The fact that this data was in nonhuman primates, a closely related species to humans, was also significant because it showed that compounds, such as AT-121, have the translational potential to be a viable opioid alternative or replacement for prescription opioids.” Next steps include conducting additional preclinical studies to collect more safety data, and then if all goes well, applying to the Food and Drug Administration for approval to begin clinical trials in people, Ko said. AT-121 was developed by Nurulain T. Zaveri, Ph.D., a member of the research team at Astraea Therapeutics.

The work was supported by grants from the National Institutes of Health, National Institute on Drug Abuse R01DA032568, R01DA027811, R44DA042465, R21DA040104, and R21DA044775, and the U.S. Department of Defense W81XWH-13-2-0045.

Read this article on ScienceDaily: Wake Forest Baptist Medical Center. “Scientists take big step toward finding non-addictive painkiller.” ScienceDaily. ScienceDaily, 29 August 2018. www.sciencedaily.com/releases/2018/08/180829143821.htm.

Chronic pain conditions exacerbated by arguments with spouse

A fight with a spouse may end in hurt feelings, but for those with chronic conditions like arthritis or diabetes, those arguments may have physical repercussions as well, according to researchers.

They found that in two groups of older individuals — one group with arthritis and one with diabetes — the patients who felt more tension with their spouse also reported worse symptoms on those days.

“It was exciting that we were able to see this association in two different data sets — two groups of people with two different diseases,” said Lynn Martire, professor of human development and family studies, Penn State Center for Healthy Aging. “The findings gave us insight into how marriage might affect health, which is important for people dealing with chronic conditions like arthritis or diabetes.”

Martire said it’s important to learn more about how and why symptoms of chronic disease worsen. People with osteoarthritis in their knees who experience greater pain become disabled quicker, and people with diabetes that isn’t controlled have a greater risk for developing complications.

The researchers said that while previous research has shown a connection between satisfying marriages and better health, both physically and psychologically, there’s been a lack of research into how day-to-day experiences impact those with chronic illness.

“We study chronic illnesses, which usually involve daily symptoms or fluctuations in symptoms,” Martire said. “Other studies have looked at the quality of someone’s marriage right now. But we wanted to drill down and examine how positive or negative interactions with your spouse affect your health from day to day.”

Data from two groups of participants were used for the study. One group was comprised of 145 patients with osteoarthritis in the knee and their spouses. The other included 129 patients with type 2 diabetes and their spouses.

Participants in both groups kept daily diaries about their mood, how severe their symptoms were, and whether their interactions with their spouse were positive or negative. The participants in the arthritis and diabetes groups kept their diaries for 22 and 24 days, respectively.

The researchers found that within both groups of participants, patients were in a worse mood on days when they felt more tension than usual with their spouse, which in turn led to greater pain or severity of symptoms.

Additionally, the researchers found that within the group with arthritis, the severity of the patient’s pain also had an effect on tensions with their spouse the following day. When they had greater pain, they were in a worse mood and had greater tension with their partner the next day.

“This almost starts to suggest a cycle where your marital interactions are more tense, you feel like your symptoms are more severe, and the next day you have more marital tension again,” Martire said. “We didn’t find this effect in the participants with diabetes, which may just be due to differences in the two diseases.”

Martire said the results — recently published in the journal Annals of Behavioral Medicine — could potentially help create interventions targeted at helping couples with chronic diseases.

“We usually focus on illness-specific communications, but looking at tension in a marriage isn’t tied to the disease, it’s not a symptom of the disease itself,” Martire said. “It’s a measure you can get from any couple. It suggests to me that looking beyond the illness, to improve the overall quality of the relationship might have some impact on health.”


Read this article on Science Daily: “Love hurts: Spats with spouse may worsen chronic pain, other symptoms.” ScienceDaily. ScienceDaily, 15 May 2018. www.sciencedaily.com/releases/2018/05/180515131553.htm.


At Summit Pain Alliance we provide individualized pain management for a pain-free life. For more information and to schedule an appointment call (707) 623-9803.

Clinical Research Department; exciting news for this month


AUGUST 2018 – NEWSLETTER – Summit Pain Alliance

This month is full with exciting new projects. Sadly we have to say good bye to one of our providers but we won’t let this slow us down in our efforts of keep offering our patients with the latest technology and advances in pain management. Here at Summit Pain Alliance, we are honored to participate in the development of the most innovative treatments and practices to better serve our patients.

Current studies status:

  • Flowonix-Prometra: Active but not enrolling, we have 4 participants remaining in this study.
  • Saluda- Evoke: active but not enrolling, we have 4 participants in this study.
  • Nevro-Tap10: active and open for enrollment, we recently submitted an abstract for the North American
    Neuromodulation Society ( NANS) annual meeting with the preliminary data of our first 5 patients.
  • Enso: active with enrollment on hold.

Hormones may be responsible for migraines in women

Research published today reveals a potential mechanism for migraine causation which could explain why women get more migraines than men. The study, in Frontiers in Molecular Biosciences, suggests that sex hormones affect cells around the trigeminal nerve and connected blood vessels in the head, with estrogens — at their highest levels in women of reproductive age — being particularly important for sensitizing these cells to migraine triggers. The finding provides scientists with a promising new route to personalized treatments for migraine patients.

“We can observe significant differences in our experimental migraine model between males and females and are trying to understand the molecular correlates responsible for these differences,” explains Professor Antonio Ferrer-Montiel from the Universitas Miguel Hernández, Spain. “Although this is a complex process, we believe that modulation of the trigeminovascular system by sex hormones plays an important role that has not been properly addressed.”

Ferrer-Montiel and his team reviewed decades of literature on sex hormones, migraine sensitivity and cells’ responses to migraine triggers to identify the role of specific hormones. Some (like testosterone) seem to protect against migraines, while others (like prolactin) appear to make migraines worse. They do this by making the cells’ ion channels, which control the cells’ reactions to outside stimuli, more or less vulnerable to migraine triggers.

Some hormones need much more research to determine their role. However, estrogen stands out as a key candidate for understanding migraine occurrence. It was first identified as a factor by the greater prevalence of migraine in menstruating women and the association of some types of migraine with period-related changes in hormone levels. The research team’s evidence now suggests that estrogen and changes in estrogen levels sensitize cells around the trigeminal nerve to stimuli. That makes it easier to trigger a migraine attack.

However, Ferrer-Montiel cautions that their work is preliminary. The role of estrogen and other hormones in migraine is complex and much more research is needed to understand it. The authors emphasize the need for longitudinal studies focusing on the relationship between menstrual hormones and migraines. Their current work relies on in vitro and animal models, which aren’t easy to translate to human migraine sufferers.

Nonetheless, Ferrer-Montiel and his colleagues see a promising future for migraine medication in their current findings. They intend to continue their research using pre-clinical, human-based models which better reflect real patients.

“If successful, we will contribute to better personalized medicine for migraine therapy,” he says.

The research is part of a special article collection on cell membrane proteins as targets for drugs.

Read this article on Science Daily:  “Why do women get more migraines? Estrogen and other sex hormones may be responsible for the higher prevalence of migraine in women.” ScienceDaily. ScienceDaily, 14 August 2018. <www.sciencedaily.com/releases/2018/08/180814075932.htm>.


At Summit Pain Alliance we provide individualized pain management for a pain-free life. For more information and to schedule an appointment call (707) 623-9803.

Dr. Yang Interview Excerpt – Focus on Inflammation

The word inflammation comes from the Latin word inflammationem, which means “a setting on fire.” Certainly anyone who has experienced the feelings of heat, redness, swelling, pain and burning that makes the origin of this word an accurate description. But what exactly is inflammation and how can it hurt—as well as help—your body?

At its most basic definition, inflammation is the body’s natural reaction to an injury or infection—its attempt to heal itself. So, while we generally have negative connotations to the word, we are nevertheless fortunate that the body has this built-in immune system in place to recognize damaged cells, irritants and pathogens to heal an injury or fight an infection. Though inflammation may be uncomfortable, it is the body’s biological response to remove a harmful affect on the body. Without it, infections, wounds, and other damage to tissue couldn’t heal.

“Inflammation overall is an immune response,” says Kim Kulp, registered dietician at Santa Rosa Memorial Hospital. “It’s your body’s way of trying to fix any foreign invader, or some damage to the body,” adds Kulp, who is also the owner of her own private practice, Health Tastes Great, seeing patients in both Novato and Mill Valley.

Generally, once the injury or infection is healed, the inflammation should stop. This normal process is usually identified as acute inflammation. However, when inflammation does not dissipate, but lingers in the body long term it becomes chronic inflammation and can lead to a variety of other diseases.

“Acute and chronic [inflammation] is just a descriptor of the chronicity, or the time, that the inflammation has taken place in your body,” says Michael Yang, M.D., Santa Rosa-based Summit Pain Alliance, a leader in pain management in Northern California, which provides cutting edge technologies, pain management therapies, and advancements in pain relief, both acute and chronic. “Generally, in the field of pain management, we demarcate that at about six months. It’s not an exact science, but we have to draw the line somewhere, so it’s generally accepted that anything beyond six months is considered chronic pain. Inflammation is exactly that. So, if you’ve had an inflammatory response in a certain body part and if it’s been there longer than six months, it’s considered chronic.”

A silent precursor to disease

Unfortunately, chronic inflammation is not only uncomfortable or painful, but more and more research shows a link to a variety of diseases. According to Harvard Medical School, “…research on inflammation has created a shift in medical thinking. For two millennia, it has been viewed mainly as a necessary, even beneficial, response to illness or injury. But now both observational studies and laboratory research are indicating that inflammation can be more of a bane than boon, the common, causative factor in many diseases.” Research now shows inflammation may be a common underlying cause of many major degenerative diseases, including coronary artery disease, diabetes, cancer and Alzheimer’s.

“Inflammation itself can be harmful to the body, even though it’s the body’s way of bringing in the healing factors,” says Yang. “If it’s chronic and it’s constantly bringing in these inflammatory cytokines that cause swelling and redness and pain, all of that is just the body trying to heal itself. But if it’s there on a chronic basis, that in itself can also cause deterioration. In medical terms, anything with –itis at the end of it means inflammation of whatever is in that base word. So, arthritis is inflammation of the joints, appendicitis is inflammation of the appendix, and bronchitis is inflammation of the bronchials. But of course, chronic bronchitis is terrible for you and arthritis—as it gets worse—causes giant swollen joints, which can cause terrible deformities. Chronic inflammation can cause a lot of damage to your body.”

Alarmingly, some inflammation that occurs deep inside the body, such as in an internal organ where there may not be any sensory nerve endings, may not have any visible or noticeable signs that make it immediately obvious what is happening in the body.

“Eventually something will go wrong,” warns Kulp. “You’re not going to be feeling well, or there will be more fatigue, or you might have some symptoms of these diseases. There isn’t just one sign of inflammation.”

Other symptoms that may eventually become present include abdominal or chest pain, fever, joint pain, or a rash, but some of these indicators can seem mild enough to not necessarily seek medical attention. However, today there are certain blood tests that show if an inflammatory process is going on.

“There are parts of the body that have little sensation,” says Yang. “You can have inflammation that is just circulating in the blood stream. You can have inflammation of your bowels, like irritable bowel syndrome and chronic ulcerative colitis—those are bowel inflammations that can wreak havoc on the body, but you don’t feel it until you have a stomach cramp. But the inflammation is there all the time.”

Read entire article on Northbay Biz

Study examines knee pain and impaired knee function relate to depression

In the U.S., about 13 percent of women and 10 percent of men aged 60 or older have knee pain due to osteoarthritis (OA). Osteoarthritis occurs when a joint becomes inflamed, usually because the protective cartilage and other tissues that cushion joints like the knee become damaged and worn over time. Knee pain from OA can make it harder to take care of yourself, which can damage your quality of life. In turn, that can lead to depression.

According to researchers, knee OA affects some 55 percent of people over age 40 in Japan. A research team from the country recently published a study in the Journal of the American Geriatrics Society examining the effects of knee pain on depression since, until now, few studies have focused on how knee pain and impaired knee function relate to depression.


To learn more, the researchers examined information from 573 people aged 65 or older who participated in the Kurabuchi Study, an ongoing look at the health of older adults living in central Japan.

When the study began (between 2005 and 2006) none of the participants had symptoms of depression. Two years later, nearly all of them completed follow-up interviews. The participants answered questions about their knee pain and were evaluated for symptoms of depression.

Nearly 12 percent of the participants had developed symptoms of depression. People who experienced knee pain at night while in bed, while putting on socks, or while getting in or out of a car were more likely to report having symptoms of depression, noted the researchers.

The researchers concluded that asking older adults with knee pain whether they have pain at night in bed, when putting on socks, or while getting in or out of a car could be useful for helping to screen people at risk for developing depression.

Read this article on Science Daily: American Geriatrics Society. “Is knee pain linked to depression?.” ScienceDaily. ScienceDaily, 23 March 2018. www.sciencedaily.com/releases/2018/03/180323121750.htm.

At Summit Pain Alliance we provide individualized pain management for a pain-free life. For more information and to schedule an appointment call (707) 623-9803.


Researchers discover a novel use of illusion to alter knee pain

In a new study published in the journal Peer J this week, researchers at UniSA’s Body in Mind Research Group have found people suffering osteoarthritis in the knees reported reduced pain when exposed to visual illusions that altered the size of their knees.

UniSA researcher and NHMRC Career Development Fellow, Dr Tasha Stanton says the research combined visual illusions and touch, with participants reporting up to a 40 per cent decrease in pain when presented with an illusion of the knee and lower leg elongated.

“We also found that the pain reduction was optimal when the illusion was repeated numerous times — that is, its analgesic effect was cumulative,” Dr Stanton says.

The small study — 12 participants — focused on people over 50 years with knee pain, and a clinical diagnosis of osteoarthritis.

Dr Stanton says the research provides “proof of concept” support that visual illusions can play a powerful role in reducing pain.

“We have shown that pain is reduced significantly when a visual stimulus, in this case a smaller or an elongated joint, is provided, but not only that, when exposed to that illusion repeatedly, pain decreases even further,” she says.

“It seems that seeing is believing, and by understanding the neurological processes at work we may be able to ease pain more effectively for people with chronic conditions, reduce their reliance on medications and find alternative physical therapies to help manage conditions like osteoarthritis.

“This research adds to a growing body of evidence that the pain experienced in osteoarthritis is not just about damage to the joint.

“There are other factors at play and the more we understand about these natural mechanisms for reducing pain and how they are triggered, the more opportunity we have to develop a range of treatments to manage chronic conditions.”


Read this article on ScienceDaily: University of South Australia. “Visual illusion proves effective in relieving knee pain for people with osteoarthritis.” ScienceDaily. ScienceDaily, 18 July 2018. www.sciencedaily.com/releases/2018/07/180718092451.htm.

Injured athletes improve pain tolerance and awareness with meditation

A new study of injured athletes carried out by the University of Kent found they can benefit from using mindfulness as part of the sport rehabilitation process to improve their pain tolerance and awareness. The research, carried out by Dr Warhel Asim Mohammed and Dr Athanasios Pappous (School of Sport and Exercise Sciences) and Dr Dinkar Sharma (School of Psychology) could have major implications in the treatment of sporting injuries at all levels.

Every year there are 29.7 million injuries among athletes in the UK. These have both psychological and physiological effects on athletes and for some it may mean the end of a career in sport.

To understand if mindfulness could play a part in the rehabilitation process of injuries, the researchers conducted tests on 20 athletes (14 male, six female), aged from 21-36 years who had severe injuries, preventing their participation in sport for more than three months.

Both groups followed their normal physiotherapy treatment but, in addition, the intervention group practised mindfulness meditation in one 90-min session per week for eight weeks.

A Cold Pressor Test (CPT) was used to assess pain tolerance. In contrast, the perception of pain was measured using a Visual Analogue Scale. Other measurements used were the Mindful Attention Awareness Scale (MAAS), Depression Anxiety and Stress Scale (DASS), and Profile of Mood States (POMS).

Results demonstrated an increase in pain tolerance for the intervention group and an increase in mindful awareness for injured athletes. Moreover, there was a promising change in positive mood for both groups. Regarding the Stress/Anxiety scores, findings showed a notable decrease across sessions.

The study used a common meditation technique, based on Mindfulness-Based Stress Reduction (MBSR), as an intervention for utilisation during the recovery period of injured athletes — this is the first study using MBSR as an intervention for this purpose.

The aim of this research was to investigate the role of MBSR practise in reducing the perception of pain and anxiety/stress and increasing pain tolerance and mindfulness. Additionally, the aim was to increase positive mood and decrease negative mood in injured athletes.

Sport injuries are a considerable public health concern. The impact of the injured athlete extends beyond the individual. Although it may impact on their seasonal and potential career performance, it additionally impacts upon the clubs and organisations for whom they perform. Furthermore, it leads to a greater general burden on the health service.

Further research is required to assess whether increasing pain tolerance could help in the therapeutic process.


 

Read this article on Science Daily: University of Kent. “Mindfulness helps injured athletes improve pain tolerance and awareness.” ScienceDaily. ScienceDaily, 26 June 2018. www.sciencedaily.com/releases/2018/06/180626113350.htm.


At Summit Pain Alliance we provide individualized pain management for a pain-free life. For more information and to schedule an appointment call (707) 623-9803.

How ending opioid treatment for chronic pain is helping patients

Stopping long-term opioid treatment does not make chronic, non-cancer-related pain worse and, in some cases, makes it better, Washington State University researchers have found.

The research marks a crucial first step towards understanding how ending long-term opioid therapy affects patients with different types of chronic pain and could help medical practitioners identify effective, alternative treatments to opioids.

“On average, pain did not become worse among patients in our study a year after discontinuing long-term opioid therapy,” said Sterling McPherson, associate professor and director for biostatistics and clinical trial design at the WSU Elson F. Floyd College of Medicine. “If anything, their pain improved slightly, particularly among patients with mild to moderate pain just after discontinuation. Clinicians might consider these findings when discussing the risks and benefits of long-term opioid therapy as compared to other, non-opioid treatments for chronic pain.”

In the study

McPherson and colleagues at the Veteran Affairs Portland Health Care System and the Oregon Health & Science University used survey responses from 551 VA patients who had been on long-term opioid therapy for chronic, non-cancer-related pain for at least a year before discontinuing the medication.

Eighty-seven percent of the patients were diagnosed with chronic musculoskeletal pain, 6 percent with neuropathic pain, and 11 percent with headache pain, including migraines.

Survey subjects rated their pain over two years, scoring it on a scale of 0-10 where 0 equals no pain and 10 equals the worst possible pain. The researchers used biostatistical analysis and computer modeling to characterize changes in pain intensity 12 months before the patients ended opioid therapy and the 12 months after.

While patients differed widely in the intensity of pain they experienced before and after stopping opioids, as a whole, their pain did not get worse and remained similar or slightly improved.

“Our results indicate that long term opioid therapy does not effectively manage patient pain intensity any more effectively than not receiving long-term opioid therapy,” McPherson said. “There are a variety of treatments available for the management of chronic pain other than opioids and our hope is that this research will help promote conversations about these alternatives between doctors and their patients.”

Next steps

McPherson plans to collect additional data and conduct qualitative interviews with patients over the next year to try and determine why some patients experience greater reductions in pain than others after discontinuing long-term opioid therapy

“As part of our study, we grouped our patients into one of four categories based on the amount of pain they reported before and after discontinuing long-term opioid therapy,” McPherson said. “We are now going to try and understand what different mechanisms may be at work for reducing or increasing chronic pain for each of these sub-groups. Our hope is this will lead to being able to target specific sub-populations with different types of treatment for their chronic pain. In addition, we hope to continue to characterize potential adverse effects from being discontinued from long-term opioid therapy.”

A national problem

Backaches, headaches and other chronic, non-cancer-related pains affect one-third of Americans and will afflict even more as the prevalence of diabetes, obesity, arthritis and other diseases grows in the United States’ aging population.

From the early 1990s through 2012, powerful opioid painkillers were increasingly used to treat these maladies in the United States. But a growing number of opioid-related overdose deaths has caused U.S. doctors and policymakers to reexamine this approach. According to the Centers for Disease Control and Prevention, more than 63,600 Americans died from drug overdose deaths in 2016, a toll five times higher than in 1999. Two thirds of these deaths, 42,249, involved opioids.

McPherson’s study, which appears in the June edition of the journal Pain, is one of the first to investigate what, if any, are the potential adverse effects of discontinuing long term opioid therapy for chronic, non-cancer-related pain.

Read more

New Study Explores Genetic Connection of Migraines

The nauseating, often debilitating, headaches affect 15-20 percent of adults in developed countries, yet they remain stubbornly hard to explain. Scientists know that migraines tend to run in families but aren’t sure exactly how. A new study published in the journal Neuron shows why some families are susceptible to migraines and how genetics may influence the type of migraine they get.

“For a long time, we have been wondering why common disease (like migraines) aggregates in families,” said Aarno Palotie of the Institute for Molecular Medicine in Finland and the Broad Institute of MIT and Harvard in Cambridge, Mass.

Previous migraine research identified two ways migraines might run in families. Linkage studies, which track sections of chromosomes passed down from parent to child, identified three genes (CACNA1A, ATP1A2 and SCN1A) associated to hemiplegic migraine, a severe form of migraine that induces stroke-like symptoms. These genes fall under a Mendelian inheritance model, meaning the two copies of a gene a child inherits from his or her parents determine a trait or disease. Sickle cell anemia could be thought of as Mendelian.

Another way migraines could run in families involves polygenic inheritance. If a trait is polygenic, that means that a group of genes collectively influence that characteristic. Like being dealt a bad hand in a card game, each common genetic variant may have only a small individual effect, but the collection of common variants builds up to influence the trait — or disease risk — a person inherits. Height is an example of a polygenic trait.

Palotie and his colleagues set out to find out whether a few, powerful Mendelian genes or a polygenic accumulation of common variants — or a combination of both — influenced how migraines are inherited in families.

First, the researchers developed a polygenic risk score to estimate the genetic burden of common variants. To do this, they gathered data from a previous genome-wide association study, which is a type of study that compares genomes of individuals and flags loci (locations on chromosomes) that differ in people with a disease. In all, hundreds (possibly even thousands) of loci linked to migraines were incorporated into the polygenic risk score.

Next, the researchers tested the influence of the polygenic risk score and the three known Mendelian migraine-linked genes within a large family study of migraine sufferers in Finland. The study included medical history and genetic data of 1,589 families (made up of 8,319 individuals) of known migraine sufferers. The family migraine cohort was compared against other large cohorts as a control, such as the FINRISK study that had 14,470 people total, including 1,101 people with migraine.

Result after result showed that the polygenic common variants were driving migraine risk more than the three Mendelian genes. If a person’s migraines started at an earlier age, if a person experienced more severe migraines, or if migraines ran in a person’s family, the data showed that it’s more likely that person had a greater genetic burden of common polygenic variants to blame.

“The strength of the common variants in these families surprised us,” said Palotie.

On the other hand, the three rare but powerful Mendelian genes linked to migraine didn’t seem to influence migraine risk as much as the researchers expected. Out of the large family study, researchers identified 45 families with hemiplegic migraine and sequenced their genes. Migraines in only four out of 45 families were driven by the rare Mendelian genes — more cases were driven by common variants.

“This really shows, in a very big sample set, that common variants are very important factors in aggregation of migraines in the family,” said Palotie.

Palotie believes more genome sequencing and larger studies will help researchers find both more common variants linked to migraines and more Mendelian variants.

“This is of special interest for drug development,” said Palotie. Even if Mendelian variants don’t drive the majority of migraine cases, scientists can research how these genes impact biological pathways responsible for migraine symptoms and potentially develop drugs to target those pathways.


Read this on Science Daily:  “New light on genetic foundation of migraines.” ScienceDaily. ScienceDaily, 3 May 2018. www.sciencedaily.com/releases/2018/05/180503142926.htm.

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