Scientific Program - Headache and Sleep

Please see below the CONy Scientific Program. Please click on the appropriate section (ordered by ABC) to view the relevant program. Please note that the program and timing is subject to change. To view the program timetable, please click here

Section Heads: Dimos Mitsikostas, Greece & Alan Rapoport, USA
FRIDAY, MARCH 24, 2017
Hall D
Chairs: Michail Vikelis, Greece; Elliott Gross, USA
Proposition: Blocking CGRP will be safe, effective and clinically meaningful for patients with migraine and chronic migraine
Capsule: CGRP plays a crucial role in migraine pathophysiology. Small molecule CGRP antagonists and monoclonal antibodies to CGRP or its receptor are promising new therapies for the treatment of migraine
Host: Alan Rapoport, USA

Yes: Messoud Ashina, Denmark
No: Christian Lampl, Austria
Discussion and rebuttals
Proposition: Correcting the derangement in sleep architecture is sufficient to treat cluster and migraine headache without medication
Capsule: Migraineurs and cluster headache patients who do not sleep well develop more frequent and severe headaches. Would optimal sleep therapies ever be good enough to take the place of medication for the treatment of these headaches, or is sleep impairment just an epiphenomenon?
Host: Jack Schim, USA
Yes: Hans Hamburger, The Netherlands
No: Oved Daniel, Israel

Discussion and rebuttals
Chairs: Theodoros Constantinidis, Greece;
Krystyna Mitosek-Szewczyk, Poland
Debate: Structural brain changes are sufficient for accurate headache diagnosis
Capsule: Recent developments in brain scanning show significant differences between the primary headache types. Will this be sufficient or confirmatory for accurate diagnosis of headache types?
Host: Lars Edvinsson, Sweden
Yes: Anna Andreou, UK
No: Messoud Ashina, Denmark
Discussion and rebuttals

Proposition: The use of a placebo is essential in headache clinical trials
The use of placebo as a control in headache trials has been questioned when efficacious treatments are already available. How critical is the placebo in clinical trials and what about ethical considerations?
Host: Klimentini Karageorgiou, Greece
Yes: Randall Weeks, USA
No: Dimos Mitsikostas, Greece
Discussion and rebuttals

Chairs: Nikolaos Fakas, Greece; Ernesto Aycardi, USA / Colombia
Lecture: The Stigma of Migraine
Robert Shapiro, USA
Proposition: New persistent daily headache is a secondary type of headache
Capsule: New daily persistent headache is a new headache that develops within 24 hours, persists constantly and its originating details are recalled by the patient years later.
Host: K. Ravishankar, India
Yes: Rob Cowan, USA
No: Randall Weeks, USA
Discussion and rebuttals

Proposition: Medication overuse headache needs to be treated with detoxification so that preventive therapy can be effective in chronic migraine
Capsule: Medication overuse headache is usually treated with detoxification from the offending agent first. There is evidence that some treatments work even prior to detoxification.
Host: MK Chu, South Korea
Yes: K. Ravishankar, India
No: Jose Miguel Lainez, Spain
Discussion and rebuttals
Chair: Mark Braschinsky, Estonia
Proposition: The thalamus and cortex are more critical to migraine pathophysiology than the trigeminal nerve
Capsule: The thalamus and cortex, but also the trigeminal nerve, are involved in migraine pathophysiology; which area is most critical in the migraine process?
Host: Christian Lampl, Austria

Thalamus and cortex: Hayrunnisa Bolay, Turkey
Trigeminal: Lars Edvinsson, Sweden
Discussion and rebuttals
Proposition: Electrical stimulation will replace medications for the treatment of cluster headache
Capsule: Several forms of electrical stimulation have been studied for migraine and cluster. Two of them have targeted cluster headache and maybe good enough to rival medication one day.
Host: Dimos Mitsikostas, Greece
Yes: Jose Miguel Lainez, Spain
No: Hayrunnisa Bolay, Turkey

Discussion and rebuttals

15:00-17:00 SLEEP 1
Chairs: John Ellul, Greece; Jozef Opara, Poland 
Proposition: CPAP is the one and only reliable treatment for OSAS
Capsule: Collapse of the upper airway can be reversed using continuous positive airway pressure through a nasal mask nCPAP. This has been considered as the golden standard for treatment for OSAS. Most obstructions however are caused by blockage of the upper airway by the tongue in supine position. Treatment could therefore also be focussed on dental devices preventing collapse of the throat or sleep position trainers (SPT) to prevent supine position during sleep.
Host: Monique Vlak, The Netherlands
Yes: Nicolas Tiberio Economou, Greece
No: Konstantinos Tsoutis, Greece
Discussion and rebuttals

Debate: Are questionnaires sufficient for diagnosing sleep disorders?
Approximately 15-20% of the world population is suffering from a sleep disorder, mainly insomnia. Even a massive number of sleep specialists armed with diagnostic centres cannot cope with these large numbers. There is just no place enough for PSG testing which is the golden standard for the diagnosis. Many sleep disorders have a specific history like insomnia, RLS, RBD and narcolepsy. Is the use of questionnaires sufficient for diagnosing sleep disorders?
Host: Dimitris Dikeos, Greece
Yes: Patricia Genet, The Netherlands
No: Monique Vlak, The Netherlands
Discussion and rebuttals

Chairs: Charalampos Mermigkis, Greece; Emeline te Veldhuis, Netherlands 
Debate: Obstructure sleep apnea syndrome (OSAS) is a cardiovascular disease
Capsule: Sleep apnea is caused by intermittent stoppage of breathing. It has therefore been adopted as a breathing disorder and is generally diagnosed and treated by pulmonologists. However there is no involvement of the lungs, the stoppage is in the upper area in the field of the ENT. The most important effect on health is on the heart. OSAS is causing cardio-vascular disease and vice versa, CVD is causing OSAS.
Host: Hans Hamburger, The Netherlands
Yes:  TBA
No: Sofia Schiza, Greece
Discussion and rebuttals

Propostion: Polysonography (PSG) is mandatory for diagnosing OSAS 
Capsule: For diagnosing most sleep disorders a sleep test is mandatory. Attended polysomnography is considered as the golden standard for the diagnosis. Second best is non-attended PSG and third is Home Sleep Apnea Testing (HSAT) with PSG or PG. However do we always need full PSG? OSAS is present in 5-7% of the world population.  PSG is not available for these numbers. HSAT with simple devices is reliable enough for diagnosing OSAS.
Host: Sofia Schiza, Greece
Yes: Monique Vlak, The Netherlands
No: Hans Hamburger, The Netherlands
Discussion and rebuttals