Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.
Department of Neurology, Tergooi Hospital, Hilversum, the Netherlands.
Headache. 2023 Jul-Aug;63(7):926-933. doi: 10.1111/head.14531. Epub 2023 Jun 26.
To evaluate the effect of treatment with anti-calcitonin gene-related peptide (CGRP; receptor) antibodies on visual hypersensitivity in patients with migraine.
Increased visual sensitivity can be present both during and outside migraine attacks. CGRP has been demonstrated to play a key role in light-aversive behavior.
In this prospective follow-up study, patients treated for migraine with erenumab (n = 105) or fremanezumab (n = 100) in the Leiden Headache Center were invited to complete a questionnaire on visual sensitivity (the Leiden Visual Sensitivity Scale [L-VISS]), pertaining to both their ictal and interictal state, before starting treatment (T0) and 3 months after treatment initiation (T1). Using a daily e-diary, treatment effectiveness was assessed in weeks 9-12 compared to a 4-week pre-treatment baseline period. L-VISS scores were compared between T0 and T1. Subsequently, the association between the reduction in L-VISS scores and the reduction in monthly migraine days (MMD) was investigated.
At 3 months, the visual hypersensitivity decreased, with a decrease in mean ± standard deviation (SD) ictal L-VISS (from 20.1 ± 7.7 to 19.2 ± 8.1, p = 0.042) and a decrease in mean ± SD interictal L-VISS (from 11.8 ± 6.6 to 11.1 ± 7.0, p = 0.050). We found a positive association between the reduction in MMD and the decrease in interictal L-VISS (β = 0.2, p = 0.010) and the reduction in ictal L-VISS (β = 0.3, p = 0.001).
A decrease in visual hypersensitivity in patients with migraine after treatment with anti-CGRP (receptor) antibodies is positively associated with clinical response on migraine.
评估抗降钙素基因相关肽（CGRP；受体）抗体治疗对偏头痛患者视觉敏感性的影响。
在偏头痛发作期间和发作之外，都可能存在视觉敏感性增加。CGRP 已被证明在回避光的行为中起关键作用。
在这项前瞻性随访研究中，莱顿头痛中心接受依那西普（n=105）或佛来美尼（n=100）治疗的偏头痛患者在开始治疗（T0）前和治疗开始后 3 个月（T1）完成了一份关于视觉敏感性的问卷（莱顿视觉敏感性量表[L-VISS]），涉及发作期和发作间期。使用每日电子日记，在第 9-12 周与治疗前 4 周的基线期相比评估治疗效果。比较 T0 和 T1 时的 L-VISS 评分。随后，研究了 L-VISS 评分的降低与每月偏头痛天数（MMD）减少之间的关系。
3 个月时，视觉敏感性下降，平均±标准差（SD）发作性 L-VISS 降低（从 20.1±7.7 降至 19.2±8.1，p=0.042），平均±SD 发作间期 L-VISS 降低（从 11.8±6.6 降至 11.1±7.0，p=0.050）。我们发现 MMD 减少与发作间期 L-VISS 减少（β=0.2，p=0.010）和发作性 L-VISS 减少（β=0.3，p=0.001）之间存在正相关。
抗 CGRP（受体）抗体治疗后偏头痛患者视觉敏感性下降与偏头痛的临床反应呈正相关。
