Examinando por Autor "Grozeva, Vasselina"

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    Ítem
    Behavioral therapy in migraine: expanding the therapeutic arsenal
    (John Wiley and Sons Inc, 2024-07-21) Mínguez Olaondo, Ane; Alves Días, Patricia; López de Munáin, Estíbaliz; Grozeva, Vasselina; Laspra Solís, Carmen; Martín Villalba, Inés; García Martín, Valvanuz; Vila Pueyo, Marta; Barandiarán Amillano, Myriam; Zabalza, Ramón J.; Bengoetxea, Ana
    Background and purpose: The US Headache Consortium developed evidence-based guidelines for the treatment of migraine and found grade A evidence in support of behavior therapy (BT). Understanding the mechanisms of BT may improve the management of migraine and reduce its burden. Methods: We performed a narrative review to define the current evidence of BT and determine its usefulness in migraine management. Results: The information was obtained from 116 publications, with 56 of them retrieved through direct searches in PubMed (2011–2020) and the remainder selected by the authors to complete the content. BT might reduce migraine impact by decreasing the sympathetic nervous system's response to stress and increasing pain tolerance. Acting in headache-related surroundings can be improved, together with headache duration and self-efficacy. Applications such as mobile health and electronic health applications can help to carry out healthier lifestyle patterns. Regarding medication overuse, BT seems to be a good choice, with similar results to pharmacological prophylaxis. Advantages of using BT are the lack of adverse effects and the unrestricted use in children, where BT is postulated to be even more effective than the standardized pharmacopeia. Conclusions: BT is an interesting tool that can be used as an add-on therapy in migraine. Through BT, the autonomy and empowerment of migraine patients is enhanced. BT may not cure migraine, but it could help to reduce pain severity perception, disability, and migraine impact, adding an emotive and cognitive approach to the perceptive role of pharmacopeia. Thus, a better approach in migraine, implementing specific therapeutic management, can improve migraine control.
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    Cutaneous allodynia in migraine: a narrative review
    (Frontiers Media S.A., 2022-01-21) Mínguez Olaondo, Ane; Quintas, Sonia; Morollón, Noemí ; López Bravo, Alba; Vila Pueyo, Marta; Grozeva, Vasselina ; Belvís Nieto, Roberto; Santos Lasaosa, Sonia; Irimia, Pablo
    In the present work, we conduct a narrative review of the most relevant literature on cutaneous allodynia (CA) in migraine. CA is regarded as the perception of pain in response to non-noxious skin stimulation. The number of research studies relating to CA and migraine has increased strikingly over the last few decades. Therefore, the clinician treating migraine patients must recognize this common symptom and have up-to-date knowledge of its importance from the pathophysiological, diagnostic, prognostic and therapeutic point of view. We performed a comprehensive narrative review to analyze existing literature regarding CA in migraine, with a special focus on epidemiology, pathophysiology, assessment methods, risk for chronification, diagnosis and management. PubMed and the Cochrane databases were used for the literature search. The prevalence of CA in patients with migraine is approximately 60%. The mechanisms underlying CA in migraine are not completely clarified but include a sensitization phenomenon at different levels of the trigemino-talamo-cortical nociceptive pathway and dysfunction of brainstem and cortical areas that modulate thalamocortical inputs. The gold standard for the assessment of CA is quantitative sensory testing (QST), but the validated Allodynia 12-item questionnaire is preferred in clinical setting. The presence of CA is associated with an increased risk of migraine chronification and has therapeutic implications. CA is a marker of central sensitization in patients with migraine that has been associated with an increased risk of chronification and may influence therapeutic decisions.
  • Miniatura
    Ítem
    Dysautonomia in COVID-19 patients: a narrative review on clinical course, diagnostic and therapeutic strategies
    (Frontiers Media S.A., 2022-05-27) Carmona de la Torre, Francisco; Mínguez Olaondo, Ane; López Bravo, Alba; Tijero Merino, Beatriz; Grozeva, Vasselina ; Walcker, Michaela ; Azkune, Harkaitz ; López de Munain Arregui, Adolfo; Alcaide, Ana Belén ; Quiroga Vila, Jorge Augusto ; Pozo, José Luis del ; Gómez Esteban, Juan Carlos
    On March 11, 2020, the World Health Organization sounded the COVID-19 pandemic alarm. While efforts in the first few months focused on reducing the mortality of infected patients, there is increasing data on the effects of long-term infection (Post-COVID-19 condition). Among the different symptoms described after acute infection, those derived from autonomic dysfunction are especially frequent and limiting. To conduct a narrative review synthesizing current evidence of the signs and symptoms of dysautonomia in patients diagnosed with COVID-19, together with a compilation of available treatment guidelines. Autonomic dysfunction associated with SARS-CoV-2 infection occurs at different temporal stages. Some of the proposed pathophysiological mechanisms include direct tissue damage, immune dysregulation, hormonal disturbances, elevated cytokine levels, and persistent low-grade infection. Acute autonomic dysfunction has a direct impact on the mortality risk, given its repercussions on the respiratory, cardiovascular, and neurological systems. Iatrogenic autonomic dysfunction is a side effect caused by the drugs used and/or admission to the intensive care unit. Finally, late dysautonomia occurs in 2.5% of patients with Post-COVID-19 condition. While orthostatic hypotension and neurally-mediated syncope should be considered, postural orthostatic tachycardia syndrome (POTS) appears to be the most common autonomic phenotype among these patients. A review of diagnostic and treatment guidelines focused on each type of dysautonomic condition was done. Symptoms deriving from autonomic dysfunction involvement are common in those affected by COVID-19. These symptoms have a great impact on the quality of life both in the short and medium to long term. A better understanding of the pathophysiological mechanisms of Post-COVID manifestations that affect the autonomic nervous system, and targeted therapeutic management could help reduce the sequelae of COVID-19, especially if we act in the earliest phases of the disease.