Migraine: from pathophysiology to treatment.

Migraine is an extremely disabling, common neurological disorder characterized by a complex neurobiology, involving a series of central and peripheral nervous system areas and networks. A growing increase in the understanding of migraine pathophysiology in recent years has facilitated translation of that knowledge into novel treatments, which are currently becoming available to patients in many parts of the world and are substantially changing the clinical approach to the disease. In the first part of this review, we will provide an up to date overview of migraine pathophysiology by analyzing the anatomy and function of the main regions involved in the disease, focusing on how these give rise to the plethora of symptoms characterizing the attacks and overall disease. The second part of the paper will discuss the novel therapeutic agents that have emerged for the treatment of migraine, including molecules targeting calcitonin gene-related peptide (gepants and monoclonal antibodies), serotonin 5-HT1F receptor agonists (ditans) and non-invasive neuromodulation, as well as providing a brief overview of new evidence for classic migraine treatments.

Visual snow syndrome and migraine: a review.

Visual snow syndrome is a neurological condition characterized by ongoing prominent phenomena described consistently as tiny dots moving across the entire visual field, often associated with complex visual symptoms. These can take the form of afterimages, entoptic phenomena, nyctalopia and light sensitivity. Although some of these symptoms can be benign, they can nonetheless become significantly impactful for many who experience them, particularly in cases that have a sudden and abrupt start. As visual snow syndrome becomes increasingly recognized in clinical practice we begin to learn about its typical presentation and underlying pathophysiology. Treatment of visual snow, however, still proves quite challenging, and efforts need to be focused on unravelling the biological mechanisms of the syndrome. This endeavour has characterized the most recent research on visual snow, mostly involving neuroimaging, neurophysiological and neurobehavioral studies aimed at understanding its underlying neural signature. Another important aspect of the syndrome, which will likely prove critical in deepening our understanding of visual snow, is represented by the intricate biological and historical connexion with migraine. This narrative review focused on visual snow syndrome will explore its clinical, pathophysiological and treatment aspects in detail.

A dor entre atletas de alto rendimento / The pain among high level athletes / El dolor entre el atleta de la alta renta

A dor pode ser definida como "experiência sensorial e emocional desagradável, associada a lesões teciduais reais ou potenciais". Dessa maneira, percebe-se que a associação estabelecida entre lesão-estímulo doloroso envolve razões biológicas e um importante componente subjetivo. Este trabalho tem como objetivo avaliar como os atletas convivem, encaram e controlam os episódios dolorosos, sua capacidade em discriminar os diferentes tipos de dor, bem como sua sensibilidade em responder aos sinais e limites, condições essenciais na busca pelo melhor resultado para a equipe e para si próprio. Para tanto foram utilizados Inventário da Dor para o Esporte e relatos em formato de histórias de dor em 32 atletas participantes dos Jogos Abertos Brasileiros de 2009. Os dados apontam que as representações sobre a dor variam conforme a faixa etária e o gênero, o que reforça o componente subjetivo implicado nessa percepção, exigindo cuidados dos profissionais que irão lidar com os pacientes nessas condições.(AU)

The pain among high level athletesPain is defined as a "sensitive and emotional displeasing experience, associated with real or potential tissue damage". In this way, one perceives that the association established between injury- painful sensation involves biological factors and an important subjective component. This work has as objective to evaluate how the athletes cope, face and control pain episodes, their capacity to discriminate the different types of pain, as well as their sensitivity to answer to signs and limits, essential conditions in the pursuit of optimum results for the team and the athlete. Therefore, we used the Sports Inventory for Pain and reports about the stories of pain of 32 participant athletes participating in the 2009 Brazilian Open Games. The data point that the representations of pain vary depending on the age and gender, what strengthens the subjective component in inherent to this perception, demanding more attention of those professionals who will deal with patients in these conditions.(AU)

El dolor entre el atleta de la alta rentaEl dolor puede ser definido como "la experiencia sensoria y emocional torpe, asociada a lesiones teciduais verdaderas o potenciales". De esta manera, uno percibe que la asociación establecida entre lesión-estimulation dolorosa implica razones biológicas y un componente subjetivo importante. Este trabajo tiene como objetivo a evaluar mientras que los atletas coexisten, hacen frente y controlan a los episodios dolorosos, su capacidad en discriminar los diversos tipos de dolor, así como su sensibilidad en contestar a las señales y a los límites, las condiciones esenciales en la búsqueda para el resultado óptimo para el equipo y para si mismo. Para esto se utilizo el Inventario de Dolor para el Deporte y relatos personales en el formato de las historias de la vida en 32 atletas que participaron de los Jogos Abertos do Interior. Las fechas señalan que las representaciones en dolor varían con la edad y la clase, qué consolida el componente subjetivo implicado en esta opinión, exigiendo cuidado bien-tomado de los profesionales que irán a tratar de los pacientes en estas condiciones.(AU)