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Ström A, Stenlund H, Ohlsson B. The Metabolomic Profile of Microscopic Colitis Is Affected by Smoking but Not Histopathological Diagnosis, Clinical Course, Symptoms, or Treatment. Metabolites 2024; 14:303. [PMID: 38921438 PMCID: PMC11205623 DOI: 10.3390/metabo14060303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Microscopic colitis (MC) is classified as collagenous colitis (CC) and lymphocytic colitis (LC). Genetic associations between CC and human leucocyte antigens (HLAs) have been found, with smoking being a predisposing external factor. Smoking has a great impact on metabolomics. The aim of this explorative study was to analyze global metabolomics in MC and to examine whether the metabolomic profile differed regarding the type and course of MC, the presence of IBS-like symptoms, treatment, and smoking habits. Of the 240 identified women with MC aged ≤73 years, 131 completed the study questionnaire; the Rome III questionnaire; and the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS). Blood samples were analyzed by ultra-high-performance liquid chromatograph mass spectrometry (UHLC-MS/UHPLC-MSMS). The women, 63.1 (58.7-67.2) years old, were categorized based on CC (n = 76) and LC (n = 55); one episode or refractory MC; IBS-like symptoms or not; use of corticosteroids or not; and smoking habits. The only metabolomic differences found in the univariate model after adjustment for false discovery rate (FDR) were between smokers and non-smokers. Serotonin was markedly increased in smokers (p < 0.001). No clear patterns appeared when conducting a principal component analysis (PCA). No differences in the metabolomic profile were found depending on the type or clinical course of the disease, neither in the whole MC group nor in the subgroup analysis of CC.
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Affiliation(s)
- Axel Ström
- Clinical Studies Sweden—Forum South, Skåne University Hospital, 22185 Lund, Sweden;
| | - Hans Stenlund
- Umeå Plant Science Centre (UPSC), Department of Plant Physiology, Umeå University, 90187 Umeå, Sweden;
| | - Bodil Ohlsson
- Department of Clinical Scineces, Lund University, 22100 Lund, Sweden
- Department of Internal Medicine, Skane University Hospital, 20502 Malmö, Sweden
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Suciu M, Vlaia L, Boujneh E, Suciu L, Buda VO, Jianu N, Vlaia V, Cristescu C. Prevalence and Determinants of Self-Medication Practices among Cardiovascular Patients from Béja, North West Tunisia: A Community-Pharmacy-Based Survey. PHARMACY 2024; 12:68. [PMID: 38668094 PMCID: PMC11054241 DOI: 10.3390/pharmacy12020068] [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: 02/20/2024] [Revised: 03/30/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
In Tunisia, self-medication is a common practice, and there is a continual rise in the prevalence of cardiovascular disease. Given the lack of data on the self-medication practices (SMPs) among cardiovascular patients in this area, the present study aimed to identify the prevalence and determinants of SMPs among cardiovascular patients in the city of Béja. A community-pharmacy-based survey was conducted among selected cardiovascular patients in Béja, Tunisia, from May 2021 to June 2021. Data were collected using a self-administered questionnaire provided by pharmacists during in-person surveys with patients. Descriptive statistics were used to summarize the data, while Fisher's exact test was used for categorical variables, with the significance level set at p < 0.05. The frequency of self-medication among the 150 respondents was 96%; 70.14% of participants reported that the primary reason why people engage in self-medication is the existence of an old prescription. The most prevalent conditions leading patients to self-medicate were headaches (100%), fever (83.33%), toothache (65.97%), and dry cough (47.92%). The most frequently self-administered drugs were paracetamol (100%), antibiotics (56.94%), and antitussives (47.92%). The results of our study indicate that SMPs among Tunisian cardiovascular patients have a high prevalence. With this in mind, healthcare practitioners should ask their patients about their self-medication practices and advise cardiovascular patients about the risks and benefits associated with this practice.
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Affiliation(s)
- Maria Suciu
- Department II—Pharmacology-Pharmacotherapy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (M.S.); (L.S.); (C.C.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Lavinia Vlaia
- Department II—Pharmaceutical Technology, Formulation and Technology of Drugs Research Center, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Eya Boujneh
- Tunisian Pharmacist, Abdellatif Boujnah Pharmacy, Avenue Mongi Slim, Béja 9000, Tunisia;
| | - Liana Suciu
- Department II—Pharmacology-Pharmacotherapy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (M.S.); (L.S.); (C.C.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Valentina Oana Buda
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
- Department I—Clinical Pharmacy, Communication in Pharmacy, Pharmaceutical Care, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
| | - Narcisa Jianu
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
- Department I—Clinical Pharmacy, Communication in Pharmacy, Pharmaceutical Care, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
| | - Vicențiu Vlaia
- Organic Chemistry, Formulation and Technology of Drugs Research Center, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Carmen Cristescu
- Department II—Pharmacology-Pharmacotherapy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (M.S.); (L.S.); (C.C.)
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Leonardi M, Martelletti P, Burstein R, Fornari A, Grazzi L, Guekht A, Lipton RB, Mitsikostas DD, Olesen J, Owolabi MO, Ruiz De la Torre E, Sacco S, Steiner TJ, Surya N, Takeshima T, Tassorelli C, Wang SJ, Wijeratne T, Yu S, Raggi A. The World Health Organization Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders and the headache revolution: from headache burden to a global action plan for headache disorders. J Headache Pain 2024; 25:4. [PMID: 38178049 PMCID: PMC10768290 DOI: 10.1186/s10194-023-01700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
The World Health Organization (WHO) Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders was developed by WHO to address the worldwide challenges and gaps in provision of care and services for people with epilepsy and other neurological disorders and to ensure a comprehensive, coordinated response across sectors to the burden of neurologic diseases and to promote brain health across life-course. Headache disorders constitute the second most burdensome of all neurological diseases after stroke, but the first if young and midlife adults are taken into account. Despite the availability of a range of treatments, disability associated with headache disorders, and with migraine, remains very high. In addition, there are inequalities between high-income and low and middle income countries in access to medical care. In line with several brain health initiatives following the WHOiGAP resolution, herein we tailor the main pillars of the action plan to headache disorders: (1) raising policy prioritization and strengthen governance; (2) providing effective, timely and responsive diagnosis, treatment and care; (3) implementing strategies for promotion and prevention; (4) fostering research and innovation and strengthen information systems. Specific targets for future policy actions are proposed. The Global Action Plan triggered a revolution in neurology, not only by increasing public awareness of brain disorders and brain health but also by boosting the number of neurologists in training, raising research funding and making neurology a public health priority for policy makers. Reducing the burden of headache disorders will not only improve the quality of life and wellbeing of people with headache but also reduce the burden of neurological disorders increasing global brain health and, thus, global population health.
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Affiliation(s)
- Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | | | - Rami Burstein
- John Hedley-Whyte Professor of Anesthesia and Neuroscience at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Arianna Fornari
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Richard B Lipton
- Montefiore Headache Center and the Albert Einstein College of Medicine, New York, Bronx, USA
| | - Dimos Dimitrios Mitsikostas
- 1st Neurology Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mayowa Ojo Owolabi
- Faculty of Clinical Sciences, Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway
- Department of Neurology, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
- Division of Brain Sciences, Imperial College London, London, UK
| | | | - Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Osaka, Japan
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Shuu-Jiun Wang
- College of Medicine and Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tissa Wijeratne
- Department of Neurology, Sunshine Hospital, St Albans, VIC, Australia
- Australian Institute of Migraine, Pascoe Vale South, Victoria, Australia
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
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Carrión-Nessi FS, Ascanio LC, Pineda-Arapé AG, Omaña-Ávila ÓD, Mendoza-Millán DL, Romero SR, Almao-Rivero AB, Camejo-Ávila NA, Gebran-Chedid KJ, Rodriguez-Saavedra CM, Freitas-De Nobrega DC, Castañeda SA, Forero-Peña JL, Delgado-Noguera LA, Meneses-Ramírez LK, Cotuá JC, Rodriguez-Morales AJ, Forero-Peña DA, Paniz-Mondolfi AE. New daily persistent headache after SARS-CoV-2 infection in Latin America: a cross-sectional study. BMC Infect Dis 2023; 23:877. [PMID: 38097988 PMCID: PMC10722794 DOI: 10.1186/s12879-023-08898-2] [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: 09/16/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. METHODS We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants' responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student's t and Mann-Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson's chi-square and Fisher's exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. RESULTS Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p < 0.05). A higher proportion of anxiety symptoms, sleep problems, myalgia, mental fog, paresthesia, nausea, sweating of the face or forehead, and ageusia or hypogeusia as concomitant symptoms were reported in participants with NDPH (p < 0.05). Palpebral edema as a concomitant symptom during the acute phase of COVID-19, occipital location, and burning character of the headache were risk factors associated with NDPH. CONCLUSION This is the first study in Latin America that explored the clinical spectrum of NDPH after SARS-CoV-2 infection and its associated factors. Clinical evaluation of COVID-19 patients presenting with persistent headache should take into consideration NDPH.
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Affiliation(s)
- Fhabián S Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Luis C Ascanio
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Andreína G Pineda-Arapé
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Óscar D Omaña-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Daniela L Mendoza-Millán
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Sinibaldo R Romero
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Medical Scientist Training Program (MD/PhD), University of Minnesota Medical School, Minneapolis, MN, USA
| | - Abranny B Almao-Rivero
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Natasha A Camejo-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | | | | | - Diana C Freitas-De Nobrega
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Sergio A Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología, Facultad de Ciencias Naturales, Universidad del Rosario (CIMBIUR), Universidad del Rosario, Bogotá, Colombia
| | - José L Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Lourdes A Delgado-Noguera
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Lucianny K Meneses-Ramírez
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Juan C Cotuá
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Alfonso J Rodriguez-Morales
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - David A Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela.
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela.
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela.
| | - Alberto E Paniz-Mondolfi
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela.
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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Zhang Y, Huang W, Pan S, Shan Z, Zhou Y, Gan Q, Xiao Z. New management strategies for primary headache disorders: Insights from P4 medicine. Heliyon 2023; 9:e22285. [PMID: 38053857 PMCID: PMC10694333 DOI: 10.1016/j.heliyon.2023.e22285] [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: 06/05/2023] [Revised: 09/21/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
Primary headache disorder is the main cause of headache attacks, leading to significant disability and impaired quality of life. This disorder is increasingly recognized as a heterogeneous condition with a complex network of genetic, environmental, and lifestyle factors. However, the timely diagnosis and effective treatment of these headaches remain challenging. Precision medicine is a potential strategy based on P4 (predictive, preventive, personalized, and participatory) medicine that may bring new insights for headache care. Recent machine learning advances and widely available molecular biology and imaging data have increased the usefulness of this medical strategy. Precision medicine emphasizes classifying headaches according to their risk factors, clinical presentation, and therapy responsiveness to provide individualized headache management. Furthermore, early preventive strategies, mainly utilizing predictive tools, are critical in reducing headache attacks and improving the quality of life of individuals with headaches. The current review comprehensively discusses the potential application value of P4 medicine in headache management.
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Affiliation(s)
| | | | - Songqing Pan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zhengming Shan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Yanjie Zhou
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Quan Gan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zheman Xiao
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
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Headache in Workers: A Matched Case-Control Study. Eur J Investig Health Psychol Educ 2022; 12:1852-1866. [PMID: 36547031 PMCID: PMC9777382 DOI: 10.3390/ejihpe12120130] [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: 08/28/2022] [Revised: 11/16/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
A case−control study including 446 workers reporting headaches (cases; 136 males and 310 females, mean age 46.71 ± 10.84 years) and 446 age- and sex-matched colleagues without headaches (controls; mean age 45.44 ± 10.13) was conducted in the second half of 2020 in a sample drawn from socio health and commercial services companies to investigate the association of headache with lifestyle, metabolic, and work-related factors. Workers suffering from headache reported higher body weight (OR: 1.92, 95% CI: 1.46−2.53, p < 0.001), higher blood cholesterol (OR: 2.01, 95% CI: 1.46−2.77, p < 0.001), triglyceride (OR: 2.01, 95% CI: 1.20−3.35, p < 0.01), blood glucose (OR: 1.91, 95% CI: 1.16−3.24, p < 0.01), and blood pressure levels (OR: 1.76, 95% CI: 1.23−2.52, p < 0.01). In the year preceding the survey, cases had experienced a higher frequency of workplace violence (OR: 2.29, 95% CI: 1.25−4.20, p < 0.01 for physical aggression, OR: 2.22, 95% CI: 1.45−3.41, p < 0.001 for threat, OR: 2.74, 95% CI: 1.72−4.38, p < 0.001 for harassment) and were more frequently distressed (effort/reward ratio > 1) (OR: 1.82, 95% CI: 1.39−2.40, p < 0.001) than the controls. Compared to the controls, cases also had higher scores on anxiety and depression scales, lower scores on happiness, and lower levels of sleep quality (p < 0.001). The association of headaches with metabolic and mental health problems suggests that monitoring headaches in the workplace could help to identify workers at risk of impairment.
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Magnavita N. Headache in the Workplace: Analysis of Factors Influencing Headaches in Terms of Productivity and Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063712. [PMID: 35329399 PMCID: PMC8953285 DOI: 10.3390/ijerph19063712] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 12/15/2022]
Abstract
Headache is a very common condition that can have a significant impact on work. This study aimed to assess the prevalence of headaches and their impact on a sample of 1076 workers from 18 small companies operating in different sectors. The workers who volunteered to participate were asked to fill in the Headache Impact Test-6 (HIT-6) and answer questions designed to assess stressful and traumatic factors potentially associated with headaches. The volunteers subsequently underwent a medical examination and tests for diagnosing metabolic syndrome. Out of the 1044 workers who completed the questionnaire (participation rate = 97%), 509 (48.8%) reported suffering from headaches. In a multivariate logistic regression model, female gender, recent bereavement, intrusive leadership, and sleep problems were significantly associated with headaches. In univariate logistic regression models, headache intensity was associated with an increased risk of anxiety (OR 1.10; CI95% 1.09; 1.12) and depression (OR 1.09; CI95% 1.08; 1.11). Headache impact was also associated with the risk of metabolic syndrome (OR 1.02; CI95% 1.00, 1.04), obesity (OR 1.02, CI95% 1.01; 1.03), and reduced HDL cholesterol (OR 1.03; CI95% 1.01; 1.04). The impact of headache calls for intervention in the workplace not only to promote a prompt diagnosis of the different forms of headaches but also to improve work organization, leadership style, and the quality of sleep.
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Affiliation(s)
- Nicola Magnavita
- Postgraduate School of Occupational Health, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Roma, Italy;
- Department of Science of Woman, Child and Public Health, A. Gemelli Foundation IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
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Agbetou M, Adoukonou T. Lifestyle Modifications for Migraine Management. Front Neurol 2022; 13:719467. [PMID: 35370920 PMCID: PMC8971279 DOI: 10.3389/fneur.2022.719467] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Migraine is a disabling disease that inflicts a heavy burden on individuals who suffer from it. Significant advances are being made in understanding the pathophysiology and treatment of the disease. The role of lifestyle modifications has become increasingly predominant. We reviewed the current and available data on the role of a healthy lifestyle in the management of migraine. Physical activity, management of obesity, a healthy diet, and a better lifestyle, such as adequate sleep and avoidance of drug abuse, significantly contribute to reducing the frequency and severity of attacks. It is important to consider these factors in the overall management strategies for migraine sufferers.
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Affiliation(s)
- Mendinatou Agbetou
- Department of Neurology, University of Parakou, Parakou, Benin
- Clinic of Neurology, Teaching Hospital of Parakou, Parakou, Benin
| | - Thierry Adoukonou
- Department of Neurology, University of Parakou, Parakou, Benin
- Clinic of Neurology, Teaching Hospital of Parakou, Parakou, Benin
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- *Correspondence: Thierry Adoukonou
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Alcohol, coffee consumption, and smoking in relation to migraine: a bidirectional Mendelian randomization study. Pain 2022; 163:e342-e348. [PMID: 35029599 DOI: 10.1097/j.pain.0000000000002360] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/25/2021] [Indexed: 11/27/2022]
Abstract
ABSTRACT We conducted a Mendelian randomization study to assess whether alcohol and coffee consumption and smoking are causally associated with risk of developing migraine. Independent single-nucleotide polymorphisms associated with the potential risk factors at P < 5 × 10-8 in large-scale genome-wide association studies were selected as instrumental variables. Summary-level data for the associations of the selected single-nucleotide polymorphisms with migraine were obtained from the FinnGen consortium comprising 6687 cases and 144,780 noncases and the UK Biobank study comprising 1072 cases and 360,122 noncases. Estimates derived from the FinnGen and UK Biobank cohorts were combined using fixed-effects meta-analysis. We found evidence for associations of genetically predicted alcohol consumption (odds ratio [OR] 0.54 per SD increase in log-transformed alcoholic drinks per week, 95% confidence interval [CI], 0.35-0.82; P = 0.004), coffee consumption (OR 0.56 per 50% increase in coffee consumption, 95% CI, 0.45-0.70; P < 0.001), and smoking initiation (OR 1.15 for one SD increase in the prevalence of smoking initiation, 95% CI, 1.01-1.31; P = 0.038). These associations persisted in sensitivity analyses, including mutual adjustment in multivariable Mendelian randomization analyses. In reverse Mendelian randomization analyses, genetic liability to migraine was inversely associated with alcohol consumption but was not associated with coffee consumption or smoking initiation. This study provides genetic evidence in support of a protective role of moderate coffee consumption and a detrimental role of cigarette smoking in the etiology of migraine. The inverse association between alcohol consumption and migraine risk may be attributable to reverse causality.
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Wang D, Le S, Luo J, Chen X, Li R, Wu J, Song Y, Xie F, Li X, Wang H, Huang X, Ye P, Du X, Zhang A. Incidence, Risk Factors and Outcomes of Postoperative Headache After Stanford Type a Acute Aortic Dissection Surgery. Front Cardiovasc Med 2022; 8:781137. [PMID: 35004895 PMCID: PMC8733002 DOI: 10.3389/fcvm.2021.781137] [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: 09/22/2021] [Accepted: 11/30/2021] [Indexed: 01/28/2023] Open
Abstract
Background: Postoperative headache (POH) is common in clinical practice, however, no studies about POH after Stanford type A acute aortic dissection surgery (AADS) exist. This study aims to describe the incidence, risk factors and outcomes of POH after AADS, and to construct two prediction models. Methods: Adults who underwent AADS from 2016 to 2020 in four tertiary hospitals were enrolled. Training and validation sets were randomly assigned according to a 7:3 ratio. Risk factors were identified by univariate and multivariate logistic regression analysis. Nomograms were constructed and validated on the basis of independent predictors. Results: POH developed in 380 of the 1,476 included patients (25.7%). Poorer outcomes were observed in patients with POH. Eight independent predictors for POH after AADS were identified when both preoperative and intraoperative variables were analyzed, including younger age, female sex, smoking history, chronic headache history, cerebrovascular disease, use of deep hypothermic circulatory arrest, more blood transfusion, and longer cardiopulmonary bypass time. White blood cell and platelet count were also identified as significant predictors when intraoperative variables were excluded from the multivariate analysis. A full nomogram and a preoperative nomogram were constructed based on these independent predictors, both demonstrating good discrimination, calibration, clinical usefulness, and were well validated. Risk stratification was performed and three risk intervals were defined based on the full nomogram and clinical practice. Conclusions: POH was common after AADS, portending poorer outcomes. Two nomograms predicting POH were developed and validated, which may have clinical utility in risk evaluation, early prevention, and doctor-patient communication.
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Affiliation(s)
- Dashuai Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Le
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingjing Luo
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Chen
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Wu
- Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Song
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Xie
- Department of Cardiovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ximei Li
- Department of Nursing, Huaihe Hospital of Henan University, Kaifeng, China
| | - Hongfei Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaofan Huang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Ye
- Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinling Du
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anchen Zhang
- Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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11
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Wang Y, Huang X, Yue S, Liu J, Li S, Ma H, Hu L, Wu J. Secular Trends in the Incidence of Migraine in China from 1990 to 2019: A Joinpoint and Age–Period–Cohort Analysis. J Pain Res 2022; 15:137-146. [PMID: 35058715 PMCID: PMC8765540 DOI: 10.2147/jpr.s337216] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/29/2021] [Indexed: 12/28/2022] Open
Abstract
Background Migraine is a common disorder of the nervous system in China, imposing heavy burdens on individual and societies. Optimal healthcare planning requires understanding the magnitude and changing the trend of migraine incidence in China. However, the secular trend of migraine incidence in China remains unclear. Methods Data were collected from the Global Burden of Disease Study 2019 in China from 1990 to 2019 to investigate changes in the incidence rate of migraine. The average annual percent change and the relative risk were calculated using the joinpoint regression model and the age–period–cohort model, respectively. Results From 1990 to 2019, the age-standardized incidence rates of migraine in China increased by 0.26% (95% CI: 0.22 to 0.31) and 0.23% (95% CI: 0.19 to 0.28) per year in males and females, respectively. Age effects exerted the most significant impact on migraine incidence. Period effects showed a slightly decreasing trend in the incidence of migraine. In terms of cohort effects, people born after the 1960s presented a higher risk of migraine as compared with the total cohort, with the incidence risk of migraine increasing with birth cohorts. Conclusion Migraine incidence shows an overall increasing trend in China, with a significant gender difference. A comprehensive understanding of the risk characteristics and disease pattern of migraine could allow the early detection of persons with a high risk of developing migraine and promote the development of timely intervention measures to relieve this burden effectively.
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Affiliation(s)
- Yufeng Wang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
| | - Xueying Huang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
| | - Suru Yue
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
| | - Jie Liu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
| | - Shasha Li
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
| | - Huan Ma
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
| | - Liren Hu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
| | - Jiayuan Wu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, People’s Republic of China
- Correspondence: Jiayuan Wu Email
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12
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Tobacco and Nervous System Development and Function-New Findings 2015-2020. Brain Sci 2021; 11:brainsci11060797. [PMID: 34208753 PMCID: PMC8234722 DOI: 10.3390/brainsci11060797] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/07/2021] [Accepted: 06/12/2021] [Indexed: 12/13/2022] Open
Abstract
Tobacco is a one of the most common addictive stimulants used by people around the world. The smoke generated during tobacco combustion is a toxic mixture of more than 5000 chemicals of which over 30 are known human carcinogens. While its negative effects on the human body are well understood, it remains a serious public health problem. One of the multiple effects of smoking is tobacco’s effect on the nervous system—its development and function. This review aims to summarize the progress made in research on the effects of tobacco on the nervous system both of the perinatal period and adults and both in animals and humans in 2015–2020. The 1245 results that corresponded to the keywords “tobacco, cigarette, nervous system, brain, morphology, function” were reviewed, of which 200 abstracts were considered significant. Most of those articles broadened the knowledge about the negative effects of smoking on the human nervous system. Tobacco has a significant negative impact on the development of nervous structures, neurotransmission and cognitive functions, and promotes the development of neurodegenerative diseases, insomnia and cerebrovascular diseases. The only exception is the protective effect of the dopaminergic system in Parkinson’s disease. In conclusion, in recent years much effort has been devoted to describing, revealing and uncovering new aspects of tobacco detrimental to human life. The nicotine contained in tobacco smoke affects the human body in a multidimensional way, including a serious impact on the broadly understood neurological health.
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13
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Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, Terrin G, Di Nardo G, Reale A, Villani A, Parisi P. Lifestyle Modifications to Help Prevent Headache at a Developmental Age. Front Neurol 2021; 11:618375. [PMID: 33603708 PMCID: PMC7884344 DOI: 10.3389/fneur.2020.618375] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Headache is the world's seventh most significant cause of disability-adjusted-life in people aged between 10 and 14 years. Therapeutic management is based on pharmacological approaches and lifestyle recommendations. Many studies show associations between each migraine-promoting lifestyle, behavioral triggers, frequency, and intensity of headaches. Nevertheless, the overall aspects of this topic lack any definitive evidence. Educational programs advise that pediatric patients who suffer from migraines follow a correct lifestyle and that this is of the utmost importance in childhood, as it will improve quality of life and assist adult patients in avoiding headache chronicity, increasing general well-being. These data are important due to the scarcity of scientific evidence on drug therapy for prophylaxis during the developmental age. The "lifestyle recommendations" described in the literature include a perfect balance between regular sleep and meal, adequate hydration, limited consumption of caffeine, tobacco, and alcohol, regular physical activity to avoid being overweight as well as any other elements causing stress. The ketogenic diet is a possible new therapeutic strategy for the control of headache in adults, however, the possible role of dietary factors requires more specific studies among children and adolescents. Educational programs advise that the improvement of lifestyle as a central element in the management of pediatric headache will be of particular importance in the future to improve the quality of life of these patients and reduce the severity of cephalalgic episodes and increase their well-being in adulthood. The present review highlights how changes in different aspects of daily life may determine significant improvements in the management of headaches in people of developmental age.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | | | - Melania Evangelisti
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Nicoletta Della Vecchia
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Margherita Velardi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Fabiana Ursitti
- Division of Neurology, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Gianluca Terrin
- Department of Gynecological Obstetric and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Giovanni Di Nardo
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Pasquale Parisi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
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14
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Ramirez-Moreno JM, Ceberino D, Gonzalez Plata A, Rebollo B, Macias Sedas P, Hariramani R, Roa AM, Constantino AB. Mask-associated 'de novo' headache in healthcare workers during the COVID-19 pandemic. Occup Environ Med 2020; 78:oemed-2020-106956. [PMID: 33380516 PMCID: PMC7780429 DOI: 10.1136/oemed-2020-106956] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/14/2020] [Accepted: 12/07/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The pandemic caused by the new coronavirus (COVID-19) has changed care activities of health professionals. We analysed the possible association between the appearance of 'de novo' headache according to the type of mask used, the related factors and the impact of the cephalalgia on health professionals. METHODS Cross-sectional study in a tertiary hospital in Extremadura, Spain. We provided an online questionnaire to healthcare workers during the period of maximum incidence of COVID-19 in our setting. RESULTS The subjects are n=306, 244 women (79.7%), with an average age of 43 years (range 23-65). Of the total, 129 (42.2%) were physicians, 112 (36.6%) nurses and 65 (21.2%) other health workers. 208 (79.7%) used surgical masks and 53 (20.3%) used filter masks. Of all those surveyed, 158 (51.6%) presented 'de novo' headache. The occurrence of a headache was independently associated with the use of a filter mask, OR 2.14 (95% CI 1.07 to 4.32); being a nurse, OR 2.09 (95% CI 1.18 to 3.72) or another health worker, OR 6.94 (95% CI 3.01 to 16.04); or having a history of asthma, OR 0.29 (95% CI 0.09 to 0.89). According to the type of mask used, there were differences in headache intensity, and the impact of a headache in the subjects who used a filter mask was worse in all the aspects evaluated. CONCLUSION The appearance of 'de novo' headache is associated with the use of filter masks and is more frequent in certain healthcare workers, causing a greater occupational, family, personal and social impact.
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Affiliation(s)
- José María Ramirez-Moreno
- Biomedical Sciences, University of Extremadura, Faculty of Medicine, Badajoz, Spain
- Neurology, Badajoz University Hospital, Badajoz, Spain
| | | | | | - Belen Rebollo
- Neurology, Badajoz University Hospital, Badajoz, Spain
| | | | | | - Ana M Roa
- Neurology, Badajoz University Hospital, Badajoz, Spain
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15
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Domínguez-Durán E, Moreno-de-Jesús C, Prieto-Sánchez-de-Puerta L, Mármol-Szombathy I, Sánchez-Gómez S. Identifying Training, Diagnostic and Therapeutic Needs From a Comparison in the Distribution of Vestibular Disorders in Primary Care and in a Neurotology Unit. Front Neurol 2020; 11:605613. [PMID: 33329367 PMCID: PMC7714908 DOI: 10.3389/fneur.2020.605613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/28/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Several epidemiological studies in Neurotology have been previously carried out in the general population. This approach is useful for learning about the most common disorders in clinical population, but it may fail when one is trying to help professionals to guide their training, to optimize their resources and to decide on the highest-priority research objectives. Objective: To identify which of the neurotological diseases are most common in two different populations, those who attended a consultation in the Neurotology Unit of a tertiary level hospital and those who did so in Primary Care in order to infer which of them requires more attention in each context and their specific needs. Methods: All the diagnoses made in Hospital Care between October 15, 2017 and October 14, 2018 were reviewed. These diagnoses were coded and classified into syndromes and diseases. Later, the proportions of each category were compared with the proportions of the neurotological diagnoses made in five Primary Care centers over the same period of time. Results: BPPV is the most common cause of vestibular symptoms in both contexts. Vestibular migraine, ischemic vestibular symptoms, orthostatic hypotension and side effects of drugs are common in Primary Care, whereas Ménière's disease and undifferentiated episodic vestibular syndrome are common in specialized centers. Conclusion: The proportion of diagnoses in neurotologic patients is different in the general population and in the specialized center population, and therefore they have different needs. Primary Care professionals would benefit from training on maneuvers for repositioning otoliths, the treatment of headache, the identification of cardiovascular risk factors, the orthostatic hypotension and the side effects of the most commonly used drugs. The professionals who work in specialized centers need strategies for dealing with cases of BPPV associated to other vestibular diseases and refractory cases and their research should focus on the development of new diagnostic tools for the diagnosis of undifferentiated episodic vestibular syndrome and new therapeutic options for Ménière's disease.
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Affiliation(s)
- Emilio Domínguez-Durán
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Carolina Moreno-de-Jesús
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Irene Mármol-Szombathy
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Serafín Sánchez-Gómez
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
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16
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Explaining Disparities in Severe Headache and Migraine Among Sexual Minority Adults in the United States, 2013-2018. J Nerv Ment Dis 2020; 208:876-883. [PMID: 32815888 PMCID: PMC7606826 DOI: 10.1097/nmd.0000000000001221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Previous work has not examined how the association of sexual orientation and severe headache/migraine may be explained by differences between sexual minorities and heterosexuals in sociodemographic and health-related characteristics. Using data from the 2013-2018 National Health Interview Survey, regression decomposition was used to identify determinants of disparities in headache/migraine between sexual minorities collectively and heterosexuals, as well as between bisexual men and gay men, and bisexual women and lesbians. The prevalence of headache/migraine was the highest among bisexual women (36.8%), followed by lesbians (24.7%), bisexual men (22.8%), heterosexual women (19.7%), gay men (14.8%), and heterosexual men (9.8%). Across all models, the largest percentage of the disparity between sexual orientation/gender groups was attributable to age (range, 18.3%-42.2%), serious psychological distress (range, 6.6%-14.0%), and hours of regular sleep (range, 1.7%-8.2%). Although age accounted for the largest part of the disparity in headache/migraine by sexual orientation, several modifiable risk factors also played a role.
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17
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Rodríguez-Almagro D, Achalandabaso-Ochoa A, Molina-Ortega FJ, Obrero-Gaitán E, Ibáñez-Vera AJ, Lomas-Vega R. Neck Pain- and Unsteadiness-Inducing Activities and their Relationship to the Presence, Intensity, Frequency, and Disability of Headaches. Brain Sci 2020; 10:brainsci10070425. [PMID: 32635312 PMCID: PMC7407814 DOI: 10.3390/brainsci10070425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/01/2023] Open
Abstract
(1) Background: Headache is a significant public health problem. Despite the association between headache and neck pain, little is known about the relationships among specific activities that generate neck pain and headache. The aim of this study was to identify the specific activities that result in neck pain and unsteadiness, and determine how they are linked to headache in university students. (2) Methods: One hundred and six patients with physician-diagnosed headache and 92 healthy university students completed surveys assessing demographics; the presence, frequency, intensity, and disability of headaches; and activities generating neck pain and unsteadiness. (3) Results: The presence of headache was related to female gender (p = 0.001), neck pain when reading or watching television (p = 0.024), and unsteadiness when moving the head (p = 0.005). Headache-related disability was associated with intensity of neck pain (p < 0.001), neck pain when reading or watching television (p = 0.033), and stumbling (p < 0.001). Headache frequency was related to smoking (p = 0.004), the duration of neck pain-associated symptoms (p = 0.047), and neck pain when driving (p = 0.039). Intensity of headache was associated with female gender (p = 0.002), smoking (p = 0.013), and neck pain-related sleep alterations (p = 0.024). (4) Conclusions: Female gender, smoking, neck pain, and unsteadiness when moving the head are factors related to headache in university students.
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18
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Perceptions, experiences, and understandings of cluster headache among GPs and neurologists: a qualitative study. Br J Gen Pract 2020; 70:e514-e522. [PMID: 32482627 DOI: 10.3399/bjgp20x710417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cluster headache is a severe primary headache with a similar prevalence to that of multiple sclerosis. Cluster headache is characterised by unilateral trigeminal distribution of pain, ipsilateral cranial autonomic features, and a tendency to circadian and circannual periodicity. AIM To explore the perceptions, experiences, and understandings of cluster headache among GPs and neurologists. DESIGN AND SETTING Qualitative interview study in primary care surgeries and neurology departments in the north of England. METHOD Semi-structured interviews were conducted with GPs and neurologists, recorded, and transcribed. A thematic analysis was applied to the dataset. RESULTS Sixteen clinicians participated in this study: eight GPs and eight neurologists. Four main themes were identified following thematic analysis: challenges with the cluster headache diagnosis; impact of cluster headache; challenges with treatment; and appropriateness of referrals to secondary care. Clinicians recognised the delays in the diagnosis of cluster headache, misdiagnosis, and mismanagement, and were aware of the potential impact cluster headache can have on patients' mental health and ability to remain in employment. Findings highlighted tensions between primary and secondary care around the cost of medication and the remit of prescribing treatment regimens. Patients' anxiety, their need for reassurance, and their insistence about seeing a specialist are some of the reasons for referrals. CONCLUSION Clinicians acknowledged delays in diagnosis, misdiagnosis, and mismanagement of cluster headache. The responsibility of prescribing causes ongoing tensions between primary and secondary care. Clear referral and management pathways for primary headaches are required to improve patient outcomes and healthcare costs.
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19
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Lee EJ. Long-Term Effects of Smoking Cessation on Depressive Symptoms, Resilience, Coping Skills, and Serotonin. Psychiatr Q 2020; 91:263-271. [PMID: 31845167 DOI: 10.1007/s11126-019-09689-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There are many studies on how smoking cigarettes is harmful to health, but research on how smoking cessation improves mental health is insufficient. The purpose of this study was to examine long-term effects of smoking cessation on depressive symptoms, resilience, coping skills, and serotonin levels in Korean adults. This was a longitudinal study that followed up on periodically participants for 2 years after the initial smoking cessation intervention. A total of 164 smokers participated within this study. Of these, 15 maintained smoking cessation for 504.93 ± 182.82 days. On the other hand, 148 participants failed to maintain smoking cessation. Depressive symptoms decreased and resilience increased significantly over 2 years in the 15 abstainers. Smoking cessation, in total, decreased depressive symptoms by 32.9% (p = .015) and also increased resilience by 37.5% (p = .012). Smoking cessation also explained for 9% of total positive interpretation at the 1-year follow-up, and 7.3% of total self-criticism at the 2-year follow-up. Serum serotonin did not change over the course of 2 years in both abstainers and smokers but did decrease in the short-term for those who maintained smoking cessation. Platelet serotonin increased over 6 months among smokers.
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Affiliation(s)
- Eun Jin Lee
- Nursing Department, Inha University, Inharo100, Michuholgu, Incheon, 22212, South Korea.
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20
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Appel AM, Török E, Jensen MA, Garde AH, Hansen ÅM, Kaerlev L, Grynderup MB, Nabe-Nielsen K. The longitudinal association between shift work and headache: results from the Danish PRISME cohort. Int Arch Occup Environ Health 2020; 93:601-610. [PMID: 31927661 DOI: 10.1007/s00420-019-01512-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/27/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE We investigated the effect of shift work on headache. Furthermore, we investigated whether the association between shift work and headache was explained by potential mediators in terms of perceived stress, poor sleep and health behaviors. METHODS In this longitudinal study, we used questionnaire data (collected in 2007 and 2009) from civil servants and hospital employees from the PRISME study. 2952 individuals were available for the analyses of shift work and headache and 2272 individuals were available for the analyses of shift work and migraine. Headache was operationalized as the participants' experience of "being bothered by headache during the past 4 weeks". Migraine was operationalized as "ever being diagnosed with migraine by a medical doctor". We used binary logistic regression to compare shift workers with permanent day workers and adjusted for socio-demographic factors. In a subsequent step, we adjusted for potential mediators. RESULTS We found higher odds of unspecific headache (OR = 1.25; 95% CI 1.02-1.54) and migraine (OR = 1.72; 95% CI 1.04-2.86) among shift workers compared with day workers. Our results suggest that the effect of shift work on headache and migraine differ between men and women. Inclusion of potential mediators in the analyses did not attenuate the associations. CONCLUSION Shift workers have higher risk of reporting being bothered by headache as well as reporting being diagnosed with migraine. Future research is needed to disentangle the underlying mechanisms with the aim of reducing headache related to occupational exposures.
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Affiliation(s)
- Andreas Moses Appel
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
| | - Eszter Török
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Marie Aarrebo Jensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Anne Helene Garde
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Linda Kaerlev
- Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Kløvervænget 30, Entrance 216 Ground Floor East, 5000, Odense, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, 5000, Odense C, Denmark
| | | | - Kirsten Nabe-Nielsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
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21
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Hua M, Sadah S, Hristidis V, Talbot P. Health Effects Associated With Electronic Cigarette Use: Automated Mining of Online Forums. J Med Internet Res 2020; 22:e15684. [PMID: 31899452 PMCID: PMC6969389 DOI: 10.2196/15684] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/11/2019] [Accepted: 10/20/2019] [Indexed: 12/22/2022] Open
Abstract
Background Our previous infodemiological study was performed by manually mining health-effect data associated with electronic cigarettes (ECs) from online forums. Manual mining is time consuming and limits the number of posts that can be retrieved. Objective Our goal in this study was to automatically extract and analyze a large number (>41,000) of online forum posts related to the health effects associated with EC use between 2008 and 2015. Methods Data were annotated with medical concepts from the Unified Medical Language System using a modified version of the MetaMap tool. Of over 1.4 million posts, 41,216 were used to analyze symptoms (undiagnosed conditions) and disorders (physician-diagnosed terminology) associated with EC use. For each post, sentiment (positive, negative, and neutral) was also assigned. Results Symptom and disorder data were categorized into 12 organ systems or anatomical regions. Most posts on symptoms and disorders contained negative sentiment, and affected systems were similar across all years. Health effects were reported most often in the neurological, mouth and throat, and respiratory systems. The most frequently reported symptoms and disorders were headache (n=939), coughing (n=852), malaise (n=468), asthma (n=916), dehydration (n=803), and pharyngitis (n=565). In addition, users often reported linked symptoms (eg, coughing and headache). Conclusions Online forums are a valuable repository of data that can be used to identify positive and negative health effects associated with EC use. By automating extraction of online information, we obtained more data than in our prior study, identified new symptoms and disorders associated with EC use, determined which systems are most frequently adversely affected, identified specific symptoms and disorders most commonly reported, and tracked health effects over 7 years.
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Affiliation(s)
- My Hua
- University of California, Riverside, Riverside, CA, United States
| | - Shouq Sadah
- University of California, Riverside, Riverside, CA, United States
| | | | - Prue Talbot
- University of California, Riverside, Riverside, CA, United States
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Ferroni P, Barbanti P, Spila A, Fratangeli F, Aurilia C, Fofi L, Egeo G, Guadagni F. Circulating Biomarkers in Migraine: New Opportunities for Precision Medicine. Curr Med Chem 2019; 26:6191-6206. [DOI: 10.2174/0929867325666180622122938] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 05/24/2018] [Accepted: 05/30/2018] [Indexed: 01/03/2023]
Abstract
Background:
Migraine is the most common neurological disorder and the second
most disabling human condition, whose pathogenesis is favored by a combination of genetic,
epigenetic, and environmental factors. In recent years, several efforts have been made to identify
reliable biomarker(s) useful to monitor disease activity and/or ascertain the response to a
specific treatment.
Objective:
To review the current evidence on the potential biological markers associated with
migraine.
Methods:
A structured search of peer-reviewed research literature was performed by searching
major publications databases up to December 2017.
Results:
Several circulating biomarkers have been proposed as diagnostic or therapeutic tools
in migraine, mostly related to migraine’s inflammatory pathophysiological aspects. Nonetheless,
their detection is still a challenge for the scientific community, reflecting, at least in part,
disease complexity and clinical diagnostic limitations. At the present time, calcitonin generelated
peptide (CGRP) represents probably the most promising candidate as a diagnostic
and/or therapeutic biomarker, as its plasma levels are elevated during migraine attack and decrease
during successful treatment. Other molecules (including some neuropeptides, cytokines,
adipokines, or vascular activation markers) despite promising, do not possess the sufficient
prerequisites to be considered as migraine biomarkers.
Conclusion:
The characterization of migraine-specific biomarkers would be fundamental in a
perspective of precision medicine, enabling risk assessment and tailored treatments. However,
speculating on the clinical validity of migraine biomarkers may be premature and controlled
clinical trials are presently needed to investigate both the diagnostic and therapeutic value of
these biomarkers in migraine.
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Affiliation(s)
- Patrizia Ferroni
- InterInstitutional Multisciplinary Biobank (BioBIM), IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Piero Barbanti
- Headache and Pain Unit, Dept. of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Antonella Spila
- InterInstitutional Multisciplinary Biobank (BioBIM), IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Federica Fratangeli
- InterInstitutional Multisciplinary Biobank (BioBIM), IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Cinzia Aurilia
- Headache and Pain Unit, Dept. of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Luisa Fofi
- Headache and Pain Unit, Dept. of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Gabriella Egeo
- Headache and Pain Unit, Dept. of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Fiorella Guadagni
- InterInstitutional Multisciplinary Biobank (BioBIM), IRCCS San Raffaele Pisana, 00166, Rome, Italy
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Jia C, Lucchese S, Zhang F, Govindarajan R. The Role of Onabotulinum Toxin Type A in the Management of Chronic Non-migraine Headaches. Front Neurol 2019; 10:1009. [PMID: 31616362 PMCID: PMC6763695 DOI: 10.3389/fneur.2019.01009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 09/04/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives: FDA has approved Onabotulinum toxin type A (BoNTA) for prophylactic treatment of chronic migraines. Recent studies have explored its potential new indications, like treating post-traumatic headaches. Patients and Methods: This is a retrospective chart review of 717 patients, who had failed at least two prophylactic treatments and received BoNTA injections at University of Missouri Hospital from July 2014 to June 2017. Patient demographics, headache type, associated symptoms, prophylaxes tried were reported. Patient's pain severity (numeric pain scale) and frequency (number of headache days/month) pretreatment, at 6 months, and at 12 months were collected. Results: For a single headache type, post-traumatic headaches showed reduction in headache pain severity at 6 months (2.9 ± 0.7) compared to pre-treatment (7 ± 0.7). Headache frequency for post-traumatic headaches was also reduced at 6 months (10.6 ± 2.3) and 12 months (5.1 ± 1.2) compared to pre-treatment (25 ± 1.8). For pseudotumor cerebri headaches, pain severity at pretreatment was 6.4 ± 0.6 compared to 2 ± 0.8 at 6 months, and headache days reduced at 6 months (9.8 ± 2.5) and 12 months (6 ± 4) compared to pretreatment (26 ± 2.9). Opioid use reduced by 67 ± 55.4 at 6 months and 133.3 ± 106.6 at 12 months in morphine equivalent units. Conclusions: Onabotulinum toxin type A is effective in treating multiple types of chronic non-migraine headaches.
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Sohail S, Nakigozi G, Anok A, Batte J, Kisakye A, Mayanja R, Nakasujja N, Robertson KR, Gray RH, Wawer MJ, Sacktor N, Saylor D. Headache prevalence and its functional impact among HIV-infected adults in rural Rakai District, Uganda. J Neurovirol 2019; 25:248-253. [PMID: 30607892 DOI: 10.1007/s13365-018-0710-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/08/2018] [Accepted: 12/03/2018] [Indexed: 02/07/2023]
Abstract
Headache is common, but its prevalence and impact in sub-Saharan Africa and especially in HIV+ individuals is relatively unknown. We sought to determine the prevalence and functional impact of headache among HIV-infected (HIV+) adults in a cross-sectional observational cohort study in rural Rakai District, Uganda. Participants completed a sociodemographic survey, depression screen, functional status assessments, and answered the headache screening question, "Do you have headaches?" Participants responding affirmatively were assessed with the ID Migraine tool for diagnosis of migraine and Headache Impact Test-6 to determine functional impact of headache. Characteristics of participants with and without headaches and with and without functional impairment were compared using t tests for continuous variables, chi-square tests for categorical variables, and multivariate logistic regression. Of 333 participants, 51% were males, mean age was 37 (SD 9) years, 94% were on antiretroviral therapy (ART) and mean CD4 count was 403 (SD 198) cells/μL. Headache prevalence was 28%. Among those reporting headache, 19% met criteria for migraine, 55% reported functional impairment, and 37% reported substantial or severe impact of headache. In multivariate analyses, female sex (odds ratio (OR) 2.58) and depression (OR 2.49) were associated with increased odds and ART (OR 0.33) with decreased odds of headache. Participants with substantial/severe functional impact were more likely to meet criteria for depression (32% vs 9%). In conclusion, headache prevalence in HIV+ rural Ugandans was lower than global averages but still affected more than one quarter of participants and was associated with significant functional impairment.
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Affiliation(s)
| | | | - Aggrey Anok
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - James Batte
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | | | | | - Kevin R Robertson
- Department of Neurology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Ronald H Gray
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria J Wawer
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ned Sacktor
- Department of Neurology, Johns Hopkins University School of Medicine, Meyer 6-113, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine, Meyer 6-113, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
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Guidry A, Crutchfield K. Athletes with neurologic disease. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:445-462. [PMID: 30482372 DOI: 10.1016/b978-0-444-63954-7.00041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Neurologic disease does not discriminate, even among athletes. Common neurologic diseases among athletes include multiple sclerosis, seizures, headaches, and sleep disorders. Although concrete guidelines for sport participation among athletes with neurologic diseases do not exist, evidence-based and consensus statements can aid healthcare providers in determining whether and to what extent such athletes should participate in sports. Moreover, sport participation is important, since multiple studies indicate that exercise improves disease-specific symptoms, manifestations, and overall quality of life. Although some risk is involved for athletes with neurologic disease, risk is mitigated with proper supervision and neurologic oversight, disease-specific accommodations, and counseling of the athletic staff and the athletes. Neurologic oversight entails an initial comprehensive neurologic assessment by a neurologist followed by regular follow-up. Preparation for environmental conditions encountered by athletes with neurologic disease will further improve safety during their participation in sport. With sound recommendations, neurologic oversight, and proper supervision, most athletes with neurologic disease can participate in athletics. The health benefits that they will gain from participation in athletics outweigh the risks.
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Affiliation(s)
- Andrew Guidry
- Sports Medicine Institute, Sandra and Malcolm Berman Brain and Spine Institute at LifeBridge Health, Baltimore, MD, United States
| | - Kevin Crutchfield
- Sports Medicine Institute, Sandra and Malcolm Berman Brain and Spine Institute at LifeBridge Health, Baltimore, MD, United States.
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Ferroni P, Barbanti P, Della-Morte D, Palmirotta R, Jirillo E, Guadagni F. Redox Mechanisms in Migraine: Novel Therapeutics and Dietary Interventions. Antioxid Redox Signal 2018; 28:1144-1183. [PMID: 28990418 DOI: 10.1089/ars.2017.7260] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
SIGNIFICANCE Migraine represents the third most prevalent and the seventh most disabling human disorder. Approximately 30% of migraine patients experience transient, fully reversible, focal neurological symptoms (aura) preceding the attack. Recent Advances: Awareness of the hypothesis that migraine actually embodies a spectrum of illnesses-ranging from episodic to chronic forms-is progressively increasing and poses novel challenges for clarifying the underlying pathophysiological mechanisms of migraine as well as for the development of novel therapeutic interventions. Several theories have evolved to the current concept that a combination of genetic, epigenetic, and environmental factors may play a role in migraine pathogenesis, although their relative importance is still being debated. CRITICAL ISSUES One critical issue that deserves a particular attention is the role of oxidative stress in migraine. Indeed, potentially harmful oxidative events occur during the migraine attack and long-lasting or frequent migraine episodes may increase brain exposure to oxidative events that can lead to chronic transformation. Moreover, a wide variety of dietary, environmental, physiological, behavioral, and pharmacological migraine triggers may act through oxidative stress, with clear implications for migraine treatment and prophylaxis. Interestingly, almost all current prophylactic migraine agents exert antioxidant effects. FUTURE DIRECTIONS Increasing awareness of the role of oxidative stress and/or decreased antioxidant defenses in migraine pathogenesis and progression to a chronic condition lays the foundations for the design of novel prophylactic approaches, which, by reducing brain oxidative phenomena, could favorably modify the clinical course of migraine. Antioxid. Redox Signal. 28, 1144-1183.
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Affiliation(s)
- Patrizia Ferroni
- 1 Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University , Rome, Italy .,2 IRCCS San Raffaele Pisana , Rome, Italy
| | - Piero Barbanti
- 3 Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana , Rome, Italy
| | - David Della-Morte
- 1 Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University , Rome, Italy .,2 IRCCS San Raffaele Pisana , Rome, Italy .,4 Department of Systems Medicine, University of Rome "Tor Vergata ," Rome, Italy
| | - Raffaele Palmirotta
- 5 Department of Biomedical Sciences and Human Oncology, "A. Moro" University , Bari, Italy
| | - Emilio Jirillo
- 6 Department of Basic Medical Sciences, Neuroscience and Sensory Organs, "A. Moro" University , Bari, Italy
| | - Fiorella Guadagni
- 1 Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University , Rome, Italy .,2 IRCCS San Raffaele Pisana , Rome, Italy
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27
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Hagen K, Åsberg AN, Stovner L, Linde M, Zwart JA, Winsvold BS, Heuch I. Lifestyle factors and risk of migraine and tension-type headache. Follow-up data from the Nord-Trøndelag Health Surveys 1995-1997 and 2006-2008. Cephalalgia 2018. [PMID: 29517305 DOI: 10.1177/0333102418764888] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS The aim of this population-based historical cohort study was to investigate the influence of lifestyle factors on the risk of developing migraine or tension-type headache (TTH). METHODS Data from the Nord-Trøndelag Health Study performed in 1995-1997 and 2006-2008 was used. A total of 15,276 participants without headache at baseline were included. A Poisson regression was used to evaluate the associations between lifestyle factors and risk ratios (RRs) of migraine and TTH 11 years later. Precision of the estimates was assessed by 95% confidence interval (CIs). RESULTS Increased risk of migraine (RR 1.30, 95% CI 1.11-1.52) was found in smokers (past or current) compared to those who had never smoked. Hard physical exercise 1-2 hours per week reduced the risk of migraine (OR 0.71, 95% CI 0.54-0.94) compared to inactivity, and the risk of migraine was also lower among those who consumed alcohol (RR 0.73, 95% CI 0.57-0.94) compared to abstainers. No association was found between smoking, physical activity, alcohol use and risk of TTH. CONCLUSIONS The main finding was that current and previous smoking was associated with increased risk of migraine, but not of TTH.
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Affiliation(s)
- Knut Hagen
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,2 Norwegian Advisory Unit on Headaches, St. Olav's University Hospital, Trondheim, Norway
| | - Anders Nikolai Åsberg
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Stovner
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,2 Norwegian Advisory Unit on Headaches, St. Olav's University Hospital, Trondheim, Norway
| | - Mattias Linde
- 1 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,2 Norwegian Advisory Unit on Headaches, St. Olav's University Hospital, Trondheim, Norway
| | - John-Anker Zwart
- 3 Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway.,4 Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,5 Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Bendik Slagsvold Winsvold
- 3 Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway.,4 Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Heuch
- 5 Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
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28
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Abstract
BACKGROUND It is accepted that smoking often triggers migraine. However, studies evaluating the relationship between the use of smokeless tobacco and migraine are limited, and there is no clear consensus on the subject. In this study, it was aimed to evaluate the relationship between migraine and Maras powder, which is the most common smokeless tobacco in Turkey. SUBJECTS AND METHODS The study included a total of 600 subjects, consisting of 300 patients (aged >18 years) diagnosed with a migraine according to the International Headache Society (IHS-ICHD-3 Beta) criteria after presenting at Sütçü Imam University Medical Faculty Neurology Policlinic with the complaint of headache between July 2016 and December 2016 and a control group of 300 individuals with similar features of age, gender, and educational level. A questionnaire was administered to each patient to record the status of smoking or using Maras powder. RESULTS In the migraine patient group, 16.4% smoked and 9.7% used Maras powder. In the control group, the rate of smoking was 8.5% and the rate of Maras powder use was 11.86%. In males diagnosed with a migraine, the use of Maras powder was found to be at a higher rate than smoking (p<0.001). The Visual Pain Score and the headache frequency values were higher in those who smoked or used Maras powder than in non-users (p<0.001). The Fagerström Test for Nicotine Dependence Smokeless Tobacco results of the patients diagnosed with migraine and who used Maras powder were found to be higher than of those who smoked (Fagerström Test for Nicotine Dependence; p<0.001). When patients were evaluated according to the Migraine Disability Assessment Scale, the majority of migraine patients were seen to be at stages 1 and 2, and one in every three patients who used Maras powder cigarette and one in every two patients who smoked had headaches of a severity which affected their daily activities (p<0.001). CONCLUSION Smoking or the use of Maras powder increases the frequency and severity of migraines in a similar way. Therefore, Maras powder must be included in the scope of the fight against tobacco and people should be warned about this issue.
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Affiliation(s)
- Yılmaz İnanç
- Department of Neurology, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey
| | - Fatma Özlem Orhan
- Department of Psychiatry, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey
| | - Yusuf İnanç
- Department of Neurology, Gaziantep University School of Medicine, Kahramanmaraş, Turkey
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Abstract
Migraine and stroke are common, disabling neurologic disorders, with a high socioeconomic burden. A link between them has been proposed years ago, and various theories have been proposed to explain this bidirectional relation. However, the precise causes remain unclear. We briefly summarize existing hypotheses of this correlation seeking for recommendations for stroke prevention in migraineurs, if any exist. Among the strongest suggested theories of migraine-stroke association are cortical spreading depression, endovascular dysfunction, vasoconstriction, neurogenic inflammation, hypercoagulability, increased prevalence of vascular risk factors, shared genetic defects, cervical artery dissection, and patent foramen ovale. There is no evidence that any preventive therapy in migraineurs should be used to decrease stroke risk, even in most predisposed subset of patients. However, a woman with migraine with aura should be encouraged to cease smoking and avoid taking oral contraceptives with high estrogen doses. We need further investigation to better understand the complexity of migraine-stroke association and to make firm recommendations for the future.
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30
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He X, Munaf A, Idrisov E, Everett G, Saikaly SK, Kim E, Abusaada K, Hsu V. Monocular diplopia-associated migraine-like headache induced by nicotine withdrawal. Clin Case Rep 2017; 5:594-597. [PMID: 28469856 PMCID: PMC5412817 DOI: 10.1002/ccr3.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/29/2016] [Accepted: 01/31/2017] [Indexed: 12/02/2022] Open
Abstract
We describe an extremely rare case of migraine‐associated monocular diplopia developed in a 23‐year‐old man after sudden cessation of smoking. The physical examination and brain MRI scan were unremarkable. The symptoms resolved after starting nicotine patch. We reviewed the literature and discussed the diagnosis and possible mechanism of this phenomenon.
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Affiliation(s)
- Xiaoping He
- Internal Medicine Residency program of Florida Hospital Orlando, Florida USA
| | - Alvina Munaf
- Internal Medicine Residency program of Florida Hospital Orlando, Florida USA
| | - Evgeny Idrisov
- Internal Medicine Residency program of Florida Hospital Orlando, Florida USA
| | - George Everett
- Internal Medicine Residency program of Florida Hospital Orlando, Florida USA
| | | | - Esther Kim
- UCF College of Medicine Orlando, Florida USA
| | - Khalid Abusaada
- Internal Medicine Residency program of Florida Hospital Orlando, Florida USA
| | - Vincent Hsu
- Internal Medicine Residency program of Florida Hospital Orlando, Florida USA
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Mikhailov N, V. Mamontov O, A. Kamshilin A, Giniatullin R. Parasympathetic Cholinergic and Neuropeptide Mechanisms of Migraine. Anesth Pain Med 2016; 7:e42210. [PMID: 28920040 PMCID: PMC5554415 DOI: 10.5812/aapm.42210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/19/2016] [Accepted: 11/21/2016] [Indexed: 12/24/2022] Open
Abstract
Context Migraine mechanisms remain largely uncovered for various reasons including a very high complexity of the neurophysiological mechanisms implicated in this disorder and a plethora of endogenous biologically active compounds involved in the pathological process. The functional role of parasympathetic innervation of meninges and cholinergic mechanisms of migraine are among little explored issues despite multiple evidence indirectly indicating the role of acetylcholine (ACh) and its analogues in migraine and other types of headache. In the current short review, we discuss morphological, functional, and clinical issues related to the role of ACh and its analogues such as carbachol and nicotine in this most common neurological disorder. Evidence Acquisition In the present work, studies published from 1953 to 2016 were investigated. Literature was searched with following keywords: acetylcholine (ACh), carbachol, nicotine, parasympathetic, mast cells, vasoactive intestinal polypeptide (VIP), and pituitary adenylate cyclase-activating polypeptide (PACAP). Results Parasympathetic fibers originated from SPG and trigeminal nerves can interact at the level of meninges which is considered to be the origin site of migraine pain. Here, in dura mater, ACh, VIP, and PACAP released by parasympathetic afferents can both affect mast cells provoking its degranulation and additional release of neurotransmitters, or they can directly affect trigeminal nerves inducing nociception. Conclusions In summary, cholinergic mechanisms in migraine and other types of headache remain little elucidated and future studies should clarify the role of parasympathetic nerves and molecular mechanisms of cholinergic modulation within the nociceptive system.
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Affiliation(s)
- Nikita Mikhailov
- Department of Neurobiology, University of Eastern Finland, 70210 Kuopio, Finland
| | - Oleg V. Mamontov
- Department of Circulation Physiology, Federal Almazov North-West Medical Research Centre, St. Petersburg, 197341, Russia
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia
| | - Alexei A. Kamshilin
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia
- Corresponding author: Alexei A. Kamshilin, Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia, E-mail:
| | - Rashid Giniatullin
- Department of Neurobiology, University of Eastern Finland, 70210 Kuopio, Finland
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia
- Laboratory of Neurobiology, Kazan Federal University, Kazan, Russia
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Lipton RB, Munjal S, Buse DC, Fanning KM, Bennett A, Reed ML. Predicting Inadequate Response to Acute Migraine Medication: Results From the American Migraine Prevalence and Prevention (AMPP) Study. Headache 2016; 56:1635-1648. [DOI: 10.1111/head.12941] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Richard B. Lipton
- Saul R. Korey Department of Neurology; Albert Einstein College of Medicine; Bronx NY USA
- Montefiore Medical Center; Bronx NY USA
| | - Sagar Munjal
- Promius Pharma; a subsidiary of Dr. Reddy's Laboratories; Princeton NJ USA
| | - Dawn C. Buse
- Saul R. Korey Department of Neurology; Albert Einstein College of Medicine; Bronx NY USA
| | | | - Alix Bennett
- Promius Pharma; a subsidiary of Dr. Reddy's Laboratories; Princeton NJ USA
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Psychosocial difficulties in patients with episodic migraine: a cross-sectional study. Neurol Sci 2016; 37:1979-1986. [PMID: 27613711 DOI: 10.1007/s10072-016-2705-8] [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] [Received: 06/13/2016] [Accepted: 08/31/2016] [Indexed: 01/07/2023]
Abstract
To explore the relationships between psychosocial difficulties (PSDs), quality of life (QoL), and disability and to explore the degree to which PSDs can be predicted by demographic variables, clinical variables, and risk and protective factors. Patients with episodic migraine completed a protocol inclusive of PARADISE 24 questionnaire (the 24-item Psychosocial Difficulties Relevant to Brain Disorders questionnaire), a new questionnaire that captures PSDs relevant to brain disorders, and assessments of disability, QoL, disease severity, presence of comorbidities, social support, and clinical and risk factors (i.e., smoking and body mass index). Spearman's correlation was used to address the relationship between PARADISE 24, and the assessments of disability and QoL; multivariable linear regression analysis was carried out to address PARADISE 24 predictors. Eighty patients were enrolled (86.3 % females, mean age 44.5). PARADISE 24 was well correlated with disability (ρ = 0.787) and moderately with QoL (ρ = -0.526). The regression analysis shows that younger age, higher migraine frequency, higher comorbidities index and being a smoker were predictors of PARADISE 24 (R 2: 0.470). Addressing the burden associated with PSDs in migraineurs is important as these might be the reason why patients look for specialists in headache disorders. PARADISE 24 represents a viable way to address patients' difficulties in daily practice.
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Tepper SJ. Alcohol, Tobacco, Triggers, and Headache Disorders. Headache 2015; 55:1027. [PMID: 26417623 DOI: 10.1111/head.12619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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