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Pi C, Tang W, Li Z, Liu Y, Jing Q, Dai W, Wang T, Yang C, Yu S. Cortical pain induced by optogenetic cortical spreading depression: from whole brain activity mapping. Mol Brain 2022; 15:99. [PMID: 36471383 PMCID: PMC9721019 DOI: 10.1186/s13041-022-00985-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cortical spreading depression (CSD) is an electrophysiological event underlying migraine aura. Traditional CSD models are invasive and often cause injuries. The aim of the study was to establish a minimally invasive optogenetic CSD model and identify the active networks after CSD using whole-brain activity mapping. METHODS CSD was induced in mice by light illumination, and their periorbital thresholds and behaviours in the open field, elevated plus-maze and light-aversion were recorded. Using c-fos, we mapped the brain activity after CSD. The whole brain was imaged, reconstructed and analyzed using the Volumetric Imaging with Synchronized on-the-fly-scan and Readout technique. To ensure the accuracy of the results, the immunofluorescence staining method was used to verify the imaging results. RESULTS The optogenetic CSD model showed significantly decreased periorbital thresholds, increased facial grooming and freezing behaviours and prominent light-aversion behaviours. Brain activity mapping revealed that the somatosensory, primary sensory, olfactory, basal ganglia and default mode networks were activated. However, the thalamus and trigeminal nucleus caudalis were not activated. CONCLUSIONS Optogenetic CSD model could mimic the behaviours of headache and photophobia. Moreover, the optogenetic CSD could activate multiple sensory cortical regions without the thalamus or trigeminal nucleus caudalis to induce cortical pain.
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Affiliation(s)
- Chenghui Pi
- grid.216938.70000 0000 9878 7032College of Medicine, Nankai University, Tianjin, China ,grid.414252.40000 0004 1761 8894Department of Neurology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Wenjing Tang
- grid.414252.40000 0004 1761 8894Department of Neurology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhishuai Li
- grid.9227.e0000000119573309The State Key Laboratory for Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yang Liu
- grid.414252.40000 0004 1761 8894Department of Neurology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Qi Jing
- grid.59053.3a0000000121679639School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Wei Dai
- grid.414252.40000 0004 1761 8894Department of Neurology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Tao Wang
- grid.414252.40000 0004 1761 8894Department of Neurology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Chunxiao Yang
- grid.216938.70000 0000 9878 7032College of Medicine, Nankai University, Tianjin, China ,grid.414252.40000 0004 1761 8894Department of Neurology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- grid.216938.70000 0000 9878 7032College of Medicine, Nankai University, Tianjin, China ,grid.414252.40000 0004 1761 8894Department of Neurology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
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Demarquay G, Rheims S. Relationships between migraine and epilepsy: Pathophysiological mechanisms and clinical implications. Rev Neurol (Paris) 2021; 177:791-800. [PMID: 34340811 DOI: 10.1016/j.neurol.2021.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 01/03/2023]
Abstract
Migraine and epilepsy are distinct neurological diseases with specific clinical features and underlying pathophysiological mechanisms. However, numerous studies have highlighted the complex and multifaceted relationships between the two conditions. The relationships between headache and epilepsy manifest themselves in different ways. Firstly, the clinical diagnosis of these disorders may be challenging in view of possible overlapping. While post-ictal headache is a frequent condition, ictal epileptic headache is a rare but challenging diagnosis. Both situations raise the question of the pathophysiological mechanism of headache triggered by seizures. Migraine aura and epilepsy can also exhibit overlapping symptoms leading to their misdiagnosis, in particular in the case of visual aura. Secondly, migraine with aura and epilepsy can occur as a co-morbid condition, particularly in familial hemiplegic migraine (FHM). From a pathophysiological perspective, the identification of genetic mutations in FHM has brought significant advances in the understanding of dysfunctions of neuronal networks leading to hyperexcitability. The purpose of this review is to present clinical situations encompassing headache and epilepsy that can be challenging in neurological practice and to discuss the underlying pathophysiological mechanism of such interactions.
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Affiliation(s)
- G Demarquay
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France; Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292 and Lyon 1 University, Lyon, France.
| | - S Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France; Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292 and Lyon 1 University, Lyon, France
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HAKİ C, AKDOĞAN Ö, BORA İ. Headaches Associated with Seizure: A Prospective Comparative Cohort Study. Noro Psikiyatr Ars 2021; 58:48-51. [PMID: 33795952 PMCID: PMC7980719 DOI: 10.29399/npa.23272] [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: 06/06/2018] [Accepted: 12/28/2018] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION The purpose of the present study is to examine the frequency of headaches based on their relationship with seizures in epileptic patients as well as types of these headaches, and their clinical characteristics. METHODS 100 patients with epilepsy (60 female, 40 male), who applied to the epilepsy outpatient clinic of Faculty of Medicine of Uludağ University, were included in the study after accepting their consent forms. Patients with symptomatic epilepsy, secondary headaches and mental retardation were excluded from the study. Patients with epilepsy were divided into two groups as the patients with or without headaches associated with seizure. In addition, according to their temporal relationships with seizures, headaches were grouped as preictal, ictal and postictal headaches and the characteristics of headaches associated with seizure were examined and the patients with and without headache associated with seizure were compared in terms of their demographic and clinical features. RESULTS In this study, the prevalence of headache associated with seizure was found as 42%. Headaches associated with seizure were more frequent in the postictal period and they were mostly characterized as migraine-like headache. According to the seizure periods, 22 (52.3%) of the patients experienced pain during every seizure period. It was determined that preictal headache was frequently migraine-like compared to postictal headache and this headache was more frequently accompanied by aura. CONCLUSION Headache and epilepsy are the most frequent paroxysmal neurological conditions. However, because the symptoms of epilepsy are more remarkable, and its clinical presentation has a more dramatic picture, additional neurological conditions may be overlooked. Since both epilepsy and headache symptoms decrease the quality of life, it is important to treat both conditions. Examination of the correlation between these two situations can guide the physicians for selecting the treatment type, as well as helping them to improve the quality of life.
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Affiliation(s)
- Cemile HAKİ
- Department of Neurology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Özlem AKDOĞAN
- Department of Neurology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - İbrahim BORA
- Department of Neurology, Uludağ University Faculty of Medicine, Bursa, Turkey
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Birk D, Noachtar S, Kaufmann E. Kopfschmerz bei Parietal- und Okzipitallappenepilepsien. ZEITSCHRIFT FÜR EPILEPTOLOGIE 2021; 34:86-92. [DOI: 10.1007/s10309-020-00381-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 08/30/2023]
Abstract
ZusammenfassungEpilepsiepatienten leiden überdurchschnittlich häufig unter Kopfschmerzen. Dies gilt insbesondere für Patienten mit idiopathisch generalisierten und parietookzipitalen Epilepsien. Die Häufigkeit des gemeinsamen Auftretens von Kopfschmerzen und Epilepsie überschreitet dabei die rechnerische Koinzidenz, sodass von einer Komorbidität beider Syndrome auszugehen ist. Bestärkt wird diese Hypothese durch überlappende genetische Veränderungen sowie gemeinsame pathophysiologische Mechanismen. Bis zu 62 % der Patienten mit z. B. Parietal- und Okzipitallappenepilepsie (POLE) geben Kopfschmerzen an. Diese treten v. a. nach dem Anfall (postiktal) auf und manifestieren sich am häufigsten als Migräne-ähnlicher Kopfschmerz oder Spannungskopfschmerz. Seltener kommt es zu Kopfschmerzen vor (periiktal), während (iktal) oder zwischen (interiktal) epileptischen Anfällen. Bei transienten neurologischen Ausfallsymptomen mit begleitenden Kopfschmerzen ist differenzialdiagnostisch neben der Migräne an vaskuläre Ereignisse wie Synkopen oder eine transiente ischämische Attacke zu denken.
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Zawadzka M, Pilarska E, Konieczna S, Szmuda M, Matheisel A, Lemska A, Modrzejewska S, Mazurkiewicz-Bełdzińska M. Peri-ictal headaches in the paediatric population - prospective study. Cephalalgia 2020; 41:690-700. [PMID: 33297744 DOI: 10.1177/0333102420977856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The co-occurrence of headache and epilepsy is well-documented in the adult population. The aim of the prospective study was to analyse in the paediatric population the correlations between the types of peri-ictal headaches and types of seizures. Furthermore, an attempt was made to find trends in characteristic features of peri-ictal headaches.Material: A total of 57 children with peri-ictal headache were enrolled in the study. The participants' guardians were asked to keep a diary of the seizure and peri-ictal headache episodes during a 180-day period. During follow-up visits, systematic history regarding peri-ictal headaches was taken. RESULTS A total of 913 seizure and 325 peri-ictal headache episodes were noted during the study. Post-ictal headaches were most common, occurring in < 1 h after the seizure, lasting minutes to hours and more likely to occur after generalised seizures, whereas pre-ictal headaches occurred 30-240 min before the seizure. In the analysed group, peri-ictal headaches were most often moderate in intensity. Only 30% of patients took analgesic medication, usually to treat post-ictal headaches. CONCLUSION Peri-ictal headaches are a significant health problem for patients with epilepsy. The most common type are post-ictal headaches, and they are most likely to appear after a generalised seizure.
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Affiliation(s)
- Marta Zawadzka
- Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Ewa Pilarska
- Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Seweryna Konieczna
- Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marta Szmuda
- Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Agnieszka Matheisel
- Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Lemska
- Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Sandra Modrzejewska
- Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland
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Whealy MA, Myburgh A, Bredesen TJ, Britton JW. Headache in epilepsy: A prospective observational study. Epilepsia Open 2019; 4:593-598. [PMID: 31819915 PMCID: PMC6885695 DOI: 10.1002/epi4.12363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To assess the frequency and characteristics of interictal and postictal headaches (using International Classification of Headache Disorders, 3rd edition criteria) in a population of patients with epilepsy admitted to the Mayo Clinic Rochester epilepsy monitoring unit and assess their localizing value. METHODS This was a cross-sectional study. Participants were voluntarily recruited upon admission to the epilepsy monitoring unit. Two separate questionnaires were then administered. The first was to assess the presence and character of headaches experienced in the past 12 months. The second was to assess characteristics of postictal headaches experienced during their admission including localization. RESULTS One-hundred and twenty subjects (77%) met inclusion criteria and completed the initial questionnaire. Mean age was 38.1 years (range 18-82), and 67 (55.8%) were female. Interictal headaches were reported in 97 of 120 (81%) subjects, and these met ICHD3 criteria for migraine in 48 (50%). Postictal headaches were reported by 75 of 120 (63%) subjects on the initial admission questionnaire, representing migraine in 38 (51%). Thirty-nine (32%) subjects completed the secondary questionnaire related to postictal headaches experienced during admission, of which nine (23%) met criteria for migraine. There was no seizure lateralizing or localizing value noted based on postictal headache localization. SIGNIFICANCE Migraine was frequent in this cohort and appears to be the dominant interictal and postictal headache type in patients with epilepsy. In this study, the first to assess incident postictal headache in the setting of an ictal EEG, headache localization was of no seizure localizing value. Few patients were being actively treated; suggesting headache management is often overlooked in the epilepsy population.
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Affiliation(s)
- Mark A. Whealy
- Department of NeurologyMayo Clinic RochesterRochesterMinnesota
- Division of Headache MedicineMayo Clinic RochesterRochesterMinnesota
| | - Anna Myburgh
- Department of NeurologyMayo Clinic RochesterRochesterMinnesota
- Division of EpilepsyMayo Clinic RochesterRochesterMinnesota
| | - Tanya J. Bredesen
- Department of NeurologyMayo Clinic RochesterRochesterMinnesota
- Division of EpilepsyMayo Clinic RochesterRochesterMinnesota
| | - Jeffrey W. Britton
- Department of NeurologyMayo Clinic RochesterRochesterMinnesota
- Division of EpilepsyMayo Clinic RochesterRochesterMinnesota
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Salma Z, Hanen HK, Salma S, Olfa H, Nouha F, Mariem D, Chokri M. Headaches and their relationships to epileptic seizures. Epilepsy Behav 2019; 90:233-237. [PMID: 30583857 DOI: 10.1016/j.yebeh.2018.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 11/03/2018] [Accepted: 11/15/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE The frequent association between headache and epilepsy has been increasingly studied in recent years. Through this study, we attempted to study possible temporal associations between epileptic seizures and headaches. We also tried to describe clinical aspects of headache in our patients with epilepsy. PATIENTS AND METHODS We included patients with epilepsy and patients without epilepsy who presented for a first neurologic episode suggestive of epileptic seizure or unusual headache. These patients were invited to answer a standardized questionnaire screening for headache characteristics. Patients with epilepsy were asked for further data about their epilepsy. Electroencephalogram (EEG) was performed in all patients. Brain Magnetic resonance imaging MRI was reserved for patients in whom we suspected a structural lesion. RESULTS Overall, we included 47 patients with a mean age of about 39 ± 15 years (19 to 68 years old) and a female predominance (Sex Ratio: SR = 1.47). Most frequently, our patients documented periictal headache (Peri-IH) (85.1%) including respectively ictal headache (IH: 31.9%); postictal headache (Post-IH: 21.3%), and preictal headache (Pre-IH: 4.3%). Less frequently, our patients noted interictal headache (Inter-IH: 31.9%). Interestingly, these subgroups exhibited different headache patterns with predominantly unclassified-type headache (U-TH) in patients with IH (72.7%), tension-type headache (T-TH) in patients with Post-IH (73.3%), and migraine-type headache (M-TH) in patients with Inter-IH (60%). CONCLUSIONS Our results suggest that patients with epilepsy could exhibit different headache types. The clinical pattern of headache seemed to be linked to the time of seizure onset.
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Affiliation(s)
- Zouari Salma
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
| | - Haj Kacem Hanen
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Sakka Salma
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Hdiji Olfa
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Farhat Nouha
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Damak Mariem
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Clinical Investigation Center "CIC", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Mhiri Chokri
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Clinical Investigation Center "CIC", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
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Kotisaari K, Virtanen P, Forss N, Strbian D, Scheperjans F. Emergency computed tomography in patients with first seizure. Seizure 2017; 48:89-93. [DOI: 10.1016/j.seizure.2017.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 04/06/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022] Open
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Cianchetti C, Avanzini G, Dainese F, Guidetti V. The complex interrelations between two paroxysmal disorders: headache and epilepsy. Neurol Sci 2017; 38:941-948. [DOI: 10.1007/s10072-017-2926-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/16/2017] [Indexed: 01/03/2023]
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High prevalence of headaches in patients with epilepsy. J Headache Pain 2014; 15:70. [PMID: 25366245 PMCID: PMC4231166 DOI: 10.1186/1129-2377-15-70] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 10/29/2014] [Indexed: 01/03/2023] Open
Abstract
Background To examine the association between headaches and epilepsy. Methods Consecutive adult epileptic patients who went to the outpatient clinic of the Epilepsy Center of PLA General Hospital between February 01, 2012, and May 10, 2013, were recruited into this study. A total of 1109 patients with epilepsy completed a questionnaire regarding headaches. Results Overall, 60.1% of the patients (male: 57.2%; female: 63.8%) reported headaches within the last year. The age-weighted prevalence of interictal migraine was 11.7% (male 8.9%, female 15.3%), which is higher than that reported in a large population-based study (8.5%, male 5.4%, female 11.6%) using the same screening questions. The prevalence of postictal headaches was 34.1% (males 32.7%, females 35.2%), and the presence of preictal headaches was 4.5% (males 4.3%, females 5.2%). The prevalence of headache yesterday in the general population was 4.8% (male 3.0%, female 6.6%). Thus, the prevalence of headaches, including migraine, is higher in epileptic patients in China. Conclusions The high prevalence of postictal headaches confirms the frequent triggering of a headache by a seizure. A much lower frequency of preictal headaches, a condition in which the real triggering effect of the headache on the seizure might be difficult to prove.
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