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Demirci K, Demirci S, Akpinar A, Demirdaş A, Atay İM. Evaluation of Eating Attitude in Patients with Migraine. Noro Psikiyatr Ars 2015; 52:367-370. [PMID: 28360741 DOI: 10.5152/npa.2015.9997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 11/16/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study aimed to investigate the eating attitudes in patients with migraine. METHODS Fifty-nine patients (mean age: 32.54±8.47 years) diagnosed with migraine according to the International Classification of Headache Disorder, 2004, and 47 age-, gender- and education-matched healthy controls (mean age: 31.85±7.14 years) were enrolled for this study. Sociodemographic data were recorded, and the body mass index was calculated as kilograms per meter squared. Data regarding the duration of illness and attack, frequency of migraine attacks, and the presence of aura were recorded. Migraine severity was assessed by Migraine Disability Assessment Score (MIDAS). Eating Attitudes Test (EAT), Beck Depression Inventory (BDI), and Beck Anxiety Inventory were applied to all participants. RESULTS The patients with migraine had significantly higher EAT scores, levels of anxiety, and depression than controls (p<.01). Furthermore, 11.9% of patients with migraine had an EAT score of 30 or higher, which is suggestive of a disordered eating attitude, whereas this rate was 2.1% in healthy controls (p<.05). The scores of EAT and BDI had positive correlation with the scores of MIDAS in patients with migraine (r=.298, p<.05; r=.332, p=.01, respectively). CONCLUSION In our study, disordered eating attitudes and the levels of anxiety and depression were high in patients with migraine than controls. Our study is important to demonstrate the connection between migraine and disordered eating attitudes.
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Affiliation(s)
- Kadir Demirci
- Department of Psychiatry, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Seden Demirci
- Department of Neurology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Abdullah Akpinar
- Department of Psychiatry, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Arif Demirdaş
- Department of Psychiatry, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - İnci Meltem Atay
- Department of Psychiatry, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
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202
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The effect of comorbidity of restless legs syndrome and migraine on sleep and mood: an integration of multicenter data. Sleep Biol Rhythms 2015. [DOI: 10.1007/s41105-015-0039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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203
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Rafie S, Namjoyan F, Hassanzadeh A, Yousefbeyk F, Hamedi S, Golfakhrabadi F. The Effect of Feverfew Cultivated in Iran for the Prophylactic Treatment of Migraine: A Randomized Placebo-controlled Clinical Trial. Jundishapur J Nat Pharm Prod 2015. [DOI: 10.17795/jjnpp-29275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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204
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Unpaid work in health economic evaluations. Soc Sci Med 2015; 144:127-37. [DOI: 10.1016/j.socscimed.2015.09.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 08/20/2015] [Accepted: 09/06/2015] [Indexed: 01/01/2023]
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205
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Rauschel V, Ruscheweyh R, Krafczyk S, Straube A. Test-retest reliability of visual-evoked potential habituation. Cephalalgia 2015; 36:831-9. [DOI: 10.1177/0333102415613613] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 09/18/2015] [Indexed: 01/03/2023]
Abstract
Objective Habituation of visual-evoked potentials (VEPs) is typically described as deficient interictally in migraine patients, supposedly indicating altered cortical excitability. Use of this parameter for monitoring changes over time, e.g. under treatment, requires demonstration of test-retest reliability. Methods VEPs were recorded interictally in 41 episodic migraine patients and 40 controls. N75–P100 amplitudes were measured over six consecutive blocks of 75 VEPs each. Amplitude regression slopes and block ratios were used to quantify VEP habituation. Test-retest reliability was assessed over 15 minutes and two to three weeks. Results Controls showed significantly more negative VEP habituation slopes than migraine patients (−0.21 ± 0.40 vs. 0.04 ± 0.46 µV/block, p < 0.05). Results were similar for block ratios, though, in the migraine group, VEP habituation significantly increased from test to two- to three-week retest ( p < 0.05). In addition, VEP habituation test-retest correlations were mostly poor both in migraine patients and controls (intraclass correlation coefficients, 15 minutes: −0.13 to 0.30, two to three weeks: 0.07 to 0.59). Conclusions Deficient VEP habituation in migraine was confirmed. However, the test-retest reliability of VEP habituation was rather weak. Therefore, we suggest that VEP habituation should be used for evaluation of cortical excitability under treatment only at the group level and only when a control group with sham treatment is included.
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206
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Bigal ME, Dodick DW, Rapoport AM, Silberstein SD, Ma Y, Yang R, Loupe PS, Burstein R, Newman LC, Lipton RB. Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of high-frequency episodic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study. Lancet Neurol 2015; 14:1081-90. [PMID: 26432182 DOI: 10.1016/s1474-4422(15)00249-5] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/14/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Calcitonin gene-related peptide (CGRP) is a validated target for the treatment of episodic migraine. Here we assess the safety, tolerability, and efficacy of TEV-48125, a monoclonal anti-CGRP antibody, in the preventive treatment of high-frequency episodic migraine. METHODS In this multicentre, randomised, double-blind, placebo-controlled, phase 2b study, we enrolled men and women (aged 18-65 years) from 62 sites in the USA who had migraine headaches 8-14 days per month. Using a randomisation list generated by a central computerised system and an interactive web response system, we randomly assigned patients (1:1:1; stratified by sex and use of concomitant preventive drugs) after a 28 day run-in period to three 28 day treatment cycles of subcutaneous 225 mg TEV-48125, 675 mg TEV-48125, or placebo. Investigators, patients, and the funder were blinded to treatment allocation. Patients reported headache information daily using an electronic diary. Primary endpoints were change from baseline in migraine days during the third treatment cycle (weeks 9-12) and safety and tolerability. The secondary endpoint was change relative to baseline in headache-days during weeks 9-12. Efficacy endpoints were analysed for the intention-to-treat population. Safety and tolerability were analysed using descriptive statistics. This trial is registered at ClinicalTrials.gov, number NCT02025556. FINDINGS Between Jan 8, 2014, and Oct 15, 2014, we enrolled 297 participants: 104 were randomly assigned to receive placebo, 95 to receive 225 mg TEV-48125, and 96 to receive 675 mg TEV-48125. The least square mean (LSM) change in number of migraine-days from baseline to weeks 9-12 was -3.46 days (SD 5.40) in the placebo group, -6.27 days (5.38) in the 225 mg dose group, and -6.09 days (5.22) in the 675 mg dose group. The LSM difference in the reduction of migraine-days between the placebo and 225 mg dose groups was -2.81 days (95% CI -4.07 to -1.55; p<0.0001), whereas the difference between the placebo and 675 mg dose group was -2.64 days (-3.90 to -1.38; p<0.0001). LSM differences in the reduction of headache-days were -2.63 days (-3.91 to -1.34; p<0.0001) between the placebo group and 225 mg dose group and -2.58 days (-3.87 to 1.30; p <0.0001) between the placebo group and the 675 mg dose group. Adverse events occurred in 58 (56%) patients in the placebo group, 44 (46%) patients in the 225 mg dose group, and 57 (59%) patients in the 675 mg dose group; moderate or severe adverse events were reported for 29 (27%) patients, 24 (25%) patients, and 26 (27%) patients, respectively. INTERPRETATION TEV-48125, at doses of 225 mg and 675 mg given once every 28 days for 12 weeks, was safe, well tolerated, and effective as a preventive treatment of high-frequency episodic migraine, thus supporting advancement of the clinical development programme to phase 3 clinical trials. FUNDING Teva Pharmaceuticals.
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Affiliation(s)
- Marcelo E Bigal
- Research and Development Department, Teva Pharmaceuticals, Frazer, PA, USA.
| | | | - Alan M Rapoport
- The David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Stephen D Silberstein
- Department of Neurology, Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Yuju Ma
- Statistics Department, Teva Pharmaceuticals, Frazer, PA, USA
| | - Ronghua Yang
- Statistics Department, Teva Pharmaceuticals, Frazer, PA, USA
| | - Pippa S Loupe
- Research and Scientific Affairs Department, Teva Pharmaceuticals, Frazer, PA, USA
| | - Rami Burstein
- Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Lawrence C Newman
- Headache Institute and St Luke's-Roosevelt Hospital Center, New York, NY, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
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207
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Diener HC, Solbach K, Holle D, Gaul C. Integrated care for chronic migraine patients: epidemiology, burden, diagnosis and treatment options. Clin Med (Lond) 2015; 15:344-50. [PMID: 26407383 PMCID: PMC4952796 DOI: 10.7861/clinmedicine.15-4-344] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Migraine is a common neurological disorder, characterised by severe headaches. Epidemiological studies in the USA and Europe have identified a subgroup of migraine patients with chronic migraine. Chronic migraine is defined as ≥15 headache days per month for ≥3 months, in which ≥8 days of the month meet criteria for migraine with or without aura, or respond to treatment specifically for migraine. Chronic migraine is associated with a higher burden of disease, more severe psychiatric comorbidity, greater use of healthcare resources, and higher overall costs than episodic migraine (<15 headache days per month). There is a strong need to improve diagnosis and therapeutic treatment of chronic migraine. Primary care physicians, as well as hospital-based physicians, are integral to the identification and treatment of these patients. The latest epidemiological data, as well as treatment options for chronic migraine patients, are reviewed here.
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Affiliation(s)
| | - Kasja Solbach
- Headache Center, University Hospital Essen, Essen, Germany
| | - Dagny Holle
- Headache Center, University Hospital Essen, Essen, Germany
| | - Charly Gaul
- Migraine and Headache Clinic, Königstein, Germany, and consulting physician, Department of Neurology and Headache Center, University Hospital Essen, Essen, Germany
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208
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Shin YW, Park HJ, Shim JY, Oh MJ, Kim M. Seasonal Variation, Cranial Autonomic Symptoms, and Functional Disability in Migraine: A Questionnaire-Based Study in Tertiary Care. Headache 2015. [DOI: 10.1111/head.12613] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yong-Won Shin
- Department of Neurology; Seoul National University Hospital; Seoul South Korea
| | - Hyun-Jung Park
- Department of Neurology; Seoul National University Hospital; Seoul South Korea
| | - Ji-Young Shim
- Department of Neurology; Seoul National University Hospital; Seoul South Korea
| | - Min-Jung Oh
- Department of Neurology; Seoul National University Hospital; Seoul South Korea
| | - Manho Kim
- Department of Neurology; Seoul National University Hospital; Seoul South Korea
- Protein Metabolism Medical & Neuroscience Research Center; College of Medicine; Seoul National University; Seoul South Korea
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209
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Blumenfeld AM, Aurora SK, Laranjo K, Papapetropoulos S. Unmet clinical needs in chronic migraine: Rationale for study and design of COMPEL, an open-label, multicenter study of the long-term efficacy, safety, and tolerability of onabotulinumtoxinA for headache prophylaxis in adults with chronic migraine. BMC Neurol 2015; 15:100. [PMID: 26133547 PMCID: PMC4489131 DOI: 10.1186/s12883-015-0353-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 06/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic migraine is a neurological condition with a large individual and socioeconomic burden of disease. The recently completed Phase III REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical development program established the efficacy and safety of onabotulinumtoxinA as a prophylactic treatment for chronic migraine patients. However, clinical questions remain. A long-term evaluation study of onabotulinumtoxinA aims to address some of the remaining questions in the treatment of chronic migraine. The clinical rationale, study design, and treatment plan of this ongoing study are reviewed in this paper. METHODS/DESIGN The Chronic migraine OnabotulinuMtoxinA Prolonged Efficacy open Label (COMPEL) study will enroll approximately 500 adult patients with chronic migraine at international sites. Patients will be evaluated over 108 weeks, following a 4-week baseline period. Qualified subjects will receive 155 U of onabotulinumtoxinA every 12 weeks for 9 open-label cycles. The primary endpoint will be mean change from baseline in frequency of headache days at 108 weeks. Other endpoints will include additional assessments of the efficacy and safety of onabotulinumtoxinA and the effect of onabotulinumtoxinA on quality-of-life measures, disability, and health economic outcomes. The impact of onabotulinumtoxinA on common comorbidities (eg, sleep, anxiety, and fatigue) will also be assessed. DISCUSSION Recruitment and enrollment are ongoing. Post-approval, open-label studies are often designed to more closely resemble clinical practice and provide an opportunity to continue the evaluation of the efficacy and safety of approved treatments. By creating a large database and analyzing a variety of outcome measures over an extended time frame, the COMPEL study will seek to contribute substantially to the existing knowledge of the chronic migraine population and the long-term management of this debilitating disorder. CLINICAL TRIAL REGISTRATION NUMBER NCT01516892.
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Affiliation(s)
- Andrew M Blumenfeld
- The Neurology Center, 320 Santa Fe Drive, Suite 150, Encinitas, CA, 92024, USA.
| | - Sheena K Aurora
- Stanford University, 300 Pasteur Drive, Room A343, MC 5235, Stanford, CA, 94305, USA.
| | - Karen Laranjo
- Formerly an employee of Allergan, Inc., Irvine, CA, USA.
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210
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John S, Singhal AB, Calabrese L, Uchino K, Hammad T, Tepper S, Stillman M, Mills B, Thankachan T, Hajj-Ali RA. Long-term outcomes after reversible cerebral vasoconstriction syndrome. Cephalalgia 2015; 36:387-94. [DOI: 10.1177/0333102415591507] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 04/25/2015] [Indexed: 11/17/2022]
Abstract
Background Long-term outcomes of reversible cerebral vasoconstriction syndrome (RCVS) have not been systematically investigated. Methods The following validated questionnaires were mailed to patients recruited from the RCVS registries of two academic hospitals: headache screening form, Headache Impact Test, Migraine Disability Assessment Test, Barthel Index (BI), EuroQoL (EQ-5D-5L) and Patient Health Questionnaire (PHQ-9). Results Of the 191 patients in the registries, 109 could be contacted and 45 responded. Median follow-up time after symptom onset was 78 months. After RCVS resolution, 24 (53%) patients continued to have headache, but the majority (88%) reported improvement in its severity. Thirteen of the 24 patients with persistent headache had a history of migraine prior to RCVS diagnosis. The majority (97.5%) of respondents were functionally independent based on BI scores. EQ-5D-5L showed better scores in the domains of mobility, self-care and usual activities, as compared to pain and anxiety/depression. Patients with persistent headache had significantly higher levels of EQ-5D-5L pain scores. PHQ-9 scores revealed only one patient (3%) with severe depression. Conclusion More than half of RCVS patients will continue to have chronic headaches of mild to moderate intensity that are distinct from the “thunderclap” headaches at RCVS onset. The vast majority regain complete functional ability. However, pain and anxiety/depression are frequent, often aggravated by concomitant chronic headaches, and may be associated with lower quality of life.
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Affiliation(s)
- Seby John
- Cerebrovascular Center, Cleveland Clinic, USA
| | | | - Leonard Calabrese
- Center for Vasculitis Care and Research, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, USA
| | - Ken Uchino
- Cerebrovascular Center, Cleveland Clinic, USA
| | - Tariq Hammad
- Center for Vasculitis Care and Research, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, USA
| | | | | | - Brittany Mills
- Department of Neurology, Massachusetts General Hospital, USA
| | - Tijy Thankachan
- Department of Neurology, Massachusetts General Hospital, USA
| | - Rula A Hajj-Ali
- Center for Vasculitis Care and Research, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, USA
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211
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Bhola R, Kinsella E, Giffin N, Lipscombe S, Ahmed F, Weatherall M, Goadsby PJ. Single-pulse transcranial magnetic stimulation (sTMS) for the acute treatment of migraine: evaluation of outcome data for the UK post market pilot program. J Headache Pain 2015; 16:535. [PMID: 26055242 PMCID: PMC4463955 DOI: 10.1186/s10194-015-0535-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 05/25/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Single pulse transcranial magnetic stimulation (sTMS) is a novel treatment for acute migraine. Previous randomised controlled data demonstrated that sTMS is effective and well tolerated in the treatment of migraine with aura. The aim of the programme reported here was to evaluate patient responses in the setting of routine clinical practice. METHODS Migraine patients with and without aura treating with sTMS had an initial review (n = 426) and training call, and then participated in telephone surveys at week six (n = 331) and week 12 during a 3-month treatment period (n = 190). RESULTS Of patients surveyed with 3 month data (n = 190; episodic, n = 59; chronic, n = 131), 62 % reported pain relief, finding the device effective at reducing or alleviating migraine pain; in addition there was relief reported of associated features: nausea- 52 %; photophobia- 55 %; and phonophobia- 53 %. At 3 months there was a reduction in monthly headache days for episodic migraine, from 12 (median, 8-13 IQ range) to 9 (4-12) and for chronic migraine, a reduction from 24 (median, 16-30 IQ range) to 16 (10-30). There were no serious or unanticipated adverse events. CONCLUSION sTMS may be a valuable addition to options for the treatment of both episodic and chronic migraine.
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Affiliation(s)
- Ria Bhola
- />eNeura Therapeutics, Sunnyvale, CA USA
| | | | - Nicola Giffin
- />Department of Neurology, Royal United Hospital, Bath, UK
| | - Sue Lipscombe
- />Brighton and Sussex University Hospitals, Royal Sussex County, Brighton, UK
| | - Fayyaz Ahmed
- />Department of Neurology, Hull Royal Infirmary, Hull, UK
| | - Mark Weatherall
- />Princess Margaret Migraine Clinic, Charing Cross Hospital, London, UK
| | - Peter J Goadsby
- />Headache Group, Basic & Clinical Neuroscience, King’s College London, London, UK
- />NIHR-Wellcome Trust Clinical Research Facility, King’s College Hospital, London, SE5 9PJ UK
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212
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Reed KL, Will KR, Conidi F, Bulger R. Concordant occipital and supraorbital neurostimulation therapy for hemiplegic migraine; initial experience; a case series. Neuromodulation 2015; 18:297-303; discussion 304. [PMID: 25688595 PMCID: PMC5024009 DOI: 10.1111/ner.12267] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/08/2014] [Accepted: 12/10/2014] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Hemiplegic migraine is a particularly severe form of the disease that often evolves to a debilitating chronic illness that is resistant to commonly available therapies. Peripheral neurostimulation has been found to be a beneficial therapy for some patients among several diagnostic classes of migraine, but its potential has not been specifically evaluated for hemiplegic migraine. MATERIALS AND METHODS Four patients with hemiplegic migraine were treated with concordant, combined occipital and supraorbital neurostimulation over periods ranging 6-92 months. The clinical indicators followed included assessments of headache frequency and severity, frequency of hemiplegic episodes, functional impairment, medication usage, and patient satisfaction. RESULTS All reported a positive therapeutic response, as their average headache frequency decreased by 92% (30 to 2.5 headache days/month); Visual Analog Score by 44% (9.5 to 5.3); frequency of hemiplegic episodes by 96% (7.5 to 0.25 hemiplegic episodes/month); headache medication usage by 96% (6 to 0.25 daily medications); and Migraine Disability Assessment score by 98% (249 to 6). All were satisfied and would recommend the therapy, and all preferred combined occipital-supraorbital neurostimulation to occipital neurostimulation alone. CONCLUSIONS Concordant combined occipital and supraorbital neurostimulation may provide effective therapy for both the pain and motor aura in some patients with hemiplegic migraine.
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Affiliation(s)
- Ken L Reed
- Interventional Pain Management and Internal Medicine, Reed Migraine Centers, Dallas, TX, USA
| | - Kelly R Will
- Interventional Pain Management, Texas Institute of Surgery, Dallas, TX, USA
| | - Frank Conidi
- Department of Neurology, Florida State University College of Medicine, West Palm Beach, FL, USA
| | - Robert Bulger
- Interventional Pain Management, Department of Anesthesiology, Presbyterian Hospital of Dallas, Dallas, TX, USA
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213
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Negative affectivity, emotion regulation, and coping in migraine and probable migraine: a New Zealand case-control study. Int J Behav Med 2015; 21:851-60. [PMID: 24242822 DOI: 10.1007/s12529-013-9370-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Migraine is a prevalent and disabling health condition. While there have been some suggestions that personality may be linked to migraine incidence, dose-response links to disability or impact are yet to be conducted and multivariate analyses are uncommon. PURPOSE The purposes of this study are to evaluate the personality characteristics differentiating migraine and probable migraine sufferers from matched controls in multivariate models and assess the possibility of a dose-response relationship. METHODS Fifty migraine sufferers and 50 age-, sex-, and ethnicity-matched controls in New Zealand completed personality measures including negative affectivity, coping, and monitoring-blunting. RESULTS Logistic regressions indicated that migraine status was concurrently predicted by Type D negative affectivity, more frequent venting and planning coping, and lower monitoring. There was little evidence to suggest a consistent dose-response type effect of personality on migraine; lower impact and disability were associated with greater openness to experiences, acceptance, and behavioural disengagement. CONCLUSIONS A personality profile characterised by moderate levels of negative emotion and irritability together with failures in inhibitory self-regulation may be associated with an increased risk of strict and probable migraine.
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214
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Raggi A, Schiavolin S, Leonardi M, Grazzi L, Usai S, Curone M, D’Amico D. Approaches to treatments of chronic migraine associated with medication overuse: a comparison between different intensity regimens. Neurol Sci 2015; 36 Suppl 1:5-8. [DOI: 10.1007/s10072-015-2134-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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215
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Difficulties in work activities and the pervasive effect over disability in patients with episodic and chronic migraine. Neurol Sci 2015; 36 Suppl 1:9-11. [DOI: 10.1007/s10072-015-2130-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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216
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de Roos NM, Giezenaar CGT, Rovers JMP, Witteman BJM, Smits MG, van Hemert S. The effects of the multispecies probiotic mixture Ecologic®Barrier on migraine: results of an open-label pilot study. Benef Microbes 2015; 6:641-6. [PMID: 25869282 DOI: 10.3920/bm2015.0003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Migraine prevalence is associated with gastrointestinal disorders. Possible underlying mechanisms could be increased gut permeability and inflammation. Probiotics may decrease intestinal permeability as well as inflammation, and therefore may reduce the frequency and/or intensity of migraine attacks. Therefore we assessed feasibility, possible clinical efficacy, and adverse reactions of probiotic treatment in migraine patients. 29 migraine patients took 2 g/d of a probiotic food supplement (Ecologic(®)Barrier, 2.5×10(9) cfu/g) during 12 weeks. Participants recorded frequency and intensity of migraine in a headache diary and completed the Migraine Disability Assessment Scale (MIDAS) and Henry Ford Hospital Headache Disability Inventory (HDI) at baseline and after 12 weeks of treatment. Compliance was measured every 4 weeks by counting the remaining sachets with probiotics. The study was completed by 27/29 (93%) patients who took 95% of the supplements. Obstipation was reported by 4 patients during the first 2 weeks of treatment only. The mean±standard deviation (SD) number of migraine days/month decreased significantly from 6.7±2.4 at baseline to 5.1±2.2 (P=0.008) in week 5-8 and 5.2±2.4 in week 9-12 (P=0.001). The mean±SD intensity of migraine decreased significantly from 6.3±1.5 at baseline to 5.5±1.9 after treatment (P=0.005). The MIDAS score improved from 24.8±25.5 to 16.6±13.5 (P=0.031). However, the mean HDI did not change significantly. In conclusion, probiotics may decrease migraine supporting a possible role for the intestine in migraine management. Feasibility and lack of adverse reactions justify further placebo-controlled studies.
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Affiliation(s)
- N M de Roos
- 1 Wageningen UR, Division Human Nutrition, P.O. Box 8129, 6700 EV Wageningen, the Netherlands
| | - C G T Giezenaar
- 1 Wageningen UR, Division Human Nutrition, P.O. Box 8129, 6700 EV Wageningen, the Netherlands
| | - J M P Rovers
- 2 Hospital Gelderse Vallei, Department of Neurology, Willy Brandtlaan 10, 6716 RP Ede, the Netherlands
| | - B J M Witteman
- 3 Hospital Gelderse Vallei, Department of Gastroenterology and Hepatology, Willy Brandtlaan 10, 6716 RP Ede, the Netherlands
| | - M G Smits
- 2 Hospital Gelderse Vallei, Department of Neurology, Willy Brandtlaan 10, 6716 RP Ede, the Netherlands
| | - S van Hemert
- 4 Winclove b.v., R&D department, Hulstweg 11, 1032 LB Amsterdam, the Netherlands
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217
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Mac Donald CL, Adam OR, Johnson AM, Nelson EC, Werner NJ, Rivet DJ, Brody DL. Acute post-traumatic stress symptoms and age predict outcome in military blast concussion. Brain 2015; 138:1314-26. [PMID: 25740219 DOI: 10.1093/brain/awv038] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 12/16/2014] [Indexed: 11/13/2022] Open
Abstract
High rates of adverse outcomes have been reported following blast-related concussive traumatic brain injury in US military personnel, but the extent to which such adverse outcomes can be predicted acutely after injury is unknown. We performed a prospective, observational study of US military personnel with blast-related concussive traumatic brain injury (n = 38) and controls (n = 34) enrolled between March and September 2012. Importantly all subjects returned to duty and did not require evacuation. Subjects were evaluated acutely 0-7 days after injury at two sites in Afghanistan and again 6-12 months later in the United States. Acute assessments revealed heightened post-concussive, post-traumatic stress, and depressive symptoms along with worse cognitive performance in subjects with traumatic brain injury. At 6-12 months follow-up, 63% of subjects with traumatic brain injury and 20% of controls had moderate overall disability. Subjects with traumatic brain injury showed more severe neurobehavioural, post-traumatic stress and depression symptoms along with more frequent cognitive performance deficits and more substantial headache impairment than control subjects. Logistic regression modelling using only acute measures identified that a diagnosis of traumatic brain injury, older age, and more severe post-traumatic stress symptoms provided a good prediction of later adverse global outcomes (area under the receiver-operating characteristic curve = 0.84). Thus, US military personnel with concussive blast-related traumatic brain injury in Afghanistan who returned to duty still fared quite poorly on many clinical outcome measures 6-12 months after injury. Poor global outcome seems to be largely driven by psychological health measures, age, and traumatic brain injury status. The effects of early interventions and longer term implications of these findings are unknown.
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Affiliation(s)
- Christine L Mac Donald
- 1 Washington University School of Medicine, Department of Neurology and Psychiatry, 660 S Euclid Ave, Saint Louis, MO 63110 USA
| | - Octavian R Adam
- 2 Naval Medical Centre Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA 23708 USA
| | - Ann M Johnson
- 1 Washington University School of Medicine, Department of Neurology and Psychiatry, 660 S Euclid Ave, Saint Louis, MO 63110 USA
| | - Elliot C Nelson
- 1 Washington University School of Medicine, Department of Neurology and Psychiatry, 660 S Euclid Ave, Saint Louis, MO 63110 USA
| | - Nicole J Werner
- 1 Washington University School of Medicine, Department of Neurology and Psychiatry, 660 S Euclid Ave, Saint Louis, MO 63110 USA
| | - Dennis J Rivet
- 2 Naval Medical Centre Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA 23708 USA
| | - David L Brody
- 1 Washington University School of Medicine, Department of Neurology and Psychiatry, 660 S Euclid Ave, Saint Louis, MO 63110 USA
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218
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Vernon H, Lawson G. Development of the headache activities of daily living index: initial validity study. J Manipulative Physiol Ther 2015; 38:102-11. [PMID: 25618575 DOI: 10.1016/j.jmpt.2014.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/04/2014] [Accepted: 11/11/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE The purpose of this study was to develop a novel instrument for assessing headache-related disability focusing solely on important activities of daily living. METHODS Part 1: A literature search was conducted in PubMed and Google Scholar, supplemented by hand searches in bibliographies to retrieve the original article for any instrument for the assessment of headache-related disability. Each instrument was evaluated for item categories, specific item content, measurement scale format for each item, and instructions to users. Together, these features constituted the construct validity of these instruments. Qualitative evaluations of these results were summarized with respect to the adequacy of each component. Psychometric features such as reliability and validity were not assessed. Part 2: An existing instrument for assessing self-rated disability, the Neck Disability Index, was modified for content and format and subjected to 2 rounds of clinician and patient review. Item contents and formats received final consensus, resulting in a 9-item instrument: the Headache Activities of Daily Living Index (HADLI). This instrument was tested in a sample of headache patients. Cronbach α and individual item correlations were obtained. Principal Components Analysis was performed. RESULTS Part 1: The search identified 6 reports on 5 preexisting instruments for self-rating of headache-related disability. Problems in content were found in all instruments, especially relating to the lack of items for specific activities of daily living. Problems were noted in most of the instruments for scaling and instructions with respect to the effect of headache on activities of daily living. Part 2: The authors first identified suitable items from an existing instrument for self-rating of disability. These were supplemented by items drawn from the literature. A panel of 3 clinicians and 2 laypersons evaluated these items. Two more focus groups of 7 headache sufferers each reviewed the new instrument. After this, a 9-item instrument for assessing activities of daily living in headache sufferers, the HADLI, was finalized. After this, 53 participants were recruited to study the face validity of the instrument. The sample consisted of 41 women and 12 men with a mean age of 37.3 (12) years; mean duration of headaches was 7.4 (8.3) years; mean frequency of headaches per week was 3.4 (2.4); and the intensity was 6 (2.4). The mean HADLI score was 26.2 (13.4), or 52%. There were no floor or ceiling effects for total score. The total Index Cronbach α was 0.96. The Principal Components Analysis identified one component which accounted for 75% of the variance. CONCLUSIONS The HADLI was created using theory and empirical-based methods. Face validity was assessed by focus group input and by first-level psychometrics. The HADLI has good face validity and is suitable for further reliability and validity testing.
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Affiliation(s)
- Howard Vernon
- Professor, Division of Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.
| | - Gordon Lawson
- Associate Professor, Division Clinical Education, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
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219
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Shaik MM, Hassan NB, Tan HL, Gan SH. Quality of life and migraine disability among female migraine patients in a tertiary hospital in Malaysia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:523717. [PMID: 25632394 PMCID: PMC4302372 DOI: 10.1155/2015/523717] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/18/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Disability caused by migraine may be one of the main causes of burden contributing to poor quality of life (QOL) among migraine patients. Thus, this study aimed to measure QOL among migraine sufferers in comparison with healthy controls. METHODS Female diagnosed migraine patients (n= 100) and healthy controls (n=100) completed the Malay version of the World Health Organization QOL Brief (WHOQOL-BREF) questionnaire. Only migraine patients completed the Malay version of the Migraine Disability Assessment questionnaire. RESULTS Females with migraines had significantly lower total WHOQOL-BREF scores (84.3) than did healthy controls (91.9, P<0.001). Similarly, physical health (23.4 versus 27.7, P<0.001) and psychological health scores (21.7 versus 23.2, P< 0.001) were significantly lower than those for healthy controls. Seventy-three percent of patients experienced severe disability, with significantly higher number of days with headaches (13.8 days/3 months, P< 0.001) and pain scores (7.4, P< 0.013). Furthermore, migraine patients with lower total QOL scores had 1.2 times higher odds of having disability than patients with higher total QOL scores. CONCLUSIONS The present study showed that migraine sufferers experienced significantly lower QOL than the control group from a similar population. Disability was severe and frequent and was associated with lower QOL among the migraine patients.
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Affiliation(s)
- Munvar Miya Shaik
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Norul Badriah Hassan
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Huay Lin Tan
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Siew Hua Gan
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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220
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Chronic migraine with medication overuse: Association between disability and quality of life measures, and impact of disease on patients' lives. J Neurol Sci 2015; 348:60-6. [DOI: 10.1016/j.jns.2014.11.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/31/2014] [Accepted: 11/03/2014] [Indexed: 01/20/2023]
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221
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A Wearable Epidural Catheter Infusion System for Patients With Intractable Spontaneous Intracranial Hypotension. Reg Anesth Pain Med 2015; 40:49-51. [DOI: 10.1097/aap.0000000000000192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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222
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Jelinski SE, Becker WJ, Christie SN, Giammarco R, Mackie GF, Gawel MJ, Eloff AG, Magnusson JE. Demographics and Clinical Features of Patients Referred to Headache Specialists. Can J Neurol Sci 2014; 33:228-34. [PMID: 16736736 DOI: 10.1017/s0317167100005035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACT:Objective:To examine demographic characteristics and clinical features of headache patients referred to neurologists specializing in headache in Canada.Methods:Demographic and clinical data were collected at the time of consultation for 865 new headache patients referred to five headache-specialty clinics in Canada. The Headache Impact Test (HIT-6) and Migraine Disability Questionnaire (MIDAS) were used to measure headache impact and disability. Data were analyzed as part of the Canadian Headache Outpatient Registry and Database (CHORD) Project.Results:The average age of the patients was 40 years and the majority were female (78%). Most were employed either full time (49%) or part time (13%). The majority of patients were diagnosed with either migraine or tension-type headache (78%). Over a third of patients experienced headache every day, and half had experienced a headache in the previous month which was of severe intensity. Most (80%) scored in the “very severe” category of the HIT-6 and over half (55%) were severely disabled as measured by the MIDAS.Conclusion:Patients referred to headache specialists in Canada are severely disabled by their headache disorders. These patients are in the most productive phase of their lives in terms of age and employment. It is important to provide the best available treatment to headache patients in order to minimize the disability and impact of their headache disorders.
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Affiliation(s)
- Susan E Jelinski
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
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Pallotta N, Piacentino D, Ciccantelli B, Rivera M, Golini N, Spagnoli A, Vincoli G, Farchi S, Corazziari E. High prevalence of symptoms in a severely abused "non-patient" women population. United European Gastroenterol J 2014; 2:513-21. [PMID: 25452847 DOI: 10.1177/2050640614552010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/19/2014] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The objective of this article is to assess the prevalence of somatic symptoms and of gastrointestinal (GI) syndromes in abused "non-patient" women and the association with the time of perpetration, type, and severity of abuse. METHODS Sixty-seven women, 18-58 years, receiving shelter in anti-violence associations were invited to fill out an anonymous questionnaire with a medical and an abuse section. The severity of abuse was expressed as the 0-6 Abuse Severity Measure (ASM). The association between abuse characteristics and the number of symptoms, and GI syndromes was assessed by Poisson regression model. RESULTS Most women suffered from childhood and adulthood sexual and physical abuse. They reported a mean of 5.1 GI symptoms (range 0-13; median 5; IQR 6) and of 1.3 extra-GI symptoms (range 0-6; median 1; IQR 2); 30% of women matched the Rome II Criteria for one, 36% for two, and 4.4% for three or more syndromes, respectively. Women with an ASM of 5-6, having suffered from both sexual and physical abuse, reported significantly (p = 0.02) more GI symptoms, but not extra-GI ones (p = 0.07), and met criteria for more GI syndromes than women with an ASM ≤4 and those reporting only one type of abuse. No association was found between the time of perpetration of the abuse and the number of GI and extra-GI symptoms. CONCLUSIONS Symptoms in abused "non-patient" women mainly concern the abdomen and the GI tract. A history of severe, combined physical and sexual abuse is associated with a higher number of GI symptoms.
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Affiliation(s)
- N Pallotta
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - D Piacentino
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy
| | - B Ciccantelli
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - M Rivera
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - N Golini
- Department of Statistical Sciences, Sapienza University, Rome, Italy
| | - A Spagnoli
- Department of Statistical Sciences, Sapienza University, Rome, Italy
| | - G Vincoli
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - S Farchi
- Istituto Superiore di Sanità, Sapienza University, Rome, Italy
| | - Es Corazziari
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
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224
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Jouzdani SR, Ebrahimi A, Rezaee M, Shishegar M, Tavallaii A, Kaka G. Characteristics of posttraumatic headache following mild traumatic brain injury in military personnel in Iran. Environ Health Prev Med 2014; 19:422-8. [PMID: 25216772 DOI: 10.1007/s12199-014-0409-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 08/28/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES The primary goal of this study was to evaluate the incidence and characteristics of posttraumatic headache attributed to mild brain injury in military personnel in Iran within a prospective and observational study design. METHODS A prospective observational descriptive study was conducted with a cohort of military personnel under military education during a 6-month period at the Military Education Center in Isfahan, Iran. 322 military personnel under education were selected randomly and were given a 13-item mild brain injury questionnaire accompanied with affective disorders and headache questionnaires and were reevaluated after a 3-month interval. RESULTS A total of 30 (9.3 %) of the 322 military personnel met criteria for a mild brain injury. Among them, 18 personnel (60 %) reported having headaches during the 3-month reevaluation. PTHs defined as headaches beginning within 1 week after a head trauma were present in 5.6 % of military personnel under study during 6 months. In total, 67 % of posttraumatic headaches (PTH) were classified as migrainous or possible migrainous features. Patients with affective disorders such as posttraumatic stress disorder and depression were at a higher risk for developing PTH following mild brain injury (p < 0.05). PTH did not relate to demographic factors such as age or type of trauma. CONCLUSIONS Posttraumatic headache attributed to mild brain injury is a common disorder in military personnel. Migrainous features are predominant among them in comparison with the general population. PTH is not related to a type of trauma, but has association with affective disorders.
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Affiliation(s)
- Saeid Rezaei Jouzdani
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, 19568-37173, Tehran, Iran
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225
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Shaik MM, Hassan NB, Tan HL, Bhaskar S, Gan SH. Validity and reliability of the Bahasa Melayu version of the Migraine Disability Assessment questionnaire. BIOMED RESEARCH INTERNATIONAL 2014; 2014:435856. [PMID: 25121099 PMCID: PMC4119890 DOI: 10.1155/2014/435856] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 06/24/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The study was designed to determine the validity and reliability of the Bahasa Melayu version (MIDAS-M) of the Migraine Disability Assessment (MIDAS) questionnaire. METHODS Patients having migraine for more than six months attending the Neurology Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia, were recruited. Standard forward and back translation procedures were used to translate and adapt the MIDAS questionnaire to produce the Bahasa Melayu version. The translated Malay version was tested for face and content validity. Validity and reliability testing were further conducted with 100 migraine patients (1st administration) followed by a retesting session 21 days later (2nd administration). RESULTS A total of 100 patients between 15 and 60 years of age were recruited. The majority of the patients were single (66%) and students (46%). Cronbach's alpha values were 0.84 (1st administration) and 0.80 (2nd administration). The test-retest reliability for the total MIDAS score was 0.73, indicating that the MIDAS-M questionnaire is stable; for the five disability questions, the test-retest values ranged from 0.77 to 0.87. CONCLUSION The MIDAS-M questionnaire is comparable with the original English version in terms of validity and reliability and may be used for the assessment of migraine in clinical settings.
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Affiliation(s)
- Munvar Miya Shaik
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Norul Badriah Hassan
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Huay Lin Tan
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Shalini Bhaskar
- Gleneagles Medical Centre, No. 1, Jalan Pangkor, 10050 Penang, Malaysia
| | - Siew Hua Gan
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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226
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Jürgens TP, Schoenen J, Rostgaard J, Hillerup S, Láinez MJA, Assaf AT, May A, Jensen RH. Stimulation of the sphenopalatine ganglion in intractable cluster headache: expert consensus on patient selection and standards of care. Cephalalgia 2014; 34:1100-10. [PMID: 24740514 DOI: 10.1177/0333102414530524] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CONTEXT AND OVERVIEW Chronic cluster headache (CCH) is a debilitating headache disorder with a significant impairment of the patients' lives. Within the past decade, various invasive neuromodulatory approaches have been proposed for the treatment of CCH refractory to standard preventive drug, but only very few randomized controlled studies exist in the field of neuromodulation for the treatment of drug-refractory headaches. Based on the prominent role of the cranial parasympathetic system in acute cluster headache attacks, high-frequency sphenopalatine ganglion (SPG) stimulation has been shown to abort ongoing attacks in some patients in a first small study. As preventive effects of SPG-stimulation have been suggested and the rate of long-term side effects was moderate, SPG stimulation appears to be a promising new treatment strategy. AIMS AND CONCLUSION As SPG stimulation is effective in some patients and the first commercially available CE-marked SPG neurostimulator system has been introduced for cluster headache, patient selection and care should be standardized to ensure maximal efficacy and safety. As only limited data have been published on SPG stimulation, standards of care based on expert consensus are proposed to ensure homogeneous patient selection and treatment across international headache centres. Given that SPG stimulation is still a novel approach, all expert-based consensus on patient selection and standards of care should be re-reviewed when more long-term data are available.
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Affiliation(s)
- Tim P Jürgens
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology, University of Liège, Belgium
| | - Jørgen Rostgaard
- Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - Søren Hillerup
- Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - Miguel J A Láinez
- Hospital Clinico Universitario, Catholic University of Valencia, Spain
| | - Alexandre T Assaf
- Department of Oral & Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Germany
| | - Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | - Rigmor H Jensen
- Danish Headache Center, Glostrup Hospital, University of Copenhagen, Denmark
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227
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Biasco L, Infantino V, Orzan F, Vicentini S, Rovera C, Longo G, Chinaglia A, Belli R, Allais G, Gaita F. Impact of transcatheter closure of patent foramen ovale in the evolution of migraine and role of residual shunt. J Cardiol 2014; 64:390-4. [PMID: 24713153 DOI: 10.1016/j.jjcc.2014.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/25/2014] [Accepted: 02/13/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To retrospectively evaluate the impact on daily activities of transcatheter closure of patent foramen ovale (PFO) versus medical therapy in patients with migraine and to analyze the role of the residual shunt after PFO closure. BACKGROUND While non-controlled observational studies reported an improvement of migraine after PFO closure, a randomized trial has shown no benefit of such an intervention. The role of residual shunt after PFO closure is also poorly known. METHODS Out of 217 patients with migraine and echocardiographic evidence of PFO, 89 were managed with percutaneous PFO closure (Group A) while 128 were medically treated (Group B). All MIDAS questionnaires were obtained at the first evaluation and repeated at least 6 months after the index evaluation or after the PFO closure. All the patients were also asked to give a subjective estimate of their migraine status. A postprocedural transcranial Doppler study was available in 70 patients in Group A. RESULTS The mean basal MIDAS score did not differ between the two groups (p = 0.859). After a mean follow-up (FU) of 1399 ± 982 days the MIDAS score decreased significantly in both groups (Group A baseline vs FU, p < 0.001; Group B baseline vs FU, p < 0.001), but no differences were observed between groups (p = 0.204). However a significantly higher number of Group A patients reported a perceived clinical benefit or the disappearance of migraine compared to Group B (p < 0.001). Patients with moderate or severe residual right to left shunt were no more likely to have an higher MIDAS score or to complain of migraine than those with mild or no shunt. CONCLUSIONS Although the overall evolution of migraine is not significantly different, the abolition of migraine occurs in a larger proportion after PFO closure.
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Affiliation(s)
- Luigi Biasco
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
| | - Vincenzo Infantino
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Fulvio Orzan
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvia Vicentini
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Chiara Rovera
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giada Longo
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Riccardo Belli
- Division of Cardiology, Ospedale Maria Vittoria, Turin, Italy
| | - Gianni Allais
- Women's Headache Center, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
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Göbel H, Heinze-Kuhn K, Petersen I, Göbel A, Heinze A. [Integrated headache care network. Kiel Migraine and Headache Center and German National Headache Treatment Network]. Schmerz 2014; 27:149-65. [PMID: 23549863 DOI: 10.1007/s00482-013-1307-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Migraine and other headaches affect 54 million people in Germany. They rank among the ten most severely disabling complaints and the three most expensive neurological disorders. Nevertheless, they are not adequately recognized in the healthcare system with sketchy diagnoses and inadequate treatment. This inadequate care is not primarily due to a lack of medical and scientific knowledge on the development and treatment of headaches but is predominantly due to organizational deficits in the healthcare system and in the implementation of current knowledge. To overcome the organizational barriers the national headache treatment network was initiated in Germany. For the first time it allows national cross-sectoral and multidisciplinary links between inpatient and outpatient care. A hand in hand treatment programme, better education, better information exchange between all partners and combined efforts using clearly defined treatment pathways and goals are the basis for state of the art and efficient treatment results. The treatment network is geared towards the specialized treatment of severely affected patients with chronic headache disorders. A national network of outpatient and inpatient pain therapists in both practices and hospitals works hand in hand to optimally alleviate pain in a comprehensive cross-sectoral and multidisciplinary manner. For therapy refractive disorders, a high-intensive supraregional fully inpatient treatment can be arranged. This concept offers for the first time a nationwide coordinated treatment without limitation by specialization and bureaucratic remuneration sectors.
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Affiliation(s)
- H Göbel
- Migräne- und Kopfschmerzzentrum, Schmerzklinik Kiel, Heikendendorfer Weg 9-27, Kiel, Germany.
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Liossi C, Schoth DE, Godwin HJ, Liversedge SP. Using eye movements to investigate selective attention in chronic daily headache. Pain 2014; 155:503-510. [DOI: 10.1016/j.pain.2013.11.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 11/15/2013] [Accepted: 11/19/2013] [Indexed: 11/17/2022]
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Reliability and validity of the migraine disability assessment scale among migraine and tension type headache in Iranian patients. BIOMED RESEARCH INTERNATIONAL 2014; 2014:978064. [PMID: 24527462 PMCID: PMC3914354 DOI: 10.1155/2014/978064] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 10/11/2013] [Accepted: 10/19/2013] [Indexed: 01/03/2023]
Abstract
Introduction. MIDAS is a valid and reliable short questionnaire for assessment of headache related disability. Linguistic validation of Persian MIDAS and assessment of psychometric properties between tension type headache (TTH) and migraine were the aims of this study. Methods. Patients with migraine or TTH were included. At the first visit, we administered a headache symptom questionnaire, MIDAS, and SF-36. Patients filled out MIDAS in second and third visit within three and eight weeks after base line visit. Internal consistency (Cronbach α) and test-retest reproducibility (Spearman correlation coefficient) were used to assess reliability. Convergent validity and MIDAS capability to differentiate between chronic and episodic headaches (migraine and TTH) were also assessed. Results. The 267 participants had episodic migraine (EM-64%), chronic migraine (CM-13.5%), episodic TTH (ETTH-13.5%), and chronic TTH (CTTH-9). Internal consistency reliability was 0.8 for the entire sample, 0.72 for TTH, and 0.82 for migraine. Test-retest reliability for all questions between visit 1 and visit 2 varied from 0.54 to 0.71. Convergent validity was assessed using SF-36 as an external referent. Patients with episodic headaches (EM and ETTH) had significantly lower MIDAS scores than chronic headaches (CM and CTTH). Conclusion. Persian MIDAS is a valid and reliable questionnaire for migraine and TTH that can differentiate between episodic headache and chronic headache.
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D'Amico D, Lanteri-Minet M. Migraine preventive therapy: selection of appropriate patients and general principles of management. Expert Rev Neurother 2014; 6:1147-57. [PMID: 16893343 DOI: 10.1586/14737175.6.8.1147] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The goal of this review is to communicate the rationale and the possible benefits of migraine preventive treatments to clinicians and patients, and to address the many problematic issues created by missed diagnosis or misdiagnoses and inadequate migraine management. Successful implementation of migraine preventive treatment requires appropriate patient selection based on several factors, including the frequency of migraine attacks (> or =2-3 attacks/month), the level of disability incurred and the frequency of acute medication usage. Unfortunately, several epidemiologic surveys indicate that preventive therapies are significantly underutilized, which supports the need for greater dialog concerning migraine prevention between consumers and physicians. Effective migraine preventive therapy should reduce the frequency, duration, and severity of migraine, and also improve function, reduce disability, and possibly reduce the risk of worsening the headache syndrome, through acute medication overuse.
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Affiliation(s)
- Domenico D'Amico
- C. Besta National Neurological Institute, Via Celoria 11, 20133 Milano, Italy.
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232
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Diener HC. Treating medication overuse headache: more than improving headache. Cephalalgia 2013; 34:405-6. [PMID: 24322482 DOI: 10.1177/0333102413515350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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233
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Conforto AB, Amaro E, Gonçalves AL, Mercante JP, Guendler VZ, Ferreira JR, Kirschner CC, Peres MF. Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine. Cephalalgia 2013; 34:464-72. [PMID: 24326236 DOI: 10.1177/0333102413515340] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (rTMS-DLPFC) is an effective treatment for depression. Preliminary studies indicated beneficial effects of rTMS-DLPFC on pain relief in patients treated for depression, and in patients with chronic migraine. METHODS In this randomized, double-blind, parallel-group, single-center, proof-of-principle clinical trial, we tested the hypothesis that 23 sessions of active rTMS-DLPFC delivered over eight weeks would be feasible, safe and superior to sham rTMS to decrease the number of headache days in 18 patients with chronic migraine without severe depression. Per-protocol analysis was performed. RESULTS rTMS-DLPFC applied over eight weeks was feasible and safe in patients with chronic migraine. Contrary to our primary hypothesis, the number of headache days decreased significantly more in the sham group than in the group treated with active rTMS-DLPFC at eight weeks. Average decrease in headache days was >50% in the sham group, indicating a powerful placebo response. Pain intensity improved in both groups to a similar extent. CONCLUSIONS Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.
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Affiliation(s)
- Adriana B Conforto
- Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Brazil
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234
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Heyer GL, Perkins SQ, Rose SC, Aylward SC, Lee JM. Comparing patient and parent recall of 90-day and 30-day migraine disability using elements of the PedMIDAS and an Internet headache diary. Cephalalgia 2013; 34:298-306. [DOI: 10.1177/0333102413508240] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim The aim of this article is to compare 90-day and 30-day recall of Pediatric Migraine Disability Assessment (PedMIDAS) elements and headache frequency against daily entries from an Internet headache diary among pediatric patients and their parents. Methods In a prospective cohort study, patients aged 10–18 years with episodic migraine or probable migraine completed a 90-day Internet-based headache diary that incorporated PedMIDAS questions. Following the 90-day diary period, patients and parents completed modified PedMIDAS instruments to assess 90-day and 30-day recall. Intraclass correlation coefficients (ICC) were calculated to measure recall reliability. The Kruskal-Wallis and Jonckheere-Terpstra tests were used to explore recall accuracy as it relates to each participant’s self-reported confidence in recall and to patient age. Results Fifty-two subjects completed 90 consecutive diary entries. Comparing 30-day to 90-day recall of PedMIDAS elements, ICC scores improved by 26.2% (patients) and 17.5% (parents). Patients had better recall than their parents for all study measures. Self-reported confidence in recall and patient age had limited and inconsistent effects on recall accuracy. Conclusion The optimal recall interval to assess migraine disability must balance recall accuracy with generalizability across a range of headache frequencies. When compared to daily diary entries, recall accuracy of PedMIDAS elements and headache frequency improves at 30 days compared to 90 days. Parent report of migraine disability should not be used as a replacement for patient report.
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Affiliation(s)
- Geoffrey L Heyer
- Departments of Pediatrics and Neurology, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Sara Q Perkins
- Center for Human Psychophysiology, Miami University, Oxford, OH, USA
| | - Sean C Rose
- Departments of Pediatrics and Neurology, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Shawn C Aylward
- Departments of Pediatrics and Neurology, Nationwide Children’s Hospital, Columbus, OH, USA
| | - JoEllen M Lee
- Departments of Pediatrics and Neurology, Nationwide Children’s Hospital, Columbus, OH, USA
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235
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Freitag FG, Lyss H, Nissan GR. Migraine disability, healthcare utilization, and expenditures following treatment in a tertiary headache center. Proc (Bayl Univ Med Cent) 2013; 26:363-7. [PMID: 24082410 DOI: 10.1080/08998280.2013.11929007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Headache is among the most common disabling pain complaints. While many patients are managed in primary care or referral neurology practices, some patients have refractive situations that necessitate referral to a tertiary headache center. Increasing frequency of headache is strongly associated with increasing disability and workplace absenteeism as well as increased healthcare utilization. Previous studies have demonstrated that headache care in a dedicated tertiary center is associated with a decrease in headache frequency and improvement in other characteristics that persist over extended periods of time. Previous studies have not examined the impact of this treatment on subsequent healthcare utilization and associated expenditures. In this study we examined the changes in healthcare utilization and expenditures as well as the impact on disability and workplace productivity with treatment in a tertiary headache care center that used initial treatment settings of inpatient and outpatient care and considered the difference between those with episodic migraine and those with chronic migraine and its complications. Tertiary care was found to produce positive reductions in disability, healthcare utilization, and expenditures. These results suggest that earlier tertiary-level intervention may avoid the complications of migraine that occur in some patients and the increasing costs and utilization of care associated with higher disability.
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Affiliation(s)
- Frederick G Freitag
- Comprehensive Headache Center, Baylor Neuroscience Center, Baylor University Medical Center at Dallas (Freitag, Nissan); and Heidi Lyss Consulting, Moraga, California (Lyss). Dr. Freitag is now with the Medical College of Wisconsin
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236
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Rockett FC, Perla ADS, Perry IDS, Chaves MLF. Cardiovascular disease risk in women with migraine. J Headache Pain 2013; 14:75. [PMID: 24011175 PMCID: PMC4014803 DOI: 10.1186/1129-2377-14-75] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 09/03/2013] [Indexed: 01/07/2023] Open
Abstract
Background Studies suggest a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting. The aim of this study was to investigate traditional and newly recognized risk factors as well as other surrogate markers of cardiovascular risk in obese and normal weight women with migraine. Methods Fifty-nine adult female probands participated in this case–control study. The sample was divided into normal weight and obese migraineurs and age- and body mass index-matched control groups. The following cardiovascular risk factors were analyzed: serum levels of lipids, fasting glucose, and insulin; insulin resistance; blood pressure; smoking (categorized as current, past or never); Framingham 10-year risk of general cardiovascular disease score; C-reactive protein; family history of cardiovascular disease; physical activity; sleep disturbances; depression; and bioelectrical impedance phase angle. The means of continuous variables were compared using Student’s t-test for independent samples or the Mann–Whitney U-test (for 2 groups) and ANOVA or the Kruskal-Wallis test (for 4 groups) depending on the distribution of data. Results All migraineurs were sedentary irrespective of nutritional status. Migraineurs had higher depression scores and shorter sleep duration, and obese migraineurs, in particular, had worse sleep quality scores. Insulin resistance and insulinaemia were associated with obesity, and obese migraineurs had lower HDL-c than normal weight controls and migraineurs. Also, the Framingham risk score was higher in obese migraineurs. Conclusion These findings suggest that female migraineurs experience marked inactivity, depression, and some sleep disturbance, that higher insulin resistance and insulinaemia are related to obesity, and that obesity and migraine probably exert overlapping effects on HDL-c levels and Framingham 10-year cardiovascular risk.
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Affiliation(s)
- Fernanda Camboim Rockett
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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237
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Baillie LE, Gabriele JM, Penzien DB. A Systematic Review of Behavioral Headache Interventions With an Aerobic Exercise Component. Headache 2013; 54:40-53. [DOI: 10.1111/head.12204] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2013] [Indexed: 01/01/2023]
Affiliation(s)
- Lauren E. Baillie
- Department of Psychology; G.V. (Sonny) Montgomery VA Medical Center; Jackson MS USA
- Department of Psychiatry; The University of Mississippi Medical Center; Jackson MS USA
| | - Jeanne M. Gabriele
- Department of Psychology; G.V. (Sonny) Montgomery VA Medical Center; Jackson MS USA
- Department of Psychiatry; The University of Mississippi Medical Center; Jackson MS USA
| | - Donald B. Penzien
- Department of Psychiatry; The University of Mississippi Medical Center; Jackson MS USA
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238
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Ruscheweyh R, Müller M, Blum B, Straube A. Correlation of headache frequency and psychosocial impairment in migraine: a cross-sectional study. Headache 2013; 54:861-71. [PMID: 23980919 DOI: 10.1111/head.12195] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate if a headache frequency of 15 days per month constitutes a turning point in the psychosocial impairment associated with migraine. BACKGROUND Migraine is differentiated into episodic and chronic forms based on a headache frequency criterion (< vs ≥15 headache days per month). It is presently not clear if this criterion represents a clinically and pathophysiologically meaningful turning point of the disease. METHODS Six hundred and one migraine patients completed measures of pain-specific disability (Migraine Disability Assessment Scale, von Korff scale), health-related quality of life (Short Form-12 Health Survey), habitual well-being (Marburg questionnaire), and anxiety and depression (Hospital Anxiety and Depression Score). RESULTS A significant increase of psychosocial impairment with the number of headache days per month was found at lower headache frequencies, but leveled off at higher headache frequencies. Visual inspection and spline interpolation suggested that the turning point was not exactly at 15 headache days per month but rather around 13.3 (confidence interval: 8.9-17.7) days. Accordingly, significant correlations between headache days and psychosocial impairment were found in the group with ≤13 headache days per month (Spearman's rho = 0.25, P < .001) but not in the group with >13 headache days (rho = -0.02, n.s.). CONCLUSION These results suggest that a meaningful turning point in psychosocial impairment associated with migraine is located around 13.3 headache days per month, somewhat below the 15-headache days criterion that by definition separates chronic from episodic migraine. However, confidence intervals surrounding the turning point were large. Further studies will be needed to more exactly localize the turning point.
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Affiliation(s)
- Ruth Ruscheweyh
- Department of Neurology, University of Munich, Munich, 81377, Germany
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239
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Carmona F, Angelucci MA, Sales DS, Chiaratti TM, Honorato FB, Bianchi RV, Pereira AMS. Lippia alba (Mill.) N. E. Brown hydroethanolic extract of the leaves is effective in the treatment of migraine in women. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2013; 20:947-950. [PMID: 23639189 DOI: 10.1016/j.phymed.2013.03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 03/28/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND There is no universally accepted and effective prophylaxis of migraine headache episodes. We aimed to investigate the effects of Lippia alba (Mill.) N. E. Brown (chemotype geranial-carvenone) in the treatment of migraine patients. METHODS Twenty-one women were enrolled in a prospective, phase 2, non-controlled cohort study to orally receive hydroethanolic extract of L. alba leaves. Symptom intensity and impact were assessed using MIDAS and HIT-6 instruments before and after 2 months of treatment. RESULTS We observed a significant decrease on HIT-6 total score, as well as MIDAS number of missed days, number of headache days, and pain intensity. More than 70% of patients experienced a minimum 50% reduction on pain frequency. CONCLUSIONS Treatment with L. alba leaves (geranial-carvenone) hydroethanolic extract is a cheap, safe, widely available, highly effective therapy to reduce both the intensity and the frequency of headache episodes of women with migraine. ClinicalTrials.gov Identifier: NCT01259947.
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Affiliation(s)
- Fabio Carmona
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil; Spiritist Society "Terra de Ismael," Jardinópolis, Brazil.
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240
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Ekici B, Unal-Cevik I, Akgul-Ercan E, Morkavuk G, Yakut Y, Erkan AF. Duration of Migraine Is Associated with Cardiac Diastolic Dysfunction. PAIN MEDICINE 2013; 14:988-93. [DOI: 10.1111/pme.12105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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241
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Suzuki K, Miyamoto T, Miyamoto M, Suzuki S, Watanabe Y, Takashima R, Hirata K. Dream-enacting behaviour is associated with impaired sleep and severe headache-related disability in migraine patients. Cephalalgia 2013; 33:868-78. [PMID: 23439573 DOI: 10.1177/0333102413477742] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sleep disorders, nightmares and visual hallucinations have been reported in migraine patients, which may suggest the involvement of rapid eye movement (REM) sleep regulation in migraine. However, the relationship between migraine and REM sleep behaviour disorder (RBD) remains unclear. METHODS To investigate the clinical correlates of dream-enacting behaviours (DEB) in migraine patients, we assessed episodic migraine patients ( N = 161, mean age 33.1 years) and headache-free control subjects ( N = 140, mean age 33.1 years) under 50 years of age in a cross-sectional, case-control study. The Japanese version of the RBD screening questionnaire was used, and subjects scoring 5 or higher were defined as having DEB. RESULTS A significantly increased frequency of DEB was observed in migraine patients compared to controls (24.2% vs. 14.3%). Migraine patients with DEB presented higher scores on the Migraine Disability Assessment and Pittsburgh Sleep Quality Index and an increased rate of smoking compared to those without DEB. Duration of migraine and headache frequency and intensity were not different between migraine patients with or without DEB. CONCLUSION DEB was associated with impaired sleep and severe headache-related disability in migraine patients and may reflect brainstem dysfunction and increased brain excitability in migraine patients.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Japan
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242
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Wang SJ, Wang PJ, Fuh JL, Peng KP, Ng K. Comparisons of disability, quality of life, and resource use between chronic and episodic migraineurs: a clinic-based study in Taiwan. Cephalalgia 2012. [PMID: 23203506 DOI: 10.1177/0333102412468668] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The International Burden of Migraine Study (IBMS) showed chronic migraine (CM) was associated with a higher disease burden than episodic migraine (EM). However, in this study Asians with CM were underrepresented. Objectives We investigated if CM and EM differed in headache-related disability, health-related quality of life (HRQoL) and health care resource utilization in Taiwan. METHODS This study recruited patients with EM and CM from two headache clinics in Taiwan. Diagnosis was made by physicians based on Silberstein-Lipton criteria. Participants completed a questionnaire including sociodemographics, Migraine Disability Assessment (MIDAS), EuroQol five-dimensions (EQ-5D), Migraine-Specific Quality of Life v2.1 (MSQ), Patient Health Questionnaire-4 (PHQ-4), productivity and health care resource utilization. RESULTS A total of 331 patients (EM, n = 164 (49.5%); CM, n = 167 (50.5%)) completed the study. CM patients reported a significantly higher MIDAS score, lower generic (EQ-5D visual analogue scale score and EQ-5D index score) and migraine-specific (all three domains of MSQ) HRQoL, higher levels of anxiety and depression (PHQ-4 ≥ 6) and greater health care resource utilization and productivity loss than those with EM. Positive correlations were found between these instruments and levels of anxiety and depression. CONCLUSION Compared to EM, CM was significantly associated with higher disability, lower HRQoL and greater health care resource utilization and productivity loss.
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Affiliation(s)
- Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
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243
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Raggi A, Leonardi M, Bussone G, D'Amico D. A 3-Month Analysis of Disability, Quality of Life, and Disease Course in Patients With Migraine. Headache 2012; 53:297-309. [DOI: 10.1111/j.1526-4610.2012.02279.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2012] [Indexed: 01/11/2023]
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244
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Wang YF, Fuh JL, Chen SP, Wu JC, Wang SJ. Clinical correlates and diagnostic utility of osmophobia in migraine. Cephalalgia 2012; 32:1180-8. [DOI: 10.1177/0333102412461401] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Osmophobia is an under-investigated associated symptom in migraine. Objective: To evaluate the clinical correlates and diagnostic utility of osmophobia. Methods: Adult patients with migraine (with or without aura), probable migraine (PM), tension-type headache (TTH), and cluster headache (CH) were recruited retrospectively from our headache registration system. Migraine patients with and without osmophobia were compared. The newly proposed criteria for migraine requiring at least two of photo-, phono-, or osmophobia instead of both photo- and phonophobia were validated. Results: In total, 2883 patients were included: 1809 migraine, 792 PM, 138 TTH, and 144 CH. Osmophobia was more common in migraine (62.2%) than in PM (33.8%), TTH (14.5%), and CH (31.3%) (all p < 0.001). Migraine patients with osmophobia scored higher on the Hospital Anxiety and Depression Scale (HADS) than those without (15.6 ± 7.6 vs. 13.3 ± 7.8, p < 0.001). The concordance in headache diagnoses between ICHD-2 (International Classification of Headache Disorders, Second Edition) and the newly proposed criteria was “almost perfect” (κ = 0.886, p < 0.001). Additionally, 16.9% of ICHD-2 PM patients were reclassified as migraine using the newly proposed criteria. Conclusions: Osmophobia was prevalent in migraineurs, and was associated with higher HADS scores. The newly proposed criteria appear comparable to the ICHD-2 criteria, and may increase the diagnostic yield for Asian migraineurs, among whom photophobia was less common.
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Affiliation(s)
- Yen-Feng Wang
- Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan
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Abstract
Migraine is a prevalent and disabling brain disorder that costs billions of dollars annually in direct healthcare costs, and school and work absenteeism and presenteeism. The objective of acute treatment is a cost-effective, rapid restoration of functional ability, with minimal recurrence and adverse effects. The acute treatment of migraine includes specific drugs, which currently all have vasoconstrictive effects (dihydroergotamine and triptans), and nonspecific drugs that include paracetamol (acetaminophen), combination analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), dopamine antagonists, narcotics and corticosteroids. NSAIDs have both peripheral and central effects on reversing migraine, and so may represent the best alternative for patients who cannot use triptans and ergots due to vascular contraindications. Narcotics and habituating medications should be avoided in the acute treatment of migraine, as the risk for transformation to chronic daily headache is excessively high at a relatively infrequent rate of exposure.
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Affiliation(s)
- Arnaldo N Da Silva
- Center for Headache and Pain, Cleveland Clinic, Cleveland, OH 44195, USA.
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246
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Raggi A, Giovannetti AM, Quintas R, D'Amico D, Cieza A, Sabariego C, Bickenbach JE, Leonardi M. A systematic review of the psychosocial difficulties relevant to patients with migraine. J Headache Pain 2012; 13:595-606. [PMID: 23001069 PMCID: PMC3484254 DOI: 10.1007/s10194-012-0482-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 08/30/2012] [Indexed: 01/11/2023] Open
Abstract
Migraine is a common disease which causes significant burden to individuals, in terms of personal suffering and activity reduction, and to societies, in terms of disease cost. The purpose of this study is to identify the most relevant psychosocial difficulties related to migraine, the variables associated with them and the most relevant determinants of their evolution over time. MEDLINE and PsychINFO were searched for studies published in English between 2000 and 2010 that examined psychosocial difficulties in persons with migraine with and without aura, from clinical trials and observational studies. Information on the description of each difficulty, its determinants of onset and change over time and associated variables were extracted and categorized at a higher level. In total, 34 difficulties have been collected from 51 papers: the most frequent were reduced vitality and fatigue, emotional problems, pain, difficulties at work, general physical and mental health, social functioning and global disability. Evidence exists that pharmacological treatments have an impact toward improvement in patients’ difficulties, in particular emotional problems, physical and mental health, difficulties with employment and global disability. Migraine treatments and decreased headaches frequency are the major determinants of improvements in psychosocial difficulties, while no information is available for determinants of worsening; understanding the role of such factors is of primary public health relevance, given the high prevalence and the relevant personal and societal costs of migraine.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy.
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247
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Andreatta M, Puschmann AK, Sommer C, Weyers P, Pauli P, Mühlberger A. Altered processing of emotional stimuli in migraine: an event-related potential study. Cephalalgia 2012; 32:1101-8. [PMID: 22992405 DOI: 10.1177/0333102412459573] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Migraine patients report psychosocial stress to be among the major triggers for their migraine attacks. The mechanisms underlying the onset of migraine attacks are not yet fully understood. Neuroimaging studies have shown changes in the cortical excitability of migraine patients. Here, we investigated cortical activation related to processing of emotional stimuli in individuals with migraine. METHOD Twenty-four participants suffering from migraine attacks and 25 healthy volunteers had to passively observe pictures of emotional facial expressions (angry, happy and neutral). Electro-cortical activity was continuously recorded by means of an electroencephalogram (EEG), and ratings of valence (unpleasant vs. pleasant) and arousal (calm vs. exciting) were collected. RESULTS The migraine and control group did not differ in their ratings of valence and arousal of the visual stimuli. However, participants with migraine, in contrast to healthy controls, showed larger N170 amplitudes toward angry facial expressions compared to neutral ones. DISCUSSION Individuals with migraine may have an altered cortical activity linked to the processing of emotional information. Thus, these individuals may process high arousing and threatening events preferentially, and this facilitated processing may be related to their already high cortical excitability.
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Affiliation(s)
- Marta Andreatta
- Department of Psychology, (Biological Psychology, Clinical Psychology, and Psychotherapy) University of Würzburg, Marcusstrasse 9-11, Würzburg, Germany.
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248
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Gerber MR, Fried LE, Pineles SL, Shipherd JC, Bernstein CA. Posttraumatic stress disorder and intimate partner violence in a women's headache center. Women Health 2012; 52:454-71. [PMID: 22747183 DOI: 10.1080/03630242.2012.684088] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Posttraumatic stress disorder has been linked to women's ill health, including headaches. Intimate partner violence, which may result in posttraumatic stress disorder, is often reported by women with headaches. Prior studies of intimate partner violence and headache have estimated lifetime but not 12-month prevalence. The researchers in this study examined the relationship between headache and posttraumatic stress disorder in a novel population, and estimated 12-month and lifetime prevalence rates of intimate partner violence. METHODS Patients were recruited from a women's headache center (n = 92) during 2006-07 and completed the Migraine Disability Assessment measure of headache severity. Posttraumatic stress disorder was measured using a modified Breslau scale. Twelve-month and lifetime physical intimate partner violence were measured with the Partner Violence Screen and the STaT ("slapped, threatened and throw") measure. Multivariable regression determined factors independently associated with headache severity. RESULTS Among all participants, 28.3% screened positive for posttraumatic stress disorder; 9.8% and 36.9% of women endorsed recent and lifetime intimate partner violence. Posttraumatic stress disorder was strongly associated with headache severity (β = 34.12, p = 0.01). Patients reporting lifetime intimate partner violence exhibited a trend of nine additional days of disability due to headache over 90 days. CONCLUSIONS Posttraumatic stress disorder and intimate partner violence occur among a sizable proportion of women referred for headache. The authors' findings reaffirm that clinicians treating women with headaches must be aware of the possibility of posttraumatic stress disorder and intimate partner violence in such patients.
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Affiliation(s)
- Megan R Gerber
- VA Boston Healthcare System/Women’s Health, Boston University School of Medicine, 150 S. Huntington Ave., Jamaica Plain, MA 02130, USA.
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249
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Guendler VZ, Mercante JPP, Ribeiro RT, Zukerman E, Peres MFP. Fatores associados ao uso excessivo de medicação sintomática em pacientes com enxaqueca crônica. EINSTEIN-SAO PAULO 2012; 10:312-7. [DOI: 10.1590/s1679-45082012000300010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 08/31/2012] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar a prevalência de transtornos psiquiátricos em pacientes com diagnóstico de enxaqueca crônica com e sem uso excessivo de medicação sintomática. MÉTODOS: Setenta e dois voluntários foram recrutados a partir de um Programa de Saúde da Família da comunidade de Paraisópolis, na cidade de São Paulo (SP). Esses pacientes foram submetidos a exames clínico e neurológico. As seguintes variáveis foram analisadas: idade, gênero, nível educacional, índice de massa corporal, tipo de uso excessivo de medicação, características da cefaleia, consumo de cafeína, presença de ansiedade e distúrbios de humor. RESULTADOS: Dos 72 pacientes, 50 (69%) tinham cefaleia crônica, com uso exagerado de medicação, e 22 (31%) tinham cefaleia crônica, sem uso excessivo de medicação. Os fatores idade, gênero, nível educacional, índice de massa corporal, tipo de uso excessivo de medicação, características da cefaleia e consumo de cafeína não mostraram diferença significante entre os grupos estudados. Os diagnósticos de ansiedade e de distúrbios de humor ao longo da vida foram mais comuns nos pacientes com uso excessivo de medicação (p=0,003 e p=0,045, respectivamente). CONCLUSÃO: Este estudo mostrou uma associação significativa entre cefaleia crônica e uso excessivo de medicação nos pacientes avaliados, quanto ao diagnóstico de transtornos de ansiedade e de humor ao longo da vida. Não foi encontrada nenhuma associação com outros distúrbios psiquiátricos pesquisados.
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Brewer AC, Trentman TL, Ivancic MG, Vargas BB, Rebecca AM, Zimmerman RS, Rosenfeld DM, Dodick DW. Long-term outcome in occipital nerve stimulation patients with medically intractable primary headache disorders. Neuromodulation 2012; 16:557-62; discussion 563-4. [PMID: 22882274 DOI: 10.1111/j.1525-1403.2012.00490.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Occipital nerve stimulation (ONS) may provide relief for refractory headache disorders. However, scant data exist regarding long-term ONS outcomes. METHODS The methods used were retrospective review of the medical records of all (nonindustry study) patients who were trialed and implanted with occipital nerve stimulator systems at our institution, followed by a phone interview. Up to three attempts were made to contact each patient, and those who were contacted were given the opportunity to participate in a brief phone interview regarding their ONS experience. Data for analysis were gleaned from both the phone interview and the patient's medical records. RESULTS Twenty-nine patients underwent a trial of ONS during the 8.5-year study period. Three patients did not go on to permanent implant, 12 could not be contacted, and 14 participated in the phone interview. Based upon the phone interview (if the patient was contacted) or chart review, ONS was deemed successful in five of the 12 migraine, four of the five cluster headache, and five of the eight miscellaneous headache patients, and therapy was documented as long as 102 months. In one of the 26 patients, success of ONS could not be determined. Among patients deemed to have successful outcomes, headache frequency decreased by 18%, severity by 27%, and migraine disability score by 50%. Fifty-eight percent of patients required at least one lead revision. DISCUSSION These results, although limited by their retrospective nature, suggest that ONS can be effective long term despite technical challenges. The number of patients within each headache subtype was insufficient to draw conclusions regarding the differential effect of ONS. CONCLUSIONS Randomized controlled long-term studies in specific, intractable, primary headache disorders are indicated.
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Affiliation(s)
- Ann Chang Brewer
- College of Medicine, University of Arizona, Phoenix, AZ, USA; Department of Anesthesiology, Mayo Clinic in Arizona, Phoenix, AZ, USA; Department of Neurology, Mayo Clinic in Arizona, Phoenix, AZ, USA; Department of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA; and Department of Neurosurgery, Mayo Clinic in Arizona, Phoenix, AZ, USA
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