nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2024-2-76-86nnp-2235Research ArticleREVIEWSОБЗОРЫRefractory migraineРефрактерная мигреньhttps://orcid.org/0000-0002-3833-532XТабееваГ. Р.TabeevaG. R.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

grtabeeva@gmail.comhttps://orcid.org/0000-0001-5827-9428КосивцоваО. В.KosivtsovaO. V.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

https://orcid.org/0000-0002-8437-7205КовальчукН. А.KovalchukN. A.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

https://orcid.org/0009-0004-5288-890XОрлюкТ. А.OrlyukT. A.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation2024240420241627686Copyright © Tabeeva G.R., Kosivtsova O.V., Kovalchuk N.A., Orlyuk T.A., 20242024Табеева Г.Р., Косивцова О.В., Ковальчук Н.А., Орлюк Т.А.Tabeeva G.R., Kosivtsova O.V., Kovalchuk N.A., Orlyuk T.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2235

Many patients with chronic migraine abuse symptomatic medications, have drug-induced headaches, psychiatric comorbidities and respond poorly to conventional preventive therapy. In these cases, the terms “resistant” and “refractory migraine” are used and an expanded therapeutic armamentarium is recommended. Currently, the use of monoclonal antibodies against calcitonin gene-related peptide is the best-studied and most effective method of preventive therapy in resistant migraine cases.

Многие пациенты с хронической мигренью злоупотребляют симптоматическими средствами, имеют лекарственно-индуцированную головную боль, сочетанные психические расстройства, и их состояние плохо поддается традиционной профилактической терапии. Применительно к этим случаям используются определения «резистентная» и «рефрактерная мигрень» и рекомендуется расширенный арсенал терапевтических подходов. В настоящее время использование моноклональных антител против кальцитонинген-родственного пептида является наиболее изученным и эффективным способом профилактической терапии резистентных случаев мигрени.

мигреньрезистентная мигреньрефрактерная мигреньпрофилактическое лечениекупирование приступов мигрениmigraineresistant migrainerefractory migrainepreventive treatmentrelief of migraine attacksReferencesGBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018 Nov;17(11):954-76. doi: 10.1016/S1474-4422(18)30322-3. Erratum in: Lancet Neurol. 2021 Dec;20(12):e7.GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018 Nov;17(11):954-76. doi: 10.1016/S1474-4422(18)30322-3. Erratum in: Lancet Neurol. 2021 Dec;20(12):e7.Ornello R, Andreou AP, De Matteis E, et al. Resistant and refractory migraine: clinical presentation, pathophysiology, and management. EBioMedicine. 2024 Jan;99:104943. doi: 10.1016/j.ebiom.2023.104943. Epub 2023 Dec 23.Ornello R, Andreou AP, De Matteis E, et al. Resistant and refractory migraine: clinical presentation, pathophysiology, and management. EBioMedicine. 2024 Jan;99:104943. doi: 10.1016/j.ebiom.2023.104943. Epub 2023 Dec 23.Groth M, Katsarava Z, Ehrlich M. Results of the gErman migraine PatIent Survey on medical Care and prOPhylactic treatment Experience (EPISCOPE). Sci Rep. 2022 Mar 17;12(1):4589. doi: 10.1038/s41598-022-08716-wGroth M, Katsarava Z, Ehrlich M. Results of the gErman migraine PatIent Survey on medical Care and prOPhylactic treatment Experience (EPISCOPE). Sci Rep. 2022 Mar 17;12(1):4589. doi: 10.1038/s41598-022-08716-wGoadsby PJ, Schoenen J, Ferrari MD, et al. Towards a definition of intractable headache for use in clinical practice and trials. Cephalalgia. 2006 Sep;26(9):1168-70. doi: 10.1111/j.1468-2982.2006.01173.xGoadsby PJ, Schoenen J, Ferrari MD, et al. Towards a definition of intractable headache for use in clinical practice and trials. Cephalalgia. 2006 Sep;26(9):1168-70. doi: 10.1111/j.1468-2982.2006.01173.xSilberstein SD, Dodick DW, Pearlman S. Defining the pharmacologically intractable headache for clinical trials and clinical practice. Headache. 2010 Oct;50(9):1499-506. doi: 10.1111/j.1526-4610.2010.01764.xSilberstein SD, Dodick DW, Pearlman S. Defining the pharmacologically intractable headache for clinical trials and clinical practice. Headache. 2010 Oct;50(9):1499-506. doi: 10.1111/j.1526-4610.2010.01764.xHeadache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202Schulman EA, Peterlin BL, Lake AE 3rd, et al. Defining refractory migraine: results of the RHSIS Survey of American Headache Society members. Headache. 2009 Apr;49(4):509-18. doi: 10.1111/j.1526-4610.2009.01370.x. Epub 2009 Feb 25.Schulman EA, Peterlin BL, Lake AE 3rd, et al. Defining refractory migraine: results of the RHSIS Survey of American Headache Society members. Headache. 2009 Apr;49(4):509-18. doi: 10.1111/j.1526-4610.2009.01370.x. Epub 2009 Feb 25.Sacco S, Lampl C, Maassen van den Brink A, et al; Burden and Attitude to Resistant and Refractory (BARR) Study Group. Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance. J Headache Pain. 2021 May 18;22(1):39. doi: 10.1186/s10194-021-01252-4Sacco S, Lampl C, Maassen van den Brink A, et al; Burden and Attitude to Resistant and Refractory (BARR) Study Group. Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance. J Headache Pain. 2021 May 18;22(1):39. doi: 10.1186/s10194-021-01252-4Schulman EA, Brahin EJ. Refractory headache: historical perspective, need, and purposes for an operational definition. Headache. 2008 Jun;48(6):770-7. doi: 10.1111/j.1526-4610.2008.01135.x. Epub 2008 May 9.Schulman EA, Brahin EJ. Refractory headache: historical perspective, need, and purposes for an operational definition. Headache. 2008 Jun;48(6):770-7. doi: 10.1111/j.1526-4610.2008.01135.x. Epub 2008 May 9.Pozo-Rosich P, Lucas C, Watson DPB, et al. Burden of Migraine in Patients With Preventive Treatment Failure Attending European Headache Specialist Centers: Real-World Evidence From the BECOME Study. Pain Ther. 2021 Dec;10(2):1691-708. doi: 10.1007/s40122-021-00331-3. Epub 2021 Oct 13.Pozo-Rosich P, Lucas C, Watson DPB, et al. Burden of Migraine in Patients With Preventive Treatment Failure Attending European Headache Specialist Centers: Real-World Evidence From the BECOME Study. Pain Ther. 2021 Dec;10(2):1691-708. doi: 10.1007/s40122-021-00331-3. Epub 2021 Oct 13.De Matteis E, Guglielmetti M, Ornello R, et al. Targeting CGRP for migraine treatment: mechanisms, antibodies, small molecules, perspectives. Expert Rev Neurother. 2020 Jun;20(6):627-41. doi: 10.1080/14737175.2020.1772758. Epub 2020 Jun 2.De Matteis E, Guglielmetti M, Ornello R, et al. Targeting CGRP for migraine treatment: mechanisms, antibodies, small molecules, perspectives. Expert Rev Neurother. 2020 Jun;20(6):627-41. doi: 10.1080/14737175.2020.1772758. Epub 2020 Jun 2.Sacco S, Amin FM, Ashina M, et al. European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update. J Headache Pain. 2022 Jun 11;23(1):67. doi: 10.1186/s10194-022-01431-xSacco S, Amin FM, Ashina M, et al. European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update. J Headache Pain. 2022 Jun 11;23(1):67. doi: 10.1186/s10194-022-01431-xSacco S, Bendtsen L, Ashina M, et al. European Headache Federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain. 2019 Jan 16;20(1):6. doi: 10.1186/s10194-018-0955-y. Erratum in: J Headache Pain. 2019 May 23;20(1):58.Sacco S, Bendtsen L, Ashina M, et al. European Headache Federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain. 2019 Jan 16;20(1):6. doi: 10.1186/s10194-018-0955-y. Erratum in: J Headache Pain. 2019 May 23;20(1):58.Lambru G, Hill B, Murphy M, et al. A prospective real-world analysis of erenumab in refractory chronic migraine. J Headache Pain. 2020 Jun 1;21(1):61. doi: 10.1186/s10194-020-01127-0Lambru G, Hill B, Murphy M, et al. A prospective real-world analysis of erenumab in refractory chronic migraine. J Headache Pain. 2020 Jun 1;21(1):61. doi: 10.1186/s10194-020-01127-0Reisman EE Jr. The use of experimental suppositories in treating refractory migraine. Am Pract Dig Treat. 1952 Apr;3(4):308-10.Reisman EE Jr. The use of experimental suppositories in treating refractory migraine. Am Pract Dig Treat. 1952 Apr;3(4):308-10.Schulman EA, Lake AE 3rd, Goadsby PJ, al. Defining refractory migraine and refractory chronic migraine: proposed criteria from the Refractory Headache Special Interest Section of the American Headache Society. Headache. 2008 Jun;48(6):778-82. doi: 10.1111/j.1526-4610.2008.01132.x. Epub 2008 May 14.Schulman EA, Lake AE 3rd, Goadsby PJ, al. Defining refractory migraine and refractory chronic migraine: proposed criteria from the Refractory Headache Special Interest Section of the American Headache Society. Headache. 2008 Jun;48(6):778-82. doi: 10.1111/j.1526-4610.2008.01132.x. Epub 2008 May 14.Martelletti P, Katsarava Z, Lampl C, et al. Refractory chronic migraine: a consensus statement on clinical definition from the European Headache Federation. J Headache Pain. 2014 Aug 28;15(1):47. doi: 10.1186/1129-2377-15-47Martelletti P, Katsarava Z, Lampl C, et al. Refractory chronic migraine: a consensus statement on clinical definition from the European Headache Federation. J Headache Pain. 2014 Aug 28;15(1):47. doi: 10.1186/1129-2377-15-47Saper J, Lake A 3rd, Lipton R. Staging headache cases: reconciling the coplexity of a case with the required intensity of treatment. Headache. 2007 Jan;47(1):90-3. doi: 10.1111/j.1526-4610.2006.00634.xSaper J, Lake A 3rd, Lipton R. Staging headache cases: reconciling the coplexity of a case with the required intensity of treatment. Headache. 2007 Jan;47(1):90-3. doi: 10.1111/j.1526-4610.2006.00634.xLoder E, Biondi D. Disease modification in migraine: a concept that has come of age? Headache. 2003 Feb;43(2):135-43. doi: 10.1046/j.1526-4610.2003.03033.xLoder E, Biondi D. Disease modification in migraine: a concept that has come of age? Headache. 2003 Feb;43(2):135-43. doi: 10.1046/j.1526-4610.2003.03033.xSilberstein SD, Dodick DW, Saper J, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: results from a randomized, multicenter, doubleblinded, controlled study. Cephalalgia. 2012 Dec;32(16):1165-79. doi: 10.1177/0333102412462642. Epub 2012 Oct 3. Erratum in: Cephalalgia. 2014 Oct;34(11):944.Silberstein SD, Dodick DW, Saper J, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: results from a randomized, multicenter, doubleblinded, controlled study. Cephalalgia. 2012 Dec;32(16):1165-79. doi: 10.1177/0333102412462642. Epub 2012 Oct 3. Erratum in: Cephalalgia. 2014 Oct;34(11):944.Saper JR, Dodick DW, Silberstein SD, et al; ONSTIM Investigators. Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study. Cephalalgia. 2011 Feb;31(3):271-85. doi: 10.1177/0333102410381142. Epub 2010 Sep 22.Saper JR, Dodick DW, Silberstein SD, et al; ONSTIM Investigators. Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study. Cephalalgia. 2011 Feb;31(3):271-85. doi: 10.1177/0333102410381142. Epub 2010 Sep 22.Sacco S, Braschinsky M, Ducros A, et al. European headache federation consensus on the definition of resistant and refractory migraine: Developed with the endorsement of the European Migraine & Headache Alliance (EMHA). J Headache Pain. 2020 Jun 16;21(1):76. doi: 10.1186/s10194-020-01130-5Sacco S, Braschinsky M, Ducros A, et al. European headache federation consensus on the definition of resistant and refractory migraine: Developed with the endorsement of the European Migraine & Headache Alliance (EMHA). J Headache Pain. 2020 Jun 16;21(1):76. doi: 10.1186/s10194-020-01130-5Филатова ЕГ, Осипова ВВ, Табеева ГР и др. Диагностика и лечение мигрени: рекомендации российских экспертов. Неврология, нейропсихиатрия, психосоматика. 2020;12(4):4-14. doi: 10.14412/2074-2711-2020-4-4-14Filatova EG, Osipova VV, Tabeeva GR, et al. Diagnosis and treatment of migraine: Russian experts' recommendations. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020; 12(4):4-14. doi: 10.14412/2074-2711-2020-4-4-14 (In Russ.).Сергеев АВ, Табеева ГР, Филатова ЕГ и др. Применение новой биологической патогенетической терапии мигрени в клинической практике: консенсус экспертов Российского общества по изучению головной боли. Неврология, нейропсихиатрия, психосоматика. 2022;14(5):109-16. doi: 10.14412/2074-2711-2022-5-109-116Sergeev AV, Tabeeva GR, Filatova EG, et al. Application of a new biological pathogenetic therapy of migraine in clinical practice: expert consensus of the Russian Headache Research Society. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(5):109-16. doi: 10.14412/2074-2711-2022-5-109-116 (In Russ.).Evers S, Afra J, Frese A, et al; European Federation of Neurological Societies. EFNS guideline on the drug treatment of migrainerevised report of an EFNS task force. Eur J Neurol. 2009 Sep;16(9):968-81. doi: 10.1111/j.1468-1331.2009.02748.xEvers S, Afra J, Frese A, et al; European Federation of Neurological Societies. EFNS guideline on the drug treatment of migrainerevised report of an EFNS task force. Eur J Neurol. 2009 Sep;16(9):968-81. doi: 10.1111/j.1468-1331.2009.02748.xD'Amico D, Leone M, Grazzi L, Bussone G. When should “chronic migraine” patients be considered “refractory” to pharmacological prophylaxis? Neurol Sci. 2008 May;29 Suppl 1:S55-8. doi: 10.1007/s10072-008-0888-3D'Amico D, Leone M, Grazzi L, Bussone G. When should “chronic migraine” patients be considered “refractory” to pharmacological prophylaxis? Neurol Sci. 2008 May;29 Suppl 1:S55-8. doi: 10.1007/s10072-008-0888-3Ковальчук НА, Кирьянова ЕА, Табеева ГР. Приверженность терапии пациентов с мигренью (по данным интернет-опроса). Неврология, нейропсихиатрия, психосоматика. 2021;13(4):81-7. doi: 10.14412/2074-2711-2021-4-81-87Kovalchuk NA, Kiryanova EA, Tabeeva GR. Medication adherence in migraine patients (data of an online survey). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(4):81-7. doi: 10.14412/2074-2711-2021-4-81-87 (In Russ.).Ornello R, Casalena A, Frattale I, et al. Real-life data on the efficacy and safety of erenumab in the Abruzzo region, central Italy. J Headache Pain. 2020 Apr 7;21(1):32. doi: 10.1186/s10194-020-01102-9Ornello R, Casalena A, Frattale I, et al. Real-life data on the efficacy and safety of erenumab in the Abruzzo region, central Italy. J Headache Pain. 2020 Apr 7;21(1):32. doi: 10.1186/s10194-020-01102-9Табеева ГР. Плацебо-аналгезия. Неврология, нейропсихиатрия, психосоматика. 2018;10(3):108-15. doi: 10.14412/2074-2711-2018-3-108-115Tabeeva GR. Placebo analgesia. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):108-15. doi: 10.14412/2074-2711-2018-3-108-115 (In Russ.).Mitsikostas DD. Nocebo in headaches: implications for clinical practice and trial design. Curr Neurol Neurosci Rep. 2012 Apr;12(2):132-7. doi: 10.1007/s11910-011-0245-4Mitsikostas DD. Nocebo in headaches: implications for clinical practice and trial design. Curr Neurol Neurosci Rep. 2012 Apr;12(2):132-7. doi: 10.1007/s11910-011-0245-4Smitherman TA, Penzien DB, Maizels M. Anxiety disorders and migraine intractability and progression. Curr Pain Headache Rep. 2008 Jun;12(3):224-9. doi: 10.1007/s11916-008-0039-9Smitherman TA, Penzien DB, Maizels M. Anxiety disorders and migraine intractability and progression. Curr Pain Headache Rep. 2008 Jun;12(3):224-9. doi: 10.1007/s11916-008-0039-9Breslau N, Lipton RB, Stewart WF, et al. Comorbidity of migraine and depression: investigating potential etiology and prognosis. Neurology. 2003 Apr 22;60(8):1308-12. doi: 10.1212/01.wnl.0000058907.41080.54Breslau N, Lipton RB, Stewart WF, et al. Comorbidity of migraine and depression: investigating potential etiology and prognosis. Neurology. 2003 Apr 22;60(8):1308-12. doi: 10.1212/01.wnl.0000058907.41080.54Edvinsson L, Haanes KA. Views on migraine pathophysiology: Where does it start? Neurol Clin Neurosci. 2020;8:120-7.Edvinsson L, Haanes KA. Views on migraine pathophysiology: Where does it start? Neurol Clin Neurosci. 2020;8:120-7.Maizels M. Does the neurobiology of migraine make migraine patients “difficult”? Headache. 2012 Nov-Dec;52(10):1612. doi: 10.1111/j.1526-4610.2012.02258.xMaizels M. Does the neurobiology of migraine make migraine patients “difficult”? Headache. 2012 Nov-Dec;52(10):1612. doi: 10.1111/j.1526-4610.2012.02258.xAshina S, Serrano D, Lipton RB, et al. Depression and risk of transformation of episodic to chronic migraine. J Headache Pain. 2012 Nov;13(8):615-24. doi: 10.1007/s10194-012-0479-9. Epub 2012 Sep 25.Ashina S, Serrano D, Lipton RB, et al. Depression and risk of transformation of episodic to chronic migraine. J Headache Pain. 2012 Nov;13(8):615-24. doi: 10.1007/s10194-012-0479-9. Epub 2012 Sep 25.Radat F. What is the link between migraine and psychiatric disorders? From epidemiology to therapeutics. Rev Neurol (Paris). 2021 Sep;177(7):821-6. doi: 10.1016/j.neurol.2021.07.007. Epub 2021 Jul 27.Radat F. What is the link between migraine and psychiatric disorders? From epidemiology to therapeutics. Rev Neurol (Paris). 2021 Sep;177(7):821-6. doi: 10.1016/j.neurol.2021.07.007. Epub 2021 Jul 27.Silvestro M, Tessitore A, Scotto di Clemente F, et al. Refractory migraine profile in CGRP-monoclonal antibodies scenario. Acta Neurol Scand. 2021 Sep;144(3):325-33. doi: 10.1111/ane.13472. Epub 2021 May 21.Silvestro M, Tessitore A, Scotto di Clemente F, et al. Refractory migraine profile in CGRP-monoclonal antibodies scenario. Acta Neurol Scand. 2021 Sep;144(3):325-33. doi: 10.1111/ane.13472. Epub 2021 May 21.Hinchey SA, Jackson JL. A cohort study assessing difficult patient encounters in a walkin primary care clinic, predictors and outcomes. J Gen Intern Med. 2011 Jun;26(6):588-94. doi: 10.1007/s11606-010-1620-6. Epub 2011 Jan 25.Hinchey SA, Jackson JL. A cohort study assessing difficult patient encounters in a walkin primary care clinic, predictors and outcomes. J Gen Intern Med. 2011 Jun;26(6):588-94. doi: 10.1007/s11606-010-1620-6. Epub 2011 Jan 25.Chalmer MA, Rasmussen AH; International Headache Genetics Consortium; 23andme Research Team; Kogelman LJA, Olesen J, Hansen TF. Chronic migraine: Genetics or environment? Eur J Neurol. 2021 May;28(5):1726-36. doi: 10.1111/ene.14724. Epub 2021 Jan 27.Chalmer MA, Rasmussen AH; International Headache Genetics Consortium; 23andme Research Team; Kogelman LJA, Olesen J, Hansen TF. Chronic migraine: Genetics or environment? Eur J Neurol. 2021 May;28(5):1726-36. doi: 10.1111/ene.14724. Epub 2021 Jan 27.Schulte LH, Allers A, May A. Hypothalamus as a mediator of chronic migraine: Evidence from high-resolution fMRI. Neurology. 2017 May 23;88(21):2011-6. doi: 10.1212/WNL.0000000000003963. Epub 2017 Apr 26.Schulte LH, Allers A, May A. Hypothalamus as a mediator of chronic migraine: Evidence from high-resolution fMRI. Neurology. 2017 May 23;88(21):2011-6. doi: 10.1212/WNL.0000000000003963. Epub 2017 Apr 26.Strother LC, Srikiatkhachorn A, Supronsinchai W. Targeted Orexin and Hypothalamic Neuropeptides for Migraine. Neurotherapeutics. 2018 Apr;15(2):377-90. doi: 10.1007/s13311-017-0602-3Strother LC, Srikiatkhachorn A, Supronsinchai W. Targeted Orexin and Hypothalamic Neuropeptides for Migraine. Neurotherapeutics. 2018 Apr;15(2):377-90. doi: 10.1007/s13311-017-0602-3Santoro JD, Moon PK, Han M, et al. Early Onset Diffusion Abnormalities in Refractory Headache Disorders. Front Neurol. 2022 Jun 14;13:898219. doi: 10.3389/fneur.2022.898219Santoro JD, Moon PK, Han M, et al. Early Onset Diffusion Abnormalities in Refractory Headache Disorders. Front Neurol. 2022 Jun 14;13:898219. doi: 10.3389/fneur.2022.898219Egorova N, Benedetti F, Gollub RL, Kong J. Between placebo and nocebo: Response to control treatment is mediated by amygdala activity and connectivity. Eur J Pain. 2020 Mar;24(3):580-92. doi: 10.1002/ejp.1510. Epub 2019 Dec 12.Egorova N, Benedetti F, Gollub RL, Kong J. Between placebo and nocebo: Response to control treatment is mediated by amygdala activity and connectivity. Eur J Pain. 2020 Mar;24(3):580-92. doi: 10.1002/ejp.1510. Epub 2019 Dec 12.Goadsby PJ, Holland PR. An Update: Pathophysiology of Migraine. Neurol Clin. 2019 Nov;37(4):651-71. doi: 10.1016/j.ncl.2019.07.008Goadsby PJ, Holland PR. An Update: Pathophysiology of Migraine. Neurol Clin. 2019 Nov;37(4):651-71. doi: 10.1016/j.ncl.2019.07.008Silberstein SD, Calhoun AH, Lipton RB, et al; EVENT Study Group. Chronic migraine headache prevention with noninvasive vagus nerve stimulation: The EVENT study. Neurology. 2016 Aug 2;87(5):529-38. doi: 10.1212/WNL.0000000000002918. Epub 2016 Jul 13.Silberstein SD, Calhoun AH, Lipton RB, et al; EVENT Study Group. Chronic migraine headache prevention with noninvasive vagus nerve stimulation: The EVENT study. Neurology. 2016 Aug 2;87(5):529-38. doi: 10.1212/WNL.0000000000002918. Epub 2016 Jul 13.Табеева ГР, Осипова ВВ, Филатова ЕГ и др. Диагностика и лечение лекарственноиндуцированной головной боли: рекомендации российских экспертов. Неврология, нейропсихиатрия, психосоматика. 2022;14(1):4-13. doi: 10.14412/2074-2711-2022-1-4-13Tabeeva GR, Osipova VV, Filatova EG, et al. Evaluation and treatment of medication-overuse headache: Russian experts' guidelines. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(1):4-13. doi: 10.14412/2074-2711-2022-1-4-13 (In Russ.).Sacco S, Lampl C, Amin FM, et al. European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure. J Headache Pain. 2022 Oct 12;23(1):133. doi: 10.1186/s10194-022-01502-zSacco S, Lampl C, Amin FM, et al. European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure. J Headache Pain. 2022 Oct 12;23(1):133. doi: 10.1186/s10194-022-01502-zSchwedt TJ, Hentz JG, Sahai-Srivastava S, et al; MOTS Investigators. Patient-Centered Treatment of Chronic Migraine With Medication Overuse: A Prospective, Randomized, Pragmatic Clinical Trial. Neurology. 2022 Apr 5;98(14):e1409-e1421. doi: 10.1212/WNL.0000000000200117. Epub 2022 Feb 15.Schwedt TJ, Hentz JG, Sahai-Srivastava S, et al; MOTS Investigators. Patient-Centered Treatment of Chronic Migraine With Medication Overuse: A Prospective, Randomized, Pragmatic Clinical Trial. Neurology. 2022 Apr 5;98(14):e1409-e1421. doi: 10.1212/WNL.0000000000200117. Epub 2022 Feb 15.Lipton RB, Buse DC, Nahas SJ, et al. Risk factors for migraine disease progression: a narrative review for a patient-centered approach. J Neurol. 2023 Dec;270(12):5692-710. doi: 10.1007/s00415-023-11880-2. Epub 2023 Aug 24.Lipton RB, Buse DC, Nahas SJ, et al. Risk factors for migraine disease progression: a narrative review for a patient-centered approach. J Neurol. 2023 Dec;270(12):5692-710. doi: 10.1007/s00415-023-11880-2. Epub 2023 Aug 24.Табеева ГР, Филатова ЕГ, Амелин АВ и др. Альтернативные и комплементарные методы лечения мигрени. Неврология, нейропсихиатрия, психосоматика. 2024;16(1):4-15. doi: 10.14412/2074-2711-2024-1-4-15Tabeeva GR, Filatova EG, Amelin AV, et al. Alternative and complementary treatments for migraine. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2024;16(1):4-15. doi: 10.14412/2074-2711-2024-1-4-15 (In Russ.).Bae JY, Sung HK, Kwon NY, et al. Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and MetaAnalysis. Medicina (Kaunas). 2021 Dec 28;58(1):44. doi: 10.3390/medicina58010044Bae JY, Sung HK, Kwon NY, et al. Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and MetaAnalysis. Medicina (Kaunas). 2021 Dec 28;58(1):44. doi: 10.3390/medicina58010044Aditya S, Rattan A. Advances in CGRP Monoclonal Antibodies as Migraine Therapy: A Narrative Review. Saudi J Med Med Sci. 2023 Jan-Mar;11(1):11-8. doi: 10.4103/sjmms.sjmms_95_22. Epub 2023 Jan 14.Aditya S, Rattan A. Advances in CGRP Monoclonal Antibodies as Migraine Therapy: A Narrative Review. Saudi J Med Med Sci. 2023 Jan-Mar;11(1):11-8. doi: 10.4103/sjmms.sjmms_95_22. Epub 2023 Jan 14.Holroyd KA, Cottrell CK, O'Donnell FJ, et al. Effect of preventive (beta blocker) treatment, behavioural migraine management, or their combination on outcomes of optimised acute treatment in frequent migraine: randomised controlled trial. BMJ. 2010 Sep 29;341:c4871. doi: 10.1136/bmj.c4871Holroyd KA, Cottrell CK, O'Donnell FJ, et al. Effect of preventive (beta blocker) treatment, behavioural migraine management, or their combination on outcomes of optimised acute treatment in frequent migraine: randomised controlled trial. BMJ. 2010 Sep 29;341:c4871. doi: 10.1136/bmj.c4871Coppola G, Magis D, Casillo F, et al. Neuromodulation for Chronic Daily Headache. Curr Pain Headache Rep. 2022 Mar;26(3):267-78. doi: 10.1007/s11916-022-01025-x. Epub 2022 Feb 7.Coppola G, Magis D, Casillo F, et al. Neuromodulation for Chronic Daily Headache. Curr Pain Headache Rep. 2022 Mar;26(3):267-78. doi: 10.1007/s11916-022-01025-x. Epub 2022 Feb 7.Lloyd JO, Hill B, Murphy M, et al. Single-Pulse Transcranial Magnetic Stimulation for the preventive treatment of difficult-to-treat migraine: a 12-month prospective analysis. J Headache Pain. 2022 Jun 6;23(1):63. doi: 10.1186/s10194-022-01428-6Lloyd JO, Hill B, Murphy M, et al. Single-Pulse Transcranial Magnetic Stimulation for the preventive treatment of difficult-to-treat migraine: a 12-month prospective analysis. J Headache Pain. 2022 Jun 6;23(1):63. doi: 10.1186/s10194-022-01428-6Casucci G, Villani V, Cologno D, D'Onofrio F. Polytherapy for migraine prophylaxis. Neurol Sci. 2012 May;33 Suppl 1:S147-50. doi: 10.1007/s10072-012-1060-7Casucci G, Villani V, Cologno D, D'Onofrio F. Polytherapy for migraine prophylaxis. Neurol Sci. 2012 May;33 Suppl 1:S147-50. doi: 10.1007/s10072-012-1060-7Joshi S, Tepper SJ, Lucas S, et al. A narrative review of the importance of pharmacokinetics and drug-drug interactions of preventive therapies in migraine management. Headache. 2021 Jun;61(6):838-53. doi: 10.1111/head.14135Joshi S, Tepper SJ, Lucas S, et al. A narrative review of the importance of pharmacokinetics and drug-drug interactions of preventive therapies in migraine management. Headache. 2021 Jun;61(6):838-53. doi: 10.1111/head.14135D'Amico D. Controversies in migraine: monotherapy. Neurol Sci. 2012 May;33 Suppl 1:S141-5. doi: 10.1007/s10072-012-1059-0D'Amico D. Controversies in migraine: monotherapy. Neurol Sci. 2012 May;33 Suppl 1:S141-5. doi: 10.1007/s10072-012-1059-0Alex A, Armand CE. Rational Polypharmacy for Migraine. Pract Neurol. 2022 May:30-4.Alex A, Armand CE. Rational Polypharmacy for Migraine. Pract Neurol. 2022 May:30-4.Silberstein SD, Dodick D, Freitag F, et al. Pharmacological approaches to managing migraine and associated comorbidities – clinical considerations for monotherapy versus polytherapy. Headache. 2007 Apr;47(4):585-99. doi: 10.1111/j.1526-4610.2007.00760.xSilberstein SD, Dodick D, Freitag F, et al. Pharmacological approaches to managing migraine and associated comorbidities – clinical considerations for monotherapy versus polytherapy. Headache. 2007 Apr;47(4):585-99. doi: 10.1111/j.1526-4610.2007.00760.xPeterlin BL, Calhoun AH, Siegel S, Mathew NT. Rational combination therapy in refractory migraine. Headache. 2008 Jun;48(6):805-19. doi: 10.1111/j.1526-4610.2008.01142.xPeterlin BL, Calhoun AH, Siegel S, Mathew NT. Rational combination therapy in refractory migraine. Headache. 2008 Jun;48(6):805-19. doi: 10.1111/j.1526-4610.2008.01142.xAilani J, Blumenfeld AM. Combination CGRP monoclonal antibody and onabotulinumtoxinA treatment for preventive treatment in chronic migraine. Headache. 2022 Jan;62(1):106-8. doi: 10.1111/head.14244. Epub 2021 Dec 7.Ailani J, Blumenfeld AM. Combination CGRP monoclonal antibody and onabotulinumtoxinA treatment for preventive treatment in chronic migraine. Headache. 2022 Jan;62(1):106-8. doi: 10.1111/head.14244. Epub 2021 Dec 7.Pellesi L, Do TP, Ashina H, et al. Dual Therapy With Anti-CGRP Monoclonal Antibodies and Botulinum Toxin for Migraine Prevention: Is There a Rationale? Headache. 2020 Jun;60(6):1056-65. doi: 10.1111/head.13843. Epub 2020 May 21.Pellesi L, Do TP, Ashina H, et al. Dual Therapy With Anti-CGRP Monoclonal Antibodies and Botulinum Toxin for Migraine Prevention: Is There a Rationale? Headache. 2020 Jun;60(6):1056-65. doi: 10.1111/head.13843. Epub 2020 May 21.Reuter U, Ehrlich M, Gendolla A, et al. Erenumab versus topiramate for the prevention of migraine – a randomised, double-blind, active-controlled phase 4 trial. Cephalalgia. 2022 Feb;42(2):108-18. doi: 10.1177/03331024211053571. Epub 2021 Nov 7.Reuter U, Ehrlich M, Gendolla A, et al. Erenumab versus topiramate for the prevention of migraine – a randomised, double-blind, active-controlled phase 4 trial. Cephalalgia. 2022 Feb;42(2):108-18. doi: 10.1177/03331024211053571. Epub 2021 Nov 7.Martelletti P, Edvinsson L, Ashina M. Shaping the future of migraine targeting Calcitonin-Gene-Related-Peptide with the Disease-Modifying Migraine Drugs (DMMDs). J Headache Pain. 2019 May 23;20(1):60. doi: 10.1186/s10194-019-1009-9Martelletti P, Edvinsson L, Ashina M. Shaping the future of migraine targeting Calcitonin-Gene-Related-Peptide with the Disease-Modifying Migraine Drugs (DMMDs). J Headache Pain. 2019 May 23;20(1):60. doi: 10.1186/s10194-019-1009-9Edvinsson L, Haanes KA, Warfvinge K, Krause DN. CGRP as the target of new migraine therapies – successful translation from bench to clinic. Nat Rev Neurol. 2018 Jun;14(6):338-50. doi: 10.1038/s41582-018-0003-1Edvinsson L, Haanes KA, Warfvinge K, Krause DN. CGRP as the target of new migraine therapies – successful translation from bench to clinic. Nat Rev Neurol. 2018 Jun;14(6):338-50. doi: 10.1038/s41582-018-0003-1Jackson JL, Cogbill E, Santana-Davila R, et al. A Comparative Effectiveness MetaAnalysis of Drugs for the Prophylaxis of Migraine Headache. PLoS One. 2015 Jul 14;10(7):e0130733. doi: 10.1371/journal.pone.0130733Jackson JL, Cogbill E, Santana-Davila R, et al. A Comparative Effectiveness MetaAnalysis of Drugs for the Prophylaxis of Migraine Headache. PLoS One. 2015 Jul 14;10(7):e0130733. doi: 10.1371/journal.pone.0130733Luykx J, Mason M, Ferrari MD, Carpay J. Are migraineurs at increased risk of adverse drug responses? A meta-analytic comparison of topiramate-related adverse drug reactions in epilepsy and migraine. Clin Pharmacol Ther. 2009 Mar;85(3):283-8. doi: 10.1038/clpt.2008.203. Epub 2008 Nov 5.Luykx J, Mason M, Ferrari MD, Carpay J. Are migraineurs at increased risk of adverse drug responses? A meta-analytic comparison of topiramate-related adverse drug reactions in epilepsy and migraine. Clin Pharmacol Ther. 2009 Mar;85(3):283-8. doi: 10.1038/clpt.2008.203. Epub 2008 Nov 5.Hepp Z, Dodick DW, Varon SF, et al. Persistence and switching patterns of oral migraine prophylactic medications among patients with chronic migraine: A retrospective claims analysis. Cephalalgia. 2017 Apr;37(5):470-85. doi: 10.1177/0333102416678382. Epub 2016 Nov 12.Hepp Z, Dodick DW, Varon SF, et al. Persistence and switching patterns of oral migraine prophylactic medications among patients with chronic migraine: A retrospective claims analysis. Cephalalgia. 2017 Apr;37(5):470-85. doi: 10.1177/0333102416678382. Epub 2016 Nov 12.Pavelic AR, Wöber C, Riederer F, Zebenholzer K. Monoclonal Antibodies against Calcitonin Gene-Related Peptide for Migraine Prophylaxis: A Systematic Review of Real-World Data. Cells. 2022 Dec 29;12(1):143. doi: 10.3390/cells12010143Pavelic AR, Wöber C, Riederer F, Zebenholzer K. Monoclonal Antibodies against Calcitonin Gene-Related Peptide for Migraine Prophylaxis: A Systematic Review of Real-World Data. Cells. 2022 Dec 29;12(1):143. doi: 10.3390/cells12010143Wang X, Wen D, He Q, et al. Efficacy and safety of monoclonal antibody against calcitonin gene-related peptide or its receptor for migraine patients with prior preventive treatment failure: a network meta-analysis. J Headache Pain. 2022 Sep 8;23(1):105. doi: 10.1186/s10194-022-01472-2Wang X, Wen D, He Q, et al. Efficacy and safety of monoclonal antibody against calcitonin gene-related peptide or its receptor for migraine patients with prior preventive treatment failure: a network meta-analysis. J Headache Pain. 2022 Sep 8;23(1):105. doi: 10.1186/s10194-022-01472-2Raffaelli B, Kalantzis R, Mecklenburg J, et al. Erenumab in Chronic Migraine Patients Who Previously Failed Five First-Line Oral Prophylactics and OnabotulinumtoxinA: A Dual-Center Retrospective Observational Study. Front Neurol. 2020 May 28;11:417. doi: 10.3389/fneur.2020.00417Raffaelli B, Kalantzis R, Mecklenburg J, et al. Erenumab in Chronic Migraine Patients Who Previously Failed Five First-Line Oral Prophylactics and OnabotulinumtoxinA: A Dual-Center Retrospective Observational Study. Front Neurol. 2020 May 28;11:417. doi: 10.3389/fneur.2020.00417Ashina M, Tepper S, Brandes JL, et al. Efficacy and safety of erenumab (AMG334) in chronic migraine patients with prior preventive treatment failure: A subgroup analysis of a randomized, double-blind, placebo-controlled study. Cephalalgia. 2018 Sep;38(10):1611-21. doi: 10.1177/0333102418788347. Epub 2018 Jul 8.Ashina M, Tepper S, Brandes JL, et al. Efficacy and safety of erenumab (AMG334) in chronic migraine patients with prior preventive treatment failure: A subgroup analysis of a randomized, double-blind, placebo-controlled study. Cephalalgia. 2018 Sep;38(10):1611-21. doi: 10.1177/0333102418788347. Epub 2018 Jul 8.Al-Hassany L, Lyons HS, Boucherie DM, et al; European Headache Federation School of Advanced Studies (EHF-SAS). The sense of stopping migraine prophylaxis. J Headache Pain. 2023 Feb 16;24(1):9. doi: 10.1186/s10194-023-01539-8Al-Hassany L, Lyons HS, Boucherie DM, et al; European Headache Federation School of Advanced Studies (EHF-SAS). The sense of stopping migraine prophylaxis. J Headache Pain. 2023 Feb 16;24(1):9. doi: 10.1186/s10194-023-01539-8Andreou AP, Fuccaro M, Hill B, et al. Two-year effectiveness of erenumab in resistant chronic migraine: a prospective real-world analysis. J Headache Pain. 2022 Nov 4;23(1):139. doi: 10.1186/s10194-022-01507-8Andreou AP, Fuccaro M, Hill B, et al. Two-year effectiveness of erenumab in resistant chronic migraine: a prospective real-world analysis. J Headache Pain. 2022 Nov 4;23(1):139. doi: 10.1186/s10194-022-01507-8

The authors declare that there are no conflicts of interest present.