Evidence map›Paper›PMID 40739615›Full record

ArticleThe journal of headache and pain2025

One-month atogepant treatment induces rapid changes in delta-band functional connectivity in migraine: an HD-EEG study.

Matteo Conti, Silvio Bagetta, Federico Carparelli, Valerio Ferrari, Vittoria Carla D'Agostino, Fabio Placidi, Alessandro Stefani, Nicola Biagio Mercuri, Maria Albanese

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Article in The journal of headache and pain, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Matteo ContiDepartment of Systems Medicine, Unit of Neurology , University of Rome Tor Vergata, Via Montpellier, Rome, 00133, Italy.
Silvio BagettaDepartment of Systems Medicine, Unit of Neurology , University of Rome Tor Vergata, Via Montpellier, Rome, 00133, Italy.
Federico CarparelliNeurology Unit, Tor Vergata University Hospital, Rome, 00133, Italy.
Valerio FerrariDepartment of Systems Medicine, Unit of Neurology , University of Rome Tor Vergata, Via Montpellier, Rome, 00133, Italy.
Vittoria Carla D'AgostinoNeurology Unit, Tor Vergata University Hospital, Rome, 00133, Italy.
Fabio PlacidiDepartment of Systems Medicine, Unit of Neurology , University of Rome Tor Vergata, Via Montpellier, Rome, 00133, Italy.
Alessandro StefaniDepartment of Systems Medicine, Unit of Neurology , University of Rome Tor Vergata, Via Montpellier, Rome, 00133, Italy.
Nicola Biagio MercuriDepartment of Systems Medicine, Unit of Neurology , University of Rome Tor Vergata, Via Montpellier, Rome, 00133, Italy.
Maria AlbaneseDepartment of Systems Medicine, Unit of Neurology , University of Rome Tor Vergata, Via Montpellier, Rome, 00133, Italy. maria.albanese@hotmail.it.

Funding

European Union-Next Generation EU PNRR-MAD-2022-12376769Ministry of University and Research (MUR) project MNESYS (PE0000006)
6 · The paper itself

Abstract

backgroundAtogepant is a novel oral calcitonin gene-related peptide (CGRP) receptor antagonist approved for the preventive treatment of migraine. While its peripheral mechanisms are well characterized, little is known about its potential effects on central functional brain networks. This study aims to investigate changes in resting-state functional connectivity (FC) using high-density EEG (HD-EEG) after one month of atogepant treatment in patients with migraine, and to assess the relationship between these changes and clinical response.

methodsTwelve patients with high-frequency episodic migraine (HFEM; n = 7) or chronic migraine (CM; n = 5) underwent HD-EEG recordings at two time points: before starting Atogepant administration (T0) and after one month of treatment (T1). Fifteen healthy controls (HC) were also enrolled. Clinical evaluations included: monthly migraine days (MMD), monthly symptomatic drugs intake (MSI), modified Migraine Disability Assessment (mMIDAS), the headache impact test (HIT-6), the Migraine-Specific Quality of Life Questionnaire (MSQ), the 12-item Allodynia Symptom Checklist (ASC-12), and the Migraine Interictal Burden Scale (MIBS-4). EEG-based FC was analyzed in source space using the weighted Phase Lag Index (wPLI) across δ, θ, α, β, low-γ, and high-γ bands. To identify changes related to treatment, we applied Network-Based Statistics (NBS), while Spearman correlation was used to explore the relationship between clinical improvements and functional changes.

resultsCompared to HCs, HFEM + CM patients exhibited increased δ band functional connectivity (FC) in temporo-parietal, orbitofrontal, insular, and limbic regions. After one month of atogepant treatment, a significant reduction in this aberrant FC was observed, particularly in bilateral temporo-parietal, cingulate, insular, and prefrontal cortices. Baseline δ-band FC correlated with greater clinical disability (mMIDAS, MSQ), while treatment-induced FC changes (ΔmNC) were associated with improvements in mMIDAS, HIT-6, and ASC-12 scores, highlighting the clinical relevance of δ band network modulation.

conclusionsThis pilot study provides preliminary evidence that atogepant modulates δ band functional brain connectivity after one month of treatment in patients with episodic and chronic migraine. These changes in central brain networks are associated with clinical improvement and may serve as a neurophysiological marker of CGRP receptor antagonist efficacy. Larger-scale studies are needed to confirm and extend these findings.

Indexed as

BrainCalcitonin Gene-Related Peptide Receptor AntagonistsDelta RhythmMigraine DisordersAdultElectroencephalographyFemaleHumansMaleMiddle AgedTreatment OutcomeCalcitonin Gene-Related Peptide Receptor AntagonistsAtogepantFunctional connectivityHD-EEGMigraine

Identifiers

PMID40739615
PMCPMC12312362

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.