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Mercante JPP, Oliveira AB, Peres MFP, Wang YP, Brunoni AR, Lotufo PA, Benseñor IM, Goulart AC. Association of mental health symptoms with the migraine-tension-type headache spectrum in the Brazilian longitudinal study of adult health. J Psychosom Res 2024; 179:111624. [PMID: 38432062 DOI: 10.1016/j.jpsychores.2024.111624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To investigate the relationship between mental health symptoms and the migraine-tension-type headache (TTH) spectrum in middle-aged adults from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil study). METHODS In this cross-sectional analysis (baseline data: 2008-2010), it was evaluated the relationship between each mental health symptom assessed by the Clinical Interview Schedule-Revised (CIS-R) questionnaire and headache subtypes (migraine and TTH) according to international criteria. It was performed binary logistic regression models, with estimated odds ratios (OR) with their respective 95% confidence intervals (CI) adjusted for confounders including migraine attack frequency. RESULTS Among 13,916 participants, 70.1% reported any major primary headache subtype within the last year. The most common subtype was definite TTH (33.4%), followed by probable migraine (21.0%), definite migraine (8.5%), and probable TTH (7.2%). Our main findings indicated positive associations between anxiety-related symptoms and the migraine-tension type headache (TTH) spectrum with a clear trend toward definite migraine more than tension-type headache. The presence of somatic symptoms presented a high likelihood for the associations with headaches, mainly definite migraine (OR: 7.9, 95% CI: 6.4-9.8), probable migraine (OR: 4.5, 95% CI 3.7-5.4) and probable TTH (OR: 3.0, 95% CI: 2.3-3.8). Other symptoms associated with headache disorders included fatigue, panic, irritability, anxiety symptoms, concentration problems, forgetfulness, depressive symptoms, and worry. The effect of associations remained significant after controlling for headache attack frequency. CONCLUSION This study provides evidence of consistent associations between mental health symptoms and primary headache disorders, with a higher burden of anxiety-based symptoms observed in people with migraine than those with TTH.
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Affiliation(s)
- Juliane Prieto Peres Mercante
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Arão Belitardo Oliveira
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Mario Fernando Prieto Peres
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Psiquiatria, Departamento de Psiquiatria, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Yuan-Pang Wang
- Instituto de Psiquiatria, Departamento de Psiquiatria, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Andre Russowsky Brunoni
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Psiquiatria, Departamento de Psiquiatria, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil; School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Psiquiatria, Departamento de Psiquiatria, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Isabela Martins Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Psiquiatria, Departamento de Psiquiatria, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alessandra Carvalho Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil; Departament of Epidemiology, School of Public Health, Universidade de São Paulo, São Paulo, SP, Brazil
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Chen X, Gui W, Li H, Deng Z, Wang Y. Alterations of amygdala volume and functional connectivity in migraine patients comorbid with and without depression. Brain Behav 2024; 14:e3427. [PMID: 38361322 PMCID: PMC10869885 DOI: 10.1002/brb3.3427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE The comorbid relationship between migraine and depression has been well recognized, but its underlying pathophysiology is unclear. Here, we aimed to explore the structural changes of the amygdala and the abnormal functional connectivity of the centromedial amygdala (CMA) in migraineurs with depression. METHODS High-resolution T1-weighted and functional magnetic resonance images were acquired from 22 episodic migraineurs with comorbid depression (EMwD), 21 episodic migraineurs without depression (EM), and 17 healthy controls (HC). Voxel-based morphometry and resting-state functional connectivity (rsFC) were applied to examine the intergroup differences in amygdala volume. RESULTS The bilateral amygdala volume was increased in the EMwD and EM groups compared with the HC group, but there were no differences between the EMwD and EM groups. The right CMA exhibited decreased rsFC in the left dorsolateral prefrontal cortex (DLPFC) in the EMwD group compared with the EM group, while rsFC increased between the CMA and the contralateral DLPFC in the EM group compared with the HC group. In addition, the EM group showed decreased rsFC between the left CMA and the left pallidum compared with the HC group. CONCLUSIONS Enlarged amygdala is an imaging feature of EM and EMwD. The inconsistency of rsFC between CMA and DLPFC between migraineurs with and without depression might indicate that decreased rsFC between CMA and DLPFC is a neuropathologic marker for the comorbidity of migraine and depression. The core regions might be a potential intervention target for the treatment of EMwD in the future.
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Affiliation(s)
- Xin Chen
- Department of NeurologyFirst Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Department of NeurologyAnhui Public Health Clinical CenterHefeiChina
| | - Wei Gui
- Department of NeurologyFirst Affiliated Hospital of University of Science and Technology of ChinaHefeiChina
| | - Han‐Li Li
- Department of Neurology, Epilepsy and Headache GroupFirst Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Zi‐Ru Deng
- Department of Neurology, Epilepsy and Headache GroupFirst Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yu Wang
- Department of Neurology, Epilepsy and Headache GroupFirst Affiliated Hospital of Anhui Medical UniversityHefeiChina
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Lv H, Liu K, Xie Y, Wang Y, Chen S, Liu P, Guan M, Cong J, Xu Y. No causal association between allergic rhinitis and migraine: a Mendelian randomization study. Eur J Med Res 2024; 29:78. [PMID: 38281051 PMCID: PMC10821569 DOI: 10.1186/s40001-024-01682-1] [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: 10/18/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024] Open
Abstract
PURPOSE Allergic rhinitis (AR) and migraine are among the most common public health problems worldwide. Observational studies on the correlation between AR and migraine have reported inconsistent results. This study aimed to investigate the causal relationship of AR with migraine and its subtypes, including migraine with aura (MA) and migraine without aura (MO). METHODS Bidirectional two-sample Mendelian randomization (MR) analysis was performed with publicly available summary-level statistics of large genome-wide association studies to estimate the possible causal effects. The inverse variance-weighted method was selected for primary analysis and was supplemented with the weighted median, weighted mode, and MR-Egger methods. The causal analysis using summary effect estimates (CAUSE) were further performed to verify the causality. Several sensitivity tests, including the leave-one-out, Cochran's Q, MR-Egger intercept, and MR-PRESSO tests, were performed to assess the robustness of the results. RESULTS AR did not exhibit a significant causal correlation with the elevated risk of any migraine (odd ratio (OR), 0.816; 95% confidence interval (CI), 0.511-1.302; P = 0.394), MA (OR, 0.690; 95% CI 0.298-1.593; P = 0.384), or MO (OR, 1.022; 95% CI 0.490-2.131; P = 0.954). Consistently, reverse MR analysis did not reveal causal effects of any migraine or its subtypes on AR. Almost all sensitivity analyses supported the robustness of the results. CONCLUSIONS This MR study did not reveal a clear causal association between AR and migraine risk. More research is warranted to reveal the complex association between AR and migraine.
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Affiliation(s)
- Hao Lv
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Kunyu Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yulie Xie
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yunfei Wang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Siyuan Chen
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Peiqiang Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Mengting Guan
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Jianchao Cong
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, 430071, Hubei, China.
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Gonzalez-Hernandez A, Cano-Yepes A, Sainz de Aja-Curbelo V, Santana-Farré R, Rodríguez-Sosa T, Cabrera-Naranjo F. Attention Deficit Hyperactivity Disorder in Adults With Migraine. J Atten Disord 2024; 28:117-122. [PMID: 37752867 DOI: 10.1177/10870547231199256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Several studies have shown increased occurrence of migraine in ADHD patients. However, there is less evidence on whether migraine patients also have a higher ADHD frequency. The aim of this paper is determining whether the prevalence of ADHD symptoms or impulsivity is higher in patients with episodic migraine. METHODS An observational cohort study has been conducted. Patients with episodic migraine were included. The ADHD Rating scale, the Adult ADHD Self-Report Scale, and the scale of impulsiveness of Plutchik were used. RESULTS The mean value of inattention, hyperactivity and impulsivity scores on the ADHD scale was 5 ± 3.8 in cases and 2.7 ± 2.2 in controls (p < .00001), 4 ± 3.2 in cases and 2.5 ± 2.4 in controls (p = .000621) and 2 ± 1.5 in cases and 1.1 ± 1 in controls (p = .000407), respectively. CONCLUSION Adults with migraine have a higher prevalence of ADHD symptoms. This should be considered when assessing these patients.
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Affiliation(s)
| | - Andres Cano-Yepes
- Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
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Androulakis XM, Yu X, Zhu X, Thiam MA, Cai G. Migraine and major depression: localizing shared genetic susceptibility in different cell types of the nervous systems. Front Neurol 2023; 14:1254290. [PMID: 38033772 PMCID: PMC10684773 DOI: 10.3389/fneur.2023.1254290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Background There is a bidirectional relationship between migraine and major depression disorder (MDD). They likely share important risk genes associated with different cell types in the central nervous system (CNS) and peripheral nervous system (PNS). Profiling the expression of these genes in specific cell types is critical in understanding the pathophysiology of the relationship between migraine and MDD. Methods Associated genes shared by migraine and MDD were identified by consolidating multiple curations of human disease-gene associations. Subsequently, the expression of overlapping genes was profiled and compared across the different cell types in CNS, PNS and neurovascular cells using eight single cell RNA sequencing datasets, including two human CNS datasets, two mouse CNS datasets, one human PNS dataset and three mouse PNS datasets. Results 45 shared genes between migraine and MDD were identified. Consistently found in all eight datasets, dopaminergic and serotonergic neurotransmitters were broadly expressed in CNS and PNS cell types. Glutamatergic and endocannabinoid genes were specifically expressed in CNS neurons and astrocytes. Synthesis and/or Release and Binding of Neuropeptides were specifically expressed in PNS peptidergic nociceptor (PEP). Genes related to inflammatory factors and immune responses were specifically expressed in CNS microglia. Among which, IL1B and COMT were highly expressed in CNS microglia cells. Conclusion Single cell RNA sequencing of the CNS and PNS helps to identify the shared genes between migraine and MDD that are enriched in specific cell types. The findings provide new insight in understanding the underlying mechanism of action for the bidirectional co-morbidity between migraine and MDD.
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Affiliation(s)
| | - Xuanxuan Yu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Xia Zhu
- Department of Environmental Health Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Melinda A. Thiam
- Department of Psychiatry, New Mexico VA Healthcare Care System, Albuquerque, NM, United States
| | - Guoshuai Cai
- Department of Surgery, College of Medicine, University of Florida, Gainesville, FL, United States
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Beech EL, Riddell N, Murphy MJ, Crewther SG. Sex and stress hormone dysregulation as clinical manifestations of hypothalamic function in migraine disorder: A meta-analysis. Eur J Neurosci 2023; 58:3150-3171. [PMID: 37452646 DOI: 10.1111/ejn.16087] [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: 11/24/2022] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
Migraine is a leading cause of disability in young adults. It occurs more frequently in females, often comorbidly with stress disorders, suggesting an association with hypothalamic sex and stress hormonal function and a likely interaction with autonomic nervous system activation. Thus, this study aimed to meta-analyse current literature pertaining to female and male sex hormones (estrogen, progesterone and testosterone concentration), hypothalamic-pituitary-adrenal axis (HPA axis) cortisol responses and heart rate variability (HRV) in migraineurs and controls aged 13-65 years. A systematic search of MEDLINE, Embase, PsycINFO, PubMed, CINAHL and Web of Science databases on 29/08/2022 identified 29 studies for meta-analysis (encompassing 719 migraineur and 592 control participants) that met inclusion and NHLBI risk of bias criteria. Results demonstrated that estrogen concentrations of female migraineurs were reduced (g = -.60, 95% CI [-.91, -.29], p < .001) in the luteal phase of the menstrual cycle, compared to controls. No differences were found in progesterone levels overall in female migraineurs, nor in testosterone levels in male migraineurs compared to controls. Further, early diurnal cortisol concentrations were elevated (g = .32, 95% CI [.00, .63], p = .036) in female and male migraineurs compared to controls, though no differences were found in HRV of female or male migraineurs compared to controls. These findings of dysregulation of estrogen in females and cortisol dysregulation in female and male migraineurs indicate perturbed hypothalamic function and highlight the association of migraine with stress and the need for further rigorous investigation of hypothalamic neuroendocrine functions in migraineurs of both sexes.
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Affiliation(s)
- Erin L Beech
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Nina Riddell
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Melanie J Murphy
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Sheila G Crewther
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
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Wang M, Gu Y, Meng S, Kang L, Yang J, Sun D, Liu Y, Wan Z, Shan Y, Xue D, Su C, Li S, Yan R, Liu Y, Zhao Y, Pan Y. Association between TRP channels and glutamatergic synapse gene polymorphisms and migraine and the comorbidities anxiety and depression in a Chinese population. Front Genet 2023; 14:1158028. [PMID: 37303955 PMCID: PMC10250607 DOI: 10.3389/fgene.2023.1158028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023] Open
Abstract
Background: Genetic and environmental factors contribute to migraine and the comorbidities of anxiety and depression. However, the association between genetic polymorphisms in the transient receptor potential (TRP) channels and glutamatergic synapse genes with the risk of migraine and the comorbidities of anxiety and depression remain unclear. Methods: 251 migraine patients containing 49 comorbidities with anxiety and 112 with depression and 600 controls were recruited. A customized 48-plex SNPscan kit was used for genotyping 13 SNPs of nine target genes. Logistic regression was conducted to analyze these SNPs' association with the susceptibility of migraine and comorbidities. The generalized multifactor dimension reduction (GMDR) was applied to analyze the SNP-SNP and gene-environment interactions. The GTEx database was used to examine the effects of the significant SNPs on gene expressions. Results: The TRPV1 rs8065080 and TRPV3 rs7217270 were associated with an increased risk of migraine in the dominant model [ORadj (95% CI): 1.75 (1.09-2.90), p = 0.025; 1.63 (1.02-2.58), p = 0.039, respectively]. GRIK2 rs2227283 was associated with migraine in the edge of significance [ORadj (95% CI) = 1.36 (0.99-1.89), p = 0.062]. In migraine patients, TRPV1 rs222741 was associated with both anxiety risk and depression risk in the recessive model [ORadj (95% CI): 2.64 (1.24-5.73), p = 0.012; 1.97 (1.02-3.85), p = 0.046, respectively]. TRPM8 rs7577262 was associated with anxiety (ORadj = 0.27, 95% CI = 0.10-0.76, p = 0.011). TRPV4 rs3742037, TRPM8 rs17862920 and SLC17A8 rs11110359 were associated with depression in dominant model [ORadj (95% CI): 2.03 (1.06-3.96), p = 0.035; 0.48 (0.23-0.96), p = 0.042; 0.42 (0.20-0.84), p = 0.016, respectively]. Significant eQTL and sQTL signals were observed for SNP rs8065080. Individuals with GRS (Genetic risk scores) of Q4 (14-17) had a higher risk of migraine and a lower risk of comorbidity anxiety than those with Genetic risk scores scores of Q1 (0-9) groups [ORadj (95% CI): 2.31 (1.39-3.86), p = 0.001; 0.28 (0.08-0.88), p = 0.034, respectively]. Conclusion: This study suggests that TRPV1 rs8065080, TRPV3 rs7217270, and GRIK2 rs2227283 polymorphism may associate with migraine risk. TRPV1 rs222741 and TRPM8 rs7577262 may associate with migraine comorbidity anxiety risk. rs222741, rs3742037, rs17862920, and rs11110359 may associate with migraine comorbidity depression risk. Higher GRS scores may increase migraine risk and decrease comorbidity anxiety risk.
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Affiliation(s)
- Mingxue Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yujia Gu
- Chronic Disease Prevention and Treatment Clinic, Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Shuhan Meng
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Lixin Kang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Jing Yang
- Department of Neurology, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Degang Sun
- Department of Neurology, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Yuxing Liu
- Catheterization Room, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Ze Wan
- Science and Education Section, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Yi Shan
- Physical Examination Section, Beidahuang Group Baoquanling Hospital, Hegang, China
| | - Dongjie Xue
- Department of Neurology, Hegang He Mine Hospital, Hegang, China
| | - Chang Su
- Department of Internal Medicine, Baoquanling Farm Hospital, Hegang, China
| | - Shufen Li
- Vaccination Clinic, Baoquanling Farm Hospital, Hegang, China
| | - Ran Yan
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yu Liu
- Chronic Disease Prevention and Treatment Clinic, Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yonghui Pan
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Giakas A, Mangold K, Androulakis A, Hyduke N, Galynker I, Thiam M, Cai G, Androulakis XM. Risks of suicide in migraine, non-migraine headache, back, and neck pain: a systematic review and meta-analysis. Front Neurol 2023; 14:1160204. [PMID: 37153662 PMCID: PMC10157105 DOI: 10.3389/fneur.2023.1160204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
Objective To conduct a systematic review and meta-analysis on suicidal ideation, attempts, and death in patients with head, neck, and back pain. Method Search was performed using PubMed, Embase, and Web of Science from the date of the first available article through September 31, 2021. A random effects model was used to estimate the pooled odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between suicidal ideation and/or attempt and head, back/neck pain conditions. Articles describing non-migraine headache disorders and death by suicide were also reviewed but not included in the meta-analysis due to an insufficient number of studies. Results A total of 20 studies met criteria for systemic review. A total of 186,123 migraine patients and 135,790 of neck/back pain patients from 11 studies were included in the meta-analysis. The meta-analysis showed that the estimated risk of combined suicidal ideation and attempt in migraine [OR 2.49; 95% CI: 2.15-2.89] is greater than that in back/neck pain pain [OR 2.00; 95% CI: 1.63-2.45] compared to non-pain control groups. Risk of suicide ideation/planning is 2 folds higher [OR: 2.03; 95% CI: 1.92-2.16] and risk of suicide attempt is more than 3 folds higher [OR: 3.47; 95% CI: 2.68-4.49] in migraine as compared to healthy controls. Conclusion There is an elevated risk of suicidal ideation and attempt in both migraine and neck/back pain patients in comparison to healthy controls, and this risk is particularly higher among migraine patients. This study underscores the critical need for suicide prevention in migraine patients.
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Affiliation(s)
- Alec Giakas
- Department of Orthopedic Surgery, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Kiersten Mangold
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Anthony Androulakis
- Department of Biological Sciences, University of South Carolina, Columbia, SC, United States
| | - Noah Hyduke
- Department of Psychiatry, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Igor Galynker
- Department of Psychiatry, Beth Israel Medical Center, New York, NY, United States
| | - Melinda Thiam
- Department of Psychiatry, New Mexico VA Hospital System, Albuquerque, NM, United States
| | - Guoshuai Cai
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, United States
| | - X. Michelle Androulakis
- Department of Neurology, Columbia VA Healthcare System, Columbia, SC, United States
- Department of Neurology, University of South Carolina School of Medicine, Columbia, SC, United States
- *Correspondence: X. Michelle Androulakis
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Antunes FTT, De Souza AH, Figueira J, Binda NS, Carvalho VPR, Vieira LB, Gomez MV. Targeting N-type calcium channels in young-onset of some neurological diseases. Front Cell Dev Biol 2022; 10:1090765. [PMID: 36601540 PMCID: PMC9806183 DOI: 10.3389/fcell.2022.1090765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
Calcium (Ca 2+) is an important second messenger in charge of many critical processes in the central nervous system (CNS), including membrane excitability, neurotransmission, learning, memory, cell proliferation, and apoptosis. In this way, the voltage-gated calcium channels (VGCCs) act as a key supply for Ca2+ entry into the cytoplasm and organelles. Importantly, the dysregulation of these channels has been reported in many neurological diseases of young-onset, with associated genetic factors, such as migraine, multiple sclerosis, and Huntington's disease. Notably, the literature has pointed to the role of N-type Ca2+ channels (NTCCs) in controlling a variety of processes, including pain, inflammation, and excitotoxicity. Moreover, several Ca2+ channel blockers that are used for therapeutic purposes have been shown to act on the N-type channels. Therefore, this review provides an overview of the NTCCs in neurological disorders focusing mainly on Huntington's disease, multiple sclerosis, and migraine. It will discuss possible strategies to generate novel therapeutic strategies.
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Affiliation(s)
- Flavia Tasmin Techera Antunes
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Alessandra Hubner De Souza
- Post-Graduate Program of Health Sciences, Faculdade de Ciências Médicas de, Belo Horizonte, Minas Gerais, Brazil,*Correspondence: Alessandra Hubner De Souza, ; Marcus Vinícius Gomez,
| | - Juliana Figueira
- Pharmacology Department, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Nancy Scardua Binda
- Pharmacology Department, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Luciene Bruno Vieira
- Pharmacology Departament, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marcus Vinícius Gomez
- Graduate Program in Health Sciences, Faculty Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil,*Correspondence: Alessandra Hubner De Souza, ; Marcus Vinícius Gomez,
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10
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Arab A, Zabibah RS, Alshahrani SH, Karimi E, Askari G, Khorvash F. Is there a relationship between 24-hour urinary sodium and potassium and mental health in migraine patients?: A cross-sectional study. Medicine (Baltimore) 2022; 101:e31037. [PMID: 36281190 PMCID: PMC9592346 DOI: 10.1097/md.0000000000031037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
There is a lack of evidence and consensus in terms of the association between dietary intake of sodium (Na) and potassium (K) with mental health. By using 24-hours urinary samples as the gold standard method, we conducted a study to explore the association between dietary intake of Na and K with parameters of mental health including depression, anxiety, and stress among an Iranian population diagnosed with migraine. In the present study, 262 subjects (20-50 years old), with a confirmed diagnosis of migraine were enrolled. Mental health was investigated by the Depression, Anxiety, and Stress Scales (DASS-21) questionnaire. Dietary intake of Na and K was estimated by means of a 24-hour urine sample. Multinomial logistic regression analysis was implemented and odds ratio (OR) with 95% confidence interval (CI) was stated. After controlling for potential confounders, the 24-hour urinary Na was associated significantly with the risk of depression (OR = 0.55, 95% CI: 0.30, 1.00; P = .053). After adjustment for confounders, those in the highest tertile of the 24-hour urinary Na/K ratio had lower odds for having depression (OR = 0.54, 95% CI: 0.31, 0.93; P = .027), and marginally significantly lower risk of anxiety (OR = 0.58, 95% CI: 0.31, 1.06; P = .079) and stress (OR = 0.56, 95% CI: 0.31, 1.02; P = .061). In conclusion, higher 24-hour urine Na was associated with a significantly lower risk of depression. Moreover, the 24-hour Na/K ratio was significantly associated with lower risk of depression, anxiety, and stress.
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Affiliation(s)
- Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahman S. Zabibah
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | | | - Elham Karimi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariborz Khorvash
- Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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11
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Arab A, Rafie N, Hadi A, Khorvash F, Heidari Z, Askari G. Empirically derived dietary patterns and their association with mental health: a cross-sectional sample of Iranian migraine patients (2019–2020). BMC Nutr 2022; 8:28. [PMID: 35379364 PMCID: PMC8978347 DOI: 10.1186/s40795-022-00522-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objectives
Based on a comprehensive search, we realized that there is no previous study conducted among migraine patients to assess the association between major dietary patterns and mental health. Therefore, the present study aims to explore the relationship between empirically-derived dietary patterns and depression, anxiety, and stress in a sample of Iranian migraine patients.
Methods
A total of 262 migraine patients (20–50 years) were selected through simple random sampling method for this study. Dietary intake during the previous year was determined using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ), and major dietary patterns were derived using principal component analysis (PCA). For mental health evaluation, authors used the Depression, Anxiety, and Stress Scales (DASS- 21) questionnaire. Statistical analysis included multinomial logistic regression analysis and results were expressed as odds ratio (OR) with a 95% confidence interval (CI).
Results
We identified three major dietary patterns including “traditional”, “western”, and “healthy”. After controlling for potential confounders, those in the highest tertile of the healthy dietary pattern had lower odds of depression (OR = 0.44, 95% CI: 0.22, 0.88; P for trend: 0.030) and stress (OR = 0.50, 95% CI: 0.25, 0.99; P for trend: 0.049). However, no significant association was observed between western and traditional dietary patterns and mental disorders.
Conclusions
In summary, significant associations were documented between healthy dietary patterns and risk of depression and stress. Current findings urge migraine patients to increase their intakes of fruits, vegetables, eggs, whole grains, nuts and seeds, meat, and poultry and reduce the intake of fast foods and snacks, processed meat, fish, cola drink, condiments, dairy, and vegetable pickles to diminish the chance of depression and stress.
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12
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Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on clinical, quality of life, and mental health outcomes in women with migraine: A randomised controlled trial. Br J Nutr 2021; 128:1535-1544. [PMID: 34763733 DOI: 10.1017/s000711452100444x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and clinical, quality of life, and mental health outcomes in migraine is unknown. To address this knowledge gap, we conducted a parallel-group, randomised controlled trial to evaluate the effect of the DASH diet on these health outcomes in women with migraine. Of 102 eligible women (20-50 years), 51 randomised to the DASH and 51 to the usual dietary advice (control) groups completed a 12-week intervention. The DASH diet was designed using a 7-day menu cycle to provide 15-20% of total daily energy requirements from proteins, 25-30% from fats, and 55-60% from carbohydrates. Dietary records and serum vitamin C levels were used to assess women's compliance with the DASH diet. The clinical symptoms of migraine (i.e., frequency, duration, severity) and quality of life and mental health (i.e., depression, anxiety, stress) outcomes were assessed in groups pre-and post-intervention. We observed greater decreases in the frequency (-3.00 vs. -1.40, P=0.025) and severity (-1.76 vs. -0.59, P<0.001) of migraine in the DASH vs. control group post-intervention. Similarly, the DASH group exhibited a tendency toward greater decreases in migraine duration (-0.58 vs -0.33 days, P=0.053) and had lower scores of depression (-4.50 vs. -2.73, P=0.019) and stress (-5.84 vs -2.98, P=0.011) vs. controls. However, the quality of life and anxiety outcomes remained comparable in groups post-intervention. Together, evidence supports the benefits of the DASH diet on improving migraine health outcomes in reproductive-aged women. Further research is needed to confirm our findings.
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Prevalence of Migraine in General Spanish Population; Factors Related and Use of Health Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111145. [PMID: 34769668 PMCID: PMC8583596 DOI: 10.3390/ijerph182111145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022]
Abstract
Migraine is a common neurological disorder considered the second most disabling condition worldwide. Its prevalence ranges from 2.6% to 21.7% in population studies. This study aimed to know the prevalence of diagnosed and undiagnosed migraine in the general Spanish adult population, their health care use, and factors related. A descriptive cross-sectional study was undertaken with 23,089 individuals >15 years from the 2017 Spanish National Health Survey. Three groups were defined: people diagnosed with migraine (DM), people reporting undiagnosed migraine (UM) and people without migraine. Sociodemographic, clinical and use of health resources data were collected. The scales Duke Social Support Index (DSSI) and General Health Questionnaire (GHQ-12) were used. Prevalence of DM and UM were determined with 95% confidence intervals. To determine the factors associated with DM and UM, a multinomial logistic regression model was used. The prevalence of DM was 8.6% (95%CI: 8.2–9), and UM, 0.9% (95%CI: 0.8–1). People with DM more frequently visited healthcare professionals (47.8%), required more supplementary tests (86.8), had a higher percentage of hospitalization (11.3%), and used emergency services (45.1%). Women had nearly three times the risk of DM and UM. Worse mental health was a risk factor for UM (OR = 1.20) and DM (OR = 1.18). The greater the work stress, the greater the risk of DM (OR = 1.12). An adequate monitoring and management of migraine in people with these characteristics could contribute to improving their quality of life and reducing costs in the system.
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Asfaw ZK, Hannah TC, Ali M, Li AY, Spiera Z, Marayati NF, Kalagara R, Dreher N, Schupper AJ, Gometz A, Lovell MR, Choudhri T. Impact of Psychiatric Illnesses and Selective Serotonin Reuptake Inhibitor Medications on Baseline Neurocognitive Testing. Arch Clin Neuropsychol 2021; 37:633-640. [PMID: 34664619 DOI: 10.1093/arclin/acab087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Neurocognitive tests are an integral component of sport-related concussion (SRC) workup. A history of psychiatric illness (HPI) is common among young athletes. Investigations of factors that influence athletes' baseline neurocognitive function are crucial for an accurate assessment of SRC. OBJECTIVE In this study, we aim to elucidate the effect of HPI and selective-serotonin reuptake inhibitor (SSRI) medication use on baseline neurocognitive performance in young athletes. METHODS We conducted a retrospective cross-sectional study of Immediate Post-Concussion Assessment and Cognitive Testing assessments. A total of 268 athletes with HPI and a control group of 6,364 athletes were included. The outcomes were total symptom score based on post-concussion symptom scale, verbal memory, visual memory, visual motor, reaction time, and impulse control scores with self-reported HPI status and SSRI use. RESULTS Athletes with HPI had an elevated symptom score in both univariate analysis (p < .0001) and multivariate analysis (p < .0001). HPI influence on visual memory score was not robust to multivariate analysis (p = .24). Athletes with HPI who reported SSRI medication use had the same baseline neurocognitive performance as other athletes with HPI. HPI influences athletes' baseline neurocognitive performance by elevating symptom scores. HPI does not alter any of the objective neurocognitive composite scores in contrast to previous work. CONCLUSIONS Clinicians should consider the impact of HPI on baseline neurocognitive performance during the assessment of a suspected SRC. Additional research is required to bolster our findings on SSRI use and ascertain the effects of other drug classes on baseline neurocognitive performance.
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Affiliation(s)
- Zerubabbel K Asfaw
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Theodore C Hannah
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Muhammad Ali
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adam Y Li
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zachary Spiera
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Naoum Fares Marayati
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roshini Kalagara
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nickolas Dreher
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander J Schupper
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Mark R Lovell
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Tanvir Choudhri
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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15
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Wei HL, Li J, Guo X, Zhou GP, Wang JJ, Chen YC, Yu YS, Yin X, Li J, Zhang H. Functional connectivity of the visual cortex differentiates anxiety comorbidity from episodic migraineurs without aura. J Headache Pain 2021; 22:40. [PMID: 34020591 PMCID: PMC8138918 DOI: 10.1186/s10194-021-01259-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/12/2021] [Indexed: 01/04/2023] Open
Abstract
Background Migraine is a common neurological disease that is often accompanied by psychiatric comorbidities. However, the relationship between abnormal brain function and psychiatric comorbidities in migraine patients remains largely unclear. Therefore, the present study sought to explore the correlations between the resting-state functional deficits and psychiatric comorbidities in migraine without aura (MwoA) patients. Methods Resting-state functional magnetic resonance images were obtained. In addition, the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values were obtained. Thereafter regional abnormalities in MwoA patients with and without anxiety (MwoA-A and MwoA-OA) were chosen as seeds to conduct functional connectivity (FC) analysis. Results Compared to the healthy controls (HCs), the MwoA-A and MwoA-OA patients had abnormal ALFF and ReHo values in the right lingual gyrus (LG). They also had abnormal FC of the right LG with the ipsilateral superior frontal gyrus (SFG) and middle cingulate cortex (MCC). Additionally, the MwoA-A patients showed higher ReHo values in the left posterior intraparietal sulcus (pIPS) and abnormal FC of the right LG with ipsilateral pIPS and primary visual cortex, compared to the MwoA-OA patients. Moreover, the MwoA-OA patients showed an increase in the FC with the right posterior cingulate cortex/precuneus (PCC/PCUN), left middle frontal gyrus (MFG) and left inferior temporal gyrus (ITG) relative to the HCs. Furthermore, the ALFF values of the right LG positively were correlated with anxiety scores in MwoA-A patients. The abnormal LG-related FCs with the PCC/PCUN, MFG and ITG were negatively associated with the frequency of headaches in MwoA-OA patients. Conclusions This study identified abnormal visual FC along with other core networks differentiating anxiety comorbidity from MwoA. This may therefore enhance the understanding of the neuropsychological basis of psychiatric comorbidities and provide novel insights that may help in the discovery of new marks or even treatment targets.
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Affiliation(s)
- Heng-Le Wei
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China
| | - Jian Li
- Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China
| | - Xi Guo
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China
| | - Gang-Ping Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China
| | - Jin-Jin Wang
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Junrong Li
- Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China.
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No.169, Hushan Road, 211100, Nanjing, Jiangsu, China.
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16
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Mastria G, Viganò A, Corrado A, Mancini V, Pirillo C, Badini S, Petolicchio B, Toscano M, Altieri M, Delle Chiaie R, Di Piero V. Chronic Migraine Preventive Treatment by Prefrontal-Occipital Transcranial Direct Current Stimulation (tDCS): A Proof-of-Concept Study on the Effect of Psychiatric Comorbidities. Front Neurol 2021; 12:654900. [PMID: 34079513 PMCID: PMC8166222 DOI: 10.3389/fneur.2021.654900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/29/2021] [Indexed: 12/26/2022] Open
Abstract
Chronic migraine (CM) is often complicated by medication overuse headache (MOH) and psychiatric comorbidities that may influence the clinical outcome. This study aimed to investigate the relationship between psychiatric comorbidities and the effect of transcranial direct current stimulation (tDCS) in patients with CM with or without MOH. We recruited 16 consecutive CM patients who had an unsatisfactory response to at least three pharmacological preventive therapies. They were treated with anodal right-prefrontal and cathodal occipital tDCS (intensity: 2 mA, time: 20 min) three times per week for 4 weeks. All patients underwent a psychopathological assessment before and after treatment, and five of them were diagnosed with bipolar disorder (BD). After treatment, all the patients showed a significant decrease of severe and overall headache days per month. Despite having a higher migraine burden at baseline, patients with CM and BD showed a significantly greater reduction of severe headaches and psychiatric symptoms. Overall, tDCS seems to be effective in the treatment of CM patients with a poor response to different classes of pharmacological therapies, whereas BD status positively influences the response of migraineurs to tDCS.
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Affiliation(s)
- Giulio Mastria
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,My Space Lab, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | | | - Alessandra Corrado
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | - Valentina Mancini
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Cristina Pirillo
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | - Simone Badini
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | | | - Massimiliano Toscano
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,Department of Neurology-Fatebenefratelli Hospital, Rome, Italy
| | - Marta Altieri
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | | | - Vittorio Di Piero
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,University Consortium for Adaptive Disorders and Head Pain-UCADH, Pavia, Italy
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17
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Wei HL, Chen YC, Yu YS, Guo X, Zhou GP, Zhou QQ, Qu LJ, Yin X, Li J, Zhang H. Aberrant activity within auditory network is associated with psychiatric comorbidities in interictal migraineurs without aura. Brain Imaging Behav 2021; 15:2464-2471. [PMID: 33479923 DOI: 10.1007/s11682-020-00446-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/20/2022]
Abstract
The present study aimed to explore associations between brain activity in the auditory cortex and clinical and psychiatric characteristics in patients with migraine without aura (MwoA) during interictal periods. Resting-state data were acquired from patients with episodic MwoA (n = 34) and healthy controls (n = 30). Independent component analysis was used to extract and calculate the resting-state auditory network. Subsequently, we analyzed the correlations between spontaneous activity in the auditory cortex and clinical and psychiatric features in interictal MwoA. Compared with healthy controls, patients with MwoA showed increased activity in the left superior temporal gyrus (STG), postcentral gyrus (PoCG) and insula. Brain activity in the left STG was positively correlated with anxiety scores, and activity in the left PoCG was negatively correlated with anxiety and depression scores. No significant differences were found in intracranial volume between the two groups. This study indicated that functional impairment and altered integration linked to the auditory cortex existed in patients with MwoA in the interictal period, suggesting that auditory-associated cortex disruption as a biomarker may be implemented for the early diagnosis and prediction of neuropsychiatric impairment in interictal MwoA patients.
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Affiliation(s)
- Heng-Le Wei
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu Province, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Xi Guo
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Gang-Ping Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Li-Jie Qu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu Province, China
| | - Junrong Li
- Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
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18
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Sheng L, Ma H, Shi Y, Dai Z, Zhong J, Chen F, Pan P. Cortical Thickness in Migraine: A Coordinate-Based Meta-Analysis. Front Neurosci 2021; 14:600423. [PMID: 33488349 PMCID: PMC7815689 DOI: 10.3389/fnins.2020.600423] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/25/2020] [Indexed: 11/13/2022] Open
Abstract
Cortical thickness (CTh) via surface-based morphometry analysis is a popular method to characterize brain morphometry. Many studies have been performed to investigate CTh abnormalities in migraine. However, the results from these studies were not consistent and even conflicting. These divergent results hinder us to obtain a clear picture of brain morphometry regarding CTh alterations in migraine. Coordinate-based meta-analysis (CBMA) is a promising technique to quantitatively pool individual neuroimaging studies to identify consistent brain areas involved. Electronic databases (PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, WanFang, and SinoMed) and other sources (bioRxiv and reference lists of relevant articles and reviews) were systematically searched for studies that compared regional CTh differences between patients with migraine and healthy controls (HCs) up to May 15, 2020. A CBMA was performed using the Seed-based d Mapping with Permutation of Subject Images approach. In total, we identified 16 studies with 17 datasets reported that were eligible for the CBMA. The 17 datasets included 872 patients with migraine (average sample size 51.3, mean age 39.6 years, 721 females) and 949 HCs (average sample size 59.3, mean age 44.2 years, 680 females). The CBMA detected no statistically significant consistency of CTh alterations in patients with migraine relative to HCs. Sensitivity analysis and subgroup analysis verified this result to be robust. Metaregression analyses revealed that this CBMA result was not confounded by age, gender, aura, attack frequency per month, and illness duration. Our CBMA adds to the evidence of the replication crisis in neuroimaging research that is increasingly recognized. Many potential confounders, such as underpowered sample size, heterogeneous patient selection criteria, and differences in imaging collection and methodology, may contribute to the inconsistencies of CTh alterations in migraine, which merit attention before planning future research on this topic.
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Affiliation(s)
- LiQin Sheng
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, China
| | - HaiRong Ma
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, China
| | - YuanYuan Shi
- Department of Central Laboratory, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
| | - ZhenYu Dai
- Department of Radiology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
| | - Fei Chen
- Department of Radiology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
| | - PingLei Pan
- Department of Central Laboratory, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
- Department of Neurology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
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19
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Bednarczuk NF, Staab JP. An Extreme Presentation of Migraine: Suicidal Ideation as a Migraine Aura. PSYCHOSOMATICS 2020; 61:795-798. [PMID: 32416958 DOI: 10.1016/j.psym.2020.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Nadja F Bednarczuk
- Faculty of Medicine, Imperial College London, London, UK; Department of Medicine, King's College Hospital, London, UK
| | - Jeffrey P Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
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20
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Clemow DB, Baygani SK, Hauck PM, Hultman CB. Lasmiditan in patients with common migraine comorbidities: a post hoc efficacy and safety analysis of two phase 3 randomized clinical trials. Curr Med Res Opin 2020; 36:1791-1806. [PMID: 32783644 DOI: 10.1080/03007995.2020.1808780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Determine whether common migraine comorbidities affect the efficacy and safety of lasmiditan, a 5-HT1F receptor agonist approved in the United States for the acute treatment of migraine. METHODS In SPARTAN and SAMURAI (double-blind Phase 3 clinical trials), patients with migraine were randomized to oral lasmiditan 50 mg (SPARTAN only), 100mg, 200 mg, or placebo. Lasmiditan increased the proportion of pain-free and most bothersome symptom (MBS)-free patients at 2 h after dose compared with placebo. Most common treatment-emergent adverse events (TEAEs) were dizziness, paraesthesia, somnolence, fatigue, nausea, muscular weakness, and hypoesthesia. Based upon literature review of common migraine comorbidities, Anxiety, Allergy, Bronchial, Cardiac, Depression, Fatigue, Gastrointestinal, Hormonal, Musculoskeletal/Pain, Neurological, Obesity, Sleep, and Vascular Comorbidity Groups were created. Using pooled results, efficacy and TEAEs were assessed to compare patients with or without a given common migraine comorbidity. To compare treatment groups, p-values were calculated for treatment-by-subgroup interaction, based on logistic regression with treatment-by-comorbidity condition status (Yes/No) as the interaction term; study, treatment group, and comorbidity condition status (Yes/No) were covariates. Differential treatment effect based upon comorbidity status was also examined. Trial registration at clinicaltrials.gov: SAMURAI (NCT02439320) and SPARTAN (NCT02605174). RESULTS Across all the Comorbidity Groups, with the potential exception of fatigue, treatment-by-subgroup interaction analyses did not provide evidence of a lasmiditan-driven lasmiditan versus placebo differential treatment effect dependent on Yes versus No comorbidity subgroup for either efficacy or TEAE assessments. CONCLUSIONS The efficacy and safety of lasmiditan for treatment of individual migraine attacks appear to be independent of comorbid conditions.
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Affiliation(s)
- David B Clemow
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Simin K Baygani
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Paula M Hauck
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Cory B Hultman
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
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21
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Jahangir S, Adjepong D, Al-Shami HA, Malik BH. Is There an Association Between Migraine and Major Depressive Disorder? A Narrative Review. Cureus 2020; 12:e8551. [PMID: 32670688 PMCID: PMC7357317 DOI: 10.7759/cureus.8551] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/10/2020] [Indexed: 12/30/2022] Open
Abstract
Various studies on the association of migraine with depression are published. The comorbidity may upgrade health conditions up to a critical degree. Besides, the duration of symptoms and treatment may be prolonged. Moreover, these conditions can force substantial financial and social hardships on patients and their families. In this literature review, we intend to examine the evidence obtained on the possible associations between migraine and major depressive disorder (MDD). This review is focused on aminergic neurons. One of the variables associated with patients who experience both of these two diseases might have a history of assault. In migraine and MDD patients, genetic evidence, such as single nucleotide polymorphisms (SNP), was found to be one of the associations. Another theory concluded that actual headache diagnosed in patients who received no treatment manifests a history of anxiety, and later, the patients display severe somatic symptoms. In conclusion, there is a robust molecular genetic background, explaining the relationship between migraines and MDD. This correlated data renders a combination of both diagnoses as single separate entities. However, further studies are encouraged to point out the issue of treatment strategies.
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Affiliation(s)
- Saira Jahangir
- Neuroscience, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Dennis Adjepong
- Neurological Surgery, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | | | - Bilal Haider Malik
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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22
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Huber CA, Agosti R, Näpflin M, Blozik E. Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database. Pharmacoepidemiol Drug Saf 2019; 29:279-287. [PMID: 31828875 DOI: 10.1002/pds.4938] [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: 03/15/2019] [Revised: 11/05/2019] [Accepted: 11/19/2019] [Indexed: 11/06/2022]
Abstract
PURPOSE In course of the new migraine drug development on the global market it is important to quantify the current burden of migraine medication. This study aimed to estimate the comorbidity burden and its relation to healthcare costs in patients using triptans in Switzerland by analyzing a large population-based database. METHODS This retrospective cohort study was based on Swiss health insurance claims data (2015/2016). The study sample comprised adult patients with ≥1 triptan prescription in 2015. We evaluated pharmaceutically treated comorbid conditions (CCs) and costs (12 months after index prescription) of patients using triptan. Multivariable linear regression models with log-transformed outcomes were performed to identify the factors related to healthcare costs. RESULTS From a total of 749 092, we identified 10,090 patients using triptans (1-year prevalence of 1.35%), whereas 58.9% had ≥2 CCs. The most frequent CCs were pain- and rheumatologic-related diseases and psychological disorders. Among triptan users, the mean total healthcare costs were highest in older patients with ≥2 CCs (>64 years: migraine with ≥2 CC "12 331 SFr"). Multivariate regression analyses showed that psychological disorders had the strongest impact on healthcare costs (Coefficient: 1.29; 95%-CI: 1.27-1.31). CONCLUSIONS The present study provides an overview of comorbidities and its related costs in migraine patients, which helps to quantify the current burden of migraine. This is relevant as the recently licensed CGRP antagonists are likely to change current treatment schemes for migraine, which strongly depends also on the comorbidities. The present study might therefore be helpful for the future development of treatment guidelines.
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Affiliation(s)
- Carola A Huber
- Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland
| | - Reto Agosti
- Headache Center Hirslanden, Hirslanden Hospital Group, Zollikon, Switzerland
| | - Markus Näpflin
- Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland
| | - Eva Blozik
- Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland.,Department of Medicine, University Medical Centre Freiburg, Freiburg, Germany
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23
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Kim SY, Lee CH, Lim JS, Kong IG, Sim S, Choi HG. Increased risk of Bell palsy in patient with migraine: A longitudinal follow-up study. Medicine (Baltimore) 2019; 98:e15764. [PMID: 31124964 PMCID: PMC6571209 DOI: 10.1097/md.0000000000015764] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Migraine is thought to be associated with Bell palsy. This study aimed to investigate the risk of Bell palsy in migraine patients.The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. A total of 45,164 migraine patients were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia and compared with 180,656 controls. The migraine group included participants diagnosed with migraine [International Classification of Disease (ICD)-10: G43] who underwent treatment more than once. Participants with Bell palsy were included on the basis of the ICD-10 (G510) and treatment with steroids. A history of hypertension, diabetes, and dyslipidemia was determined using ICD-10 codes. Crude (simple) and adjusted hazard ratios (HRs) of Bell palsy in migraine patients were analyzed using the Cox proportional hazards model. Subgroup analyses were conducted based on age and sex.Bell palsy occurred in 0.6% (262/44,902) of the migraine group and 0.5% (903/179,753) of the control group. The adjusted HR of Bell palsy was 1.16 in the migraine group compared with the control group [95% confidence interval (95% CI) = 1.01-1.33, P = .34]. Among age-related subgroups, participants ≥30 and <60 years old in the migraine subgroup demonstrated a 1.28-times higher risk of Bell palsy than the control group (95% CI = 1.05-1.57, P = .014).Migraine increased the risk of Bell palsy in the total population. Among age subgroups, migraine patients ≥30 and <60 years old had an increased risk of Bell palsy.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam
| | - Chang-Ho Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang
| | - Il Gyu Kong
- Department of Statistics, Hallym University, Chuncheon
| | - Songyong Sim
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Department of Statistics, Hallym University, Chuncheon
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24
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Abstract
BACKGROUND AND PURPOSE Migraine headache is an enormous health care burden resulting in billions of dollars in workforce revenue lost and millions of lost workdays per year. Migraine headaches and depression are common comorbidities and require expertise in treatment and prevention. METHODS The aim of this article is to update the nurse practitioner (NP) on best clinical practices for managing the patient with migraine and previously diagnosed depression. This will include an overview of the pathophysiology of migraine, as well as criteria for diagnosis, treatment, prevention, and patient teaching. CONCLUSIONS Migraine and depression are commonly linked and require expertise in treatment to achieve the best patient outcomes. IMPLICATIONS FOR PRACTICE Patients with migraine are more likely to have depression than the general population. Both conditions require optimal treatment and patient education to reduce overall disease burden. A better understanding of the relationship between depression and migraine will enable the NP to better manage patients with migraine and comorbid depression.
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25
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Rains JC. Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders. Headache 2018; 58:1074-1091. [PMID: 30095163 DOI: 10.1111/head.13357] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2018] [Indexed: 12/16/2022]
Abstract
The relationship of sleep and migraine is unequivocal and familiarity with the nature and magnitude of these associations may inform clinical practice. Recent prospective, longitudinal, and time-series analysis has begun to unravel the magnitude and temporal patterns of sleep and migraine. Prospective evidence has shown that sleep variables can trigger acute migraine, precede and predict new onset headache by several years, and indeed, sleep disturbance and snoring are risk factors for chronification. The presence of a sleep disorder is associated with more frequent and severe migraine and portends a poorer headache prognosis. Interestingly, the disorders linked to migraine are quite varied, including insomnia, snoring and obstructive sleep apnea, restless legs, circadian rhythm disorders, narcolepsy, and others. Insomnia is by far the most common sleep disorder in headache patients. In fact, the majority of patients with chronic migraine presenting for treatment have insomnia. Despite a rapidly expanding literature, very few controlled treatment studies have been published to guide clinical practice. This paper focuses on clinical assessment and treatment of sleep disorders. An algorithm is presented for sleep disorders management in the migraine patient, which highlights major sleep disorders and psychiatric comorbidity. Diagnostic procedures are recommended that are conducive to clinical practice. Suggested tools include the sleep history, screening mnemonics, prediction equation, and sleep diary. New developments in treatment have produced abbreviated and cost-effective therapies for insomnia and obstructive sleep apnea that may reach a larger population. Revisions in the diagnostic manuals for sleep and headache disorders enhance recognition of sleep-related headache. Recommendations include behavioral sleep regulation, shown in recent controlled trials to decrease migraine frequency, management for sleep apnea headache, cognitive behavioral therapy (CBT) for insomnia abbreviated for the physician practice setting, sleep-related headache trigger, and others. There is no empirical evidence that sleep evaluation should delay or supersede usual headache care. Rather, sleep management is complimentary to standard headache practice.
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Affiliation(s)
- Jeanetta C Rains
- Center for Sleep Evaluation, Elliot Hospital, Manchester, NH, USA
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