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Yeral C, Yaman H, Gündoğdu O, Mutlu BÖ, Polat B, Yılmaz O. Does migraine affect central auditory processing abilities? Clin Neurol Neurosurg 2024; 243:108364. [PMID: 38838420 DOI: 10.1016/j.clineuro.2024.108364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE Migraine is a neurological disease associated with an altered cortical excitability level. Several studies have investigated the relationship between migraine and central auditory processing (CAP), with deficits in CAP being common among migraine patients. However, studies on the factors affecting these CAP changes observed in migraine patients are still few and controversial. This study aims to investigate CAP changes in migraine patients with Duration Pattern Test (DPT) and Frequency Pattern Test (FPT), which have not been used in previous studies. METHODS Sixty subjects were divided into two groups and one migraine subgroup: control group, twenty normal healthy subjects, fourty subjects diagnosed with migraine. They were evaluated using the CAP test including DPT and FPT. To identify the variables and possible effects of the variables, a questionnaire describing the characteristics of migraine features was administered to participants with migraine. RESULTS No significant difference was found the between the control and study group in CAP tests scores. No significant correlation was found between migraine characteristics and CAP tests scores. Males had significantly higher FPT scores in both ears than females (p<0.05). Significant statistical negative correlation was found between age and FPT scores for both ears and left DPT scores (p<0.05). CONCLUSION Although migraine patients generally showed lower CAP ability than the control group, no significant difference was observed between them. This was also valid for subgroups of migraine. However, as age increased in the migraine group, a significant decrease in CAP performance was observed. It was observed that male migraine patients had better CAP ability, especially FPT scores. Migraine may affect performance in CAP depending on gender and age factors.
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Affiliation(s)
- Cem Yeral
- Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
| | - Handan Yaman
- Department of Audiology, Istanbul Medipol University Mega Hospital, Istanbul, Türkiye; Functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Türkiye.
| | - Oğulcan Gündoğdu
- Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
| | - Berna Özge Mutlu
- Department of Audiology, Istanbul Medipol University Mega Hospital, Istanbul, Türkiye.
| | - Burcu Polat
- Department of Neurology, School of Medicine, Duzce University, Duzce, Türkiye.
| | - Oğuz Yılmaz
- Department of Audiology, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Türkiye.
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Irfan S, Mohammed F, Hameed S, Ravi V, V K, S S, Arumugam S, Subramanian B, Ravichandran S, Ravichandran U. The Assessment of Clinical Characteristics, Treatment Patterns, and Burden of Illness in Patients With Episodic and Chronic Migraine: A Cross-Sectional Study. Cureus 2024; 16:e59073. [PMID: 38800196 PMCID: PMC11128265 DOI: 10.7759/cureus.59073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Migraine is a prevalent and disabling primary headache disorder worldwide, causing significant years lost due to disability (YLD) and impacting various aspects of everyday life. Despite its high prevalence and substantial burden, there is a lack of comprehensive data on clinical patterns and management trends, in places like Tamil Nadu, India. This study aims and also fill gaps by investigating and analyzing the clinical characteristics, treatment patterns, and illness burden among patients with episodic migraine (EM) and chronic migraine (CM) in the state of Tamil Nadu. STUDY This cross-sectional retrospective study was conducted at the Department of Neurology, Madras Medical College, Chennai, over a three-month period starting from January 2024 to March 2024. The study included migraine patients aged 18 years and above who met the International Classification of Headache Disorders (ICHD)-3 criteria and took treatment at the department. Data were collected using patient interviews, medical records, and counseling sessions and using a pre-designed questionnaire. Patient demographics, clinical characteristics, symptom prevalence, prescription patterns, and illness burden were analyzed accordingly. The Migraine Disability Assessment (MIDAS) questionnaire was used to measure the burden of illness. RESULTS The analysis involved 400 migraine patients, 92.5% of them having EM and 7.5% of them having CM. The mean age of patients was 37.5 years, with a predominance of females (73.5%). Patients with CM had having significantly higher average number of headache days per month when compared to those with EM. Tension-type headache (TTH) and medication-overuse headache (MOH) were more prevalent in those CM patients. Trigger factors include lack of sleep, bright light exposure, and stress. Comorbidities such as diabetes mellitus, obesity, and depression were significantly higher in CM patients. Acute treatment included NSAIDs and Triptans, while preventive therapy was more commonly used in CM patients. The mean MIDAS score was significantly higher in CM patients, which indicates greater disability. CONCLUSION The study provides valuable insights into the clinical characteristics, treatment patterns, and burden of illness among migraine patients in Tamil Nadu, India. Significant differences were observed between EM and CM patients, which highlights the need for comprehensive management strategies. Preventive therapy, lifestyle modifications, and comprehensive assessment of disability are all important in addressing the variable needs of migraine patients and also reducing the burden of illness. Further research is necessary to explore additional factors influencing migraine outcomes in this population.
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Affiliation(s)
- Shahul Irfan
- Internal Medicine, Government Medical College and Hospital Cuddalore, Chidambaram, IND
| | - Fadhil Mohammed
- Radiology, Stanley Medical College and Hospital, Chennai, IND
| | - Shahul Hameed
- Medicine and Surgery, Stanley Medical College and Hospital, Chennai, IND
| | - Vasupriya Ravi
- Medicine and Surgery, Stanley Medical College and Hospital, Chennai, IND
| | - Kashish V
- Internal Medicine, Government Medical College and Hospital Cuddalore, Chidambaram, IND
| | - Srimati S
- Medicine, Government Medical College and Hospital Cuddalore, Chidambaram, IND
| | - Sashanga Arumugam
- Internal Medicine, Government Medical College and Hospital Cuddalore, Chidambaram, IND
| | - Bala Subramanian
- Internal Medicine, Government Medical College and Hospital Cuddalore, Chidambaram, IND
| | | | - Umarani Ravichandran
- Internal Medicine, Government Medical College and Hospital Cuddalore, Chidambaram, IND
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Liu X, Yu Y, Hou L, Yu Y, Wu Y, Wu S, He Y, Ge Y, Wei Y, Luo Q, Qian F, Feng Y, Li H, Xue F. Association between dietary habits and the risk of migraine: a Mendelian randomization study. Front Nutr 2023; 10:1123657. [PMID: 37351190 PMCID: PMC10282154 DOI: 10.3389/fnut.2023.1123657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
Objective The important contribution of dietary triggers to migraine pathogenesis has been recognized. However, the potential causal roles of many dietary habits on the risk of migraine in the whole population are still under debate. The objective of this study was to determine the potential causal association between dietary habits and the risk of migraine (and its subtypes) development, as well as the possible mediator roles of migraine risk factors. Methods Based on summary statistics from large-scale genome-wide association studies, we conducted two-sample Mendelian randomization (MR) and bidirectional MR to investigate the potential causal associations between 83 dietary habits and migraine and its subtypes, and network MR was performed to explore the possible mediator roles of 8 migraine risk factors. Results After correcting for multiple testing, we found evidence for associations of genetically predicted coffee, cheese, oily fish, alcohol (red wine), raw vegetables, muesli, and wholemeal/wholegrain bread intake with decreased risk of migraine, those odds ratios ranged from 0.78 (95% CI: 0.63-0.95) for overall cheese intake to 0.61 (95% CI: 0.47-0.80) for drinks usually with meals among current drinkers (yes + it varies vs. no); while white bread, cornflakes/frosties, and poultry intake were positively associated with the risk of migraine. Additionally, genetic liability to white bread, wholemeal/wholegrain bread, muesli, alcohol (red wine), cheese, and oily fish intake were associated with a higher risk of insomnia and (or) major depression disorder (MDD), each of them may act as a mediator in the pathway from several dietary habits to migraine. Finally, we found evidence of a negative association between genetically predicted migraine and drinking types, and positive association between migraine and cups of tea per day. Significance Our study provides evidence about association between dietary habits and the risk of migraine and demonstrates that some associations are partly mediated through one or both insomnia and MDD. These results provide new insights for further nutritional interventions for migraine prevention.
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Affiliation(s)
- Xinhui Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuanyuan Yu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lei Hou
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yifan Yu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yutong Wu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Sijia Wu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yina He
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yilei Ge
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yun Wei
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qingxin Luo
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fengtong Qian
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yue Feng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Hongkai Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Athar F, Zahid A, Farooq M, Ayyan M, Ashraf M, Farooq M, Naeem F, Badar A, Ehsan M, Hussain A, Ilyas MA. Frequency of migraine according to the ICHD-3 criteria and its association with sociodemographic and triggering factors in Pakistan: A cross-sectional study. Ann Med Surg (Lond) 2022; 82:104589. [PMID: 36268304 PMCID: PMC9577507 DOI: 10.1016/j.amsu.2022.104589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Migraine is a primary headache disorder marked by episodes of moderate to severe headache that is unilateral, throbbing in character, having a duration of 4 h to three days, and associated with nausea, vomiting, photophobia, and phonophobia. Aims Our study aims to determine the frequency of migraine in Pakistan, its association with sociodemographic variables and triggering factors, and the coping mechanisms used. Methods A cross-sectional study was conducted through an online survey from March 19, 2022, to June 15, 2022. The snowball sampling technique was used for data collection. The questions asked included those on sociodemographic information, screening questions, and questions on triggering factors and coping mechanisms. The screening was done using the ICHD-3 criteria and percentages were calculated using SPSS. Results Of the 986 respondents, 393 suffered from migraine. The majority of them were female (78.1%), belonged to the age group 20–29 years (69.2%), and were students (76.1%). 32.8% of the migraineurs had a family history of migraine. Most frequent triggers included sleep disturbance (70.5%), stress (66.7%) and fatigue (64.4%). Of the female migraineurs, 31.8% had menstruation as a trigger. The coping mechanisms used included taking rest, medication, staying in a quiet and dark place, and doing massage. Conclusion The findings suggest that young adults, especially females, with a stressful and sleep-deprived lifestyle are more vulnerable to migraine. However, further studies must focus on trigger synergy and interrelation of triggers that precipitate migraine so a better understanding can be developed for the prevention, diagnosis, and treatment of migraine. Females, majorly students, of the age group 20–29 years were the most affected by migraine. The migraine attacks were mostly triggered by sleep disturbance, stress, excess screen time, loud noise, and missed meals. The most frequently used coping mechanism by the migraineurs to relieve pain was taking rest.
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Hajjarzadeh S, Shalilahmadi D, Nikniaz Z, Mahdavi R, Hajjarzadeh S. The comparison of the main dietary and non-dietary trigger factors in women with chronic and episodic migraine. Nutr Diet 2022; 79:616-622. [PMID: 35983599 DOI: 10.1111/1747-0080.12761] [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: 12/25/2021] [Revised: 06/12/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
AIMS Migraine is one of the most common neurological diseases and the second cause of disability worldwide. Various trigger factors have been reported in different populations. The current study was designed to extract the main trigger factors using factor analysis, and compare the chronic and episodic patient scores for every extracted pattern. METHODS In this cross-sectional study, 300 migrainous women (25-55 years old) participated. A constructed 46-item Likert questionnaire was developed to assess the primary triggers. The validity of the designed questionnaire was assessed by Content Validity Ratio and Content Validity Index coefficients. The test-retest method was employed to assess reliability. The exploratory factor analysis was performed to extract patterns of correlation among 46 triggers. Each participant was given a score for every extracted pattern. The mean scores of chronic and episodic patients were compared using the Mann-Whitney test. RESULTS The mean body mass index of participants was 28.17 ± 5.44 kg/m2 . Most participants (90.7%) had migraine without aura. Four factors were extracted using factor analysis that explained 22.37% of the total variance: (1) environmental and behavioural factors; (2) condiments; (3) nitrite, tyramine and caffeine; and (4) fats. None of these factors explained the difference between chronic and episodic migrainous women. CONCLUSIONS The current study suggests that environmental and behavioural factors, relative to dietary triggers, play an essential role in causing migraine in women and more than dietary triggers. The most important triggers did not differ between episodic and chronic migrainous women.
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Affiliation(s)
- Samaneh Hajjarzadeh
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Davood Shalilahmadi
- Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Mahdavi
- Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Hajjarzadeh
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Maksemous N, Blayney CD, Sutherland HG, Smith RA, Lea RA, Tran KN, Ibrahim O, McArthur JR, Haupt LM, Cader MZ, Finol-Urdaneta RK, Adams DJ, Griffiths LR. Investigation of CACNA1I Cav3.3 Dysfunction in Hemiplegic Migraine. Front Mol Neurosci 2022; 15:892820. [PMID: 35928792 PMCID: PMC9345121 DOI: 10.3389/fnmol.2022.892820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/13/2022] [Indexed: 01/12/2023] Open
Abstract
Familial hemiplegic migraine (FHM) is a severe neurogenetic disorder for which three causal genes, CACNA1A, SCN1A, and ATP1A2, have been implicated. However, more than 80% of referred diagnostic cases of hemiplegic migraine (HM) are negative for exonic mutations in these known FHM genes, suggesting the involvement of other genes. Using whole-exome sequencing data from 187 mutation-negative HM cases, we identified rare variants in the CACNA1I gene encoding the T-type calcium channel Cav3.3. Burden testing of CACNA1I variants showed a statistically significant increase in allelic burden in the HM case group compared to gnomAD (OR = 2.30, P = 0.00005) and the UK Biobank (OR = 2.32, P = 0.0004) databases. Dysfunction in T-type calcium channels, including Cav3.3, has been implicated in a range of neurological conditions, suggesting a potential role in HM. Using patch-clamp electrophysiology, we compared the biophysical properties of five Cav3.3 variants (p.R111G, p.M128L, p.D302G, p.R307H, and p.Q1158H) to wild-type (WT) channels expressed in HEK293T cells. We observed numerous functional alterations across the channels with Cav3.3-Q1158H showing the greatest differences compared to WT channels, including reduced current density, right-shifted voltage dependence of activation and inactivation, and slower current kinetics. Interestingly, we also found significant differences in the conductance properties exhibited by the Cav3.3-R307H and -Q1158H variants compared to WT channels under conditions of acidosis and alkalosis. In light of these data, we suggest that rare variants in CACNA1I may contribute to HM etiology.
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Affiliation(s)
- Neven Maksemous
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Claire D Blayney
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Heidi G Sutherland
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Robert A Smith
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rod A Lea
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kim Ngan Tran
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Omar Ibrahim
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jeffrey R McArthur
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Larisa M Haupt
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - M Zameel Cader
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Rocio K Finol-Urdaneta
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - David J Adams
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Lyn R Griffiths
- Genomics Research Centre, The Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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Saçmacı H, Tanik N, İnan LE. Current Perspectives on the Impact of Chronic Migraine on Sleep Quality: A Literature Review. Nat Sci Sleep 2022; 14:1783-1800. [PMID: 36225323 PMCID: PMC9549806 DOI: 10.2147/nss.s335949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Recent studies have shown that sleep problems occur in migraineurs and poor sleep causes chronification, but the mechanisms by which chronic migraine affects sleep quality are still unknown. This review aims to analyze commonly reported sleep disturbances in chronic migraine (CM) and determine the effect of CM on sleep quality. MATERIALS AND METHODS We conducted a comprehensive review of all published articles on CM and sleep quality from inception to March 2022 in the literature. Clinical trials, observational studies, and case series (≥20 cases) were included. Two reviewers and a supervisor reviewed the titles and abstracts of all search results with predefined inclusion and exclusion criteria. PubMed search for randomized controlled trials and open studies on CM and sleep quality reported in English between 1983 and 2022 was conducted using the keywords including chronic migraine, sleep, insomnia, sleep quality, polysomnography, and Pittsburgh Sleep Quality Index. RESULTS A total of 535 potentially relevant articles were found. A total of 455 articles and reviews, meta-analyses published in any language other than English, with other exclusion criteria, were excluded from the review. In the remaining articles, 36 clinical studies, reviewing sleep quality and its association with migraine, were identified and reviewed. Evidence from this review shows that poor sleep and migraine chronicity are intertwined with other accompanying comorbidities and dysregulation of circadian rhythm that innovative treatments promise to bring relief to both poor sleep as well as migraine. CONCLUSION Sleep disorders are common in CM and the association between migraine chronification and sleep quality is bidirectional. Comorbid conditions with accompanying frequent attacks in migraine may impair sleep quality. While the maladaptive pain process worsens sleep, poor sleep quality also negatively affects migraine pain. Sleep disturbance, which is affected by worsening migraine attacks, causes deterioration in the quality of life, loss of workforce, and economic burden.
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Affiliation(s)
- Hikmet Saçmacı
- Department of Neurology, Yozgat Bozok University, School of Medicine, Yozgat, 66100, Turkey
| | - Nermin Tanik
- Department of Neurology, Yozgat Bozok University, School of Medicine, Yozgat, 66100, Turkey
| | - Levent Ertuğrul İnan
- Department of Neurology, Ministry of Health Ankara Research and Training Hospital, Ankara, 06230, Turkey
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Ibrahim EAA, Badri GAM, Ahmed KAHM, Omer MEA. Migraine headache in Sudan. Brain Behav 2021; 11:e2429. [PMID: 34775687 PMCID: PMC8671772 DOI: 10.1002/brb3.2429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Migraine is a main form of headache, it is also a chronic and complex neuroinflammatory disease; it is characterized by recurrent severe headaches, usually affecting one side of the head, and often accompanied by nausea and blurred vision. In susceptible individuals, irritants can trigger migraine attacks, which can be considered as triggers or accelerators. OBJECTIVE To describe the precipitating factors, clinical presentation, and treatment of migraine headache in Sudanese patients. METHODS This is a descriptive hospital-based prospective study covering 130 patients during the study period from January 2016 to December 2018. At the National Centre for Neurological Science, Khartoum, participants were Sudanese patients with migraine headache after exclusion of other causes of headache. Data was collected using structured questionnaire entered and analyzed using SPSS version 22.0, p value < .05 is considered significant. RESULTS The study covered 130 study participants most of them were females (80%), within 26-35 years of age (56.9%) and a considerable proportion of them were housewives (40%). The majority of the study participants had headache without aura in 81.5% and headache with aura in 18.5% (mainly visual type 87.5%). Photophobia and nausea were the main associated symptoms in 51.5% and 50%, respectively. Acetaminophen was the main prescribed treatment in 46.1%, beta blockers was the main prophylaxis in 29.2%. Environmental triggers were the prevalent predisposing factors (43.8%) followed by fasting, lack of sleep, and exertion (24.6% for each). CONCLUSION Environmental conditions were the commonest triggering factors of migraine headache, while Acetaminophen was the most common drug used for relieving migraine in this population.
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Affiliation(s)
- Etedal Ahmed A Ibrahim
- Faculty of Medicine, Al Neelain University, Department of Internal Medicine, Khartoum, Sudan.,The National Centre for Neurological Sciences, Department of Neurology, Khartoum, Sudan
| | - Ghada A Mutaal Badri
- The National Centre for Neurological Sciences, Department of Neurology, Khartoum, Sudan
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Sarrouilhe D, Defamie N, Mesnil M. Is the Exposome Involved in Brain Disorders through the Serotoninergic System? Biomedicines 2021; 9:1351. [PMID: 34680468 PMCID: PMC8533279 DOI: 10.3390/biomedicines9101351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
Abstract
Serotonin (5-hydroxytryptamine, 5-HT) is a biogenic monoamine acting as a neurotransmitter in the central nervous system (CNS), local mediator in the gut, and vasoactive agent in the blood. It has been linked to a variety of CNS functions and is implicated in many CNS and psychiatric disorders. The high comorbidity between some neuropathies can be partially understood by the fact that these diseases share a common etiology involving the serotoninergic system. In addition to its well-known functions, serotonin has been shown to be a mitogenic factor for a wide range of normal and tumor cells, including glioma cells, in vitro. The developing CNS of fetus and newborn is particularly susceptible to the deleterious effects of neurotoxic substances in our environment, and perinatal exposure could result in the later development of diseases, a hypothesis known as the developmental origin of health and disease. Some of these substances affect the serotoninergic system and could therefore be the source of a silent pandemic of neurodevelopmental toxicity. This review presents the available data that are contributing to the appreciation of the effects of the exposome on the serotoninergic system and their potential link with brain pathologies (neurodevelopmental, neurodegenerative, neurobehavioral disorders, and glioblastoma).
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Affiliation(s)
- Denis Sarrouilhe
- Laboratoire de Physiologie Humaine, Faculté de Médecine et Pharmacie, 6 Rue de la Milétrie, Bât D1, TSA 51115, CEDEX 09, 86073 Poitiers, France
| | - Norah Defamie
- Laboratoire STIM, ERL7003 CNRS-Université de Poitiers, 1 Rue G. Bonnet–TSA 51106, CEDEX 09, 86073 Poitiers, France; (N.D.); (M.M.)
| | - Marc Mesnil
- Laboratoire STIM, ERL7003 CNRS-Université de Poitiers, 1 Rue G. Bonnet–TSA 51106, CEDEX 09, 86073 Poitiers, France; (N.D.); (M.M.)
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Papetti L, Moavero R, Ferilli MAN, Sforza G, Tarantino S, Ursitti F, Ruscitto C, Vigevano F, Valeriani M. Truths and Myths in Pediatric Migraine and Nutrition. Nutrients 2021; 13:2714. [PMID: 34444875 PMCID: PMC8399652 DOI: 10.3390/nu13082714] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 12/19/2022] Open
Abstract
The link between migraine and nutrition can be explored from several points of view. Lifestyle and, in particular, aspects of nutrition can have a significant impact on the course of pediatric migraine. In addition, some dietary treatments, such as the ketogenic diet, and some active ingredients present in foods (nutraceuticals) may have a therapeutic effect on migraine. A diet that can control weight gain and obesity has beneficial effects on migraine severity. On the other hand, when we talk about the link between nutrition and headaches, it is also necessary to point out that some public information is actually fake news that has no scientific basis. The purpose of this review is to provide an update on the salient points linking pediatric migraine to nutritional principles, focusing on the relationship between weight and headaches, the therapeutic effect of food for medical purposes, the ketogenic diet as a migraine treatment, and the relationship between migraine and dietary habits.
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Affiliation(s)
- Laura Papetti
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Romina Moavero
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00165 Rome, Italy;
| | - Michela A. N. Ferilli
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Giorgia Sforza
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Samuela Tarantino
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Fabiana Ursitti
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Claudia Ruscitto
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00165 Rome, Italy;
| | - Federico Vigevano
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Massimiliano Valeriani
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
- Center for Sensory-Motor Interaction, Denmark Neurology Unit, Aalborg University, 9100 Aalborg, Denmark
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11
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Westergaard ML, Lau CJ, Allesøe K, Andreasen AH, Jensen RH. Poor social support and loneliness in chronic headache: Prevalence and effect modifiers. Cephalalgia 2021; 41:1318-1331. [PMID: 34162255 DOI: 10.1177/03331024211020392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To explore the prevalence of poor social support and loneliness among people with chronic headache, and how these might be effect modifiers in the relationships between chronic headache and stress, medication overuse, and self-rated health. BACKGROUND Poor social support and loneliness are consistently linked to worse health outcomes. There are few epidemiologic studies on their effect on headache. METHODS The Danish Capital Region Health Survey, a cross-sectional survey, was conducted in 2017. Participants were asked about headache, pain medication use, social support, loneliness, perceived stress, and self-rated health. Data were accessed from sociodemographic registers. Logistic regression analyses were performed to test for effect modification. RESULTS The response rate was 52.6% (55,185 respondents) and was representative of the target population. People with chronic headache were more likely to report poor social support and loneliness compared to those without chronic headache (p < 0.0001 for both). Odds ratios for the combination of chronic headache and poor social support were very high for stress (odds ratio 8.1), medication overuse (odds ratio 21.9), and poor self-rated health (odds ratio 10.2) compared to those without chronic headache and with good social support. Those who reported both chronic headache and loneliness had a very high odds ratio for stress (odds ratio 14.4), medication overuse (odds ratio 20.1), and poor self-rated health (odds ratio 15.9) compared to those without chronic headache and low loneliness score. When adjusted for sociodemographic factors, poor social support and loneliness were not significant effect modifiers in almost all these associations. Loneliness was a significant effect modifier in the association between chronic headache and medication overuse, but exerted greater effect among those who did not report they were lonely. CONCLUSION Poor social support and loneliness were prevalent among people with chronic headache. The combination of chronic headache and poor social support or loneliness showed higher odds ratios for stress, medication overuse, and poor self-rated health compared to those with good social support and low loneliness scores. The effect of loneliness in the relationship between chronic headache and medication overuse warrants further study.
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Affiliation(s)
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark
| | - Karen Allesøe
- Center for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark.,Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Anne Helms Andreasen
- Center for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark
| | - Rigmor Højland Jensen
- Danish Headache Center, Rigshospitalet‒Glostrup, University of Copenhagen, Glostrup, Denmark
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12
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Robbins MS, Victorio MC, Bailey M, Cook C, Garza I, Huff JS, Ready D, Schuster NM, Seidenwurm D, Seng E, Szperka C, Lee E, Villanueva R. Quality improvement in neurology: Headache Quality Measurement Set. Neurology 2020; 95:866-873. [PMID: 32967929 PMCID: PMC7713732 DOI: 10.1212/wnl.0000000000010634] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/14/2020] [Indexed: 01/03/2023] Open
Affiliation(s)
- Matthew S Robbins
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - M Cristina Victorio
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Mark Bailey
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Calli Cook
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Ivan Garza
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - J Stephen Huff
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Duren Ready
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Nathaniel M. Schuster
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - David Seidenwurm
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Elizabeth Seng
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Christina Szperka
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Erin Lee
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Raissa Villanueva
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
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13
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Robbins MS, Victorio MCC, Bailey M, Cook C, Garza I, Huff JS, Ready D, Schuster NM, Seidenwurm D, Seng E, Szperka C, Lee E, Villanueva R. Quality Improvement in Neurology: Headache Quality Measurement Set. Headache 2020; 61:219-226. [PMID: 32965046 DOI: 10.1111/head.13988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - Mark Bailey
- University of Alabama at Birmingham, Indian Springs, AL
| | - Calli Cook
- Emory University, School of Nursing, Healthcare, Atlanta, GA
| | | | - J Stephen Huff
- University of Virginia Health System, Charlottesville, VA
| | | | - Nathaniel M Schuster
- University of California San Diego Center for Pain Medicine, Department of Anesthesiology, La Jolla, CA
| | | | - Elizabeth Seng
- Albert Einstein College of Medicine and Yeshiva University, Bronx, NY
| | - Christina Szperka
- Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Erin Lee
- American Academy of Neurology, Minneapolis, MN
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14
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Nowaczewska M, Wiciński M, Kaźmierczak W. The Ambiguous Role of Caffeine in Migraine Headache: From Trigger to Treatment. Nutrients 2020; 12:nu12082259. [PMID: 32731623 PMCID: PMC7468766 DOI: 10.3390/nu12082259] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/25/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023] Open
Abstract
Migraine is a chronic disorder, and caffeine has been linked with migraine for many years, on the one hand as a trigger, and on the other hand as a cure. As most of the population, including migraineurs, consume a considerable amount of caffeine daily, a question arises as to whether it influences their headaches. Indeed, drinking coffee before a migraine attack may not be a real headache trigger, but a consequence of premonitory symptoms, including yawning, diminished energy levels, and sleepiness that may herald a headache. Here, we aim to summarize the available evidence on the relationship between caffeine and migraines. Articles concerning this topic published up to June 2020 were retrieved by searching clinical databases, and all types of studies were included. We identified 21 studies investigating the prevalence of caffeine/caffeine withdrawal as a migraine trigger and 7 studies evaluating caffeine in acute migraine treatment. Among them, in 17 studies, caffeine/caffeine withdrawal was found to be a migraine trigger in a small percentage of participants (ranging from 2% to 30%), while all treatment studies found caffeine to be safe and effective in acute migraine treatment, mostly in combination with other analgesics. Overall, based on our review of the current literature, there is insufficient evidence to recommend caffeine cessation to all migraine patients, but it should be highlighted that caffeine overuse may lead to migraine chronification, and sudden caffeine withdrawal may trigger migraine attacks. Migraine sufferers should be aware of the amount of caffeine they consume and not exceed 200 mg daily. If they wish to continue drinking caffeinated beverages, they should keep their daily intake as consistent as possible to avoid withdrawal headache.
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Affiliation(s)
- Magdalena Nowaczewska
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
- Correspondence: ; Tel.: +48-52-585-4716
| | - Michał Wiciński
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland;
| | - Wojciech Kaźmierczak
- Department of Sensory Organs Examination, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland;
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15
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Negro A, Seidel JL, Houben T, Yu ES, Rosen I, Arreguin AJ, Yalcin N, Shorser-Gentile L, Pearlman L, Sadhegian H, Vetrivelan R, Chamberlin NL, Ayata C, Martelletti P, Moskowitz MA, Eikermann-Haerter K. Acute sleep deprivation enhances susceptibility to the migraine substrate cortical spreading depolarization. J Headache Pain 2020; 21:86. [PMID: 32631251 PMCID: PMC7339460 DOI: 10.1186/s10194-020-01155-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Migraine is a common headache disorder, with cortical spreading depolarization (CSD) considered as the underlying electrophysiological event. CSD is a slowly propagating wave of neuronal and glial depolarization. Sleep disorders are well known risk factors for migraine chronification, and changes in wake-sleep pattern such as sleep deprivation are common migraine triggers. The underlying mechanisms are unknown. As a step towards developing an animal model to study this, we test whether sleep deprivation, a modifiable migraine trigger, enhances CSD susceptibility in rodent models. METHODS Acute sleep deprivation was achieved using the "gentle handling method", chosen to minimize stress and avoid confounding bias. Sleep deprivation was started with onset of light (diurnal lighting conditions), and assessment of CSD was performed at the end of a 6 h or 12 h sleep deprivation period. The effect of chronic sleep deprivation on CSD was assessed 6 weeks or 12 weeks after lesioning of the hypothalamic ventrolateral preoptic nucleus. All experiments were done in a blinded fashion with respect to sleep status. During 60 min of continuous topical KCl application, we assessed the total number of CSDs, the direct current shift amplitude and duration of the first CSD, the average and cumulative duration of all CSDs, propagation speed, and electrical CSD threshold. RESULTS Acute sleep deprivation of 6 h (n = 17) or 12 h (n = 11) duration significantly increased CSD frequency compared to controls (17 ± 4 and 18 ± 2, respectively, vs. 14 ± 2 CSDs/hour in controls; p = 0.003 for both), whereas other electrophysiological properties of CSD were unchanged. Acute total sleep deprivation over 12 h but not over 6 h reduced the electrical threshold of CSD compared to controls (p = 0.037 and p = 0.095, respectively). Chronic partial sleep deprivation in contrast did not affect CSD susceptibility in rats. CONCLUSIONS Acute but not chronic sleep deprivation enhances CSD susceptibility in rodents, possibly underlying its negative impact as a migraine trigger and exacerbating factor. Our findings underscore the importance of CSD as a therapeutic target in migraine and suggest that headache management should identify and treat associated sleep disorders.
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Affiliation(s)
- Andrea Negro
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Jessica L Seidel
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Thijs Houben
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Esther S Yu
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Ike Rosen
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Andrea J Arreguin
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Nilufer Yalcin
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Lea Shorser-Gentile
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Lea Pearlman
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Homa Sadhegian
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Ramalingam Vetrivelan
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Cenk Ayata
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Michael A Moskowitz
- Department of Radiology, and Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Katharina Eikermann-Haerter
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the role of avoidance behavior in headache-related disability and overview relevant clinical implications. RECENT FINDINGS Avoidance occupies a central role in contemporary psychological perspectives on headache disorders and other chronic pain conditions. Several cognitive constructs of relevance to headache are influenced and maintained by avoidance behavior. A growing body of literature attests to the notion that avoidance of headache triggers, of stimuli that exacerbate headache, and of broader life domains can negatively affect headache progression, disability/quality of life, and comorbid psychiatric symptoms. Interventions targeting avoidance behavior, such as therapeutic exposure to headache triggers, mindfulness, and acceptance and commitment therapy (ACT), hold promise for headache disorders but need to be tested in larger trials. Researchers and clinicians are encouraged to attend to functional impairment as a critically important treatment outcome. Comprehensive understanding of headache disorders necessitates attention not merely to diagnostic symptoms and their reduction, but to patterns of avoidance behavior that inadvertently exacerbate headache and contribute to functional impairment.
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Hindiyeh NA, Zhang N, Farrar M, Banerjee P, Lombard L, Aurora SK. The Role of Diet and Nutrition in Migraine Triggers and Treatment: A Systematic Literature Review. Headache 2020; 60:1300-1316. [PMID: 32449944 PMCID: PMC7496357 DOI: 10.1111/head.13836] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022]
Abstract
Background Migraine is a disabling primary headache disorder often associated with triggers. Diet‐related triggers are a common cause of migraine and certain diets have been reported to decrease the frequency of migraine attacks if dietary triggers or patterns are adjusted. Objective The systematic literature review was conducted to qualitatively summarize evidence from the published literature regarding the role of diet patterns, diet‐related triggers, and diet interventions in people with migraine. Methods A literature search was carried out on diet patterns, diet‐related triggers, and diet interventions used to treat and/or prevent migraine attacks, using an a priori protocol. MEDLINE and EMBASE databases were searched to identify studies assessing the effect of diet, food, and nutrition in people with migraine aged ≥18 years. Only primary literature sources (randomized controlled trials or observational studies) were included and searches were conducted from January 2000 to March 2019. The NICE checklist was used to assess the quality of the included studies of randomized controlled trials and the Downs and Black checklist was used for the assessment of observational studies. Results A total of 43 studies were included in this review, of which 11 assessed diet patterns, 12 assessed diet interventions, and 20 assessed diet‐related triggers. The overall quality of evidence was low, as most of the (68%) studies assessing diet patterns and diet‐related triggers were cross‐sectional studies or patient surveys. The studies regarding diet interventions assessed a variety of diets, such as ketogenic diet, elimination diets, and low‐fat diets. Alcohol and caffeine uses were the most common diet patterns and diet‐related triggers associated with increased frequency of migraine attacks. Most of the diet interventions, such as low‐fat and elimination diets, were related to a decrease in the frequency of migraine attacks. Conclusions There is limited high‐quality randomized controlled trial data on diet patterns or diet‐related triggers. A few small randomized controlled trials have assessed diet interventions in preventing migraine attacks without strong results. Although many patients already reported avoiding personal diet‐related triggers in their migraine management, high‐quality research is needed to confirm the effect of diet in people with migraine.
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Affiliation(s)
| | - Niushen Zhang
- Department of Neurology, Stanford University, Stanford, CA, USA
| | | | - Pixy Banerjee
- Eli Lilly Services India Pvt. Ltd., Bangalore, India
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Seng EK. Using Cognitive Behavioral Therapy Techniques to Treat Migraine. ACTA ACUST UNITED AC 2020; 44:68-73. [PMID: 33907734 DOI: 10.1007/bf03544665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Migraine is a common and disabling neurologic disorder that often occurs alongside anxiety and mood disorders. Information is provided on the biological basis of the disorder, the interactive effects of co-morbidity, and common psychological distortions manifested by individuals with migraine. Psychological treatments based on cognitive behavioral techniques have demonstrated efficacy to treat migraine. Migraine treatment can be incorporated in private practice and integrated care settings.
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Walter SM, Banvard-Fox C, Cundiff C. Evaluation and Treatment of Primary Headaches in Adolescents. Prim Care 2020; 47:241-256. [PMID: 32423712 DOI: 10.1016/j.pop.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Headache is a common episodic and chronic pain syndrome in adolescents. Evaluation of headaches in primary care requires a comprehensive assessment including lifestyle behaviors and physical examination, as well as an understanding of when to pursue appropriate testing. Primary headache disorders seen in adolescents include migraine and tension-type headache. Pharmacologic management for primary headache includes both acute and prophylactic treatment strategies.
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Affiliation(s)
- Suzy Mascaro Walter
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, WV 26505, USA.
| | - Christine Banvard-Fox
- Department of Pediatrics, Division of Adolescent Medicine, WVU Medicine, West Virginia University, 6040 University Town Center Drive, Morgantown, WV 26501, USA
| | - Courtney Cundiff
- Department of Emergency Medicine, WVU Medicine, West Virginia University, 1 Medical Center Drive, Morgantown, WV, 26505, USA
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Tanik N, Saçmaci H, Aktürk T. The relationship between exposure to hot/cold weather and the clinical features of headaches in patients with migraine and tension-type headaches. Neurol Res 2020; 42:239-243. [PMID: 32048556 DOI: 10.1080/01616412.2020.1723300] [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] [Indexed: 01/07/2023]
Abstract
Background and purpose: This study investigates the relationship between exposure to hot/cold weather and the characteristic clinical features of headaches in patients with migraine and tension-type headaches.Methods: This cross-sectional study was conducted with the participation of 190 patients with migraine, and 140 patients with tension-type headaches. The patients were evaluated using a form that collected data on their sociodemographic profile, the clinical features of their headaches, any accompanying symptoms and their relationships with changes in the weather (hot/cold). The headaches of all the participants in the study were thought to be triggered by exposure to hot/cold weather.Results: In the patients with migraine, the exposure to hot/cold weather as a trigger was not found to have a significant relationship with age, body mass index or the characteristic clinical features of headaches (p > 0.05). In patients with tension-type headaches, exposure to hot/cold weather as a trigger was found to have a significant relationship with body mass index (p = 0.019), but not with age or the characteristic clinical features of headaches (p > 0.05).Conclusions: In obese patients with tension-type headache, it was found that hot weather triggered headache more than cold weather. In patients with migraine and tension-type headaches, no relationship was found between exposure to hot/cold weather as a trigger and the clinical features of headaches. The accurate identification of the factors precipitating headaches by both clinicians and patients can help lower the frequency of headaches.
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Affiliation(s)
- Nermin Tanik
- Assoc. Prof. MD, Yozgat Bozok University Medical School, Department of Neurology, Turkey
| | - Hikmet Saçmaci
- Assist. Prof. MD, Yozgat Bozok University Medical School, Department of Neurology, Turkey
| | - Tülin Aktürk
- Assist. Prof. MD, Yozgat Bozok University Medical School, Department of Neurology, Turkey
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21
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Seng EK, Singer AB, Metts C, Grinberg AS, Patel ZS, Marzouk M, Rosenberg L, Day M, Minen MT, Lipton RB, Buse DC. Does Mindfulness-Based Cognitive Therapy for Migraine Reduce Migraine-Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial. Headache 2019; 59:1448-1467. [PMID: 31557329 PMCID: PMC6788949 DOI: 10.1111/head.13657] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The current Phase 2b study aimed to evaluate the efficacy of mindfulness-based cognitive therapy for migraine (MBCT-M) to reduce migraine-related disability in people with migraine. BACKGROUND Mindfulness-based interventions represent a promising avenue to investigate effects in people with migraine. MBCT teaches mindfulness meditation and cognitive-behavioral skills and directly applies these skills to address disease-related cognitions. METHODS Participants with migraine (6-30 headache days/month) were recruited from neurology office referrals and local and online advertisements in the broader New York City area. During the 30-day baseline period, all participants completed a daily headache diary. Participants who met inclusion and exclusion criteria were randomized in a parallel design, stratified by chronic migraine status, to receive either 8 weekly individual MBCT-M sessions or 8 weeks of waitlist/treatment as usual (WL/TAU). All participants completed surveys including primary outcome evaluations at Months 0, 1, 2, and 4. All participants completed a headache diary during the 30-day posttreatment evaluation period. Primary outcomes were the change from Month 0 to Month 4 in the headache disability inventory (HDI) and the Migraine Disability Assessment (MIDAS) (total score ≥ 21 indicating severe disability); secondary outcomes (headache days/30 days, average headache attack pain intensity, and attack-level migraine-related disability [Migraine Disability Index (MIDI)]) were derived from the daily headache diary. RESULTS Sixty participants were randomized to receive MBCT-M (n = 31) or WL/TAU (n = 29). Participants (M age = 40.1, SD = 11.7) were predominantly White (n = 49/60; 81.7%) and Non-Hispanic (N = 50/60; 83.3%) women (n = 55/60; 91.7%) with a graduate degree (n = 35/60; 55.0%) who were working full-time (n = 38/60; 63.3%). At baseline, the average HDI score (51.4, SD = 19.0) indicated a moderate level of disability and the majority of participants (50/60, 83.3%) fell in the "Severe Disability" range in the MIDAS. Participants recorded an average of 16.0 (SD = 5.9) headache days/30 days, with an average headache attack pain intensity of 1.7 on a 4-point scale (SD = 0.3), indicating moderate intensity. Average levels of daily disability reported on the MIDI were 3.1/10 (SD = 1.8). For the HDI, mean scores decreased more from Month 0 to Month 4 in the MBCT-M group (-14.3) than the waitlist/treatment as an usual group (-0.2; P < .001). For the MIDAS, the group*month interaction was not significant when accounting for the divided alpha, P = .027; across all participants in both groups, the estimated proportion of participants falling in the "Severe Disability" category fell significantly from 88.3% at Month 0 to 66.7% at Month 4, P < .001. For diary-reported headache days/30 days an average headache attack pain intensity, neither the group*month interaction (Ps = .773 and .888, respectively) nor the time effect (Ps = .059 and .428, respectively) was significant. Mean MIDI scores decreased in the MBCT-M group (-0.6/10), whereas they increased in the waitlist/treatment as an usual group (+0.3/10), P = .007. CONCLUSIONS MBCT-M demonstrated efficacy to reduce headache-related disability and attack-level migraine-related disability. MBCT-M is a promising emerging treatment for addressing migraine-related disability.
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Affiliation(s)
- Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Montefiore Headache Center, Montefiore Medical Center, Bronx, NY, USA
| | - Alexandra B Singer
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Christopher Metts
- Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Amy S Grinberg
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Zarine S Patel
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Maya Marzouk
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Lauren Rosenberg
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Melissa Day
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Mia T Minen
- Department of Neurology, New York University Langone Health, New York, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dawn C Buse
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Geographical Differences in Trigger Factors of Tension-Type Headaches and Migraines. Curr Pain Headache Rep 2019; 23:12. [DOI: 10.1007/s11916-019-0760-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Lee HJ, Lee JH, Cho EY, Kim SM, Yoon S. Efficacy of psychological treatment for headache disorder: a systematic review and meta-analysis. J Headache Pain 2019; 20:17. [PMID: 30764752 PMCID: PMC6734438 DOI: 10.1186/s10194-019-0965-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/22/2019] [Indexed: 01/11/2023] Open
Abstract
Background Headache disorder is not only a common complaint but also a global burden. Pharmacotherapeutic and non-pharmacotherapeutic approaches have been developed for its treatment and prophylaxis. The present study included a systematic review of psychological treatments for primary headache disorder accessible in Korea. Methods We included English and Korean articles from EMBASE, MEDLINE, Cochrane library database, SCOPUS, ScienceDirect, Web of Science, CINAHL, PsycArticles and Korean database, KoreaMed and KMBASE which studied primary headache and medication-overuse headache. The primary efficacy measure was the number of headache days per month, while secondary efficacy measures were the number of headache attacks per week, headache index, treatment response rate, and migraine disability assessment. The meta-analysis was performed using R 3.5.1. to obtain pooled mean difference and pooled relative risk with 95% confidence interval (CI) for continuous data and dichotomous data, respectively. Results From 12,773 identified articles, 27 randomized clinical trials were identified. Primary outcome showed significant superiority of psychological treatments (pooled mean difference = − 0.70, 95% CI [− 1.22, − 0.18]). For the secondary outcomes, the number of headache attacks (pooled mean difference = − 1.15, 95% CI [− 1.63, − 0.67]), the headache index (pooled mean difference = − 0.92, 95% CI [− 1.40 to − 0.44]) and the treatment response rate (pooled relative risk = 3.13, 95% CI [2.24, 4.37]) demonstrated significant improvements in the psychological treatment group over the control group. Conclusion Psychological treatments for primary headache disorder reduced headache frequency and the headache index. Future research using standardized outcome measures and strategies for reducing bias is needed. Electronic supplementary material The online version of this article (10.1186/s10194-019-0965-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hye Jeong Lee
- Department of Psychiatry, Catholic university of Daegu, School of Medicine, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, Republic of Korea
| | - Jin Hyeok Lee
- Department of Psychiatry, Catholic university of Daegu, School of Medicine, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, Republic of Korea
| | - Eun Young Cho
- Department of Biostatistics, Korea University Graduate School, Seoul, South Korea
| | - Sun Mi Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Seoyoung Yoon
- Department of Psychiatry, Catholic university of Daegu, School of Medicine, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, Republic of Korea.
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Tsai SJ, Huang MH, Chan YL, Hsu JW, Bai YM, Huang KL, Su TP, Li CT, Lin WC, Chen TJ, Chen MH. Risk of developing migraine among patients with posttraumatic stress disorder: A nationwide longitudinal study. TAIWANESE JOURNAL OF PSYCHIATRY 2019. [DOI: 10.4103/tpsy.tpsy_40_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Tai MLS, Yap JF, Goh CB. Dietary trigger factors of migraine and tension-type headache in a South East Asian country. J Pain Res 2018; 11:1255-1261. [PMID: 29988763 PMCID: PMC6029602 DOI: 10.2147/jpr.s158151] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The literature on the dietary trigger factors of headache among the South East Asians is limited. OBJECTIVE The objective of the study was to examine the dietary trigger factors of migraine and tension-type headache (TTH) in Malaysian patients, consisting of Malays, Chinese and Indians. METHODS In this prospective cross-sectional study, patients presenting with migraine and TTH to a neurology clinic between April 2010 and June 2017 were recruited. The patients were given a comprehensive dietary list consisting of 25 specified types of food and drink items as well as other unspecified types of food and drink items which were possible dietary triggers. The data on these dietary triggers and missing meals were collected. RESULTS A total of 684 patients with headache (319 migraine and 365 TTH patients) were recruited. One hundred and fifty-eight (23.1%) patients had missing meals as trigger. Two hundred and fifty-five (37.3%) patients had dietary triggers; 141 (44.2%) patients with migraine and 114 (31.2%) patients with TTH had dietary triggers. Eighty-four (52.8%) Malay, 28 (41.8%) Chinese, 25 (32.5%) Indian migraine patients and five (38.5%) migraine patients from other ethnic groups, had dietary triggers. Some 58 (40.0%) Malay, 27 (25.2%) Chinese, 22 (23.9%) Indian patients and 7 (29.2%) patients from other ethnic groups with TTH had dietary triggers. The most common dietary trigger factors were coffee (19.9%), chocolate (7.5%) and food rich in monosodium glutamate (5.6%). Logistic regression showed that chocolate (OR 2.16, 95% CI 1.06-4.41, p = 0.035) and coffee (OR 1.73, 95% CI 1.12-2.68, p = 0.014) were significantly associated with migraine compared to TTH. CONCLUSION Chocolate and coffee significantly triggered migraine compared to TTH. Inter-ethnic differences were observed for dietary trigger factors.
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Affiliation(s)
- Mei-Ling Sharon Tai
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,
| | - Jun Fai Yap
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,
| | - Cheng Beh Goh
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,
- Department of Medicine, Sultan Ismail Hospital, Johor Bahru, Johor, Malaysia
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Andreeva VA, Fezeu LK, Hercberg S, Galan P. Obesity and Migraine: Effect Modification by Gender and Perceived Stress. Neuroepidemiology 2018; 51:25-32. [PMID: 29843127 DOI: 10.1159/000489663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 04/25/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The association between obesity and migraine has been established; however, it is unclear whether it varies by perceived stress within each gender. METHODS This cross-sectional study used data from the ongoing NutriNet-Santé e-cohort with enrollees from the general population. Anthropometric and migraine data were provided via self-report questionnaires (2013-2016). Migraine was defined using established criteria. Perceived stress was assessed with Cohen's Perceived Stress Scale-10. Associations were estimated via gender- and stress-stratified multivariable polytomous logistic regression models. RESULTS Among 32,835 participants with complete data (75% women; mean age = 51.9 ± 13.8 years), 34% reported no headache, 44% non-migraine headache, and 22% migraine with or without aura during one's lifetime. In these groups, obesity was present in 8.6, 9.9, and 11.6%, respectively. Stress was a significant moderator of the obesity-migraine association only among women. The largest significant adjusted odds ratio (aOR) was found between obesity and migraine in women with high stress (aOR 1.61, 95% CI 1.35-1.91). CONCLUSIONS We found support for gender- and stress-dependent associations between obesity and migraine using a large, heterogeneous adult sample. This underscores the need for evidence-based strategies for weight loss and stress reduction for female migraineurs.
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Affiliation(s)
- Valentina A Andreeva
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Léopold K Fezeu
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne, Bobigny, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
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Esposito M, Messina A, Monda V, Bitetti I, Salerno F, Precenzano F, Pisano S, Salvati T, Gritti A, Marotta R, Lavano SM, Lavano F, Maltese A, Parisi L, Salerno M, Tripi G, Gallai B, Roccella M, Bove D, Ruberto M, Toraldo R, Messina G, Carotenuto M. The Rorschach Test Evaluation in Chronic Childhood Migraine: A Preliminary Multicenter Case-Control Study. Front Neurol 2017; 8:680. [PMID: 29312117 PMCID: PMC5733029 DOI: 10.3389/fneur.2017.00680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/29/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECT About 1.2-3.2% of children at 7 years of age with increasing age up to 4-19% in adolescents are suffering from migraine without aura (MwA). The aim of the present study is investigating the personality style associated with children and adolescents affected by MwA, administrating the Rorschach test, and comparing with typical developing healthy controls (TD). METHODS 137 patients (74 males), aged 7.3-17.4 years (mean age 11.4, SD 3.02 years), affected by MwA according to the IHs-3 criteria. The Rorschach variables were treated as numerical variables and statistically tested with t-Student's analysis. RESULTS No statistical differences were found between the MwA and TD for age (p = 0.55), and gender (p = 0.804). From the comparison between the two samples, MwA group shows lower W responses (p < 0.001), good quality W responses (p < 0.001), high frequency of detailed responses (p < 0.001), the presence of even minor form of good quality responses (p < 0.001), increased presence of animals answers (A%) (p < 0.001), more frequent trivial answers (Ban%) (p < 0.001). DISCUSSION Rorschach interpretation pinpointed many interesting and, perhaps, peculiar aspects in our MwA population such as a trend predisposition for: analytical reasoning rather than synthetic, ease/practicality rather than creativity, oppositionality rather than external adaptation to the environment that may be interpreted as effect of general maladaptivity.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Monda
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ilaria Bitetti
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Filomena Salerno
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesco Precenzano
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Simone Pisano
- Department of Child and Adolescent Neuropsychiatry, University of Salerno, Salerno, Italy
| | - Tiziana Salvati
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Antonella Gritti
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Rosa Marotta
- Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, Italy
| | | | - Francesco Lavano
- Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Agata Maltese
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Margherita Salerno
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Tripi
- Department PROSAMI, University of Palermo, Palermo, Italy
- Childhood Psychiatric Service for Neurodevelopmentals Disorders, Chinon, France
| | - Beatrice Gallai
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Domenico Bove
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Maria Ruberto
- Department of Medical-Surgical and Dental Specialties, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Roberto Toraldo
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Carotenuto
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
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Seng EK, Buse DC, Klepper JE, Mayson SJ, Grinberg AS, Grosberg BM, Pavlovic JM, Robbins MS, Vollbracht SE, Lipton RB. Psychological Factors Associated With Chronic Migraine and Severe Migraine-Related Disability: An Observational Study in a Tertiary Headache Center. Headache 2017; 57:593-604. [PMID: 28139000 PMCID: PMC5378650 DOI: 10.1111/head.13021] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 10/19/2016] [Accepted: 11/13/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. BACKGROUND Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. METHODS Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score ≥ 21), and modifiable psychological factors (depressive symptoms [Patient Health Questionnaire-9], anxious symptoms [Generalized Anxiety Disorder-7], Pain Catastrophizing Scale and Headache Specific Locus of Control). Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. RESULTS Among 90 eligible participants the mean age was 45.0 (SD = 12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR = 1.99, 95% CI = 1.11, 3.55) and chance HSLC (OR = 1.85, 95% CI = 1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR = 3.54, 95%CI = 1.49, 8.41), anxiety symptoms (OR = 3.65, 95% CI = 1.65, 8.06), and pain catastrophizing (OR = 1.95, 95% CI = 1.14, 3.35), were associated with severe migraine-related disability. CONCLUSIONS Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate the relationships among naturalistic variation in psychological factors, migraine-related disability, and migraine chronification.
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Affiliation(s)
- Elizabeth K. Seng
- Ferkauf Graduate School of Psychology, Yeshiva University
- Albert Einstein College of Medicine
- Montefiore Medical Center
| | - Dawn C. Buse
- Ferkauf Graduate School of Psychology, Yeshiva University
- Albert Einstein College of Medicine
- Montefiore Medical Center
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Lillis J, Graham Thomas J, Seng EK, Lipton RB, Pavlović JM, Rathier L, Roth J, O'Leary KC, Bond DS. Importance of Pain Acceptance in Relation to Headache Disability and Pain Interference in Women With Migraine and Overweight/Obesity. Headache 2017; 57:709-718. [PMID: 28295273 DOI: 10.1111/head.13058] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Pain acceptance involves willingness to experience pain and engaging in valued activities while pain is present. Though pain acceptance could limit both headache-related disability and pain interference in individuals with migraine, few studies have addressed this issue. This study evaluated whether higher levels of total pain acceptance and its two subcomponents, pain willingness and activity engagement, were associated with lower levels of headache-related impairment in women who had both migraine and overweight/obesity. METHODS In this cross-sectional study, participants seeking weight loss and headache relief in the Women's Health and Migraine trial completed baseline measures of pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]), headache-related disability (Headache Impact Test-6), and pain interference (Brief Pain Inventory). Migraine headache frequency and pain intensity were assessed daily via smartphone diary. Using CPAQ total and subcomponent (pain willingness and activity engagement) scores, headache frequency, pain intensity, and body mass index (BMI) as predictors in linear regression, headache-related disability, and pain interference were modeled as outcomes. RESULTS On average, participants (n = 126; age = 38.5 ± 8.2 years; BMI = 35.3 ± 6.6 kg/m2 ) reported 8.4 ± 4.7 migraine days/month and pain intensity of 6.0 ± 1.5 on a 0-10 scale on headache days. After correcting for multiple comparisons (adjusted α = .008), pain willingness was independently associated with both lower headache-related disability (P < .001; β = -0.233) and pain interference (P < .001; β = -0.261). Activity engagement was not associated with headache-related disability (P = .128; β = -0.138) and pain interference (P = .042; β = -0.154). CPAQ total score was not associated with headache-related disability (P = .439; β = 0.066) and pain interference (P = .305; β = 0.074). Pain intensity was significantly associated with outcomes in all analyses (Ps < .001; βs 0.343-0.615). CONCLUSIONS Higher pain willingness, independent of degree of both migraine severity and overweight, is associated with lower headache-related disability and general pain interference in treatment-seeking women with migraine and overweight/obesity. Future studies are needed to clarify direction of causality and test whether strategies designed to help women increase pain willingness, or relinquish ineffective efforts to control pain, can improve functional outcomes in women who have migraine and overweight/obesity.
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Affiliation(s)
- Jason Lillis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Elizabeth K Seng
- Department of Neurology, Albert Einstein College of Medicine, Ferkauf Graduate School of Psychology, Yeshiva University, New York City, NY, USA
| | - Richard B Lipton
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Jelena M Pavlović
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Lucille Rathier
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Julie Roth
- Department of Neurology, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA
| | - Kevin C O'Leary
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Dale S Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
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Seng EK, Klepper JE. Development of the Cogniphobia Scale for Headache Disorders (CS-HD): A pilot study. Psychol Assess 2017; 29:1296-1301. [PMID: 28125248 DOI: 10.1037/pas0000432] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cogniphobia refers to the specific fear and avoidance of cognitive exertion, which is believed to precipitate or exacerbate headache. This parallels a well-documented phenomenon, kinesiophobia (fear of movement), in chronic pain. The existing measure of cogniphobia (C-Scale) was developed in persons with posttraumatic headache, and item content may not generalize to the broader headache population. This study aimed to develop and begin the initial examination of the psychometrics of a novel measure of cogniphobia for headache disorders: The Cogniphobia Scale for Headache Disorders (CS-HD). Candidate CS-HD items were developed through content analysis, patient evaluation, and peer debriefing. Eighty adults with migraine recruited from a headache center completed 23 candidate items for the CS-HD and surveys of demographics, anxiety, and headache locus of control. A series of dimensionality analyses identified a single component, composed of 15 items, which accounted for 54.05% of the variance in the CS-HD items. The CS-HD demonstrated high internal consistency in this sample (α = 0.94). Preliminary convergent validity analyses found CS-HD total scores were positively associated with anxiety (ρ = .37, p = .001) and locus of control (internal, r = .45, p < .001; chance, r = .30, p = .009). This study provides initial evidence supporting the use of the CS-HD to evaluate cogniphobia in people with headache. (PsycINFO Database Record
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Shao E, Hughes J, Eley R. The presenting and prescribing patterns of migraine in an Australian emergency department: A descriptive exploratory study. World J Emerg Med 2017; 8:170-176. [PMID: 28680512 PMCID: PMC5496823 DOI: 10.5847/wjem.j.1920-8642.2017.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 03/26/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Migraine is a common neurological condition that frequently presents to the emergency department (ED). Many medications are available to treat migraine. This study aims to characterize the demographics of patients who present to a large metropolitan ED with migraine, and to identify the medications used in treating this condition. METHODS This study is a retrospective database interrogation of clinical records, used to collect quantitative data on patient demographics and medication prescriptions in the ED. RESULTS A total of 2 228 patients were identified as being treated for migraine over a 10-year period. The proportion of the ED population presenting with migraine steadily increased in this time. Females (71%) more commonly presented to the ED with migraine than males. The migraine population was significantly younger (M=37.05, SD=13.23) than the whole ED population (M=46.17 SD=20.50) (P<0.001). A variety of medications were used in the treatment of migraine in the ED. Simple analgesics such as paracetamol and ibuprofen, anti-emetics and intravenous (IV) fluids with phenothiazine additives were commonly used. Over 20% of patients were prescribed oral or parenteral opiates (42 of 194 initial medication prescriptions, and 64 of 292 as required medication prescriptions). Triptans were very rarely used. CONCLUSION Migraine is an increasingly common presentation to the ED. People presenting to the ED with migraine are more likely to be younger and female than the general ED population. Peak presentations for migraines occurred in January and February. The medications that are prescribed in the ED for migraine is varied and are not always in line with current evidence for the treatment of migraine. The excessive reliance on opiates and lack of the use of triptans denotes a significant variation from published guidelines.
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Affiliation(s)
- Emily Shao
- Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - James Hughes
- Emergency Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Rob Eley
- Emergency Department, Princess Alexandra Hospital, Brisbane, Australia
- Emergency Medicine Research Program, The University of Queensland Faculty of Medicine, Brisbane, Australia
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Woldeamanuel YW, Cowan RP. Migraine affects 1 in 10 people worldwide featuring recent rise: A systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci 2017; 372:307-315. [PMID: 28017235 DOI: 10.1016/j.jns.2016.11.071] [Citation(s) in RCA: 234] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/19/2016] [Accepted: 11/29/2016] [Indexed: 12/30/2022]
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Vladetić M, Jančuljak D, Butković Soldo S, Kralik K, Buljan K. Health-related quality of life and ways of coping with stress in patients with migraine. Neurol Sci 2016; 38:295-301. [PMID: 27838832 DOI: 10.1007/s10072-016-2759-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/27/2016] [Indexed: 01/03/2023]
Abstract
The aim of our study was to examine the relationship between the mode of coping and health-related quality of life (HRQoL) in patients with migraine. We have also tried to examine the relationship of disease duration and the frequency of attacks with HRQoL and the ways of coping with stress. The research was done on a sample consisting of 106 participants (95 women and 11 men); mean age of 40 years (IQR 28-48) with the migraine lasting for 10 years (IRQ 5-20 years). The average number of attacks, over the last month, was two attacks (IRQ 1-3 attacks). Ways of coping questionnaire were used to estimate the mode of coping with stress and SF-36 questionnaire for HRQoL. The result showed the self-control as the most common way of coping with stress in patients with migraine. They also confirmed the existence of a significant connection of ways of coping with stress and HRQoL in people with migraine. There is a larger number of significant correlations of ways of coping connected with the domains of mental health than with the physical health. Escape/avoidance is significantly negatively correlated with the largest number of HRQoL domains, especially with existence of significant mental health (ρ = -0.447) and role limitation due to the emotional problems (ρ = -0.361). The number of migraine attacks has greater influence on HRQoL in patients with migraine than the disease duration. Our study showed the existence of significant correlations between the ways of coping with stress and HRQoL, especially with mental domains. In some domains, the correlation was even stronger than the one showing the disease duration and the number of attacks. The above-mentioned results suggest the directions in further formulation of psychological interventions that would be helpful for the additional treatment of migraine.
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Affiliation(s)
- Mirjana Vladetić
- Department of Neurology, Faculty of Medicine Osijek, Osijek University Hospital, Huttlerova 4, 31000, Osijek, Croatia.
| | - Davor Jančuljak
- Department of Neurology, Faculty of Medicine Osijek, Osijek University Hospital, Huttlerova 4, 31000, Osijek, Croatia
| | - Silva Butković Soldo
- Department of Neurology, Faculty of Medicine Osijek, Osijek University Hospital, Huttlerova 4, 31000, Osijek, Croatia
| | - Kristina Kralik
- Department of Neurology, Faculty of Medicine Osijek, Osijek University Hospital, Huttlerova 4, 31000, Osijek, Croatia
| | - Krunoslav Buljan
- Department of Neurology, Faculty of Medicine Osijek, Osijek University Hospital, Huttlerova 4, 31000, Osijek, Croatia
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Cervoni C, Bond DS, Seng EK. Behavioral Weight Loss Treatments for Individuals with Migraine and Obesity. Curr Pain Headache Rep 2016; 20:13. [PMID: 26862055 DOI: 10.1007/s11916-016-0540-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Migraine and obesity are each prevalent disorders involving significant personal and societal burden. Epidemiologic research demonstrates a link between migraine and obesity that is further substantiated by putative behavioral, psychosocial, and physiological mechanisms. As obesity is considered a modifiable risk factor for exacerbation of migraine, weight loss may be a particularly useful treatment option for people with comorbid migraine and obesity. Behavioral weight loss interventions complement existing behavioral treatments for migraine and offer patients evidence-based effective strategies for achieving weight loss that could help reduce frequency, severity, and impact of migraine attacks.
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Affiliation(s)
- Cynthia Cervoni
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, New York, 10461, NY, USA.
| | - Dale S Bond
- The Miriam Hospital and Warren Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI, 02903, USA.
| | - Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, New York, 10461, NY, USA. .,Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.
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Fife B, Forste R. Physical and social factors associated with early adolescent headache and stomachache pain. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0062/ijamh-2016-0062.xml. [PMID: 27665418 DOI: 10.1515/ijamh-2016-0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/14/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Approximately one third of adolescents in the United States report experiencing frequent headaches and stomachaches. We examined the association of psychosocial and physical factors with the report of weekly headaches or stomachaches using a representative sample of US teens. METHODS Data for this project are from the survey of Health Behavior in School-Aged Children (HBSC), 2005-2006, a nationally representative sample of students in grades 6-10 in the United States. The total sample includes 12,070 students aged 11-17. Using logistic regression we modeled chronic headache and stomachache separately with the same set of physical predictors (dieting and substance use habits) and psychosocial predictors (attitudes towards self-image, peers, and family) along with demographic controls. RESULTS Almost 20% of respondents experienced headaches weekly, and 12% experienced abdominal pain. Both physical and psychosocial factors were predictive of chronic symptoms. Increased substance usage and unhealthy eating practices were associated with the likelihood of experiencing both headaches and stomachaches. Negative self-image, family relationships, and school life were also predictive of symptom frequency. CONCLUSION Headaches and stomachaches are associated with poor eating and substance use habits, as well as problems with self-image or social relationships among adolescents. For health care professionals, a holistic approach is needed to effectively address symptoms and prevent long-term health problems.
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Affiliation(s)
- Benjamin Fife
- Department of Sociology, Brigham Young University, Provo, UT,United States of America
| | - Renata Forste
- Department of Sociology, Brigham Young University, Provo, UT,United States of America
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Abstract
Assessment provides the foundation for diagnosis, selection of treatments, and evaluation of treatment effectiveness for pediatric patients with acute, recurrent, and chronic pain. Extensive research has resulted in the availability of a number of valid, reliable, and recommended tools for assessing children's pain. Yet, evidence suggests children's pain is still not optimally measured or treated. In this article, we provide an overview of pain evaluation for premature neonates to adolescents. The difference between pain assessment and measurement is highlighted; and the key steps to follow are identified. Information about self-report and behavioral pain assessment tools appropriate for children are provided; and factors to be considered when choosing a specific one are outlined. Finally, we preview future approaches to personalized pain medicine in pediatrics that include harnessing the use of potential digital health technologies and genomics.
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Peris F, Donoghue S, Torres F, Mian A, Wöber C. Towards improved migraine management: Determining potential trigger factors in individual patients. Cephalalgia 2016; 37:452-463. [DOI: 10.1177/0333102416649761] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Certain chronic diseases such as migraine result in episodic, debilitating attacks for which neither cause nor timing is well understood. Historically, possible triggers were identified through analysis of aggregated data from populations of patients. However, triggers common in populations may not be wholly responsible for an individual’s attacks. To explore this hypothesis we developed a method to identify individual ‘potential trigger’ profiles and analysed the degree of inter-individual variation. Methods We applied N = 1 statistical analysis to a 326-migraine-patient database from a study in which patients used paper-based diaries for 90 days to track 33 factors (potential triggers or premonitory symptoms) associated with their migraine attacks. For each patient, univariate associations between factors and migraine events were analysed using Cox proportional hazards models. Results We generated individual factor-attack association profiles for 87% of the patients. The average number of factors associated with attacks was four per patient: Factor profiles were highly individual and were unique in 85% of patients with at least one identified association. Conclusion Accurate identification of individual factor-attack profiles is a prerequisite for testing which are true triggers and for development of trigger avoidance or desensitisation strategies. Our methodology represents a necessary development toward this goal.
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Affiliation(s)
| | | | - Ferran Torres
- Biostatistics and Data Management Core Facility, IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer), Hospital Clinic Barcelona, Barcelona, Spain
- Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Christian Wöber
- Headache Group, Department of Neurology, Medical University of Vienna, Vienna, Austria
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Abstract
Alcoholic drinks (ADs) have been reported as a migraine trigger in about one-third of the migraine patients in retrospective studies. Some studies found that ADs trigger also other primary headaches. The studies concerning the role of ADs in triggering various types of primary headaches published after the International Headache Society classification criteria of 1988 were reviewed, and the pathophysiological mechanisms were discussed. Many studies show that ADs are a trigger of migraine without aura (MO), migraine with aura (MA), cluster headache (CH), and tension-type headache (TH). While data on MO and CH are well delineated, those in MA and TH are discordant. There are sparse reports that ADs are also triggers of less frequent types of primary headache such as familial hemiplegic migraine, hemicrania continua, and paroxysmal hemicrania. However, in some countries, the occurrence of alcohol as headache trigger is negligible, perhaps determined by alcohol habits. The frequency estimates vary widely based on the study approach and population. In fact, prospective studies report a limited importance of ADs as migraine trigger. If ADs are capable of triggering practically all primary headaches, they should act at a common pathogenetic level. The mechanisms of alcohol-provoking headache were discussed in relationship to the principal pathogenetic theories of primary headaches. The conclusion was that vasodilatation is hardly compatible with ADs trigger activity of all primary headaches and a common pathogenetic mechanism at cortical, or more likely at subcortical/brainstem, level is more plausible.
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Affiliation(s)
- Alessandro Panconesi
- Department of Neurology, Headache Center, San Giuseppe Hospital, Empoli, FI, Italy
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Turner DP, Smitherman TA, Black AK, Penzien DB, Porter JAH, Lofland KR, Houle TT. Are migraine and tension-type headache diagnostic types or points on a severity continuum? An exploration of the latent taxometric structure of headache. Pain 2016; 156:1200-1207. [PMID: 25775357 DOI: 10.1097/j.pain.0000000000000157] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The objective of this study was to assess whether migraine and tension-type headache (TTH) are best viewed as discrete entities or points on a severity continuum using taxometric analysis. Historically, classification systems have conceptualized the primary headache disorders of migraine and TTH as fundamentally different disorders that are differentiated by their characteristic symptom profiles and, as such, imply differing pathophysiologies and required treatments. Despite this categorical nosology, findings continue to emerge suggesting that migraine and TTH instead reflect dimensions of severity within the same headache construct. However, few studies have assessed this issue using taxometric statistical analyses or investigated how this taxonomic structure varies as a function of age and headache frequency. We conducted a latent-mode factor analysis of headache symptomatology obtained from 3449 individuals with headache from 2 previous, large-scale cross-sectional studies of primary headache sufferers (Martin et al., 2005, and Smitherman and Kolivas, 2013). Stratified taxometric analyses suggest that the validity of a categorical vs dimensional classification varies as a function of sample characteristics. Specifically, graphical results revealed that high headache frequency (>15 d/mo) and younger age (<24 years old) were associated with unimodal distributions suggestive of a dimensional construct of primary headache, whereas lower headache frequency and older age were associated with bimodal distributions characteristic of discrete diagnostic entities. Conceptualizing primary headache as a severity continuum was supported for young adults and those with frequent headaches. The distinctions of a categorical classification system were supported for adults (>24 years old) and those with infrequent headache.
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Affiliation(s)
- Dana P Turner
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA Department of Psychology, University of Mississippi, Oxford, MS, USA Advance Neurology and Pain, Advance, NC, USA Northshore Integrative Healthcare, Chicago, IL, USA Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Altintaş E, Karakurum Göksel B, Taşkintuna N, Saritürk Ç. Correlation Between Life Events and Quality of Life in Patients with Medication-Overuse Headache. Noro Psikiyatr Ars 2015; 52:233-239. [PMID: 28360716 DOI: 10.5152/npa.2015.8799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/14/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The present study aimed to determine (a) the correlation between type and number of stressful life events and quality of life in patients with medication-overuse headache (MOH) and (b) whether stressful life events could be attributed to medication overuse and the conversion of headache to a chronic type. METHODS The present study included 114 patients aged between 15 and 65 years who met the criteria for headache classification of International Headache Society (IHS). The patients were divided into three groups according to the revised 2004 IHS classification; MOH (n=64), chronic migraine (n=25) and episodic migraine (n=25). Detailed data on clinical and sociodemographic characteristics were recorded. Neurological and physical examinations were performed for differential diagnosis. The patients underwent structured clinical interviews for DSM-IV Inventory (SCID-I), Beck Anxiety Inventory, Beck Depression Inventory, Short Form-36 (SF-36) and Life Events List. Scores of these inventories were statistically compared. RESULTS Comparing MOH group with episodic migraine group via SF-36, statistically significant decreases were observed in the subscales of physical role limitation (p=.024), pain (p=.0001), general health (p=.043) and social functioning (p=.004). There was a statistically significant correlation between the number of life events and the time the disease became chronic in the patient group with non-MOH chronic migraine (p=.027). Moreover, a statistically significant correlation was observed between stressful family life events and the body pain subscale of quality of life scale (p=.038). CONCLUSION The present study demonstrates that stressful life events impair quality of life in patients with MOH. It was also found that number of stressful life events could be attributed to the conversion of headache to a chronic type.
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Affiliation(s)
- Ebru Altintaş
- Department of Psychiatry, Başkent University Faculty of Medicine, Adana, Turkey
| | | | - Nilgün Taşkintuna
- Department of Psychiatry, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Çağla Saritürk
- Department of Biostatistics, Başkent University Faculty of Medicine, Adana, Turkey
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Zebenholzer K, Frantal S, Pablik E, Lieba-Samal D, Salhofer-Polanyi S, Wöber-Bingöl Ç, Wöber C. Reliability of assessing lifestyle and trigger factors in patients with migraine - findings from the PAMINA study. Eur J Neurol 2015; 23:120-6. [DOI: 10.1111/ene.12817] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/23/2015] [Indexed: 01/11/2023]
Affiliation(s)
- K. Zebenholzer
- Department of Neurology; Medical University of Vienna; Vienna Austria
| | - S. Frantal
- CeMSIIS Section for Medical Statistics; Medical University of Vienna; Vienna Austria
| | - E. Pablik
- CeMSIIS Section for Medical Statistics; Medical University of Vienna; Vienna Austria
| | - D. Lieba-Samal
- Department of Neurology; Medical University of Vienna; Vienna Austria
| | | | - Ç. Wöber-Bingöl
- Department of Child and Adolescent Psychiatry; Medical University of Vienna; Vienna Austria
| | - C. Wöber
- Department of Neurology; Medical University of Vienna; Vienna Austria
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Semwal DK, Mishra SP, Chauhan A, Semwal RB. Adverse Health Effects of Tobacco and Role of Ayurveda in their Reduction. JOURNAL OF MEDICAL SCIENCES 2015. [DOI: 10.3923/jms.2015.139.146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Odawara M, Hashizume M, Yoshiuchi K, Tsuboi K. Real-Time Assessment of the Effect of Biofeedback Therapy with Migraine: A Pilot Study. Int J Behav Med 2015; 22:748-54. [DOI: 10.1007/s12529-015-9469-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Affiliation(s)
- Dawn C Buse
- Albert Einstein College of Medicine, Bronx, NY, USA
- Montefiore Headache Center, Bronx, NY, USA
| | - Richard B Lipton
- Albert Einstein College of Medicine, Bronx, NY, USA
- Montefiore Headache Center, Bronx, NY, USA
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Hoffmann J, Schirra T, Lo H, Neeb L, Reuter U, Martus P. The influence of weather on migraine - are migraine attacks predictable? Ann Clin Transl Neurol 2014; 2:22-8. [PMID: 25642431 PMCID: PMC4301671 DOI: 10.1002/acn3.139] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 10/06/2014] [Accepted: 10/07/2014] [Indexed: 01/03/2023] Open
Abstract
Objective The study aimed at elucidating a potential correlation between specific meteorological variables and the prevalence and intensity of migraine attacks as well as exploring a potential individual predictability of a migraine attack based on meteorological variables and their changes. Methods Attack prevalence and intensity of 100 migraineurs were correlated with atmospheric pressure, relative air humidity, and ambient temperature in 4-h intervals over 12 consecutive months. For each correlation, meteorological parameters at the time of the migraine attack as well as their variation within the preceding 24 h were analyzed. For migraineurs showing a positive correlation, logistic regression analysis was used to assess the predictability of a migraine attack based on meteorological information. Results In a subgroup of migraineurs, a significant weather sensitivity could be observed. In contrast, pooled analysis of all patients did not reveal a significant association. An individual prediction of a migraine attack based on meteorological data was not possible, mainly as a result of the small prevalence of attacks. Interpretation The results suggest that only a subgroup of migraineurs is sensitive to specific weather conditions. Our findings may provide an explanation as to why previous studies, which commonly rely on a pooled analysis, show inconclusive results. The lack of individual attack predictability indicates that the use of preventive measures based on meteorological conditions is not feasible.
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Affiliation(s)
- Jan Hoffmann
- Department of Neurology, Charité - Universitätsmedizin Berlin Charitéplatz 1, 10117, Berlin, Germany
| | - Tonio Schirra
- Department of Neurology, Charité - Universitätsmedizin Berlin Charitéplatz 1, 10117, Berlin, Germany
| | - Hendra Lo
- Department of Neurology, Charité - Universitätsmedizin Berlin Charitéplatz 1, 10117, Berlin, Germany
| | - Lars Neeb
- Department of Neurology, Charité - Universitätsmedizin Berlin Charitéplatz 1, 10117, Berlin, Germany
| | - Uwe Reuter
- Department of Neurology, Charité - Universitätsmedizin Berlin Charitéplatz 1, 10117, Berlin, Germany
| | - Peter Martus
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin Charitéplatz 1, 10117, Berlin, Germany ; Institute for Clinical Epidemiology and Applied Biometry Silcherstraße 5, 72076, Tübingen, Germany
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Watemberg N, Matar M, Har-Gil M, Mahajnah M. The influence of excessive chewing gum use on headache frequency and severity among adolescents. Pediatr Neurol 2014; 50:69-72. [PMID: 24188910 DOI: 10.1016/j.pediatrneurol.2013.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 08/13/2013] [Accepted: 08/15/2013] [Indexed: 01/07/2023]
Abstract
BACKGROUND Excessive gum-chewing is underreported as a headache precipitant in children and adolescents. We evaluated the influence of daily excessive gum-chewing in older children and teenagers with chronic headache, emphasizing the impact of habit discontinuation and its reintroduction. METHODS Patients with chronic headache and excessive gum-chewing were consecutively recruited and asked to fill questionnaire pertaining headache characteristics, potential triggers, family history of headaches, and gum-chewing habits. These individuals were classified into four groups depending on the number of daily hours of gum-chewing. All children discontinued chewing for 1 month, reintroduced the habit, and were reinterviewed after 2 to 4 weeks. RESULTS Thirty patients (25 girls) were recruited. Median age was 16 years. Most had migraine-like headaches. Following gum-chewing discontinuation, 26 reported significant improvement, including headache resolution in 19. All 20 patients reinstituting the habit reported symptom relapse within days. Duration of headache before discontinuation and the number of daily hours of chewing had no influence on the response to habit discontinuation. CONCLUSION Excessive daily gum-chewing may be associated with chronic headache and should get more attention in the medical literature. Physician and patient awareness of this association could have a meaningful impact on the quality of life of children and adolescents with chronic headache who chew gum excessively.
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Affiliation(s)
- Nathan Watemberg
- Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University, Kfar Saba, Israel.
| | - Manar Matar
- Pediatrics Department, Meir Medical Center, Tel Aviv University, Kfar Saba, Israel
| | - Miki Har-Gil
- Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University, Kfar Saba, Israel
| | - Muhammad Mahajnah
- Child Neurology Unit and Child Development Center, Hilel Yaffe Medical Center, Technion University, Hadera, Israel
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Abstract
The influence of environmental factors on the clinical manifestation of migraine has been a matter of extensive debate over the past decades. Migraineurs commonly report foods, alcohol, meteorologic or atmospheric changes, exposure to light, sounds, or odors, as factors that trigger or aggravate their migraine attacks. In the same way, physicians frequently follow this belief in their recommendations in how migraineurs may reduce their attack frequency, especially with regard to the consumption of certain food components. Interestingly, despite being such a common belief, most of the clinical studies have shown conflicting results. The aim of the review is to critically analyze clinical and pathophysiological facts that support or refute a correlation between certain environmental stimuli and the occurrence of migraine attacks. Given the substantial discrepancy between patients' reports and objective clinical data, the methodological difficulties of investigating the link between environmental factors and migraine are highlighted.
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Affiliation(s)
- Jan Hoffmann
- Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ana Recober
- Department of Neurology, University of Iowa, Iowa City, IA 52242, USA
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Dzoljic E, Vlajinac H, Sipetic S, Marinkovic J, Grbatinic I, Kostic V. A survey of female students with migraine: what is the influence of family history and lifestyle? Int J Neurosci 2013; 124:82-7. [DOI: 10.3109/00207454.2013.823961] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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