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Kang S, Eun Y, Han K, Jung J, Kim H, Min JH, Lee S, Cha HS, Shin DW, Lee J. Heightened migraine risk in patients with rheumatoid arthritis: A national retrospective cohort study. Headache 2024. [PMID: 39269010 DOI: 10.1111/head.14832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 07/01/2024] [Accepted: 07/17/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE This study aimed to evaluate the association between rheumatoid arthritis (RA) and subsequent migraine risk using the Korean National Health Insurance Service database. BACKGROUND Migraine may be related to immune dysfunction and previous studies have suggested an association with chronic inflammatory rheumatic diseases; however, the relationship between RA and migraine remains unclear. METHODS This was a population-based, nationwide, retrospective, longitudinal cohort study. Participants were enrolled from 2010 to 2017 and followed up until 2019. A total of 42,674 patients who had undergone a health checkup within 2 years prior to the initial diagnosis of RA were included in the study, after applying the exclusion criteria (previous migraine, other rheumatic disease, missing variables of interest). A non-RA control was obtained by age and sex-matching (1:5). Finally, 42,644 patients with RA were enrolled, with 213,370 individuals without RA included as controls. Among the patients with RA, 29,744 had seropositive RA (SPRA), and 12,900 had seronegative RA (SNRA). SPRA was defined by the International Classification of Diseases 10th revision (ICD-10) code M05, prescription of disease-modifying anti-rheumatic drugs (DMARDs), and enrollment in a special copayment reduction program. SNRA was defined by the ICD-10 code M06 and prescription of any DMARD. The primary endpoint was the occurrence of migraine incidents, defined using the ICD-10 code of migraine (G43). RESULTS A total of 22,294 migraine cases (17,912/213,370 [8.3%] in controls and 4382/42,674 [10.2%] in RA) were reported during a mean follow-up of 4.4 years after a 1-year lag period. Patients with RA had a 1.2-fold higher risk of migraine compared with controls (adjusted hazard ratio [aHR] 1.21, 95% confidence interval [CI] 1.17-1.26). Increased risk of migraine was found in both patients with SNRA and SPRA compared with controls (aHR 1.20, CI 1.15-1.24 in SPRA; aHR 1.26, CI 1.19-1.34 in SNRA). Compared to patients with SNRA, those with SPRA did not demonstrate a heightened risk (aHR 0.94, CI 0.88-1.01). A significant interaction was confirmed between covariates (male, current smoker, those with diabetes mellitus, and dyslipidemia) and the risk of migraine (p for interaction of <0.05). CONCLUSION RA was linked to a higher migraine risk, regardless of seropositivity.
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Affiliation(s)
- Seonyoung Kang
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yeonghee Eun
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jinhyung Jung
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hyungjin Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ju-Hong Min
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seulkee Lee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hoon-Suk Cha
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jaejoon Lee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Lloyd K, Harrison S, Sallis HM, Davey Smith G, Munafò MR, Wootton RE. Exploring the Bidirectional Causal Pathways Between Smoking Behaviors and Headache: A Mendelian Randomization Study. Nicotine Tob Res 2024; 26:903-912. [PMID: 37702655 PMCID: PMC11190053 DOI: 10.1093/ntr/ntad173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 07/21/2023] [Accepted: 09/07/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Although observational data suggest a relationship between headache and smoking, there remain questions about causality. Smoking may increase headache risk, individuals may smoke to alleviate headaches, or smoking and headache may share common risk factors. Mendelian randomization (MR) is a method that uses genetic variants as instruments for making causal inferences about an exposure and an outcome. AIMS AND METHODS First, we conducted logistic regression of observational data in UK Biobank assessing the association between smoking behaviors (smoking status, cigarettes per day amongst daily smokers, and lifetime smoking score) on the risk of self-reported headache (in the last month and for more than 3 months). Second, we used genetic instruments for smoking behaviors and headache (identified in independent genome-wide association studies [GWAS]) to perform bidirectional MR analysis. RESULTS Observationally, there is a weak association between smoking behavior and experiencing headache, with increased cigarettes per day associated with increased headache risk. In the MR analysis, genetic liability to smoking initiation and lifetime smoking increased odds of headache in the last month but not odds of headaches lasting more than 3 months. In the opposite direction, there was weak evidence for higher genetic liability to headaches decreasing the chance of quitting. CONCLUSIONS There was weak evidence for a partially bidirectional causal relationship between smoking behaviors and headache in the last month. Given this relationship is distinct from smoking heaviness, it suggests headache and smoking may share common risk factors such as personality traits. IMPLICATIONS Using MR, this study addresses the uncertainty regarding the observed relationship between headache and smoking. There was evidence for weak causal effects of smoking initiation and lifetime smoking (but not smoking heaviness) on likelihood of experiencing headache in the last month, but not over a prolonged period of more than 3 months. Those with higher genetic liability to headaches were also less likely to successfully stop smoking. This partially bidirectional causal relationship distinct from smoking heaviness suggests that observed associations are unlikely due to biological effects of tobacco smoke exposure and may be explained by shared personality traits.
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Affiliation(s)
- Katherine Lloyd
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sean Harrison
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol, UK
| | - Hannah M Sallis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - George Davey Smith
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
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Sgro M, Ray J, Foster E, Mychasiuk R. Making migraine easier to stomach: the role of the gut-brain-immune axis in headache disorders. Eur J Neurol 2023; 30:3605-3621. [PMID: 37329292 DOI: 10.1111/ene.15934] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/30/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND PURPOSE Headache disorders place a significant burden on the healthcare system, being the leading cause of disability in those under 50 years. Novel studies have interrogated the relationship between headache disorders and gastrointestinal dysfunction, suggesting a link between the gut-brain-immune (GBI) axis and headache pathogenesis. Although the exact mechanisms driving the complex relationship between the GBI axis and headache disorders remain unclear, there is a growing appreciation that a healthy and diverse microbiome is necessary for optimal brain health. METHODS A literature search was performed through multiple reputable databases in search of Q1 journals within the field of headache disorders and gut microbiome research and were critically and appropriately evaluated to investigate and explore the following; the role of the GBI axis in dietary triggers of headache disorders and the evidence indicating that diet can be used to alleviate headache severity and frequency. The relationship between the GBI axis and post-traumatic headache is then synthesized. Finally, the scarcity of literature regarding paediatric headache disorders and the role that the GBI axis plays in mediating the relationship between sex hormones and headache disorders are highlighted. CONCLUSIONS There is potential for novel therapeutic targets for headache disorders if understanding of the GBI axis in their aetiology, pathogenesis and recovery is increased.
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Affiliation(s)
- Marissa Sgro
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jason Ray
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Neurology, Austin Health, Melbourne, Victoria, Australia
| | - Emma Foster
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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Shen Y, Li D, Cao Q, Hu M, Hou Z, Xu L, Li Y, Hong D. Risk factors of vestibular migraine-related brain white matter lesions. Acta Neurol Belg 2023; 123:1833-1839. [PMID: 36071312 DOI: 10.1007/s13760-022-02076-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/22/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE AND PURPOSE Migraine is related to white matter lesions (WMLs), and attack frequency and duration in migraine patients are thought to increase WMLs. However, the relationship between vestibular migraine (VM) and WMLs remains unclear. This study explored the risk factors for WMLs in VM patients and provided a basis for the prevention of WMLs in VM patients. METHODS A large single-center cross-sectional study of patients with VM was conducted. None of the patients had comorbidities, such as hypertension and diabetes, or adverse lifestyle habits (smoking and drinking). All patients were divided into WML + and WML- groups after assessment of WMLs using magnetic resonance imaging (MRI). After collecting the patient's detailed medical history, statistical analysis was performed. RESULTS In univariate analysis, the frequency of vertigo was statistically significant between the WML + and WML- groups. However, there was no significant difference in other clinical features. Multivariate regression analysis found that the frequency of vertigo (OR 2.399; 95% CI 1.014-5.679; p = 0.046) was an independent risk factor for WMLs. High frequency of vertigo episodes showed more pronounced risk factors (OR 9.607; 95% CI 1.061-87.014; p = 0.044). CONCLUSION These results substantiate that vertigo frequency is an independent risk factor for WMLs in VM. A high frequency of vertigo episodes is more likely to be associated with WMLs than a low frequency. These results suggest a possible approach to the prevention of WMLs in VM patients.
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Affiliation(s)
- Yu Shen
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Yong Wai Zheng Street 17, Nanchang, Jiangxi, China
| | - Defu Li
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, Jiangxi, China
| | - Qian Cao
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Mengyao Hu
- The Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhou Hou
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lijun Xu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yanping Li
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Yong Wai Zheng Street 17, Nanchang, Jiangxi, China.
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Tiberio P, Viganò A, Ilieva MB, Pindilli S, Bianchi A, Zambelli A, Santoro A, De Sanctis R. The Role of Female Reproductive Hormones in the Association between Migraine and Breast Cancer: An Unanswered Question. Biomedicines 2023; 11:1613. [PMID: 37371707 DOI: 10.3390/biomedicines11061613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Accumulating epidemiological studies have investigated a possible interconnection between migraine (Mi) and breast cancer (BC) because of the strong link between these diseases and female reproductive hormones. This review aims to consolidate findings from epidemiological studies and explore biologically plausible hypothetical mechanisms related to hormonal pathways. Current evidence suggests a protective role of Mi in BC development, particularly in case-control studies but not in cohort ones. The inconsistency among studies may be due to several reasons, including diagnostic criteria for Mi and the age gap between the development of these two diseases. Furthermore, recent research has challenged the concept of a net beneficial effect of Mi on BC, suggesting a more complex relationship between the two conditions. Many polymorphisms/mutations in hormone-related pathways are involved in at least one of the two conditions. The most promising evidence has emerged for a specific alteration in the estrogen receptor 1 gene (rs2228480). However, the possible specific mutation or polymorphism involved in this association has not yet been identified. Further studies with robust methodologies are needed to validate the protective role of Mi in BC and fully elucidate the precise nature of this causal relationship.
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Affiliation(s)
- Paola Tiberio
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Alessandro Viganò
- Neurology Unit, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
| | - Mariya Boyanova Ilieva
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
| | | | - Anna Bianchi
- Neurology Unit, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
| | - Alberto Zambelli
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
| | - Armando Santoro
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
| | - Rita De Sanctis
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
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Abstract
PURPOSE OF REVIEW Tobacco use is associated with significant health consequences especially for people with medical conditions. Although lifestyle strategies (e.g., sleep, diet) are commonly recommended as part of migraine treatment, tobacco-related strategies (e.g., smoking cessation) are rarely included. This review is aimed at elucidating what is known about tobacco use and migraine and at identifying gaps in the research. RECENT FINDINGS The prevalence of smoking is higher among people with migraine, and people with migraine believe that smoking makes migraine attacks worse. There is also evidence that smoking may exacerbate migraine-related consequences (e.g., stroke). Very few studies have examined other aspects of smoking and migraine or tobacco products other than cigarettes. There are significant gaps in our knowledge of smoking and migraine. More research is needed to understand the relationship of tobacco use to migraine and potential benefits of adding smoking cessation efforts into migraine care.
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Al-Hayani M, AboTaleb H, Bazi A, Alghamdi B. Depression, anxiety and stress in Saudi migraine patients using DASS-21: local population-based cross-sectional survey. Int J Neurosci 2023; 133:248-256. [PMID: 33843418 DOI: 10.1080/00207454.2021.1909011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Psychiatric comorbidity is common among migraineurs, such as anxiety and depression. This type of comorbidity contributed to migraine chronicity, management efficacy, and increasing the risk for other comorbidities. This study designed to estimate the prevalence of depression, anxiety, and stress (DAS) symptoms among Saudi migraine patients using the validated instrument (DASS-21) and considering socio-demographic factors and individual differences that affect migraine progression and prognosis.Design/methods: Cross-sectional, self-administered, web-based-questionnaire distributed among Saudi Arabia general population. Only migraine patients with clinical diagnosis allowed to complete the survey.Results: A total of 247 migraine patients participated and they are predominantly females, with ages between 16 and 45 years, Saudi nationals, married, non-smokers but do not exercise regularly. About 73.3% met the abnormal score in anxiety on DASS-21, as well as 70.9% in depression and 72.3% in stress. Four statistically significant correlations with DAS were identified. Migraine patients who are smoking have a higher prevalence of depression and stress (p < 0.05). Those who do not exercise regularly have a higher prevalence only for depression (p = 0.03). A higher prevalence of all emotional states was found in patients with more than one co-morbidity and patients with a clinical diagnosis of depression and anxiety disorders (p < 0.02). The sensitivity of DASS-21 for depression and anxiety are 96.9% and 93.3%, respectively.Conclusions: Both smoking cessation and exercise to prevent migraine attacks deserve a clinical trial. A holistic approach is needed to decrease psychiatry-related disability and promote management outcomes in migraineurs. Using DASS-21 for migraine patients as a routine screening instrument is valuable to prevent psychiatric comorbidity.
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Affiliation(s)
- Majed Al-Hayani
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hanin AboTaleb
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulrahman Bazi
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Badrah Alghamdi
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,Neuroscience Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saud Arabia.,Pre-Clinical Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Flynn O, Fullen BM, Blake C. Migraine in university students: A systematic review and meta-analysis. Eur J Pain 2023; 27:14-43. [PMID: 36288401 DOI: 10.1002/ejp.2047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 10/10/2022] [Accepted: 10/23/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Migraine is a complex, neurobiological disorder usually presenting as a unilateral, moderate to severe headache accompanied by sensory disturbances. Migraine prevalence has risen globally, affecting 14% of individuals and 16% of students and carries many negative impacts in both cohorts. With no recent meta-analysis of global migraine prevalence or associated factors in students, this systematic review and meta-analysis were conducted. DATABASES AND DATA TREATMENT The review was registered with PROSPERO (CRD42020167927). Electronic databases (n = 12) were searched for cross-sectional studies (1988 to August 2021, IHS criteria). Ninety-two articles were meta-analysed and 103 were narratively reviewed. The risk of bias was assessed using an established tool. RESULTS The risk of bias ranged from low to moderate. Migraine pooled prevalence (R-Studio) was demonstrated at 19% (95% CI, 16%-22%, p < 0.001, I^2 98%): females 23% (95% CI, 19%-27%, p < 0.001), males 12% (95% CI, 9%-15%, p < 0.001). Gender (p < 0.0001), geographical region (p = 0.01), migraine types (p = 0.0002) and prevalence timeframes (p = 0.02) may be influencing the substantial heterogeneity. Migraine triggers were primarily behavioural and environmental and treatments were predominantly pharmaceutical. Impacts ranged from academic performance impairment to psychological co-morbidities. CONCLUSIONS This study offers the most comprehensive overview of migraine prevalence and associated factors in university students. Migraine prevalence in university students has increased and has many negative effects. Enhancing migraine recognition and management at university may have positive implications for an improved educational experience, as well as for the burden migraine currently incurs, both in university and beyond. SIGNIFICANCE This global systematic review and meta-analysis of 92 studies and narrative review of 103 studies provide the most comprehensive synthesis to date of migraine prevalence and associated factors in university students. Pooled prevalence has increased to 19%. The significant heterogeneity demonstrated is influenced by gender, geographical region, migraine type and prevalence timeframes. Students manage migraines primarily with pharmaceuticals. Further studies conducted in low and middle-income countries, following headache protocols and reporting frequency of treatment-seeking and medication usage are warranted.
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Affiliation(s)
- Orla Flynn
- UCD School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland.,UCD Centre for Translational Pain Research, Dublin, Ireland
| | - Brona M Fullen
- UCD School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland.,UCD Centre for Translational Pain Research, Dublin, Ireland
| | - Catherine Blake
- UCD School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland.,UCD Centre for Translational Pain Research, Dublin, Ireland
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Body mass index and incidence of lung cancer in the HUNT study: using observational and Mendelian randomization approaches. BMC Cancer 2022; 22:1152. [DOI: 10.1186/s12885-022-10215-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 10/23/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
Traditional observational studies have shown an inverse association between body mass index (BMI) and lung cancer risk. Mendelian randomization (MR) analysis using genetic variants as instruments for BMI may clarify the nature of the association.
Aims
We studied the causal association between BMI and lung cancer incidence using observational and MR approaches.
Methods
We followed up 62,453 cancer-free Norwegian adults from 1995–97 (HUNT2) until 2017. BMI at baseline in HUNT2 was classified as < 25.0, 25.0–29.9 and ≥ 30.0 kg/m2. BMI change over ten years between HUNT1 (1984–86) and HUNT2 was calculated and classified into quartiles. Seventy-five genetic variants were included as instruments for BMI (among which 14 also associated with smoking behavior). Incident lung cancer cases were ascertained from the Cancer Registry of Norway. Cox regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable MR was used to examine the effect of BMI after genetically controlling for smoking.
Results
During a median follow-up of 21.1 years, 1009 participants developed lung cancer including 327 with lung adenocarcinoma. The HRs and 95% CIs for incidence of adenocarcinoma were 0.73 (0.58–0.92) for BMI 25.0–29.9 kg/m2 and 0.53 (0.37–0.76) for BMI ≥ 30 kg/m2 compared with BMI < 25.0 kg/m2 in HUNT2 (P for trend < 0.001). However, there was little evidence of a dose–response relationship between the BMI change from HUNT1 to HUNT2 in quartiles and the incidence of adenocarcinoma (P for trend = 0.08). Furthermore, multivariable MR approach suggested a positive association between genetically determined 1 kg/m2 increase in BMI and the incidence of adenocarcinoma (HR 1.25, 95% CI 1.02–1.53). No associations were found with other lung cancer histologic types.
Conclusions
Our study suggests that the inverse association between baseline BMI and lung adenocarcinoma in observational analysis may not be causal. More MR studies are needed to confirm our finding of a positive association between BMI and lung adenocarcinoma.
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Siokas V, Liampas I, Aloizou AM, Papasavva M, Bakirtzis C, Lavdas E, Liakos P, Drakoulis N, Bogdanos DP, Dardiotis E. Deciphering the Role of the rs2651899, rs10166942, and rs11172113 Polymorphisms in Migraine: A Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58040491. [PMID: 35454329 PMCID: PMC9031971 DOI: 10.3390/medicina58040491] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022]
Abstract
The genetic basis of migraine is rather complex. The rs2651899 in the PR/SET domain 16 (PRDM16) gene, the rs10166942 near the transient receptor potential cation channel subfamily M member 8 (TRPM8) gene, and the rs11172113 in the LDL receptor-related protein 1 (LRP1) gene, have been associated with migraine in a genome-wide association study (GWAS). However, data from subsequent studies examining the role of these variants and their relationship with migraine remain inconclusive. The aim of the present study was to meta-analyze the published data assessing the role of these polymorphisms in migraine, migraine with aura (MA), and migraine without aura (MO). We performed a search in the PubMed, Scopus, Web of Science, and Public Health Genomics and Precision Health Knowledge Base (v7.7) databases. In total, eight, six, and six studies were included in the quantitative analysis, for the rs2651899, rs10166942, and rs11172113, respectively. Cochran’s Q and I2 tests were used to calculate the heterogeneity. The random effects (RE) model was applied when high heterogeneity was observed; otherwise, the fixed effects (FE) model was applied. The odds ratios (ORs) and the respective 95% confidence intervals (CIs) were calculated to estimate the effect of each variant on migraine. Funnel plots were created to graphically assess publication bias. A significant association was revealed for the CC genotype of the rs2651899, with the overall migraine group (RE model OR: 1.32; 95% CI: 1.02−1.73; p-value = 0.04) and the MA subgroup (FE model OR: 1.40; 95% CI: 1.12−1.74; p-value = 0.003). The rs10166942 CT genotype was associated with increased migraine risk (FE model OR: 1.36; 95% CI: 1.18−1.57; p-value < 0.0001) and increased MO risk (FE model OR: 1.41; 95% CI: 1.17−1.69; p-value = 0.0003). No association was detected for the rs11172113. The rs2651899 and the rs10166942 have an effect on migraine. Larger studies are needed to dissect the role of these variants in migraine.
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Affiliation(s)
- Vasileios Siokas
- Laboratory of Neurogenetics, Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece; (V.S.); (I.L.); (A.-M.A.)
| | - Ioannis Liampas
- Laboratory of Neurogenetics, Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece; (V.S.); (I.L.); (A.-M.A.)
| | - Athina-Maria Aloizou
- Laboratory of Neurogenetics, Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece; (V.S.); (I.L.); (A.-M.A.)
| | - Maria Papasavva
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece; (M.P.); (N.D.)
| | - Christos Bakirtzis
- B’ Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Eleftherios Lavdas
- Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece;
- Department of Medical Imaging, Animus Kyanoys Larisas Hospital, 41222 Larissa, Greece
| | - Panagiotis Liakos
- Laboratory of Biochemistry, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece;
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece; (M.P.); (N.D.)
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Viopolis, 40500 Larissa, Greece;
| | - Efthimios Dardiotis
- Laboratory of Neurogenetics, Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece; (V.S.); (I.L.); (A.-M.A.)
- Correspondence: ; Tel.: +30-241-350-1137
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Agbetou M, Adoukonou T. Lifestyle Modifications for Migraine Management. Front Neurol 2022; 13:719467. [PMID: 35370920 PMCID: PMC8971279 DOI: 10.3389/fneur.2022.719467] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Migraine is a disabling disease that inflicts a heavy burden on individuals who suffer from it. Significant advances are being made in understanding the pathophysiology and treatment of the disease. The role of lifestyle modifications has become increasingly predominant. We reviewed the current and available data on the role of a healthy lifestyle in the management of migraine. Physical activity, management of obesity, a healthy diet, and a better lifestyle, such as adequate sleep and avoidance of drug abuse, significantly contribute to reducing the frequency and severity of attacks. It is important to consider these factors in the overall management strategies for migraine sufferers.
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Affiliation(s)
- Mendinatou Agbetou
- Department of Neurology, University of Parakou, Parakou, Benin
- Clinic of Neurology, Teaching Hospital of Parakou, Parakou, Benin
| | - Thierry Adoukonou
- Department of Neurology, University of Parakou, Parakou, Benin
- Clinic of Neurology, Teaching Hospital of Parakou, Parakou, Benin
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- *Correspondence: Thierry Adoukonou
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12
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Association between dietary acid load and clinical features of migraine headaches among Iranian individuals. Sci Rep 2022; 12:2460. [PMID: 35165363 PMCID: PMC8844046 DOI: 10.1038/s41598-022-06515-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/24/2022] [Indexed: 11/09/2022] Open
Abstract
There is limited evidence regarding the possible role of dietary acid load (DAL) in the pathophysiology of migraine headaches. Therefore, we sought to examine DAL in relation to the clinical features of migraine including headache frequency, severity and duration, headache impact test-6 (HIT-6), and serum levels of nitric oxide (NO). In the present cross-sectional study, 262 patients (38 men and 224 women aged 20–50 years) were recruited through a simple random sampling method. Dietary intakes were obtained by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). DAL was then calculated by two different methods; potential renal acid load (PRAL) and net endogenous acid production (NEAP). In total, 262 patients with a mean (SE) age of 36.1 (0.53) and a BMI of 25.55 (0.21) were included in the current study. After controlling for potential confounders, a higher DAL was positively associated with headache frequency in those with the highest DAL score compared to the lowest (PRAL; β = 2.33; 95% CI 0.78, 3.88; NEAP; β = 1.74; 95% CI 0.13, 3.34). Increasing NEAP from 28.96 to 35.89 resulted in a 3.43 and 2.74 increment in HIT-6 scores in the crude (95% CI 1.35, 5.52) and fully-adjusted models (95% CI 0.40, 5.07), respectively. Moreover, a higher dietary PRAL was significantly associated with migraine-related disability, as shown by HIT-6, in subjects of the third tertile compared to those in the first tertile after controlling for confounders (β = 2.42; 95% CI 0.13, 4.70). In conclusion, our study highlighted the importance of the acid–base properties of a diet in the pathophysiology of migraine headaches. However, further well-designed studies are needed to confirm our findings.
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Hamit G, Ayca O, Omer B, Nevra O, Aynur O. Association of circadian locomotor output cycles kaput rs1801260 and hypocretin receptor 1 rs2271933 polymorphisms in patients with chronic migraine and sleep disorder. NEUROL SCI NEUROPHYS 2022. [DOI: 10.4103/nsn.nsn_195_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Hassan M, Belavadi R, Gudigopuram SVR, Raguthu CC, Gajjela H, Kela I, Kakarala CL, Modi S, Sange I. Migraine and Stroke: In Search of Shared Pathways, Mechanisms, and Risk Factors. Cureus 2021; 13:e20202. [PMID: 34900505 PMCID: PMC8647778 DOI: 10.7759/cureus.20202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 01/01/2023] Open
Abstract
Migraines are one of the emerging causes of disabilities experienced worldwide, and strokes are the second leading cause of death globally. Migraines with aura have been reported to be associated with a higher risk of ischemic strokes, whereas hemorrhagic strokes are more closely associated with migraines without aura, possible mechanisms that link migraines to strokes. These can be categorized into vascular mechanisms such as vasospasm, endothelial and platelet dysfunction, and alteration in the vessel wall seen in migraineurs, further perpetrated by vascular risk factors such as hypertension and hyperlipidemias. Cerebral hypoperfusion that occurs in migraines can cause an electrical aberrance, leading to a phenomenon known as "spreading depression" which can contribute to strokes. In this review, we discuss bloodstream elevation in procoagulants such as antiphospholipid antibodies, homocysteine, von Willebrand factor, and prothrombin. Maintaining pregnant women who actively experience migraines with aura under close observation may be of some value in achieving better outcomes. Women who experience migraines after starting hormonal contraception are at a higher risk of experiencing strokes and stand to benefit from being switched to non-hormonal methods. In this article, we discuss the mechanisms linking migraines and strokes, briefly discuss the pathogenesis, and explore the risk factors contributing to the association therein. In addition, we examine the relationship between migraines and ischemic strokes, as well as hemorrhagic strokes, and review management considerations.
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Affiliation(s)
- Mohammad Hassan
- Internal Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, PAK
| | - Rishab Belavadi
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | | | | | - Harini Gajjela
- Research, Our Lady of Fatima University College of Medicine, Valenzuela, PHL
| | - Iljena Kela
- Family Medicine, Jagiellonian University Medical College, Krakow, POL
| | - Chandra L Kakarala
- Internal Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Srimy Modi
- Research, K. J. Somaiya Medical College, Mumbai, IND
| | - Ibrahim Sange
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Research, K. J. Somaiya Medical College, Mumbai, IND
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15
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Bandara SMR, Samita S, Kiridana AM, Herath HMMTB. Elevated nitric oxide and carbon monoxide concentration in nasal-paranasal sinus air as a diagnostic tool of migraine: a case - control study. BMC Neurol 2021; 21:407. [PMID: 34702215 PMCID: PMC8547087 DOI: 10.1186/s12883-021-02434-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A recent study showed that 60-s paranasal air suction results in an immediate pain relief in acute migraine. This is the study to assess the Nitric Oxide (NO) and Carbon Monoxide (CO) concentration in nasal-paranasal sinus air of migraine patients and to compare it with healthy controls. METHODOLOGY The NO and CO levels of air sucked out from nasal-paranasal sinuses of 20 migraine adolescent and young adults among school students, aged 16 -19 years, and 22 healthy similar aged school students as controls were measured as key responses using a portable NO and a portable CO analyzer. RESULTS Patients had comparatively high values compared to the controls for paranasal NO (both left and right sides), paranasal CO (both left and right sides), Fraction Exhaled NO (FeNO) and Fraction Exhaled CO (FeCO). Patients had median paranasal NO contents of 132.5 ppb and 154 ppb on left and right sides respectively compared to 36 ppb and 34.5 ppb corresponding values in controls (P < 0.0001). Similar pattern was observed with paranasal CO (P < 0.0001). FeNO and FeCO content were also higher in patients (P < 0.0001). Receiver characteristic operating curves of all gas measurements showed that they all could classify patients and controls effectively and NO was the most effective followed by paranasal CO. After air suction, the mean pain scores of general headache and tenderness dropped by a very large margin in migraine patients (P < 0.0001). CONCLUSIONS Suctioned out high nasal-paranasal sinus NO and CO levels can be used to distinguish migraine patients from healthy subjects. In fact, suctioned out paranasal NO measurements of both sides with a cutoff point of 50 ppb provided a perfect classification of patients and controls. Increased sinus NO and CO during acute episode of migraine is an observation we had and we agree that further studies are needed to conclude that NO and CO can be a causative molecule for migraine headache. TRAIL REGISTRATION Clinical Trial Government Identification Number - 1548/2016. Ethical Clearance Granted Institute - Medical Research Institute, Colombo, Sri Lanka (No 38/2016). Sri Lanka Clinical Trial Registration number: SLCTR/ 2017/018 (29/06/2017). Approval Granting Organization to use the device in the clinical trial- National Medicines Regulatory Authority Sri Lanka (16/06/2018), The device won award at Geneva international inventers exhibition in 2016 and President award in 2018 in Sri Lanka. It is a patented device in Sri Lanka and patent number was SLKP/1/18295. All methods were carried out in accordance with CONSORT 2010 guidelines.
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Affiliation(s)
| | - S Samita
- University of Peradeniya, Peradeniya, Sri Lanka
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Rivera-Mancilla E, Al-Hassany L, Villalón CM, MaassenVanDenBrink A. Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus. Front Neurol 2021; 12:686398. [PMID: 34177788 PMCID: PMC8219973 DOI: 10.3389/fneur.2021.686398] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
Migraine is a disabling neurovascular disorder, characterized by moderate to severe unilateral headaches, nausea, photophobia, and/or phonophobia, with a higher prevalence in women than in men, which can drastically affect the quality of life of migraine patients. In addition, this chronic disorder is related with metabolic comorbidities associated with the patient's lifestyle, including obesity and diabetes mellitus (DM). Beyond the personal and socioeconomic impact caused by migraine, obesity and DM, it has been suggested that these metabolic disorders seem to be related to migraine since: (i) they are a risk factor for developing cardiovascular disorders or chronic diseases; (ii) they can be influenced by genetic and environmental risk factors; and (iii) while clinical and epidemiological studies suggest that obesity is a risk factor for migraine, DM (i.e., type 1 and type 2 DM) have been reported to be either a protective or a risk factor in migraine. On this basis, and given the high worldwide prevalence of migraine, obesity, and DM, this article provides a narrative review of the current literature related to the association between the etiology and pathophysiology of migraine and these metabolic disorders, considering lifestyle aspects, as well as the possible involvement of neurotransmitters, neuropeptides, and/or sex hormones. While a link between migraine and metabolic disorders has been suggested, many studies are contradictory and the mechanisms involved in this association are not yet sufficiently established. Therefore, further research should be focused on understanding the possible mechanisms involved.
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Affiliation(s)
- Eduardo Rivera-Mancilla
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Linda Al-Hassany
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Antoinette MaassenVanDenBrink
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
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17
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Effect of synbiotic supplementation on migraine characteristics and inflammatory biomarkers in women with migraine: Results of a randomized controlled trial. Pharmacol Res 2021; 169:105668. [PMID: 33989763 DOI: 10.1016/j.phrs.2021.105668] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 12/19/2022]
Abstract
Literature suggests a relationship between gut microbiome and migraine headache pathogenesis. However, the effect of manipulating gut microbiome on migraine remains unclear. This study aimed to investigate the effect of synbiotics on migraine characteristics and inflammatory markers in women with migraines. Sixty-nine participants completed a randomized double-blind controlled trial, receiving synbiotic (109 CFU of 12 types of probiotics + fructooligosaccharides prebiotic) or placebo supplementation, twice per day for 12 weeks. Migraine severity, migraine days per month, frequency and duration of attacks, number of painkillers consumed, gastrointestinal problems, serum High sensitive C-Reactive Protein (Hs-CRP) (a marker of inflammation) and zonulin (a marker of gut permeability) levels were measured at baseline and the end of the intervention. Bivariate comparison and intention-to-treat (ITT) were used for analysis. Synbiotic supplementation compare to the placebo resulted in a significant reduction in the mean frequency of migraine attacks (-1.02 vs -0.30, respectively, P = 0.011), percentage change of the number of painkillers used (-7.5% vs 27.5%, respectively, P = 0.008) and gastrointestinal problems (-35% vs -2.5%, respectively, P = 0.005), zonulin level (-4.12 vs 0.85 ng/ml, respectively, P = 0.034), and Hs-CRP level (-0.43 vs -0.09 mg/l, respectively, P = 0.022). Reduction in the migraine severity and duration did not reach a statistically significant level. Synbiotic supplementation may be considered as a complementary treatment for women with migraines to improve migraine characteristics and markers of inflammation and gut permeability and reduce the burden of disease.
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18
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Lin JY, Tung CS, Wang JC, Chien WC, Chung CH, Lin CY, Tsai SH. The Association between Migraine and Abdominal Aortic Aneurysms: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084389. [PMID: 33924263 PMCID: PMC8074774 DOI: 10.3390/ijerph18084389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/15/2021] [Accepted: 04/18/2021] [Indexed: 12/18/2022]
Abstract
Previous studies have indicated that patients with migraine have a higher prevalence of risk factors known to be associated with cardiovascular diseases. There are also shared epidemiology and molecular mechanisms between migraine and abdominal aortic aneurysm (AAA). We hypothesized that patients with migraine could have an increased risk of AAA. To test this hypothesis, we used the National Health Insurance Research Database (NHIRD) to evaluate whether associations exist between migraine and AAA. The data for this nationwide population-based retrospective cohort study were obtained from the NHIRD in Taiwan. The assessed study outcome was the cumulative incidence of AAA in patients with migraine during a 15-year follow-up period. Among the 1,936,512 patients from the NHIRD, 53,668 (2.77%) patients were identified as having been diagnosed with migraine. The patients with migraine had a significantly higher cumulative risk of 3.558 of developing an AAA 5 years after the index date compared with the patients without migraine. At the end of the 15-year follow-up period, a significantly higher incidence of AAA (0.98%) was observed in the patients with migraine than in those without migraine (0.24%). We revealed an association between the development of migraine and AAA.
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Affiliation(s)
- Jou-Yu Lin
- Department of Rehabilitation, Cheng Hsin General Hospital, Taipei 11220, Taiwan;
| | - Che-Se Tung
- Division of Medical Research & Education, Cheng Hsin General Hospital, Taipei 11220, Taiwan;
| | - Jen-Chun Wang
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (S.-H.T.); Tel.: +886-2-87923311-16877 (W.-C.C. & S.-H.T.)
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei 11490, Taiwan
| | - Chih-Yuan Lin
- Department of Surgery, Division of Cardiovascular Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (S.-H.T.); Tel.: +886-2-87923311-16877 (W.-C.C. & S.-H.T.)
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Jiang L, Sun YQ, Langhammer A, Brumpton BM, Chen Y, Nilsen TI, Leivseth L, Wahl SGF, Mai XM. Asthma and asthma symptom control in relation to incidence of lung cancer in the HUNT study. Sci Rep 2021; 11:4539. [PMID: 33633205 PMCID: PMC7907333 DOI: 10.1038/s41598-021-84012-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/11/2021] [Indexed: 11/08/2022] Open
Abstract
Large prospective studies on asthma, especially asthma symptom control, as a potential risk factor for lung cancer are limited. We followed up 62,791 cancer-free Norwegian adults from 1995-1997 to 2017. Self-reported doctor-diagnosed asthma was categorized into active and non-active asthma. Levels of asthma symptom control were classified into controlled and partially controlled (including partly controlled and uncontrolled) according to the Global Initiative for Asthma guidelines. Incident lung cancer cases were ascertained from the Cancer Registry of Norway. Cox regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for possible associations. Totally, 984 participants developed lung cancer during a median follow-up of 21.1 years. After adjustment for smoking and other potential confounders, an increased incidence of lung cancer was found for adults with partially controlled asthma (HR 1.39, 95% CI 1.00-1.92) compared with those without asthma at baseline. Adults with active asthma had a tendency of increased lung cancer incidence (HR 1.29, 95% CI 0.95-1.75). Sensitivity analyses indicated that the observed associations were less likely resulted from reverse causation or residual confounding by smoking. Our findings suggested that proper control of asthma symptoms might contribute to a reduced incidence of lung cancer.
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Affiliation(s)
- Lin Jiang
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Postbox 8905, MTFS, N-7491, Trondheim, Norway.
| | - Yi-Qian Sun
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pathology, Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- TkMidt-Center for Oral Health Services and Research, Mid-Norway, Trondheim, Norway
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ben Michael Brumpton
- Clinic of Thoracic and Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Tom Il Nilsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Postbox 8905, MTFS, N-7491, Trondheim, Norway
- Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Linda Leivseth
- Centre for Clinical Documentation and Evaluation (SKDE), Northern Norway Regional Health Authority, Tromsø, Norway
| | - Sissel Gyrid Freim Wahl
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pathology, Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Postbox 8905, MTFS, N-7491, Trondheim, Norway
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20
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Migraine-Related Disabilities Among Saudi Migraine Patients and Its Association with Social Factors. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.108778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Migraine is a complex disorder triggered by an interaction of multiple abnormalities involving genes, blood vessels, and brain structures. It is characterized by throbbing headaches, mostly on one side of the head. It is one of the most common causes of disability, as announced by the Global Burden of the Diseases (GBD). Objectives: We aimed at assessing disabilities in Saudi migraine patients and addressing the relation between migraine-associated disabilities and social factors in Saudi Arabia. Methods: We conducted a web-based survey randomly through social media channels to the general population around Saudi Arabia. Basic personal information, along with a confirmation of the migraine diagnosis, were included in the first part of the questionnaire, and the respondent’s eligibility was determined to complete the survey. Specified questions about the sociodemographic characteristics, migraine attacks and medications, and the items of Migraine Disability Assessment score (MIDAS), were included in the next parts of the survey. Results: Of the 480 total responses, 250 (52.1%) eligible participants were included (mean age of 34.84 ± 10.14 years; 83.2% females). Most of the participants were married (59.6%), had three or more kids (50.7%), had a bachelor’s degree (60.8%), and 52.8% were employed. Only 16.4% of the subjects did regular exercise, and 16.8% were current smokers. No significant association was detected between the MIDAS score and most of the social characteristics, including marital status, number of kids, education level, occupation, and smocking. Conclusions: Most of the migraineurs in Saudi Arabia had a severe disability according to the MIDAS score. Gender, regular exercise, the severity of the disease, and frequency of attack had a statistically significant relationship with migraine-related disabilities. Migraine treatment and prophylaxis were incompetent in decreasing migraine severity and related disabilities in our selected participants.
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Mathew PG, Krivitski D, Sharon R. Erenumab-Induced Severe Nausea Leading to Smoking Cessation: A Retrospective Case Series. Headache 2020; 60:2563-2569. [PMID: 33202039 DOI: 10.1111/head.13979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/15/2020] [Accepted: 08/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Erenumab is a novel treatment modality with a relatively benign and safe side effect profile, currently approved for the prevention of migraine headache. We present 3 cases with chronic migraine who are cigarette smokers were prescribed erenumab, and developed an intense smoking-induced nausea which eventually led to smoking cessation. METHODS A multicenter retrospective review of 3 cases with cigarette smoking, one of whom was also smoking marijuana, suffering from chronic migraine resistant to multiple preventive therapies was studied. All were prescribed monthly injections of erenumab 70 mg. Response in terms of headache frequency and intensity and smoking habits was obtained through medical record review. RESULTS Out of 3 patients, 2 reported reduced headache frequency and intensity. All patients developed severe nausea while smoking cigarettes after their first dose of erenumab, leading to smoking cessation. One patient co-smoked marijuana, which did not result in nausea after being treated. CONCLUSION To the best of our knowledge, this is the first report of severe nausea secondary to erenumab administration and smoking cigarettes, which finally resulted in complete cigarette smoking cessation. As such, further study is indicated on the benefit of erenumab and other calcitonin gene-related peptide antagonists in migraineurs who smoke to promote smoking cessation.
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Affiliation(s)
- Paul G Mathew
- Department of Neurology, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Harvard Vanguard Medical Associates, Braintree, MA, USA
| | - David Krivitski
- Department of General, Yitzhak Shamir Medical Center, Be'er Ya'akov, Israel
| | - Roni Sharon
- Department of Neurology, Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel
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Wienholtz NKF, Christensen CE, Haugaard JH, Zhang DG, Ashina M, Thyssen JP, Egeberg A. Cohort profile: COpenhagen ROsacea COhort (COROCO) and COpenhagen MIgraine COhort (COMICO). BMJ Open 2020; 10:e039445. [PMID: 32819957 PMCID: PMC7440817 DOI: 10.1136/bmjopen-2020-039445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Migraine has consistently been connected with rosacea. Commonalities in epidemiology, trigger factors and associated neuropeptides support shared aetiology and pathophysiological pathways, though underlying mechanisms remain unclear. We established two cohorts of patients diagnosed with either migraine and/or rosacea. All patients were phenotyped in regard to migraine and rosacea. In this article, we describe the baseline parameters of the cohorts. In the future, we expect that these cohorts will help uncover potential disease overlaps and allow for prolonged follow-up through national Danish health registers. PARTICIPANTS COpenhagen ROsacea COhort (COROCO) and COpenhagen MIgraine COhort (COMICO) are prospective cohorts based in the Capital region of Denmark. Participants for COROCO were recruited primarily through two tertiary dermatology clinics in Copenhagen, Denmark and patients for COMICO were recruited through a tertiary neurology clinic in Copenhagen, Denmark. FINDINGS TO DATE COROCO: 67.7% women (median age 51 years (interquartile range (IQR) 43.0-61.0)). Family history of migraine: 44.3%. Family history of rosacea: 45%. There were 13% who currently smoked, and 36.6% were former smokers. Regular intake of alcohol was present in 79.3% (median 4 items/week (IQR 1.0-9.0)). Median body mass index (BMI): 25.7 (IQR 23.1-29.0). Median Dermatology Life Quality Index (DLQI): 2 (IQR 1-5). COMICO 88.5% women (median age 41 years (IQR 29.5-51.0)). Family history of migraine: 73.4%. Family history of rosacea: 18.4%. There were 17.1% who currently smoked, and 26.0% former smokers. Regular intake of alcohol was present in 62.2% (median intake: 2 item/week (IQR 1.0-3.0)). Median BMI was 24.6 (IQR 21.5-28.2). Median DLQI was 1 (IQR 0-2). FUTURE PLANS COROCO and COMICO serve as strong data sources that will be used for future studies on rosacea and migraine with focus on risk factors, occurrence, treatment, natural history, complications, comorbidities and prognosis. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03872050).
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Affiliation(s)
- Nita Katarina Frifelt Wienholtz
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Casper Emil Christensen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Jeanette Halskou Haugaard
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Ditte Georgina Zhang
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Jacob Pontoppidan Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
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Rościszewska-Żukowska I, Zając-Mnich M, Janik P. Characteristics and clinical correlates of white matter changes in brain magnetic resonance of migraine females. Neurol Neurochir Pol 2018; 52:695-703. [PMID: 30297100 DOI: 10.1016/j.pjnns.2018.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 09/16/2018] [Accepted: 09/17/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE White matter hyperintensities (WMHs) were often found in migraine patients. The aim of study was to characterize WMHs, assess their prevalence, determine relationship to clinical symptoms and homocysteine levels in migraine females. METHODS 69 women 38 with migraine without aura (MO), 31 with migraine with aura (MA) who underwent brain MRI with 1.5T scanner were enrolled. The WMHs number, location and size in FLAIR sequence were evaluated. Migraine severity was measured by pain intensity, number of attacks per month and MIDAS scale. RESULTS WMHs were found in 39.1% females. There was no WMHs and migraine type correlation. The total WMHs number was higher in MO (p=0.027). Patients with WMHs were older (p=0.025), have higher BMI (p=0.042), suffered longer (p=0.001), more often had positive pregnancy history (p=0.010) and less frequent prodromal symptoms. The age of onset, migraine's severity and homocysteine did not correlate with WMHs. No effect of antimigraine medication and oral contraceptive pills (OCP) was found. Both in MO and MA groups WMHs were located only supratentorially. In MO females WMHs were mainly located in one cerebral hemisphere (p=0.024) whereas in MA were found bilaterally. WMHs were most commonly located in the frontal lobes. In MO lesions were small ≤3mm and present in almost all MO patients (p=0.027). CONCLUSION WMHs are present in more than one third of migraine females, regardless of aura. WHMs are located supratentorially, subcortically and in the frontal lobes. Older age, longer disease's duration, obesity and positive history of pregnancy are main risk factors for WMHs. Symptomatology and migraine severity, hyperhomocysteinemia, OCP and anti-migraine medications do not increase WMHs.
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Affiliation(s)
| | - Monika Zając-Mnich
- Clinical Department of Radiology, Provincial Hospital No. 2, named after St. Jadwiga the Queen, Rzeszow, Poland
| | - Piotr Janik
- Department of Neurology, Medical University of Warsaw, Poland
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Abstract
BACKGROUND It is accepted that smoking often triggers migraine. However, studies evaluating the relationship between the use of smokeless tobacco and migraine are limited, and there is no clear consensus on the subject. In this study, it was aimed to evaluate the relationship between migraine and Maras powder, which is the most common smokeless tobacco in Turkey. SUBJECTS AND METHODS The study included a total of 600 subjects, consisting of 300 patients (aged >18 years) diagnosed with a migraine according to the International Headache Society (IHS-ICHD-3 Beta) criteria after presenting at Sütçü Imam University Medical Faculty Neurology Policlinic with the complaint of headache between July 2016 and December 2016 and a control group of 300 individuals with similar features of age, gender, and educational level. A questionnaire was administered to each patient to record the status of smoking or using Maras powder. RESULTS In the migraine patient group, 16.4% smoked and 9.7% used Maras powder. In the control group, the rate of smoking was 8.5% and the rate of Maras powder use was 11.86%. In males diagnosed with a migraine, the use of Maras powder was found to be at a higher rate than smoking (p<0.001). The Visual Pain Score and the headache frequency values were higher in those who smoked or used Maras powder than in non-users (p<0.001). The Fagerström Test for Nicotine Dependence Smokeless Tobacco results of the patients diagnosed with migraine and who used Maras powder were found to be higher than of those who smoked (Fagerström Test for Nicotine Dependence; p<0.001). When patients were evaluated according to the Migraine Disability Assessment Scale, the majority of migraine patients were seen to be at stages 1 and 2, and one in every three patients who used Maras powder cigarette and one in every two patients who smoked had headaches of a severity which affected their daily activities (p<0.001). CONCLUSION Smoking or the use of Maras powder increases the frequency and severity of migraines in a similar way. Therefore, Maras powder must be included in the scope of the fight against tobacco and people should be warned about this issue.
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Affiliation(s)
- Yılmaz İnanç
- Department of Neurology, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey
| | - Fatma Özlem Orhan
- Department of Psychiatry, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey
| | - Yusuf İnanç
- Department of Neurology, Gaziantep University School of Medicine, Kahramanmaraş, Turkey
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Jakobsen GS, Timm AM, Hansen ÅM, Garde AH, Nabe-Nielsen K. The association between shift work and treatment-seeking migraine in Denmark. ERGONOMICS 2017; 60:1207-1217. [PMID: 28042740 DOI: 10.1080/00140139.2016.1278463] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/28/2016] [Indexed: 06/06/2023]
Abstract
In Europe, the one-year prevalence of migraine is 14.9% and migraine is on the top-10 list of leading causes of years lost to disability. Sleep disturbances and irregular daily routines are considered triggers of migraine and these factors are well-known consequences of shift work. We studied the association between treatment-seeking migraine and shift work, categorised as fixed evening work, fixed night work and variable working hours with and without night work in a Danish working population of 5872 participants. When compared with fixed day workers, only participants with fixed evening work were found to have significantly increased odds of reporting treatment-seeking migraine after adjustment for socio-demographic and behavioural covariates (OR = 1.56; 95% CI 1.05-2.32). Participants with seniority of 10 years or more notably accounted for this association. Due to the cross-sectional design, selection mechanisms may have biased the results. Practitioner Summary: The study showed higher odds of treatment-seeking migraine among evening workers even when taking a range of potential confounders into account. Due to the cross-sectional design, we cannot draw any causal inferences, but potential mechanisms underlying the present study are discussed, with an emphasis on possible selection into evening work.
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Affiliation(s)
- Gitte Sofie Jakobsen
- a The National Research Centre for the Working Environment , Copenhagen , Denmark
| | - Anne Matilde Timm
- a The National Research Centre for the Working Environment , Copenhagen , Denmark
| | - Åse Marie Hansen
- b Department of Public Health , University of Copenhagen , Copenhagen , Denmark
| | - Anne Helene Garde
- a The National Research Centre for the Working Environment , Copenhagen , Denmark
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Ibrahim NK, Alotaibi AK, Alhazmi AM, Alshehri RZ, Saimaldaher RN, Murad MA. Prevalence, predictors and triggers of migraine headache among medical students and interns in King Abdulaziz University, Jeddah, Saudi Arabia. Pak J Med Sci 2017; 33:270-275. [PMID: 28523020 PMCID: PMC5432687 DOI: 10.12669/pjms.332.12139] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Objectives: To determine the prevalence, predictors, triggers and educational outcome of migraine among medical students and interns in King Abdulaziz University, Jeddah, Saudi Arabia. Methods: A cross-sectional study was completed among 566 participants selected through a multistage stratified random sample method. A validated, confidential, self-administered data collection sheet was utilized. It contained ID Migraine test™, Numeric Pain Rating Scale (NPRS). Questions about possible predictors, triggers and impact of migraine were asked. Descriptive, inferential statistics and multiple logistic regression analysis were conducted. Results: More than one-half (54.9%) of the participants had ≥ 2 headache attacks during the three months preceded the study. The prevalence of migraine was 26.3%, and 41.6% of the cases suffered from severe pain. The main migraine predictors were Functional Gastrointestinal Disorders (FGIDs), family history of migraine, female gender, and enrollment in the second academic year. Exam stress and sleep disturbances were the commonest triggers. The majority of the participants reported that their educational performance and ability to attend sessions were affected during migraine attacks. Conclusion: A relatively high prevalence of migraine was seen among our participants. FGIDs, gender and academic year were the predictors. Screening and management of migraine among medical students are required. Conduction of relaxation programs and stress management courses are also recommended.
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Affiliation(s)
- Nahla Khamis Ibrahim
- Nahla Khamis Ibrahim, Professor at Family & Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia. Professor, Epidemiology Department, HIPH, Alexandria University
| | - Afnan Khalid Alotaibi
- Afnan Khalid Alotaibi, Sixth Year Medical Students at King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abrar Mansour Alhazmi
- Abrar Mansour Alhazmi, Sixth Year Medical Students at King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rawan Zaher Alshehri
- Rawan Zaher Alshehri, Sixth Year Medical Students at King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rawan Nabeel Saimaldaher
- Rawan Nabeel Saimaldaher, Sixth Year Medical Students at King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maradi Abdulkader Murad
- Maradi Abdulkader Murad, Sixth Year Medical Students at King Abdulaziz University, Jeddah, Saudi Arabia
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Sedlic M, Mahovic D, Kruzliak P. Epidemiology of Primary Headaches Among 1,876 Adolescents: A Cross-Sectional Survey. PAIN MEDICINE 2017; 17:353-9. [PMID: 26814268 DOI: 10.1093/pm/pnv033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/19/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND The main goal of our research was to perform an epidemiological study of migraine and tension-type headache (TTH) among high school students in the Republic of Croatia. METHODS The authors surveyed 1,876 students attending high schools in the Republic of Croatia using a self-administered 36-item questionnaire. RESULTS Among 1,876 students who completed the questionnaire, prevalence of migraine was 12.8% (17% in women and 8.1% in men) and prevalence of TTH was 38.3% (40.6% in women and 35.7% in men). Prevalence of migraine with TTH was 2.9% (3.1% in women and 2.7% in men). The authors found a significantly greater prevalence of migraine in female than in male students (OR = 2.3), as in TTH (OR = 1.23). Compared with students with TTH, migraine sufferers were more inclined to take medications (OR = 3.29) and use health care (OR = 8.12) and were more likely to smoke (OR = 2.34). CONCLUSION The prevalence of primary headaches in Croatia is similar to that in other countries of the world. TTH is the most common primary headache, occurring later in relation to migraine, and both types are more common in females. Teenagers who suffer from migraines are more likely to smoke in comparison to TTH. Although migraine patients visit the doctor and take medications more frequently than those with TTH, both headaches are being underdiagnosed and undertreated.
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Wang X, Zhou HB, Sun JM, Xing YH, Zhu YL, Zhao YS. The prevalence of migraine in university students: a systematic review and meta‐analysis. Eur J Neurol 2015; 23:464-75. [DOI: 10.1111/ene.12784] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 06/05/2015] [Indexed: 12/15/2022]
Affiliation(s)
- X. Wang
- Department of Epidemiology School of Public Health Harbin Medical University Harbin HeilongjiangChina
| | - H. B. Zhou
- Department of Epidemiology School of Public Health Harbin Medical University Harbin HeilongjiangChina
| | - J. M. Sun
- Department of Epidemiology School of Public Health Harbin Medical University Harbin HeilongjiangChina
| | - Y. H. Xing
- Department of Epidemiology School of Public Health Harbin Medical University Harbin HeilongjiangChina
| | - Y. L. Zhu
- Department of Neurology Second Affiliated Hospital Harbin Medical University Harbin Heilongjiang China
| | - Y. S. Zhao
- Department of Epidemiology School of Public Health Harbin Medical University Harbin HeilongjiangChina
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Toghae M, Rahimian E, Abdollahi M, Shoar S, Naderan M. The Prevalence of Magnetic Resonance Imaging Hyperintensity in Migraine Patients and Its Association with Migraine Headache Characteristics and Cardiovascular Risk Factors. Oman Med J 2015; 30:203-7. [PMID: 26171127 DOI: 10.5001/omj.2015.42] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 05/03/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To determine the frequency of hyperintense foci in migraine patients and the relationship with migraine headache characteristics and cardiovascular risk factors. METHODS Ninety patients with migraine headache (70 without aura and 20 with aura) were enrolled and interviewed. Information on their headache (severity, frequency, and mean disease duration) and other related data was obtained by completing a clinical checklist. Subsequently, brain magnetic resonance imaging (MRI) was performed and each patient was then evaluated for hyperintense lesions. RESULTS Of the 90 patients, 29 (32%) had silent hyperintense lesions on their MRI. The mean age of the patients with hyperintense foci was 41 years while those with no lesions was 33 years (p<0.010). Supratentorial hyperintense lesions represented the majority of lesions in the patients (n=46, 63%). Moreover, 56.3% of the lesions (n=41) were located within the right hemisphere. Cardiovascular risk factors such as smoking, serum cholesterol, oral contraceptive pills use, and body mass index (BMI) were not significantly different in these two groups (p>0.050). The lesions were found significantly more frequently in the patients who experienced chronic migraine (p=0.032). CONCLUSION Our study adds weight to the theory that disease duration has a key role in the formation of hyperintense brain lesions. Certain cardiovascular risk factors such as sex, smoking, serum cholesterol, and BMI, do not affect the presence or absence of such lesions, suggesting that the relationship between migraine and these lesions may be directly due to the effects of migraine itself.
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Affiliation(s)
- Mansoureh Toghae
- Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran ; Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Rahimian
- Haghighat MRI Center and Khatam MRI Center, Tehran, Iran
| | - Mohammad Abdollahi
- Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Shoar
- Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naderan
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
BACKGROUND Migraineurs variably attribute the cause of their headache to tobacco exposure, whereas tobacco is often stated to cause headache-related disability worldwide. Given tobacco's physiological and emotional addictiveness and migraine's substantial economic impact, improved functionality can be difficult for those with migraine exposed to tobacco products. Environmental tobacco exposure in indoor spaces and workplaces is associated with exacerbation of headache. Avoidance of headache triggers is included in most comprehensive migraine treatment programs, yet tobacco awareness, avoidance, or coping is rarely emphasized as part of that regimen. OBJECTIVE The aims of this study were to examine the various types of tobacco products to which headache sufferers are exposed and the known basic mechanisms by which tobacco (nicotine) exposure promotes headache pain, and to review the extensive literature on tobacco related to headache with a detailed descriptive narrative providing the basis for conclusions regarding association of noncluster headache-related tobacco exposure. Tobacco-related recommendations are offered. METHODS MEDLINE, EMBASE, and Google Scholar databases were searched without yearly restriction through the date of submission (May 2015), using the MeSH terms "tobacco," "tobacco products," "smoking," "tobacco use," "headache," and "headache disorders." The selection of articles was not limited to English studies or to humans. Articles were excluded when "headache" and "tobacco" were not both mentioned with data provided. Case series were included. Bibliographies of all articles were screened for additional relevant articles. RESULTS Although migraineurs worldwide report tobacco smoke among triggers, it is rarely among the highest in frequency, and biases abound with predominantly noncontrolled retrospective data. Prospective population-based diary data are extremely limited, and no controlled trials exist to confirm a cause and effect for headache of any type. Although some studies are nonsupportive and even conflicting, headache, pain, and tobacco exposure currently remain associated. CONCLUSION Conflicting data support the validity of patient-reported environmental tobacco exposure as a headache trigger. Prospective controlled studies are needed, but unlikely to be performed, to determine the extent that tobacco influences the headache process, in addition to other under-recognized factors. Meanwhile, because of numerous other negative health effects, decreased tobacco exposure should be recommended to headache patients of all ages in hopes of decreasing disability and improving functionality.
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Affiliation(s)
- Frederick R Taylor
- Department of Neurology, University of Minnesota School of Medicine, Minneapolis, MN, USA
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An Association between Carpal Tunnel Syndrome and Migraine Headaches-National Health Interview Survey, 2010. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e333. [PMID: 25878944 PMCID: PMC4387155 DOI: 10.1097/gox.0000000000000257] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 11/13/2014] [Indexed: 12/31/2022]
Abstract
Background: Migraine headaches have not historically been considered a compression neuropathy. Recent studies suggest that some migraines are successfully treated by targeted peripheral nerve decompression. Other compression neuropathies have previously been associated with one another. The goal of this study is to evaluate whether an association exists between migraines and carpal tunnel syndrome (CTS), the most common compression neuropathy. Methods: Data from 25,880 respondents of the cross-sectional 2010 National Health Interview Survey were used to calculate nationally representative prevalence estimates and 95% confidence intervals (95% CIs) of CTS and migraine headaches. Logistic regression was used to calculate adjusted odds ratios (aORs) and 95% CI for the degree of association between migraines and CTS after controlling for known demographic and health-related factors. Results: CTS was associated with older age, female gender, obesity, diabetes, and smoking. CTS was less common in Hispanics and Asians. Migraine was associated with younger age, female gender, obesity, diabetes, and current smoking. Migraine was less common in Asians. Migraine prevalence was 34% in those with CTS compared with 16% in those without CTS (aOR, 2.60; 95% CI, 2.16–3.13). CTS prevalence in patients with migraine headache was 8% compared with 3% in those without migraine headache (aOR, 2.67; 95% CI, 2.22–3.22). Conclusions: This study is the first to demonstrate an association between CTS and migraine headache. Longitudinal and genetic studies with physician verification of migraine headaches and CTS are needed to further define this association.
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Abstract
Several dietary habits and lifestyles can be associated with different headache types or with their progression to chronic forms. Different population-based studies have tried to investigate this relationship with poor or contradictory results. We shortly reported the current knowledges available in literature in this regard, paying particular attention to the role that certain factors play in modifying frequency and intensity of headache in adults and in adolescents. Future studies are necessary to clarify the real weight which the different factors have in natural history and in clinic evolution of headache, especially in adolescence, but the already known data suggest an important modulating action. If they will be confirmed, these results will be likely to influence clinical practice as well to address educational programs in preadolescents and adolescents.
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Sarker MAB, Rahman M, Harun-Or-Rashid M, Hossain S, Kasuya H, Sakamoto J, Hamajima N. Association of smoked and smokeless tobacco use with migraine: a hospital-based case-control study in Dhaka, Bangladesh. Tob Induc Dis 2013; 11:15. [PMID: 23826945 PMCID: PMC3710238 DOI: 10.1186/1617-9625-11-15] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 06/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies in the past have reported inconclusive evidences on association of smoking and migraine. Nevertheless, no study so far reported association of smokeless tobacco with migraine. The objective of this study was to examine the association of smoked and smokeless tobacco use with migraine. METHODS A hospital-based case-control study was conducted at the neurology outpatient department of a tertiary care hospital in Dhaka, Bangladesh. We enrolled 138 migraine cases diagnosed during March-September 2010 in neurology outpatient department, and 276 gender and age matched healthy controls from among their attendants. Diagnosis of migraine was based on the International Headache Society criteria. Use of smokeless tobacco and smoking (cigarette/bidi/hukka) were determined by an interviewer administered questionnaire. RESULTS Among the cases, 52.9% were overall tobacco users; 24.6% were only smokers, 15.9% only smokeless tobacco users and 12.3% used both. The respective figures among controls were 14.5%, 7.2%, 6.9% and 0.4% (P <0.001 for all). The conditional logistic regression analysis found that migraine had higher odds of exposure to smoked tobacco use, smokeless tobacco use, and both compared to control after adjusting for confounding variables (alcohol drinking, insufficient sleep, mental stress, and number of family members); adjusted odds ratio (aOR) was 6.6 (95% confidence interval [CI] = 2.2-19.6, P = 0.001), 5.8 (95%CI = 1.9-17.4, P = 0.001), and 54.2 (95%CI = 4.3-684.4, P = 0.002), respectively. The aOR of cigarette/bidi/hukka smoking for different doses was 5.5 (95%CI = 1.2-24.8, P = 0.027) for 1-5 times per day, 6.3 (95%CI = 1.8-21.2, P = 0.003) for 6-10 times per day, and 6.7 (95%CI = 1.9-23.2, P = 0.003) for >10 times per day relative to non users. CONCLUSIONS Both smoked and smokeless tobaccos were found to be associated with migraine. There is a need to incorporate smokeless tobacco along with smoked tobacco into the anti-tobacco awareness programs to reduce the burden of migraine in Bangladesh.
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Affiliation(s)
- Mohammad Abul Bashar Sarker
- Young Leaders' Program in Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Schankin CJ, Reifferscheid AK, Krumbholz M, Linn J, Rachinger W, Langer S, Sostak P, Arzberger T, Kretzschmar H, Straube A. Headache in patients with pituitary adenoma: Clinical and paraclinical findings. Cephalalgia 2012; 32:1198-207. [DOI: 10.1177/0333102412462639] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [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 generate hypotheses for the mechanism of pituitary adenoma headache. Patients and methods: Fifty-eight patients with pituitary adenoma were prospectively analysed for prevalence and manifestation of tumour headache. Intrapersonal and neoplasm-associated risk factors were assessed. Results: Twenty-four patients (41%) had tumour-attributed headache, seven had migraine-like, 11 tension-type headache-like headache, and three both. Cluster headache-like headache was found once, and two headaches remained unclassified. Tumour-attributed headache was associated with a positive history of headache ( p = 0.03; OR 3.4), nicotine abuse ( p < 0.01; OR 4.7), intake of acute headache medication ( p = 0.04; OR 3.3), and a higher tumour proliferation indicated by a Ki67-labelling index (LI) >3% ( p = 0.02; OR 11.0). For patients with migraine-like tumour-attributed headache, risk factors were younger age ( p = 0.02), nicotine abuse ( p < 0.01; OR 10.9), acute headache treatment ( p < 0.01; OR 9.0), and Ki67-LI >3% ( p = 0.03; OR 14.1). For tension-type headache-like headache, the main risk factor was a positive history of tension-type headache ( p = 0.045; OR 5.6). Conclusion: Headache predisposition and local tumour effects might be important for the pathophysiology of pituitary adenoma headache and tumour headache in general.
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Affiliation(s)
- Christoph J Schankin
- Department of Neurology, University of Munich Hospital – Großhadern, Munich, Germany
| | - Anna K Reifferscheid
- Department of Neurology, University of Munich Hospital – Großhadern, Munich, Germany
| | - Markus Krumbholz
- Institute of Clinical Neuroimmunology, University of Munich Hospital – Großhadern, Munich, Germany
- Department for Neuroimmunology, Max Planck Institute for Neurobiology, Martinsried, Germany
| | - Jennifer Linn
- Department of Neuroradiology, University of Munich Hospital – Großhadern, Munich, Germany
| | - Walter Rachinger
- Department of Neurosurgery, University of Munich Hospital – Großhadern, Munich, Germany
| | - Sigrid Langer
- Department of Neurology, University of Munich Hospital – Großhadern, Munich, Germany
| | - Petra Sostak
- Department of Neurology, University of Munich Hospital – Großhadern, Munich, Germany
| | - Thomas Arzberger
- Center for Prion Disease and Neuropathology, University of Munich, Munich, Germany
| | - Hans Kretzschmar
- Center for Prion Disease and Neuropathology, University of Munich, Munich, Germany
| | - Andreas Straube
- Department of Neurology, University of Munich Hospital – Großhadern, Munich, Germany
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Ashina S, Serrano D, Lipton RB, Maizels M, Manack AN, Turkel CC, Reed ML, Buse DC. Depression and risk of transformation of episodic to chronic migraine. J Headache Pain 2012; 13:615-24. [PMID: 23007859 PMCID: PMC3484253 DOI: 10.1007/s10194-012-0479-9] [Citation(s) in RCA: 184] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 08/10/2012] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to assess the role of depression as a predictor of new onset of chronic migraine (CM) among persons with episodic migraine (EM). The American Migraine Prevalence and Prevention (AMPP) study followed 24,000 persons with severe headache identified in 2004. Using random-effects logistic regression, we modeled the probability that persons with EM in 2005 or 2006 would develop CM in the subsequent year. Depression was assessed in two ways, using a validated questionnaire (PHQ-9 score ≥15) and based on self-reported medical diagnosis. Analyses were adjusted for multiple covariates including sociodemographics, body mass index, headache pain intensity, headache frequency, migraine symptom severity, cutaneous allodynia, acute medication overuse, anti-depressant use and anxiety. Of 6,657 participants with EM in 2005, 160 (2.4 %) developed CM in 2006. Of 6,852 participants with EM in 2006, 144 (2.2 %) developed CM in 2007. In fully adjusted models, PHQ-9 defined depression was a significant predictor of CM onset [odds ratio (OR) = 1.65, 95 % CI 1.12-2.45]. There was a depression-dose effect; relative to participants with no depression or mild depression, those with moderate (OR = 1.77, 95 % CI 1.25-2.52), moderately severe (OR = 2.35, 95 % CI 1.53-3.62), and severe depression (OR = 2.53, 95 % CI 1.52-4.21) were at increased risk for the onset of CM. Among persons with EM, depression was associated with an increased risk of CM after adjusting for sociodemographic variables and headache characteristics. Depression preceded the onset of CM and risk increased with depression severity suggesting a potentially causal role though reverse causality cannot be excluded.
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Affiliation(s)
- Sait Ashina
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY USA
- Department of Pain Medicine and Palliative Care, Albert Einstein College of Medicine, Beth Israel Medical Center, New York, NY USA
| | | | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY USA
- Montefiore Headache Center, 1575 Blondell Avenue, Suite 225, Bronx, NY 10461 USA
| | | | | | | | | | - Dawn C. Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY USA
- Montefiore Headache Center, 1575 Blondell Avenue, Suite 225, Bronx, NY 10461 USA
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Chronic migraine plus medication overuse headache: two entities or not? J Headache Pain 2011; 12:593-601. [PMID: 21938457 PMCID: PMC3208042 DOI: 10.1007/s10194-011-0388-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 09/09/2011] [Indexed: 12/11/2022] Open
Abstract
Chronic migraine (CM) represents migraine natural evolution from its episodic form. It is realized through a chronicization phase that may require months or years and varies from patient to patient. The transition to more frequent attacks pattern is influenced by lifestyle, life events, comorbid conditions and personal genetic terrain, and it often leads to acute drugs overuse. Medication overuse headache (MOH) may complicate every type of headache and all the drugs employed for headache treatment can cause MOH. The first step in the management of CM complicated by medication overuse must be the withdrawal of the overused drugs and a detoxification treatment. The goal is not only to detoxify the patient and stop the chronic headache but also to improve responsiveness to acute or prophylactic drugs. Different methods have been suggested: gradual or abrupt withdrawal; home treatment, hospitalization, or a day-hospital setting; re-prophylaxes performed immediately or at the end of the wash-out period. Up to now, only topiramate and local injection of onabotulinumtoxinA have shown efficacy as therapeutic agents for re-prophylaxis after detoxification in patients with CM with and without medication overuse. Although the two treatments showed similar efficacy, onabotulinumtoxinA is associated with a better adverse events profile. Recently, the Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program proved that patients with CM, even those with MOH, are the ones most likely to benefit from onabotulinumtoxinA treatment. Furthermore, it provided an injection paradigm that can be used as a guide for a correct administration of onabotulinumtoxinA.
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Di Fabio R, Vanacore N, Davassi C, Serrao M, Pierelli F. Scuba diving is not associated with high prevalence of headache: a cross-sectional study in men. Headache 2011; 52:385-92. [PMID: 21906053 DOI: 10.1111/j.1526-4610.2011.01994.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To study the prevalence of cephalalgia in male divers. BACKGROUND Scuba divers work in stressing environments and have a high cerebrovascular risk, both conditions which are supposed to contribute to the genesis of cephalalgia. However, no study assessed expressly the prevalence of cephalalgia in divers, to date. METHODS We enrolled 201 professional male scuba divers (41.0 ± 7.2 years) and controls (41.1 ± 7.2 years), and the risk ratio and its corresponding 95% confidence of suffering from cephalalgia was calculated. RESULTS We found that 16% of divers and 22% of matched controls were affected by cephalalgia (P > .05), accounting for a risk ratio of 0.71 (95% CI 0.47-1.07). Divers reported fewer attacks per month (1.8 ± 0.7, n = 32) with regard to controls (2.5 ± 1.8, n = 45) (P = .02), but no differences concerning age at onset and severity were detected (P > .05). Divers suffered from migraine, migraine with aura and tension headache as much as controls. CONCLUSION Scuba diving, an intense physical activity characterized by cerebral micro-vascular distress, is not associated with cephalalgia, as a whole, or migraine, tension headache or migraine with aura, more commonly than in a matched, non-diving, population. A longitudinal study may disclose if diving may act as a protective factor in the occurrence of crises of cephalalgia.
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Affiliation(s)
- Roberto Di Fabio
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
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Rozen TD. A history of cigarette smoking is associated with the development of cranial autonomic symptoms with migraine headaches. Headache 2011; 51:85-91. [PMID: 20553330 DOI: 10.1111/j.1526-4610.2010.01707.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To look at the smoking history of migraine patients and to determine if a history of cigarette smoking is associated with the development of cranial autonomic symptoms with migraine headaches. BACKGROUND It has recently been noted that a significant number of migraine patients may develop autonomic symptoms during their attacks of headache. Why some headache patients activate the trigeminal autonomic reflex and develop cranial autonomic symptoms while others do not is unknown. Cluster headache occurs more often in patients with a history of cigarette smoking, suggesting a link between tobacco exposure and cluster headache pathogenesis. Could cigarette smoking in some manner lead to activation of the trigeminal-autonomic reflex in headache patients? If cigarette smoking does lower the threshold for activation of the trigeminal autonomic reflex then do migraine patients who have a history of cigarette smoking more often develop cranial autonomic symptoms than migraineurs who have never smoked? METHODS Consecutive patients diagnosed with migraine (episodic or chronic) who were seen over a 7-month time period at a newly established headache center were asked about the presence of cranial autonomic symptoms during an attack of head pain. Patients were deemed to have positive autonomic symptoms along with headache if they experienced at least one of the following symptoms: eyelid ptosis or droop, eyelid or orbital swelling, conjunctival injection, lacrimation, or nasal congestion/rhinorrhea. A smoking history was determined for each patient including was the patient a current smoker, past smoker, or had never smoked. Patients were deemed to have a positive history of cigarette smoking if they had smoked continuously during their lifetime for at least at 1 year. RESULTS A total of 117 migraine patients were included in the analysis (96 female, 21 male). Forty-six patients had a positive smoking history, while 71 patients had no smoking history. Some 70% (32/46) of migraineurs with a positive history of cigarette smoking had cranial autonomic symptoms along with their headaches, while only 42% (30/71) of the nonsmoking patients experienced at least 1 autonomic symptom along with headaches and this was a statistically significant difference (P < .005). In total, 74% of current smokers had autonomic symptoms with their headaches compared with 61% of past smokers and this was not a statistically significant difference. There was a statistically significant difference between the number of current smokers who had autonomic symptoms with their headaches compared with the number of patients who never smoked and had autonomic symptoms (P < .05). Overall, 52% of the studied migraineurs had autonomic symptoms. There was a statistically significant difference between autonomic symptom occurrence in male and female smokers vs male and female nonsmokers. Each subtype of cranial autonomic symptoms was all more frequent in smokers. CONCLUSION A history of cigarette smoking appears to be associated with the development of cranial autonomic symptoms with migraine headaches.
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Affiliation(s)
- Todd D Rozen
- Geisinger Wyoming Valley, Department of Neurology, Wilkes-Barre, PA, USA
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Association between migraine, lifestyle and socioeconomic factors: a population-based cross-sectional study. J Headache Pain 2011; 12:157-72. [PMID: 21390550 PMCID: PMC3072515 DOI: 10.1007/s10194-011-0321-9] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 12/06/2010] [Indexed: 10/26/2022] Open
Abstract
To investigate whether sex-specific associations exist between migraine, lifestyle or socioeconomic factors. We distinguished between the subtypes migraine with aura (MA) and migraine without aura (MO). In 2002, a questionnaire containing validated questions to diagnose migraine and questions on lifestyle and socioeconomic factors was sent to 46,418 twin individuals residing in Denmark. 31,865 twin individuals aged 20-71 were included. The twins are representative of the Danish population with regard to migraine and other somatic diseases and were used as such in the present study. An increased risk of migraine was significantly associated with lower level of schooling and education, retirement, unemployment, and smoking. A decreased risk of migraine was significantly associated with heavy physical exercise and intake of alcohol. Direct comparison between the subtypes showed a decreased risk of MA compared to MO in subjects with low education or weekly intake of alcohol. The risk of MA was increased compared to MO in unemployed or retired subjects. Direct comparison between sexes showed a decreased risk of migraine for men compared to women in subjects who were low educated, unemployed or studying. The risk was increased for men compared to women in subjects with heavy physical exercise, intake of alcohol, and body mass index >25. Migraine was associated with several lifestyle and socioeconomic factors. Most associations such as low education and employment status were probably due to the negative effects of having migraine while others such as smoking were risk factors for migraine.
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Pascual J. Prevalence of primary headaches: it is not the behavior, but still we have to pay attention to it! J Headache Pain 2011; 12:139-40. [PMID: 21347796 PMCID: PMC3072489 DOI: 10.1007/s10194-011-0319-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 02/10/2011] [Indexed: 12/01/2022] Open
Affiliation(s)
- Julio Pascual
- Neuroscience Area, Service of Neurology, University Hospital Central de Asturias, Calle Celestino Villamil s/n, 33006 Oviedo, Spain.
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Risk factors of migraine-related brain white matter hyperintensities: an investigation of 186 patients. J Headache Pain 2011; 12:97-103. [PMID: 21331756 PMCID: PMC3056006 DOI: 10.1007/s10194-011-0299-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 11/23/2010] [Indexed: 11/03/2022] Open
Abstract
Brain white matter hyperintensities are more prevalent in migraine patients than in the general population, but the pathogenesis and the risk factors of these hyperintensities are not fully elucidated. The authors analyzed the routine clinical data of 186 migraine patients who were referred to the Outpatient Headache Department of the Department of Neurology, Medical School, University of Pécs, Hungary between 2007 and 2009: 58 patients with white matter hyperintensities and 128 patients without white matter hyperintensities on 3 T MRI. Significant associations between the presence of white matter hyperintensities and longer disease duration (14.4 vs. 19.9 years, p = 0.004), higher headache frequency (4.1 vs. 5.5 attacks/month, p = 0.017), hyperhomocysteinemia (incidence of hyperintensity is 9/9 = 100%, p = 0.009) and thyroid gland dysfunction (incidence of hyperintensity is 8/14 = 57.1%, p = 0.038) were found. These data support the theory that both the disease duration and the attack frequency have a key role in the formation of migraine-related brain white matter hyperintensities, but the effects of comorbid diseases may also contribute to the development of the hyperintensities.
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Brandão MP, Pimentel FL, Cardoso MF. Impact of academic exposure on health status of university students. Rev Saude Publica 2011; 45:49-58. [DOI: 10.1590/s0034-89102011000100006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 06/17/2010] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: To assess the impact of academic life on health status of university students. METHODS: Longitudinal study including 154 undergraduate students from the Universidade de Aveiro, Portugal, with at least two years of follow-up observations. Sociodemographic and behavioral characteristics were collected using questionnaires. Students' weight, height, blood pressure, serum glucose, serum lipids and serum homocysteine levels were measured. Regression analysis was performed using linear mixed-effect models, allowing for random effects at the participant level. RESULTS: A higher rate of dyslipidemia (44.0% vs. 28.6%), overweight (16.3% vs. 12.5%) and smoking (19.3% vs. 0.0%) was found among students exposed to the academic life when compared to freshmen. Physical inactivity was about 80%. Total cholesterol, high density lipoprotein-cholesterol (HDL-C), triglycerides, systolic blood pressure, and physical activity levels were significantly associated with gender (p<0.001). Academic exposure was associated with increased low density lipoprotein-cholesterol (LDL-C) levels (about 1.12 times), and marginally with total cholesterol levels (p=0.041). CONCLUSIONS: High education level does not seem to have a protective effect favoring a healthier lifestyle and being enrolled in health-related areas does not seem either to positively affect students' behaviors. Increased risk factors for non-transmissible diseases in university students raise concerns about their well-being. These results should support the implementation of health promotion and prevention programs at universities.
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Affiliation(s)
- Maria Piedade Brandão
- Universidade de Aveiro, Portugal; Universidade de Aveiro; Centro Interdisciplinar de Investigação Marinha e Ambiental, Portugal
| | - Francisco Luís Pimentel
- Universidade de Aveiro, Portugal; Universidade de Aveiro; Hospital Infante D. Pedro, Portugal; Universidade de Coimbra, Portugal
| | - Margarida Fonseca Cardoso
- Centro Interdisciplinar de Investigação Marinha e Ambiental, Portugal; Universidade do Porto, Portugal; Universidade do Porto, Portugal
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Association between lifestyle factors and headache. J Headache Pain 2011; 12:147-55. [PMID: 21222138 PMCID: PMC3072498 DOI: 10.1007/s10194-010-0286-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 12/21/2010] [Indexed: 10/27/2022] Open
Abstract
Modification of lifestyle habits is a key preventive strategy for many diseases. The role of lifestyle for the onset of headache in general and for specific headache types, such as migraine and tension-type headache (TTH), has been discussed for many years. Most results, however, were inconsistent and data on the association between lifestyle factors and probable headache forms are completely lacking. We evaluated the cross-sectional association between different lifestyle factors and headache subtypes using data from three different German cohorts. Information was assessed by standardized face-to-face interviews. Lifestyle factors included alcohol consumption, smoking status, physical activity and body mass index. According to the 2004 diagnostic criteria, we distinguished the following headache types: migraine, TTH and their probable forms. Regional variations of lifestyle factors were observed. In the age- and gender-adjusted logistic regression models, none of the lifestyle factors was statistically significant associated with migraine, TTH, and their probable headache forms. In addition, we found no association between headache subtypes and the health index representing the sum of individual lifestyle factors. The lifestyle factors such as alcohol consumption, smoking, physical activity and overweight seem to be unrelated to migraine and TTH prevalence. For a judgement on their role in the onset of new or first attacks of migraine or TTH (incident cases), prospective cohort studies are required.
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