Adnkronos Helsinki, 23 June (Adnkronos Salute) – "Migraine can be prevented, but it requires a change of mentality: we all think of taking drugs when we have the symptom, the pain, but for migraine another approach is needed, also because the excessive intake of analgesics worsens the clinical picture". This is how Patricia Pozo-Rosich, Head of Section of the Neurology Department, Director of Headache and Craniofacial Pain Clinical Unit and the Migraine Adaptive Brain Center at the Vall d'Hebron University Hospital, Barcelona, comments to Adnkronos Salute on the results of the Resolution study, presented today in Helsinki at the 11th Congress of the European Academy of Neurology (EAN), which highlight the effectiveness of an educational intervention and the use of eptinezumab in patients with chronic migraine and medication-overuse headache (Moh).
"Migraine, unlike diabetes or hypertension – observes Pozo-Rosich – is not known and considered in its complexity, yet it is a disease that has a strong impact on public health. This is why education on brain health should start in middle school. We must work on prevention because with 3 days of migraine a month the anxiety that it may recur increases, and with 15 days of migraine a month there is depression – he points out – Migraine affects more than 1 billion people in the world and begins to manifest itself in adolescence, even in children. There is a hormonal component, but the important issue is that if the acute attack is not treated adequately, the pathology gradually worsens, and from 3-4 days of symptoms it goes to 15 or more days a month, triggering a series of other disorders such as depression, anxiety, obesity, sleep disorders, as well as increasing cardiovascular risk, chronic pain and respiratory disorders such as asthma. All this without considering the impact on the quality of life. life and work or family projects".
In Spain "we are trying to start programs in schools - explains the expert - There is a lot of talk about affective education, but we should really strengthen health education and, in particular, education about the brain, because the brain is who you are. The risk of suffering from this disease is not low: 1 in 5 women and 1 in 10 men, practically in every middle school class there are 4-5 girls and 2-3 boys who will develop migraines. For this reason - she points out - we need to educate children about brain health and a little about pain management, which means taking care of yourself and understanding that knowing how to manage yourself today allows you to be free tomorrow".
"Then when you are 20 or 30 years old - continues Pozo-Rosich - migraines can really manifest themselves in a significant way. Then you need specific education on how to deal with them, because it is not intuitive. It is not natural. And when you are 40 years old, migraines are at their peak of disability and affect women much more. At that point, in addition to education, you can add interventions such as psychotherapy. Because it is difficult to accept having a chronic disease. You don't want it. It always seems that you can manage it alone, but that is not the case. And accepting it requires professional support, including psychological support. Finally, awareness is also needed, that is, education of the population. I dream of the day when I no longer have to explain what migraines are. No one - the expert points out - explains what diabetes is: everyone knows that it has to do with blood sugar, insulin, nutrition, exercise. Even for hypertension. But with migraines, everything has to be explained every time, because it is complex, but also because there is not enough information public".
Pozo-Rosich has no doubts about the warning signs to consider. "You should listen to your children," he recommends. "This is a very hereditary disease. If you, as a parent, have migraines and your child complains of headaches, he or she is probably not imitating you or making fun of you. My recommendation is to take him or her to a good doctor. There are children with migraines as young as 2, 4, 6, 7 years old. But in general, the biggest increase in incidence occurs between 12 and 14 years old. These are the years in which the brain develops the most: every stimulus, positive or negative, has a big impact on brain development. If you don't eat, for example, you don't myelinate the nervous system well. Migraines can also negatively influence its development if neglected. And this can predispose to chronicity."
Of course, there should also be greater involvement from pediatricians and general practitioners who "are often the first to say that 'it's nothing' - the expert notes - In Spain we are trying to create a consensus between general practitioners and specialists on the patient's path. The good news is that there is more awareness than 25 years ago. But there is a problem: there is no biomarker and the system does not incentivize diagnosis. In Spain, for example, general practitioners are incentivized to measure cholesterol and blood sugar, for hypertension and diabetes respectively; for migraines we do not have a marker to measure, but headaches are worth half the costs of all neurological diseases: in Europe it is the pathology with the greatest economic impact. We must invest in research - she concludes - but also in training citizens, starting with the youngest".