Altered amyloid plasma profile in patients with disabling headaches after SARS-CoV-2 infection and vaccination

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Paper Summary

Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Potential amyloid link to long COVID headaches, but more research is needed!

This study found altered levels of proteins related to amyloid processing in people with persistent headaches after COVID-19 or vaccination. These findings suggest a potential link between amyloid processing and these headaches, especially in those with cognitive symptoms after COVID-19. However, larger studies, particularly with cerebrospinal fluid samples, are needed.

Possible Conflicts of Interest

The corresponding author (AHA) reports receiving honoraria for advice or lecturing from several pharmaceutical companies and a research grant from another pharmaceutical company. One other author (ACP) reports involvement in lecturing, advisory boards, and/or clinical studies with several pharmaceutical companies.

Identified Weaknesses

Small sample size

The overall participant numbers (29 post-COVID, 31 post-vaccine, and 16 controls) are limited, potentially affecting the generalizability of the findings.

Lack of CSF samples

Cerebrospinal fluid would provide more direct insight into brain amyloid processing compared to plasma.

Suboptimal control group

The control group was not age-matched and did not undergo the same detailed clinical interviews and assessments as the headache groups.

Lack of a headache group without amyloid processing changes

The absence of a group experiencing similar headaches but WITHOUT changes in amyloid markers limits the ability to definitively link the observed biomarker changes to the headaches.

Limited generalizability to other populations.

Study population was primarily white and from a specific geographic region.

Rating Explanation

This is a potentially interesting pilot study but methodological limitations, particularly the small sample size and the lack of ideal controls, warrant further investigation and stronger evidence before firm conclusions can be drawn. The potential conflict of interest with pharmaceutical companies, although not directly related to this study's focus, is also noted.

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