Migraine Resource Network is a comprehensive educational initiative for clinicians seeking current and emerging information on migraine headache. Our mission is to provide ongoing medical education that embodies evidence-based scientific data, current treatment strategies, and the insightful knowledge of expert faculty. Our goal is to support your ongoing dedication to optimizing treatment outcomes for your patients.

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Brains, Sex Hormones & Women: Neural Mechanisms of Migraine

Release Date: August 31, 2008
Expiration Date: August 31, 2009


Migraine headaches, especially those that are hormonally triggered, are highly prevalent in women. Estrogen fluctuation is considered one causal factor, but it is also regarded as the primary factor for predisposition of menstrual migraine. Determining how endogenous and synthetic estrogen levels impact other neuroagents (eg, serotonin, inflammatory agents), and which events these neurochemicals initiate (eg, ion flux, cortical spreading depression) relative to types of migraine is an area of active translational research. Translational research interprets empirical data for improved patient management in clinical practice; transitioning knowledge from “bench” to practical application at “bedside.” Recent research findings in migraine, especially those in menstrual migraine, will be presented. Practical translation of these findings for improved patient management in the clinic will be explored.

Target Audience

This activity is designed for physicians, physician assistants, nurse practitioners, nurses and other healthcare professionals involved in the management of migraine.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Explain how translational research findings in migraine may increase diagnostic insight for therapeutic options
  • Interpret new and emerging research which further demonstrates the role of estrogen in migraine
  • Identify how the complexity of migraine etiology affects diagnosis and management of the disease
  • Formulate patient care leading to improved outcomes in the treatment of migraine through improved understanding of hormonal headache patterns

General Information

This activity is eligible for credit through August 31, 2009. After this date, this activity will expire and no further credit will be awarded.

There are no fees for participating in this activity. All participants must complete the Online Activity Evaluation. Participants must receive a minimum score of 70% on the self-assessment portion of the form to qualify for CE credit. Certificates may be printed immediately after successfully completing the online self-assessment and evaluation.

This activity is supported by an independent educational grant from
Endo  Pharmaceuticals

Faculty Biographies

Stephen D. Silberstein, MD, FACP - Chairman
Professor of Neurology and Director
Jefferson Headache Center
Thomas Jefferson University
Philadelphia, Pennsylvania

Dr. Stephen Silberstein received his medical degree from the University of Pennsylvania. After com­pleting a fellowship in neurology at the National Hospital for Nervous Diseases in London, he served as a pharmacology research associate in the toxicology laboratory of clinical science at the National In­stitutes of Mental Health and completed a neurology residency at the Hos­pital of the University of Pennsyl­vania. Dr. Silberstein is a professor of neurology and director of Jefferson Headache Center in Philadelphia.

A fellow of the American College of Physicians and the American Headache Society (AHS), Dr. Silberstein has served the AHS as president, treasurer, and board member. He has served on the publications, scientific, and educational committees of the AHS and was co-chairman of the Annual Scientific Meeting. He is senior editor of Wolff's Headache and Other Head Pain, 8th edition, associate editor of Cephalalgia and CNS Drugs, and on the editorial boards of Headache, Journal of Neurology, Neurosurgery and Psychology, and Topics in Pain Management. In addition, Dr. Silberstein is an ad hoc reviewer for The New England Journal of Medicine, The Lancet, and Neurology. He has published over 300 publications and lectures extensively on headache.

Andrew C. Charles, MD
Professor of Neurology
Headache Research and Treatment Program
UCLA School of Medicine
Los Angeles, California

Dr. Andrew Charles received his medical degree from the University of California, Los Angeles. He completed his neurology residency training and did a neuropharmacology research fellowship at UCLA before joining the faculty full-time in 1992. Dr. Charles is currently a professor of neurology, vice chairman for research, and director of the Headache Research and Treatment Program in the Department of Neurology at the UCLA School of Medicine. His laboratory uses advanced imaging and electrophysiological techniques to investigate basic mechanisms of neuronal, glial, and vascular signaling related to migraine and other brain disorders. As director of the UCLA Headache Research and Treatment Program, he oversees a multidisciplinary approach to headache that includes basic research, clinical research, education, and patient care.

Dr. Charles is board certified by the American Board of Psychiatry and Neurology, with headache medicine specialty certification. He is a member of the American Neurological Association, the Society for Neuroscience, the American Society for Neurochemistry, and the American Headache Society. In addition, he is an ad hoc reviewer for numerous professional journals, including the Journal of Neuroscience Research, Neurobiology of Disease, The Lancet, and Neurology, among others.

Lawrence C. Newman, MD
Director, The Headache Institute
St. Luke’s-Roosevelt Hospital Center
New York, New York

Dr. Lawrence Newman received his medical degree from the Universidad Autonoma de Guadalajara, Jalisco, Mexico. He completed his internal medicine residency at Elmhurst Hospital Center, along with a residency and chief residency in neurology at Albert Einstein College of Medicine. In addition he completed a headache fellowship at Montefiore Medical Center. Dr. Newman is the director of The Headache Institute and an attending neurologist at St. Luke's-Roosevelt Hospital Center, Beth Israel Medical Center and Montefiore Medical Center. He is an associate professor of clinical neurology at the Albert Einstein College of Medicine.

Board certified in neurology, Dr. Newman is also a member of the National Headache Foundation, the International Headache Society, and the American Association for the Study of Headache. He is an internationally recognized headache expert and has published extensively on headache disorders. He also reviews for several neurology and headache journals. Dr. Newman's areas of interest include migraine, cluster, daily headaches, and unusual headache disorders.


Accreditation Statement: MediCom Worldwide, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: MediCom Worldwide, Inc. designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

MediCom LogoNursing Credit
Accreditation Statement: MediCom Worldwide, Inc., 101 Washington Street, Morrisville, PA 19067 is approved by the California Board of Registered Nursing, Provider Number CEP11380. MediCom designates this CNE activity for 1.0 contact hour.
Program Number: 08-209-205


In accordance with the Accreditation Council for Continuing Medical Education (ACCME), ACPE and California Board of Nursing, MediCom Worldwide, Inc. requires that all program planners, faculty, and providers who are in a position to control the content of a CE activity are required to disclose any relevant financial relationships they may have or have had within the last 12 months with the commercial supporter or the manufacturer(s) of any commercial device(s) discussed in this educational activity. Accordingly the following disclosures were made.

Faculty Disclosure

Dr. Stephen Silberstein has received honoraria as a consultant from Allergan Inc., Endo Pharmaceuticals, GlaxoSmithKline, Medtronic, Inc., Merck & Co., Inc., NuPathe Inc., Ortho-McNeil, Inc., Pfizer Inc., Pozen Inc., and Valeant Pharmaceuticals International. He has received honoraria related to speakers’ bureau activities from AstraZeneca Pharmaceuticals LP; GlaxoSmithKline, Merck, Ortho, and Pfizer. In addition he has received grant support related to research activities from Abbott Laboratories, Advanced Bionics Corporation, Advanced Neuromodulation Systems, Inc., AGA; Allergan, AstraZeneca Pharmaceuticals LP, Endo, GlaxoSmithKline, Eli Lilly and Company, Medtronic, Merck, Ortho, Pfizer, Pozen, ProEthic Pharmaceuticals, Inc., Valeant, and Vernalis plc.

Dr. Andrew Charles has received honoraria related to speakers’ bureau activities from Ortho-McNeil, Inc. and Merck & Co., Inc., as well as consultant fees from Merck. He has received grant support related to research activities from Minster Pharmaceuticals plc.

Dr. Lawrence Newman has received honoraria related to speakers’ bureau activities and as a consultant from Endo Pharmaceuticals, GlaxoSmithKline, and Merck & Co., Inc.

Provider Disclosures

The MediCom Worldwide, Inc. education staff who were involved in the development of this activity have no financial relationships with any commercial interests that are relevant to this activity.

Michael Oshinsky, PhD, medical reviewer, has disclosed that he has received support from Merck & Co., Inc. for speakers’ bureau activities and Endo Pharmaceuticals for grant/research support.

Heidi Belden, PharmD, medical reviewer, has nothing to disclose.

Off-Label/Investigational Disclosures

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/ participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

Dr. Silberstein indicated that his presentation would not include the discussion of unlabeled uses of commercial products or investigational products not yet approved by the FDA for any use in the United States.

Dr. Charles indicated that his presentation would include the discussion of unlabeled uses of memantine and investigational uses of tonabersat which are not approved by the FDA for certain uses in the United States.

Dr. Newman indicated that his presentation would include the discussion of triptans and hormones as short-term prevention of headaches. These drugs are not approved by the FDA for this use in the United States. Dr. Newman indicated that his presentation would not include the discussion of products that have not been approved by the FDA for any use in the United States.

Conflict of Interest Resolution

To resolve identified conflicts of interest, the educational content was fully peer reviewed by members of the MediCom Content Review Committee. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.

Hardware/Software Requirements

MediCom Worldwide, Inc. requires Internet Explorer® version 7.0 or higher, or Firefox 3.0 or higher, a computer running Windows® XP, Windows® Vista, or Mac OS X, 512MB of RAM or greater, 1.5 GHZ or faster processor, and a screen resolution of 1024x768 or higher. Certain educational activities may require additional software to view. These activities will be marked with the information and/or links to the required software. That software may be Adobe® Flash® Player, Adobe® Acrobat®, or Windows Media® Player.

©2008 MediCom Worldwide, Inc., 101 Washington St., Morrisville, PA 19067.

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