Clara Domínguez

Is Periodontal Disease Associated with Alzheimer's Disease A Systematic Review with Meta-Analysis

Background: In the last decade, several observational studies have suggested that there exists an association between periodontal disease (PD) and Alzheimers disease (AD). The aim of this systematic review was to investigate whether or not this link exists. Summary: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline for systematic review was used and registered at PROSPERO (CRD42016035377). The search strategy included using electronic databases and by hand searching articles published up to January 2016. MEDLINE via PubMed, EMBASE and Web of Science were searched by 2 independent reviewers. Observational studies including patients meeting criteria for both AD and PD were eligible to be included in the analysis. Quality assessment of selected studies was performed by the Newcastle-Ottawa Scale. From a total of 550 titles and abstracts, 5 studies were included (2 cross-sectional, 2 case-control and one cohort study) in the review. A fixed effects meta-analysis showed that the presence of PD is associated with the presence of AD (OR 1.69, 95% CI 1.21-2.35). When only severe forms of PD were evaluated, a significant association was also observed (OR 2.98, 95% CI 1.58-5.62). Key Messages: In the present review, a significant association was observed between PD and AD. Further studies should be carried out in order to investigate the direction of the association and factors that may confound it.

OnabotulinumtoxinA in chronic migraine: predictors of response. A prospective multicentre descriptive study

OnabotulinumtoxinA is a treatment specifically approved for the prophylaxis of chronic migraine in adults. The aim of this study was to assess the effectiveness of OnabotulinumtoxinA in chronic migraine after 1 year of treatment in a real‐life setting and to identify clinical predictors of outcome.

Role of adipocytokines in the pathophysiology of migraine. A cross-sectional study.

We are writing with regard to the letter sent by Hyun Jin Min and Kyung Soo Kim (1) in connection with our recently published work in Cephalalgia, ‘‘Role of adipocytokines in the pathophysiology of migraine. A cross-sectional study’’ (2). First of all, we want to thank the authors for the attention and time devoted to the analysis of our work and all their valuable comments. We acknowledge there were two minor transcription mistakes in our paper regarding mean age and prevalence of females in Table 1 and the acronym used for high-sensitivity C-reactive protein in Table 2. In our study, there was no statistically significant difference in levels of leptin and adiponectin between patients suffering migraine with aura and migraine without aura. We did not expect to see a difference between these two groups, considering that we assume the same pathophysiology under both types of migraine and that this difference has not been previously evaluated or reported (3,4). Regarding the effect of BMI and hemodilution on adipocytokine levels, our results are already adjusted by BMI, age and sex by logistic regression analysis. Therefore, the possible effect of hemodilution on adypocitokine levels should be already controlled. Moreover, if hemodilution had an important effect on levels of leptin or adiponectin, levels of both molecules would be inversely correlated with BMI, and not positively correlated in the case of leptin and inversely correlated in the case of adiponectin. Finally, all the studies mentioned by the authors (5–7) refer to tumor markers and obesity; in our study we try to correlate adipocytokine levels with BMI, without comparing values in obese and non-obese subjects. Last, levels of adiponectin in our sample are different in patients and controls, and also different when we analyze the subgroup of chronic migraineurs (CM) and the subgroup of episodic migraineurs (EM). Mean levels of adiponectin are lower in EM patients than in healthy controls, but this difference does not have statistical signification; therefore, we should assume these values as equal. Besides, values in EM in our sample are more scattered than in healthy controls if we look at standard deviation values. This variability suggests that there may be great clinical and physiopathological variations in the group of patients that we categorize as EM compared with the CM group and healthy controls. Previous studies also report very diverse levels of adipocytokine in migraineurs and controls: Bernecker et al. did not find statistically significant differences in ADP levels between migraineurs and controls(8,9); Peterlin et al. (10) analyzed results in EM and CM separately, but did not compare episodic migraineurs and controls; a later study by Duarte et al. (11) compared EM and CM with no significant differences, and more recently Dearborn et al. (9) also found higher levels in migraineurs, including CM and EM, but again did not compare levels in EM and controls. There is also a great variability in the levels of ADP reported in the mentioned studies, probably due to the different ADP multimers and its relation to inflammation, which make the study of this molecule and its role in migraine much more complex (12).

CGRP and PTX3 as Predictors of Efficacy of Onabotulinumtoxin Type A in Chronic Migraine: An Observational Study

The aim of this study is to find a relation between several biomarkers in peripheral blood and outcome after treatment with onabotulinumtoxin A (OnabotA).

Asociación entre enfermedad periodontal y demencia. Revisión de la bibliografía

INTRODUCTION Periodontal disease and dementia are very prevalent, especially in elderly populations. Multiple studies have shown a link between these diseases; however, the conditions are highly heterogeneous and so is the diagnostic methodology, which may hinder interpretation and comparison of the results. The aim of this article is to provide a critical review of the literature linking these 2 processes. DEVELOPMENT We retrieved 22 studies, most of which were retrospective, and analysed various methodological variables including study population, diagnosis of periodontitis, definition of dementia, adjusted variables, and results. The different aetiopathogenic mechanisms that may affect the progression and interaction of these 2 conditions were also analysed. CONCLUSIONS Although available evidence indicates a positive association between periodontitis and dementia, both the strength of that association and the presence of a causal relationship have yet to be determined.

Association between periodontitis and chronic migraine: a case–control study

The aim of this investigation was to examine whether chronic periodontitis (CP) is a risk indicator of chronic migraine (CM). We performed a case–control study consisted of 102 cases (patients diagnosed with CM) and 91 controls (non-CM individuals) matched by age and gender. Full-mouth periodontal charts, demographic, medical, clinical, as well as neurological data were obtained. In addition, high sensitive C-reactive protein serum levels were determined from blood samples of both cases (taken during migraine interictal period) and controls. The prevalence of CP was significantly higher in patients with CM compared to those without CM (58.8 vs. 30.8%, p < 0.0001). Logistic regression analysis showed that CP was significantly associated with the presence of CM, independently of well-known chronifying factors of migraine (OR 2.4; 95% CI 1.2–4.7; p = 0.012). Based on our results, CP could be considered as a risk indicator of CM. However, more evidence is necessary to investigate if this relationship is causal or not.

Unilateral pain and shorter duration of chronic migraine are significant predictors of response to onabotulinumtoxin A

C. Dom ınguez, P. Pozo-Rosich, Y. Leira and R. Leira Service of Neurology, Headache Unit, Hospital Cl ınico Universitario, University of Santiago de Compostela, Santiago de Compostela, Hospital Universitario Vall d’Hebron, Headache Research Group, Vall d’Hebron Institute of Research (VHIR), Universitat Autonoma de Barcelona, Barcelona, and OMEQUI Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain

Comorbidity between idiopathic overactive bladder and chronic migraine.

Objective We tested whether overactive bladder (OAB) and chronic migraine (CM) could be comorbid. Patients and methods CM women, aged 40–69 years, answered a validated OAB questionnaire. Prevalence data were compared with those reported in our country in the general population (GP) using the same questionnaire. Results We interviewed 231 CM women. Eighty-four met OAB criteria. OAB prevalence in CM patients was significantly higher than that found in the GP (36.4% vs. 21.8% in the GP; p = 0.0001). There were 34 CM women aged 40–49 years (34.3% vs. 15.2%; p = 0.001), 35 aged 50–59 years (38.9% vs. 21.7%; p = 0.004) and 15 aged 60–69 years (35.7% vs. 24.5%; p = 0.15) meeting OAB criteria. Seventy-seven (33% vs. 9.9%; p = 0.002) needed more than eight micturitions/24 h, 61 (26.4% vs. 8.1%, p = 0.002) experienced nocturia and 43 (18.6% vs. 8.1%; p = 0.001) urinary incontinence. Conclusion In this exploratory study, at least in women, OAB and CM are comorbid, which suggests shared mechanisms.