{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:02:01Z","timestamp":1785240121014,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Medications for migraine prevention targeting the calcitonin gene\u2010related peptide (\n CGRP<\/jats:styled-content>\n ) pathway have substantially reduced symptom burden in many patients that have failed previous treatment strategies. In contrast, data on treatment response to monoclonal antibodies (\n mAbs<\/jats:styled-content>\n ) or small molecule receptor antagonists (gepants) in patients suffering from vestibular migraine (\n VM<\/jats:styled-content>\n ) is scarce and preliminary.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We discuss the existing literature on\n VM<\/jats:styled-content>\n \u2010prevention using\n mAbs<\/jats:styled-content>\n and gepants with a special focus on biases and limitations such as small sample sizes, retrospective study design, lack of blinding, and patient selection.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Studies identified (\n n<\/jats:italic>\n \u2009=\u20098) assessed different\n mAbs<\/jats:styled-content>\n and gepants and generally reported improvement of vestibular symptoms and scores used, but were often of small sample size and lacked blinding and control groups. In a single randomized controlled trial, a significant treatment response to galcanezumab was identified, with a medium to large effect size (ranging between 0.56 and 1.02) for dizzy days reported and on scores applied (dizziness handicap inventory [\n DHI<\/jats:styled-content>\n ] and Vestibular Migraine Patient Assessment Tool and Handicap Inventory [\n VM<\/jats:styled-content>\n \u2010\n PATHI<\/jats:styled-content>\n ]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Data on anti\u2010\n CGRP<\/jats:styled-content>\n treatments for\n VM<\/jats:styled-content>\n remain limited, and efficacy established in headache migraine cannot be straightforwardly extrapolated to\n VM<\/jats:styled-content>\n given differences in underlying pathophysiology. There remains a risk that initial effect estimates may diminish over time, with early outcomes partially inflated by a novelty effect, expectancy, and more nuanced methodological approaches. Targeted treatment options for this common and often debilitating condition are genuinely welcomed, but the current evidence warrants careful interpretation for\n CGRP<\/jats:styled-content>\n \u2010related therapies.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ene.70688","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:45:32Z","timestamp":1783071932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CGRP<\/scp>\n \u2010Targeted Therapy in Vestibular Migraine\u2014How Strong Is the Evidence?"],"prefix":"10.1111","volume":"33","author":[{"given":"Alexander Andrea","family":"Tarnutzer","sequence":"first","affiliation":[{"name":"Neurology, Cantonal Hospital of Baden Baden Switzerland"},{"name":"Faculty of Medicine University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Castro Abarca","sequence":"additional","affiliation":[{"name":"School of Allied Health Sciences, Faculty of Health and Life Sciences De Montfort University Leicester UK"},{"name":"SENSE Research Unit, Department of Clinical and Movement Neurosciences UCL London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-646X","authenticated-orcid":false,"given":"Diego","family":"Kaski","sequence":"additional","affiliation":[{"name":"SENSE Research Unit, Department of Clinical and Movement Neurosciences UCL London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00109-6"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.14692"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-201644"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-025-04490-0"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac264"},{"key":"e_1_2_5_7_1","article-title":"Pharmacological Interventions for Prophylaxis of Vestibular Migraine","volume":"2023","author":"Webster K.","year":"2023","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.799002"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/01455613231202200"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-024-01094-z"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59091560"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/03331024231161809"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.14835"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-025-02243-5"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.70196"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12601"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2025.1006"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2015.00012"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70688","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.70688","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70688","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:20:36Z","timestamp":1785237636000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":17,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/ene.70688"],"URL":"https:\/\/doi.org\/10.1111\/ene.70688","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70688"}}