Charly Gaul

Headache Center Frankfurt

Background Although good treatment options exist for many headache disorders, not all patients benefit and disability continues to be large. To design strategies for improving headache care, real-world data observing standard care is necessary. Therefore, the German Migraine and Headache Society (DMKG) has established the DMKG Headache Registry. He...

Migraine is a headache disorder associated with a high socioeconomic burden. The digital therapeutic sinCephalea provides an individualized low-glycemic diet based on continuous glucose measurement and is intended to provide a non-pharmacological migraine prophylaxis. We performed two prospective studies with migraine patients who used sinCephalea...

Neck and/or shoulder pain (NSP) frequently occurs together with headache. Therefore, we explored how patients with and without concomitant NSP differ in their baseline characteristics and in perceived treatment responses to an analgesic. An anonymous survey was performed among 895 patients with headache (735 self-reported tension-type headache [TTH...

Background CGAR, a Phase 3b open-label study, evaluated the long-term safety of galcanezumab in patients with cluster headache who completed one of two Phase 3 double-blind studies in chronic or episodic cluster headache. Methods Patients (N = 164) received galcanezumab 300 mg subcutaneously up to once a month. Primary endpoint was safety, as asse...

Background Overall, 55% of the German population suffers from primary episodic headaches according to recent studies. Inadequate management of headache disorders is a significant medical problem. The prevalence of medication overuse headache (MOH) is about 1% with an estimated number of 800,000 people in Germany. Medication overuse (MO) and MOH are...

Background: Cluster headache (CH) is a highly debilitating headache disorder characterized by frequent attacks of excruciating unilateral pain accompanied by cranial autonomic symptoms. Calcitonin gene-related peptide (CGRP) is implicated in the pathophysiology of CH. Objectives: Preventive efficacy and tolerability of the anti-CGRP antibody gal...

Background: Behavioral approaches are central to the preventive treatment of migraine but empirical evidence regarding efficacy and effectiveness is still sparse. This study aimed to evaluate the efficacy of a newly developed migraine-specific, integrative cognitive-behavioral therapy program (miCBT) combining several approaches (trigger and stres...

Introduction: The aim of this analysis is to determine whether regular physical activity is associated with less analgesic use in men and women suffering from headache disorders based on population-based cross-sectional data. Methods: We used data from a random general population sample in Germany that comprised 2477 participants aged ≥ 14 years...

Background: Migraine is a headache disorder with the highest socioeconomic burden. The aim of this study was to deliver the first proof-of-concept data of the potential role of an individual low-glycemic diet provided by a novel digital health application in the prophylaxis of migraine. Methods: We analyzed data from a retrospective survey of in...

Objective: This study aimed to develop a self-report questionnaire for the assessment of attack-related fear in migraine, and to determine its factor structure as well as its psychometric properties by the primary analysis of a cross-sectional survey's data. Background: High fear of attacks in migraine increases the burden of disease and is assu...

Neue Entwicklungen der Pharmakotherapie haben die Migräneprophylaxe deutlich verbessert, auch die Akuttherapie der meisten Kopfschmerzerkrankungen erfolgt primär pharmakologisch. Doch die Verordnung von Medikamenten macht einen komplementären Ansatz in der Kopfschmerzbehandlung keineswegs überflüssig.

Background: Chronic migraine (CM) is associated with substantial economic burden. Real-world data suggests that onabotulinumtoxinA treatment for CM reduces healthcare resource utilisation (HRU) and related costs. Methods: REPOSE was a 2-year prospective, multicentre, non-interventional, observational study to describe the real-world use of onabo...

Background Erenumab, the first-in-class fully human monoclonal antibody targeting the calcitonin gene-related peptide receptor, was shown to be efficacious and safe for the prophylactic treatment of migraine in adults in randomized clinical trials. Large-scale, real-world evidence in multi-centre settings is still needed to confirm these results. E...

Background The aim of this work is to analyze reports of migraine attacks collected online in the citizen science project CLUE with respect to gender- and migraine type-specific differences in drug effectiveness and pain perception. Citizen science project data collection opens the possibility to examine these differences based on a large number of...

Introduction: Migraine is consistently ranked as one of the most disabling neurological conditions in the world, often causing a substantial impairment of daily activities and quality of life. It also carries a high economic burden of direct and indirect healthcare costs. Patients with difficult-to-treat migraine often cycle through different prev...

Citation: Burow, P.; Haselier, M.; Naegel, S.; Scholle, L.M.; Gaul, C.; Kraya, T. The Mitochondrial Biomarkers FGF-21 and GDF-15 in Patients with Episodic and Chronic Migraine. Cells 2021, 10, 2471.

Aim Many migraine patients rely on over-the-counter (OTC) analgesics for the treatment of migraine attacks. Fixed-dose combinations of aspirin, paracetamol and caffeine (APC) are used for treating migraine in many countries for a long time. We performed a meta-analysis for the comparison of APC vs placebo, which has not been done so far. Methods R...

Background Triptans are a highly effective substance class in the acute treatment of migraine attacks. They contribute to a substantial improvement in the quality of life and help to reduce the socioeconomic burden of the disease.ResultsSumatriptan is the only triptan that is available for subcutaneous administration. It is primarily indicated in p...

Purpose: In a phase 3 study, galcanezumab significantly reduced the frequency of episodic cluster headache attacks across weeks 1-3 (primary endpoint) compared with placebo. However, multiple pain dimensions may contribute to the total burden of episodic cluster headache pain. This post hoc analysis assessed the impact of galcanezumab on the total...

Background Erenumab, the first-in-class fully human monoclonal antibody targeting the calcitonin gene-related peptide receptor, was shown to be efficacious and safe for the prophylactic treatment of migraine in adults in randomized clinical trials. Large-scale, real-world evidence in multi-centre settings is still needed to confirm these results. E...

Introduction Migraine is the most common neurological disorder and one of the major causes of years lived with disability. Its treatment (especially of chronic forms) is often challenging and accompanied with adverse effects. Although new therapeutic approaches have recently emerged (eg, calcitonin gene-related peptide antibodies), these are linked...

Migraine is one of the leading causes of years lived with disability and considered to be a major global health concern. Pharmacological preventive treatment often causes side effects that limit the adherence to longer-term treatment regiments. Both experimental and clinical evidence suggests that positive expectations can modulate pain and analges...

Background The aim of this work is to analyze the reports on cluster headache attacks collected online in the citizen science project CLUE with respect to the effectiveness of drugs taken during the attacks. The collection of data within the framework of citizen science projects opens up the possibility of investigating the effectiveness of acute m...

Background: To provide an overview on the status of clinical research in neurology in Germany. Methods: German university, non-university hospitals and neurological medical practices were surveyed regarding their clinical research activities in the period from 2013 - 2017. Results: 50% of university hospitals, 10.6% of non-university hospitals...

Objective and aim: To describe differences in pain locations for onset, peak, and radiation aspects of cluster headache (CH) attacks. Methods and materials: Data were collected for 23 months using a cross-sectional online survey composed of 117 questions on pain location, demographics, and clinical features. 5260 datapoints on 44 pain locations...

Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (Erenumab) or against CGRP (Eptinezumab, Fremanezumab, Galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options, which already exist in migraine prevention. In randomized, placebo-controlled stud...

Background Migraine is common and ranked as the first cause of disability in people under fifty. Despite significant advances in its pharmacological treatment, it often remains intractable. Neuromodulation is one option considered in the management of those patients.Objective To assess the safety and efficacy of neuromodulation in the treatment of...

Trigeminal autonomic cephalalgias are characterized by unilateral headaches accompanied by cranial autonomic symptoms and a sense of restlessness. Clinical trials have been conducted on acute therapy and prophylaxis of cluster headache in recent years. Since the other trigeminal autonomic cephalalgias are rare, it is virtually impossible to conduct...

Background Prednisone is commonly used for initial short-term therapy of episodic cluster headaches before preventive medication such as verapamil becomes effective, but this strategy has not been tested in large randomised trials. We aimed to access the safety and efficacy of this treatment approach. Methods This study was a multicentre, randomi...

As neck and/or shoulder pain (NSP) frequently occur together with tension-type headache (TTH) and migraine, we explored how concomitant NSP affects perceived treatment responses to an analgesic. An anonymous survey was performed among 895 TTH and migraine sufferers who used the analgesic 400 mg ibuprofen/100 mg caffeine. NSP was relatively abundant...

Die Bedeutung der Medizin in der Zahnmedizin liegt allein schon darin begründet, dass kaum ein Arzt von den Patienten häufiger gesehen wird als der Zahnarzt. Dement sprechend kommt Zahnmedizinern einerseits bei der Früherkennung internistischer Erkrankungen eine besondere Bedeutung zu, während andererseits bereits vorliegende Allgemeinerkrankungen...

Background: Cluster headache (CH) is a highly disabling primary headache disorder. To date, characterization of outcomes in the preventive treatment of episodic CH, including precise definitions of clinically meaningful attack frequency reduction and impact on acute treatment management, is lacking. Methods: This was a Phase 3, randomized, doubl...

Background and Objective: Applying local treatments like neuromodulation or injections for cluster headache, requires exact knowledge of the anatomical structures and pain topography. However studies with emphasis on exact pain localization are rare although local treatments are increasingly used for patients in whom systemic pharmacotherapy is ine...

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve s...

Die monoklonalen Antikörper gegen CGRP oder den CGRP-Rezeptor sind eine wichtige Ergänzung der bisherigen Medikamente zu Migräneprophylaxe. Für eine Differenzierung fehlen aber direkte Vergleichsstudien.

Objective: To examine the factor structure of the Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ) and its German version (HTSAQ-G), in order to identify potential different types of triggers. Furthermore, a short form of the questionnaire was developed. Background: The HTSAQ includes 24 of the most commonly reported headache tr...

Chronic migraine (CM) is a highly disabling primary headache. Botulinum toxin (onabotulinumtoxinA) is effective for treatment of CM, with ~ 50% of patients responding after 24 weeks. A response predictor would prevent unnecessary treatments. Inhibiting calcitonin gene related peptide (CGRP) release from trigeminal nociceptive fibres is one of the m...

Background Cluster headache (CH) is clinically associated with considerable psychosocial burden. However, instruments to assess and characterize psychosocial factors in cluster headache more specifically are lacking. This study aimed to develop a self-report questionnaire, which assesses the broadest possible spectrum of psychosocial factors in clu...

Background: Headache sufferers in need of professional health care often do not utilize the care available, and factors influencing headache-specific physician consultation are not yet understood. Objectives of this study are (1) to assess self-reported headache-specific physician consultations and (2) to identify headache-related and sociodemogra...

ZUSAMMENFASSUNG Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (erenumab) or against CGRP (eptinezumab, fremanezumab, galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options which already exist in migraine prevention. In registration studies...

In diesem Kapitel werden alle gängigen Schmerzerkrankungen beschrieben, deren Vorkommen, die diagnostische Abklärung durch den Arzt, die Ursachen und die Möglichkeiten der Behandlung, die je nach Schmerz sehr unterschiedlich sein können. Neben Schmerzerkrankungen wie Rückenschmerzen, Kopfschmerzen und Migräne sowie Nervenschmerzen wird auch auf Erk...

Aim To investigate whether the self-treatment of migraine among neurologists and pain specialists corresponds to national medical guidelines and treatment of patients. Methods An email cross-sectional survey was sent to members of the German Society for Neurology, German Pain Society and German Migraine and Headache Society containing questions on...

Monoklonale Antikörper gegen den CGRP-Rezeptor (Erenumab [CGRP: „calcitonin gene-related peptide“]) oder gegen CGRP (Eptinezumab, Fremanezumab, Galcanezumab) sind neue Substanzen zur prophylaktischen Behandlung der Migräne. Sie stellen eine Erweiterung der therapeutischen Optionen in der Migräneprophylaxe dar. In Zulassungsstudien wurden die Wirksa...

Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (erenumab) or against CGRP (eptinezumab, fremanezumab, galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options which already exist in migraine prevention. In registration studies, the efficacy a...

Background Effects of emotion suppression on physical health might be contingent on culture. Existing research on emotion regulation has mainly included western participants. Herewith the question arises, whether this gained expertise is transferable to an Asian culture. Objectives This cross-sectional study evaluated to what extent the regulation...

Background: Reliable population-based data on the prevalence and characteristics of primary headache across the lifespan are essential. However, robust data are lacking. Methods: We utilized questionnaire data from a random general population sample in Germany, that comprised 2,478 participants aged ≥14 years. A standardized questionnaire addressin...

ZUSAMMENFASSUNG Die Therapie akuter Migräneattacken und die Prophylaxe der Migräne wurde durch Fortschritte in den Erkenntnissen der Pathophysiologie der Migräne und die Entwicklung neuer Substanzklassen in den letzten 30 Jahren dramatisch verbessert. Dazu gehört die Einführung der Triptane. Antagonisten gegen Substanz-P waren allerdings nicht wirk...

Introduction Non-invasive vagus nerve stimulation (nVNS; gammaCore®) has the potential to prevent migraine days in patients with migraine on the basis of mechanistic rationale and pilot clinical data. Methods This multicentre study included a 4-week run-in period, a 12-week double-blind period of randomised treatment with nVNS or sham, and a 24-we...

We developed a self-report questionnaire that measures a broad range of relevant psychological aspects of CH – the Cluster Headache Scales (CHS).

Hintergrund: Die Vermeidung von Kopfschmerzauslösern kann zur Entwicklung primärer Kopfschmerzerkrankungen führen. Daraus können verhaltenstherapeutische Behandlungsoptionen abgeleitet werden, die auf einen differen­zierten Umgang mit Kopfschmerztriggern abzielen. Zur ­Unterstützung der Therapieevaluation und -planung bei primären Kopfschmerzen wur...

Background: Two randomized, double-blind, sham-controlled trials (ACT1, ACT2) evaluated non-invasive vagus nerve stimulation (nVNS) as acute treatment for cluster headache. We analyzed pooled ACT1/ACT2 data to increase statistical power and gain insight into the differential efficacy of nVNS in episodic and chronic cluster headache. Methods: Dat...

Lasmiditan, a serotonin 5-HT1F receptor agonist, was effective for acute treatment of patients with migraine in a phase 3 double-blind randomized controlled study. The current study was designed to replicate these findings in a generalizable population of patients with migraine, including those with a cardiovascular medical history. This prospectiv...

Die Klassifikation der Gesichtsschmerzen hat sich mit der Überarbeitung der Internationalen Kopfschmerzklassifikation von 2018 verändert. Erstmals werden nun bildgebende Befunde bei der Diagnosestellung berücksichtigt. Dies hat auch Auswirkungen auf das Vorgehen in der Therapie.