Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.
Neurol Sci. 2022 Dec;43(12):6955-6959. doi: 10.1007/s10072-022-06391-3. Epub 2022 Sep 13.
Migraine is a common condition in mitochondrial diseases, with a higher prevalence than in the general population. Although several clinical studies support the hypothesis that mitochondrial dysfunction plays a central role in the pathophysiology of migraine, currently there are few data in the literature regarding the efficacy and safety of drugs for the treatment and prophylaxis for this condition in patients with primary mitochondrial disorders. We report a 37-year-old woman affected by mitochondrial disease with progressive external ophthalmoplegia phenotype (PEO) associated with POLG mutation effectively treated with erenumab, in the absence of side effects. Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) or against its receptor are innovative and specific therapies for migraine prophylaxis. This class of drugs is particularly suitable for subjects, such as those suffering from genetically determined mitochondrial dysfunction, in which pharmacological management can represent a challenge due to the nature of these neurogenetic disorders and/or the frequently associated comorbidities.
偏头痛在线粒体疾病中很常见，其患病率高于普通人群。尽管有几项临床研究支持线粒体功能障碍在偏头痛病理生理学中起核心作用的假说，但目前关于原发性线粒体疾病患者偏头痛的治疗和预防药物的疗效和安全性的数据很少。我们报告了一例 37 岁的女性，患有伴有 POLG 突变的进行性眼外肌麻痹表型（PEO）的线粒体疾病，她使用依那西普治疗有效，且无副作用。降钙素基因相关肽（CGRP）或其受体的单克隆抗体是偏头痛预防的创新和特异性治疗方法。这类药物特别适合因遗传决定的线粒体功能障碍而患病的患者，由于这些神经遗传疾病的性质和/或经常相关的合并症，药物治疗可能具有挑战性。
