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Angelopoulou E, Papadopoulos AN, Spantideas N, Bougea A. Migraine, Tension-Type Headache and Parkinson's Disease: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1684. [PMID: 36422223 PMCID: PMC9697239 DOI: 10.3390/medicina58111684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/12/2022] [Accepted: 11/17/2022] [Indexed: 12/01/2023]
Abstract
Background and Objectives: The relationship between migraine and tension-type headache (TTH) with Parkinson's disease (PD) is controversial, while a common pathophysiological link remains obscure. The aim of this systematic review is to investigate the association between PD, migraine and TTH. Materials and Methods: Following PRISMA, we searched MEDLINE, WebofScience, Scopus, CINAHL, Cochrane Library and ClinicalTrials.gov up to 1 July 2022 for observational studies examining the prevalence and/or associations of PD with migraine and TTH. We pooled proportions, standardized mean differences (SMD) and odds ratios (OR) with random effects models. The risk of bias was assessed with the Newcastle-Ottawa scale (PROSPERO CRD42021273238). Results: Out of 1031 screened studies, 12 were finally included in our review (median quality score 6/9). The prevalence of any headache among PD patients was estimated at 49.1% (760 PD patients; 95% CI 24.8-73.6), migraine prevalence at 17.2% (1242 PD patients; 95% CI 9.9-25.9), while 61.5% (316 PD patients; 95% CI 52.6-70.1) of PD patients with migraine reported headache improvement after PD onset. Overall, migraine was not associated with PD (302,165 individuals; ORpooled = 1.11; 95% CI 0.72-1.72).However, cohort studies demonstrated a positive association of PD among lifetime migraineurs (143,583 individuals; ORpooled = 1.54, 95% CI 1.28-1.84), while studies on 12-month migraine prevalence yielded an inverse association (5195 individuals; ORpooled = 0.64, 95% CI 0.43-0.97). Similar findings were reported by 3 studies with data on the TTH-PD relationship (high prevalence, positive association when examined prospectively and an inverse relationship on 12-month prevalence). These data were not quantitatively synthesized due to methodological differences among the studies. Finally, PD patients suffering from any headache had a lower motor unified Parkinson's disease rating scale (UPDRS) score (503 PD patients; SMD -0.39; 95% CI -0.57 to -0.21) compared to PD patients not reporting headache. There is an unclear association of headaches in genetic PD cohorts. Conclusions: Observational data suggest that migraine and TTH could be linked to PD, but the current literature is conflicting.
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Affiliation(s)
- Efthalia Angelopoulou
- Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Andreas Nikolaos Papadopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Spantideas
- Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastasia Bougea
- Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Brain Energy Deficit as a Source of Oxidative Stress in Migraine: A Molecular Basis for Migraine Susceptibility. Neurochem Res 2021; 46:1913-1932. [PMID: 33939061 DOI: 10.1007/s11064-021-03335-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/06/2021] [Accepted: 04/22/2021] [Indexed: 02/06/2023]
Abstract
People with migraine are prone to a brain energy deficit between attacks, through increased energy demand (hyperexcitable brain) or decreased supply (mitochondrial impairment). However, it is uncertain how this precipitates an acute attack. Here, the central role of oxidative stress is adduced. Specifically, neurons' antioxidant defenses rest ultimately on internally generated NADPH (reduced nicotinamide adenine dinucleotide phosphate), whose levels are tightly coupled to energy production. Mitochondrial NADPH is produced primarily by enzymes involved in energy generation, including isocitrate dehydrogenase of the Krebs (tricarboxylic acid) cycle; and an enzyme, nicotinamide nucleotide transhydrogenase (NNT), that depends on the Krebs cycle and oxidative phosphorylation to function, and that works in reverse, consuming antioxidants, when energy generation fails. In migraine aura, cortical spreading depression (CSD) causes an initial severe drop in level of NADH (reduced nicotinamide adenine dinucleotide), causing NNT to impair antioxidant defense. This is followed by functional hypoxia and a rebound in NADH, in which the electron transport chain overproduces oxidants. In migraine without aura, a similar biphasic fluctuation in NADH very likely generates oxidants in cortical regions farthest from capillaries and penetrating arterioles. Thus, the perturbations in brain energy demand and/or production seen in migraine are likely sufficient to cause oxidative stress, triggering an attack through oxidant-sensing nociceptive ion channels. Implications are discussed for the development of new classes of migraine preventives, for the current use of C57BL/6J mice (which lack NNT) in preclinical studies of migraine, for how a microembolism initiates CSD, and for how CSD can trigger a migraine.
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Suzuki K, Okuma Y, Uchiyama T, Miyamoto M, Sakakibara R, Shimo Y, Hattori N, Kuwabara S, Yamamoto T, Kaji Y, Hirano S, Suzuki S, Haruyama Y, Kobashi G, Hirata K. The prevalence, course and clinical correlates of migraine in Parkinson's disease: A multicentre case-controlled study. Cephalalgia 2017; 38:1535-1544. [PMID: 29073773 DOI: 10.1177/0333102417739302] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Previous studies have reported a lower migraine prevalence in Parkinson's disease (PD) patients and improvements in migraine headaches after PD onset, but the clinical association of migraines with PD is unclear. Methods We analysed headache and migraine prevalence and clinical correlates in 436 PD patients (mean age, 69.3 ± 7.8 years) and 401 age- and sex-matched controls (mean age, 69.2 ± 8.6 years) in a case-controlled, multicentre study. Migraines were diagnosed by a questionnaire developed according to the International Classification of Headache Disorders, second edition. We evaluated changes in headache intensity, frequency and severity over several years around the onset of PD among PD patients with headaches or migraines, and over the past several years among control subjects with headaches or migraines. Results PD patients had lower lifetime (9.6% vs. 18.0%) and 1-year (6.7% vs. 11.0%) migraine prevalences than controls. However, lifetime (38.5% vs. 38.9%) and 1-year (26.1% vs. 26.2%) headache prevalence did not differ between PD patients and controls. After adjusting for gender, timing of the evaluation of headache changes, and recall period, PD patients with headaches or migraines exhibited a pronounced reduction in the intensity, frequency and overall severity of their headaches and migraines after the onset of PD compared with controls with headaches or migraines. PD patients with migraines exhibited a higher rate of depression and higher Pittsburgh Sleep Quality Index and PD sleep scale-2 scores than those without headaches. Conclusion While overall headache and migraine severity reduced after PD onset, the presence of migraines was associated with sleep disturbances and depression in PD patients.
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Affiliation(s)
- Keisuke Suzuki
- 1 Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yasuyuki Okuma
- 2 Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Tomoyuki Uchiyama
- 1 Department of Neurology, Dokkyo Medical University, Tochigi, Japan.,3 Neuro-urology and Continence Center, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Masayuki Miyamoto
- 4 Department of Clinical Medicine for Nursing, Dokkyo Medical University School of Nursing, Tochigi, Japan
| | - Ryuji Sakakibara
- 5 Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Yasushi Shimo
- 6 Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- 6 Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Satoshi Kuwabara
- 7 Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Yoshiaki Kaji
- 1 Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Shigeki Hirano
- 7 Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shiho Suzuki
- 1 Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yasuo Haruyama
- 9 Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Gen Kobashi
- 9 Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Koichi Hirata
- 1 Department of Neurology, Dokkyo Medical University, Tochigi, Japan
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Vollono C, Primiano G, Della Marca G, Losurdo A, Servidei S. Migraine in mitochondrial disorders: Prevalence and characteristics. Cephalalgia 2017; 38:1093-1106. [PMID: 28762753 DOI: 10.1177/0333102417723568] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Migraine is a well-known feature of mitochondrial disorders (MDs). However, no systematic epidemiological data are available in large populations of patients. Aims The aim of this cross-sectional cohort study was to describe the prevalence and migraine characteristics in a large cohort of patients with mitochondrial encephalomyopathies. Methods We studied 93 consecutive patients with characterised MDs referred to our Neuromuscular Unit during a 12-month period. All patients (age range = 16-78 years; 31 men; 58 progressive external ophthalmoplegia [PEO], 12 myoclonic epilepsy with ragged red fibres [MERRF], eight mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes [MELAS], two mitochondrial neurogastrointestinal encephalomyopathy [MNGIE] and 13 other MDs) underwent a structured diagnostic headache interview using an operational diagnostic tool following the IHS criteria. If they met the criteria for migraine, they were included in the 'Migraine Group'. The other patients were counted in the 'No Migraine Group'. Patient demographic and migraine characteristics were examined. Clinical, neuroradiological and neurophysiological data were compared between groups. Results Migraine was reported in 35.5% of patients. Migraine without aura was the most common headache (81.8%). The migraine group showed younger age ( P < 0.01), increased prevalence of epilepsy ( P = 0.01), myoclonus ( P = 0.03), stroke-like episodes ( P = 0.03) and decreased prevalence of muscle weakness ( P < 0.01). Multivariate analysis showed that migraine was positively associated with absence of muscle weakness ( P = 0.04) and presence of EEG abnormalities ( P = 0.02). Conclusion Migraine has a higher prevalence in MDs compared with general population-based data, independently from genotype or phenotype. Migraine is not merely a phenotypic aspect of specific MDs but is rather the expression of vulnerability of the central nervous system, probably directly related with defects of the respiratory chain.
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Affiliation(s)
- Catello Vollono
- 1 Unità di Neurofisiopatologia, Area Neuroscienze, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Guido Primiano
- 1 Unità di Neurofisiopatologia, Area Neuroscienze, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Giacomo Della Marca
- 1 Unità di Neurofisiopatologia, Area Neuroscienze, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Anna Losurdo
- 2 Institute of Neurology, Istituto Auxologico Italiano, Milan, Italy
| | - Serenella Servidei
- 1 Unità di Neurofisiopatologia, Area Neuroscienze, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
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Yang Y, Ligthart L, Terwindt GM, Boomsma DI, Rodriguez-Acevedo AJ, Nyholt DR. Genetic epidemiology of migraine and depression. Cephalalgia 2016; 36:679-91. [DOI: 10.1177/0333102416638520] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 02/17/2016] [Indexed: 12/24/2022]
Abstract
Background Migraine and major depressive disorder (commonly referred to as depression) are both common disorders with a significant impact on society. Studies in both clinical and community-based settings have demonstrated a strong relationship between migraine and depression. In addition to complicating the diagnosis, depression that is comorbid with migraine may lower treatment adherence, increase risk of medication overuse and is associated with migraine chronification, thus leading to higher direct and indirect costs and poorer health-related outcomes with increased disability. Aim The aim of this review is to summarise the current knowledge on the genetic epidemiology of migraine and depression and the possible biological mechanisms underlying their comorbidity. Methods We present a narrative review reporting on the current literature. Results and conclusions Epidemiological findings indicate that there is a bidirectional relationship between migraine and depression, with one disorder increasing the risk for the other and vice versa, suggesting shared biological mechanisms. Twin and family studies indicate that this bidirectional relationship can be explained, at least partly, by shared underlying genetically determined disease mechanisms. Although no genes have been robustly associated with the aetiology of both migraine and depression, genes from serotonergic, dopaminergic and GABAergic systems together with variants in the MTHFR and BDNF genes remain strong candidates.
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Affiliation(s)
- Yuanhao Yang
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Lannie Ligthart
- Department of Biological Psychology, VU University, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Centre, The Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University, The Netherlands
| | - Astrid J Rodriguez-Acevedo
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Dale R Nyholt
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
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de Oliveira Vilaça C, Leite MAA, de Souza JA, Orsini M, Pereira JS, Amaral C. The Behavior of Migraine in Patients with Parkinson's Disease. Neurol Int 2015; 7:6133. [PMID: 26788267 PMCID: PMC4704473 DOI: 10.4081/ni.2015.6133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/05/2015] [Accepted: 11/12/2015] [Indexed: 11/23/2022] Open
Abstract
Parkinson’s disease (PD) is characterized by the degeneration of dopaminergic systems in the central nervous system. In migraine it is supposed to occur hyperactivation of central dopaminergic pathways. We verified the hypothesis of improved migraine in patients who manifest PD. We evaluated 109 patients with PD over 40 years (57 men and 52 women) about the presence throughout the life of migraine, as well as the possibility of improvement in migraine after the onset of motor symptoms of PD. This group was compared to a control group of 152 people (41 men and 152 women) without PD regarding the presence of migraine and its improvement. Twenty-one patients manifested migraine in the group with PD (16 women and 5 men) in which 13 reported improvement in migraine after the onset of symptoms of PD. Among the controls, 37 interviewed had migraine history (32 women and 5 men) among which 20 showed improvement. There was no significant difference when comparing the two groups (χ21:0,05=0.337; P<0.382). We were unable to relate the improvement of migraine with the emergence of PD motor signs, despite the degeneration of dopaminergic pathways of the central nervous system.
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Affiliation(s)
| | | | - Jano Alves de Souza
- Headache Research Sector, Antônio Pedro University Hospital, Fluminense Federal University , Niterói
| | | | - João Santos Pereira
- Movement Disorders Section, Neurology Service, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto , Rio de Janeiro, Brazil
| | - Clayton Amaral
- Division of Neurology, Movement Disorders Unit; Headache Research Sector, Antônio Pedro University Hospital, Fluminense Federal University, Niterói
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Borkum JM. Migraine Triggers and Oxidative Stress: A Narrative Review and Synthesis. Headache 2015; 56:12-35. [PMID: 26639834 DOI: 10.1111/head.12725] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Blau theorized that migraine triggers are exposures that in higher amounts would damage the brain. The recent discovery that the TRPA1 ion channel transduces oxidative stress and triggers neurogenic inflammation suggests that oxidative stress may be the common denominator underlying migraine triggers. OBJECTIVE The aim of this review is to present and discuss the available literature on the capacity of common migraine triggers to generate oxidative stress in the brain. METHODS A Medline search was conducted crossing the terms "oxidative stress" and "brain" with "alcohol," "dehydration," "water deprivation," "monosodium glutamate," "aspartame," "tyramine," "phenylethylamine," "dietary nitrates," "nitrosamines," "noise," "weather," "air pollutants," "hypoglycemia," "hypoxia," "infection," "estrogen," "circadian," "sleep deprivation," "information processing," "psychosocial stress," or "nitroglycerin and tolerance." "Flavonoids" was crossed with "prooxidant." The reference lists of the resulting articles were examined for further relevant studies. The focus was on empirical studies, in vitro and of animals, of individual triggers, indicating whether and/or by what mechanism they can generate oxidative stress. RESULTS In all cases except pericranial pain, common migraine triggers are capable of generating oxidative stress. Depending on the trigger, mechanisms include a high rate of energy production by the mitochondria, toxicity or altered membrane properties of the mitochondria, calcium overload and excitotoxicity, neuroinflammation and activation of microglia, and activation of neuronal nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. For some triggers, oxidants also arise as a byproduct of monoamine oxidase or cytochrome P450 processing, or from uncoupling of nitric oxide synthase. CONCLUSIONS Oxidative stress is a plausible unifying principle behind the types of migraine triggers encountered in clinical practice. The possible implications for prevention and for understanding the nature of the migraine attack are discussed.
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Affiliation(s)
- Jonathan M Borkum
- Department of Psychology, University of Maine, Orono, ME, USA.,Health Psych Maine, Waterville, ME, USA
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Scher AI, Ross GW, Sigurdsson S, Garcia M, Gudmundsson LS, Sveinbjörnsdóttir S, Wagner AK, Gudnason V, Launer LJ. Midlife migraine and late-life parkinsonism: AGES-Reykjavik study. Neurology 2014; 83:1246-52. [PMID: 25230997 DOI: 10.1212/wnl.0000000000000840] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE In the present study, we tested the hypothesis that having migraine in middle age is related to late-life parkinsonism and a related disorder, restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED). METHODS The AGES-Reykjavik cohort (born 1907-1935) has been followed since 1967. Headaches were classified based on symptoms assessed in middle age. From 2002 to 2006, 5,764 participants were reexamined to assess symptoms of parkinsonism, diagnosis of Parkinson disease (PD), family history of PD, and RLS/WED. RESULTS Subjects with midlife migraine, particularly migraine with aura (MA), were in later life more likely than others to report parkinsonian symptoms (odds ratio [OR]MA = 3.6 [95% CI 2.7-4.8]) and diagnosed PD (ORMA = 2.5 [95% CI 1.2-5.2]). Women with MA were more likely than others to have a parent (ORMA = 2.26 [95% CI 1.3-4.0]) or sibling (ORMA = 1.78 [95% CI 1.1-2.9]) with PD. Late-life RLS/WED was increased for headache generally. Associations were independent of cardiovascular disease and MRI-evident presumed ischemic lesions. CONCLUSIONS These findings suggest there may be a common vulnerability to, or consequences of, migraine and multiple indicators of parkinsonism. Additional genetic and longitudinal observational studies are needed to identify candidate pathways that may account for the comorbid constellation of symptoms.
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Affiliation(s)
- Ann I Scher
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA.
| | - G Webster Ross
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Sigurdur Sigurdsson
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Melissa Garcia
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Larus S Gudmundsson
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Sigurlaug Sveinbjörnsdóttir
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Amy K Wagner
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Vilmundur Gudnason
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Lenore J Launer
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
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Vincent MB, Carvalho-e-Silva FML, Luiz RR. The digiti quinti sign in hemiplegic migraine. Cephalalgia 2010; 31:13-7. [PMID: 20974599 DOI: 10.1177/0333102410372424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The digiti quinti sign (DQS), described originally as a clinical indication of subtle motor deficit, consists of a relatively greater abduction of the fifth finger on the affected side when both arms are extended forwards. This sign was previously observed interictally in three consecutive hemiplegic migraine (HM) patients. PATIENTS AND METHODS To verify whether the DQS specifically discriminates HM from non-hemiplegic migraine (nHM), the angle between the fourth and fifth fingers (ANG) was measured interictally in 10 HM patients, 44 migraine with aura and migraine without aura patients, and 45 healthy controls. RESULTS The ANG was significantly wider at the symptomatic side in HM as compared with nHM and controls. The differences between the symptomatic and non-symptomatic (for HM) or between the right and left sides (absolute values for nHM and controls) were, respectively, 10.10° ± 9.58°, 4.15° ± 3.95° and 5.37° ± 4.74° (p = .007). The optimal cutoff point for ANG was 15° at the symptomatic side (sensitivity and specificity of 80.0% and 72.2%, respectively), 10.5° at the non-symptomatic side (sensitivity and specificity of 60.0% and 52.3%), and 3° for the difference between sides (sensitivity and specificity of 90.0% and 79.5%). CONCLUSION Data show that the DQS discriminates HM from nHM and controls.
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Affiliation(s)
- Maurice B Vincent
- Universidade Federal do Rio de Janeiro, Av. das Américas 1155, Rio de Janeiro, Brazil.
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Greco R, Tassorelli C, Armentero MT, Sandrini G, Nappi G, Blandini F. Role of central dopaminergic circuitry in pain processing and nitroglycerin-induced hyperalgesia. Brain Res 2008; 1238:215-23. [PMID: 18761334 DOI: 10.1016/j.brainres.2008.08.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 07/31/2008] [Accepted: 08/01/2008] [Indexed: 01/12/2023]
Abstract
Experimental evidence shows that dopaminergic transmission within the basal ganglia is involved in the modulation of nociceptive information. Epidemiological studies show that in some disease states inherent pathophysiological mechanisms that involve degenerative changes (Parkinson's disease; PD) can also impact negatively on other unrelated functional systems (i.e. nociception). Delayed Fos expression in response to nitroglycerin (NTG) administration is a procedure used to identify the neuroanatomical substrates of the migraine condition. In this study, we investigated the influence of dopaminergic nigrostriatal denervation, obtained by intrastriatal injection of 6-hydroxydopamine (6-OHDA), on this response in Sprague-Dawley rats. We also explored the effects on the NTG-induced hyperalgesic response to painful stimuli (formalin and tail-flick tests). Nigrostriatal lesion prevented the neuronal activation typically induced by NTG in sub-cortical areas involved in pain perception, autonomic control and neuroendocrine functions, such as hypothalamic nuclei, periaqueductal grey, parabrachial nucleus and the medullary nuclei. In addition, 6-OHDA-induced lesion inhibited NTG-induced hyperalgesia. Our data show that integrity of central dopaminergic neurotransmission is required for the NTG-induced activation of sub-cortical areas involved in the expression of migraine symptoms, as well as for the hyperalgesic response to painful stimuli elicited by the drug.
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Affiliation(s)
- Rosaria Greco
- Interdepartmental Research Center for Parkinson's Disease, IRCCS Neurological Institute C Mondino, Pavia, Italy
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Park JW, Lee KS, Kim JS, Kim YI, Shin HE. Genetic Contribution of Catechol-O-methyltransferase Polymorphism in Patients with Migraine without Aura. J Clin Neurol 2007; 3:24-30. [PMID: 19513339 PMCID: PMC2686934 DOI: 10.3988/jcn.2007.3.1.24] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2006] [Accepted: 01/09/2007] [Indexed: 01/27/2023] Open
Abstract
Background Recent genetic association studies have investigated the possible genetic role of the dopaminergic system in migraine. Catechol-O-methyltransferase (COMT) is an enzyme that plays a crucial role in the metabolism of dopamine and its genetic polymorphism is associated with three- to fourfold variation of enzymatic activity. Objectives The objective of this study was to elucidate the role of the COMT polymorphism in the genetic susceptibility to migraine and its phenotypic expression in patients with migraine without aura (MWOA). Methods Ninety-seven patients with MWOA and 94 healthy volunteers were included in the study. After amplifying COMT genes by the polymerase chain reaction, we assessed their genotype frequencies and allele distributions by based on restriction fragment length polymorphisms. We classified all MWOA patients into two groups according to their COMT genotype: with the L allele (N = 43), and without this allele (N = 54). Results The genotype frequency and allele distribution of the COMT polymorphism did not differ between MWOA patients and the control group. During migraine attacks, MWOA patients with the L allele showed a higher pain intensity of headache (P = 0.001) and a higher incidence of the accompanying nausea/vomiting (94% vs 75%; P = 0.026) compared with MWOA patients without the L allele. Conclusions Although the COMT polymorphism does not appear to be involved in predisposition to the development of MWOA, this genetic factor could be involved in the phenotypic expression of MWOA.
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Affiliation(s)
- Jeong Wook Park
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Cubo E, Kompoliti K, Leurgans SE, Raman R. Dopaminergic Hypersensitivity In Patients With Parkinson Disease And Migraine. Clin Neuropharmacol 2004; 27:30-2. [PMID: 15090934 DOI: 10.1097/00002826-200401000-00009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Because migraine has been associated with dopaminergic receptor hypersensitivity, the authors hypothesized that patients with Parkinson disease with current or prior migraine have better dopaminergic response and less motor disability than Parkinson disease patients without migraine. Twenty-eight patients with Parkinson disease were included and matched (10 patients with migraine and 18 patients without migraine). Patients with Parkinson disease and migraine showed greater motor improvement during the ON state than patients without migraine with the same medication exposure. These data support the hypothesis that migraine may be associated with dopaminergic hypersensitivity.
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Affiliation(s)
- Esther Cubo
- Sanatorio del Rosario, Clinica de la Zarzuela, Department of Neurology, Madrid, Spain.
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13
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Abstract
This review explores a large series of observations from clinical and experimental studies on the interactions between migraine and the extrapyramidal system (EPS). A critical appraisal of these data suggests that the EPS is somehow involved in migraine. However, primary involvement of the EPS in the pathophysiology of migraine, as hinted at by the apparent concomitance of migraine, extrapyramidal symptoms and diseases, as well as by the common involvement of neurotransmitters and pathways, cannot as yet be proven. On the other hand, the involvement of EPS in migraine may reflect its more general role in the processing of nociceptive information and/or may be part of the complex behavioural adaptive response that characterizes migraine.
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Affiliation(s)
- P Barbanti
- Department of Neurological Sciences, University La Sapienza, Rome, Italy.
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Barbanti P, Fabbrini G, Vanacore N, Rum A, Lenzi GL, Meco G, Cerbo R. Dopamine and migraine: does Parkinson's disease modify migraine course? Cephalalgia 2000; 20:720-3. [PMID: 11167901 DOI: 10.1111/j.1468-2982.2000.00123.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
As brainstem mechanisms and dopaminergic neurotransmission are involved in migraine pathophysiology, we decided to investigate the course of migraine in Parkinson's disease (PD), the paradigm of brainstem dopaminergic disease. We screened 237 consecutive PD out-patients by direct interview to assess the prevalence of lifetime and current migraine. Moreover, we compared the course of migraine in PD patients with that of otherwise healthy age- (+/- 3 years) and sex-paired migraine controls in a cross-sectional study. PD patients showed a lifetime migraine prevalence of 27.8% and a current migraine prevalence of 13.1%. A positive family history of migraine was less frequent in PD patients than in controls. The frequency of current migraine was significantly lower in PD patients than in controls (47.0% vs. 68.2%; odds ratio = 0.41, 95% confidence interval = 0.19-0.89). Approximately two-thirds of PD patients reported an improvement in or remission of migraine after PD onset. Effects of menopause on migraine course were similar in patients and controls. These findings suggest that PD might somehow shorten the clinical course of migraine. Possible explanations include a prolonged prophylactic effect by chronic dopaminergic therapy or a positive effect of PD pathophysiology, namely nigral degeneration, on migraine mechanisms.
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Affiliation(s)
- P Barbanti
- Department of Neurosciences, University La Sapienza, Rome, Italy.
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Piovesan EJ, Lange MC, Teive HA, Tatsui CE, Kowacs PA, Piovesan LM, Werneck LC. [Change in the biological pattern of migraine with aura after the use of tetrabenazine: case report]. ARQUIVOS DE NEURO-PSIQUIATRIA 2000; 58:566-71. [PMID: 10920424 DOI: 10.1590/s0004-282x2000000300027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The influence of the dopaminergic system on the pathophysiology of migraine has been suggested as a result of recent genetic discoveries. A possible hyper-reactivity of the dopaminergic receptors DRD2 reinforced the evidence regarding this. We describe a 31 years-old male patient affected by a generalized dystonia secondary to perinatal hypoxia. At age 16, the patient started having headache crises that met the criteria for migraine with aura. After three years of treatment for dystonia with tetrabenazine, a clear reduction in the frequency, intensity and duration of the crises was perceived. During two periods longer than two months, the interruption of the treatment with tetrabenazine brought about an aggravation of the migraine crises. We present this case as being the first description in the literature showing the beneficial effects of tetrabenazine, a blocker of dopaminergic receptors, on the behavior of migraine with aura.
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Affiliation(s)
- E J Piovesan
- Setor de Neurologia, Departamento de Clínica Médica, Hospital de Clínicas, Universidade Federal do Paraná, Brazil
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Barbanti P, Bronzetti E, Ricci A, Cerbo R, Fabbrini G, Buzzi MG, Amenta F, Lenzi GL. Increased density of dopamine D5 receptor in peripheral blood lymphocytes of migraineurs: a marker for migraine? Neurosci Lett 1996; 207:73-6. [PMID: 8731424 DOI: 10.1016/0304-3940(96)12491-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The expression of dopamine D5 receptor was investigated in peripheral blood lymphocytes of 11 migraine patients and of ten healthy control subjects using a radioligand binding technique with [3H]SCH 23390 as a ligand. [3H]SCH 23390 is a benzazepine derivative with potent antagonist properties at the dopamine D1-like receptors. [3H]SCH 23390 was specifically bound to peripheral blood lymphocytes of migraineurs and control subjects in a manner consistent with the labelling of a dopamine D5 receptor. In migraineurs a statistically significant higher density of lymphocyte dopamine D5 receptor compared with controls was noticeable, whereas the affinity of the radioligand was unchanged. The increased density of dopamine D5 receptor in peripheral blood lymphocytes may reflect the dopaminergic hypersensitivity displayed by migraineurs and may represent a relatively simple and reliable peripheral marker of altered dopaminergic function.
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Affiliation(s)
- P Barbanti
- Dipartimento di Scienze Neurologiche, Università La Sapienza, Rome, Italy
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