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Su Y, Tay VQ, Singh S, Leary MC, Koss V, Kincaid HM, Yacoub HA, Castaldo J. A retrospective review of sex differences of white matter hyperintensities in brain MRI of patients with migraine. Headache 2024; 64:612-623. [PMID: 38785411 DOI: 10.1111/head.14714] [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: 08/25/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The primary objective of this study was to evaluate the prevalence of white matter hyperintensities (WMHs) in patients who experience migraine and compare findings between adult male and female patients. Specific symptoms and comorbidities also were analyzed to determine whether they were associated with WMH prevalence or the sex of patients with migraine. We hypothesized that females would have a higher prevalence of WMHs, experience more frequent and more severe migraine headaches, and be more likely to have certain comorbidities associated with migraine than males. BACKGROUND An increased prevalence of WMHs in patients with migraine has been proposed, although this relation is not well-supported by data from population-based MRI studies. The difference in brain morphology between males and females is of research interest, and females in the general population appear to have a higher prevalence of WMHs. Sex differences and various comorbidities in patients with migraine relative to the number of WMHs on brain imaging have not been fully investigated. METHODS This was a cross-sectional study of 177 patients aged 18 years and older with a diagnosis of migraine who were seen in the Lehigh Valley Fleming Neuroscience Institute's Headache Center between January 1, 2000, and January 1, 2017. Patients' baseline characteristics were extracted from electronic medical records, including demographics, review of systems documentation, and brain imaging from MRI. Variables including headache severity, frequency of head pain, insomnia, and comorbidities (anxiety, depression, diabetes, hyperlipidemia, hypertension, and neck pain) also were analyzed for associations with the presence of WMHs. RESULTS Females were found to have a significantly higher number of WMHs than males (median 3 [IQR: 0-7] vs. 0 [IQR: 0-3], p = 0.023). Patients with WMHs were significantly more likely than those without WMHs to have hypertension (39.8% of patients with WMHs vs. 20.3% without WMHs, p = 0.011), constipation (20.9% vs. 8.3%, p = 0.034), and sleep disorder (55.7% vs. 37.3%, p = 0.022). Females with migraine were significantly more likely to experience constipation than males (20.0% vs. 2.9%, p = 0.015). None of the migraine characteristics studied (frequency, severity, presence of aura) were different between sexes, nor were they significantly associated with the presence of WMHs. CONCLUSION This study suggests that females with migraine may be more likely to have WMHs and experience constipation than males with migraine. Migraine frequency and severity were not different between sexes, nor were they significantly associated with the presence of WMHs. The findings of this study do not support a specific etiology of WMH development in individuals with migraine that differs from findings in the general population. Further studies are warranted.
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Affiliation(s)
- Ye Su
- Department of Neurology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
| | - Victoria Q Tay
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Satinderpal Singh
- Department of Neurology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
| | - Megan C Leary
- Department of Neurology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Vitaliy Koss
- Department of Neurology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Hope M Kincaid
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
- Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
| | - Hussam A Yacoub
- Department of Neurology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
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Lackovic M, Jankovic M, Mihajlovic S, Milovanovic Z, Nikolic D. Exploring the Connection between Migraines and Pregnancy: The Impact of Physical Activity on Symptom Management. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:49. [PMID: 38256310 PMCID: PMC10820455 DOI: 10.3390/medicina60010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024]
Abstract
Migraine is a prevalent neurological disorder that significantly impacts the quality of life for affected individuals. The pathogenesis behind migraines is not yet fully understood, but hormonal changes, especially fluctuations in, estrogen and progesterone levels, have a significant role in the susceptibility of women to migraines. Pregnancy introduces a unique set of challenges for women who experience migraines, as they must navigate the complexities of managing their condition while safeguarding the health of both them and their unborn child. Pharmacological options for treating migraines during pregnancy are limited, and, therefore, there is a growing interest in exploring alternative approaches to migraine symptom relief and management. Physical activity during pregnancy provides a range of benefits, and it has gained attention as a potentially valuable tool for alleviating migraine symptoms in pregnant patients. This review explores the intricate relationship between migraines and pregnancy, emphasizing how physical activity and other alternative approaches may influence the frequency, severity, and overall experience of migraines during pregnancy. Through collaboration with healthcare providers and the adoption of personalized management strategies, women can strike a balance that supports both their own well-being and the healthy development of their unborn child. By examining existing research and emerging insights, we aim to provide a comprehensive understanding of the potential benefits and considerations of incorporating physical activity and other treatment options into migraine management strategies for pregnant women. Further research is needed to elucidate the specific mechanisms linking migraines, pregnancy, and physical activity, enabling the development of more targeted interventions and guidelines.
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Affiliation(s)
- Milan Lackovic
- Department of Obstetrics and Gynecology, University Hospital “Dragisa Misovic”, Milana Tepica 1, 11000 Belgrade, Serbia; (M.L.); (S.M.)
| | - Milena Jankovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
- Neurology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Sladjana Mihajlovic
- Department of Obstetrics and Gynecology, University Hospital “Dragisa Misovic”, Milana Tepica 1, 11000 Belgrade, Serbia; (M.L.); (S.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
| | - Zagorka Milovanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
- Clinic for Gynecology and Obstetrics “Narodni Front”, 11000 Belgrade, Serbia
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
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3
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He M, Kis-Jakab G, Komáromy H, Perlaki G, Orsi G, Bosnyák E, Rozgonyi R, John F, Trauninger A, Eklics K, Pfund Z. The volume of the thalamus and hippocampus in a right-handed female episodic migraine group. Front Neurol 2023; 14:1254628. [PMID: 37928149 PMCID: PMC10622660 DOI: 10.3389/fneur.2023.1254628] [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: 09/25/2023] [Indexed: 11/07/2023] Open
Abstract
Background/aim Migraine is a disabling headache with clinical and radiological complications. The aim of this study was to investigate the volume of the thalamus and hippocampus in migraineurs, the role of white matter lesions (WMLs), and the migraine characteristics in volume changes. Methods Brain MRIs of 161 right-handed female episodic migraine patients and 40 right-handed, age-related, healthy women were performed. Left and right thalamus segmentation was performed on the 3D MPRAGE images using the Freesurfer 5.3 image analysis suite. Hippocampal subfield segmentation was based on a novel statistical atlas built primarily upon ultra-high-resolution ex vivo MRI data. Results The left hippocampus had a smaller and the left thalamus had a larger total volume than the right one in both the control (p < 0.001) and migraine groups (p <0.001). Patients with white matter lesions (L+) showed smaller right thalamus and right hippocampal tail volumes than patients without lesions (L-) (p = 0.002 and p = 0.015, respectively) and controls (p = 0.039 and p = 0.025, respectively). For the right hippocampal body, we found significantly smaller volume in L+ patients when compared to L- patients (p = 0.018) and a similar trend when compared to the control group (p = 0.064). Patients without aura (A-) showed a larger right hippocampus (p = 0.029), right hippocampal body (p = 0.012), and tail volumes (p = 0.011) than patients with aura (A+). Inverse correlations were found between attack frequency and the volumes of the left and right hippocampal tails (p = 0.018 and p = 0.008, respectively). Conclusion These findings indicate that WMLs may influence the volume of the right thalamus and hippocampus, while migraine aura and attack frequency may lead to volume changes in different parts of the hippocampi in migraine patients. These data support the necessity of effective migraine management to limit subcortical volume loss in migraineurs.
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Affiliation(s)
| | - Gréta Kis-Jakab
- The Hungarian Research Network-Pécsi Tudományegyetem, Clinical Neuroscience Magnetic Resonance Research Group, Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | | | - Gábor Perlaki
- Pécs Diagnostic Center, Pécs, Hungary
- The Hungarian Research Network-Pécsi Tudományegyetem, Clinical Neuroscience Magnetic Resonance Research Group, Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Gergely Orsi
- Pécs Diagnostic Center, Pécs, Hungary
- The Hungarian Research Network-Pécsi Tudományegyetem, Clinical Neuroscience Magnetic Resonance Research Group, Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Edit Bosnyák
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Renáta Rozgonyi
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Flóra John
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Trauninger
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Kata Eklics
- Department of Languages for Biomedical Purposes and Communication, University of Pécs, Pécs, Hungary
| | - Zoltán Pfund
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
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Vila-Pueyo M, Cuenca-León E, Queirós AC, Kulis M, Sintas C, Cormand B, Martín-Subero JI, Pozo-Rosich P, Fernàndez-Castillo N, Macaya A. Genome-wide DNA methylation analysis in an antimigraine-treated preclinical model of cortical spreading depolarization. Cephalalgia 2023; 43:3331024221146317. [PMID: 36759321 DOI: 10.1177/03331024221146317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Cortical spreading depolarization, the cause of migraine aura, is a short-lasting depolarization wave that moves across the brain cortex, transiently suppressing neuronal activity. Prophylactic treatments for migraine, such as topiramate or valproate, reduce the number of cortical spreading depression events in rodents. OBJECTIVE To investigate whether cortical spreading depolarization with and without chronic treatment with topiramate or valproate affect the DNA methylation of the cortex. METHODS Sprague-Dawley rats were intraperitoneally injected with saline, topiramate or valproate for four weeks when cortical spreading depolarization were induced and genome-wide DNA methylation was performed in the cortex of six rats per group. RESULTS The DNA methylation profile of the cortex was significantly modified after cortical spreading depolarization, with and without topiramate or valproate. Interestingly, topiramate reduced by almost 50% the number of differentially methylated regions, whereas valproate increased them by 17%, when comparing to the non-treated group after cortical spreading depolarization induction. The majority of the differentially methylated regions lay within intragenic regions, and the analyses of functional group over-representation retrieved several enriched functions, including functions related to protein processing in the cortical spreading depolarization without treatment group; functions related to metabolic processes in the cortical spreading depolarization with topiramate group; and functions related to synapse and ErbB, MAPK or retrograde endocannabinoid signaling in the cortical spreading depolarization with valproate group. CONCLUSIONS Our results may provide insights into the underlying physiological mechanisms of migraine with aura and emphasize the role of epigenetics in migraine susceptibility.
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Affiliation(s)
- Marta Vila-Pueyo
- Headache and Neurological Pain Research Group, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.,Pediatric Neurology Research Group, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain
| | - Ester Cuenca-León
- Headache and Neurological Pain Research Group, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.,Departament de Genètica, Facultat de Biologia, Universitat de Barcelona, Spain
| | - Ana C Queirós
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Spain
| | - Marta Kulis
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Spain
| | - Cèlia Sintas
- Departament de Genètica, Facultat de Biologia, Universitat de Barcelona, Spain
| | - Bru Cormand
- Departament de Genètica, Facultat de Biologia, Universitat de Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - José Ignacio Martín-Subero
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Patricia Pozo-Rosich
- Headache and Neurological Pain Research Group, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.,Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Noèlia Fernàndez-Castillo
- Departament de Genètica, Facultat de Biologia, Universitat de Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Alfons Macaya
- Pediatric Neurology Research Group, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.,Institute of Neuroscience, Universitat Autònoma de Barcelona, Barcelona Spain
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Guo Z, Wang J, Liu D, Tian E, Chen J, Kong W, Zhang S. Early detection and monitoring of hearing loss in vestibular migraine: Extended high-frequency hearing. Front Aging Neurosci 2023; 14:1090322. [PMID: 36704499 PMCID: PMC9871761 DOI: 10.3389/fnagi.2022.1090322] [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: 11/05/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Background Vestibular migraine (VM) presents mainly with recurrent vestibular symptoms and migraine. A great number of patients with VM have cochlea symptoms such as tinnitus, hearing loss. Methods A cross-sectional study was conducted on patients with definite VM (dVM) and probable VM (pVM) who met the diagnostic criteria. Auditory-vestibular tests and psychological assessments were performed. Logistic regression was used to evaluate the predictive effect of EHF pure tone audiometry (PTA) for standard frequency (SF) hearing loss. Results Fifteen patients with pVM and 22 patients with dVM were recruited. Overall, the two most vertigo types were vestibulo-visual symptoms (83.78%) and internal vertigo (54.05%). A vertigo attack persisted for <5 min in approximately 57% of patients, compared with 5 min to 72 h in 43%, and lasted longer than 72 h in 8%. Approximately 87% of patients had psychological disorders. Most patients with VM (92%) suffered from some degree of EHF hearing impairment, and 68% had SF hearing loss, which is substantially higher than their complaints (43%). Moreover, the mean EHF hearing threshold cutoff value (57 dB HL) worked well in predicting SF hearing loss (area under curve, AUC, 0.827), outperforming distortion product optoacoustic emission (AUC, 0.748). Conclusion VM has a wide range of clinical manifestations. Hearing loss had a considerably higher rate compared to actual complaints. Moreover, patients with VM tended to have bilateral EHF and high-frequency hearing loss. The effectiveness of the mean EHF hearing threshold cutoff value in predicting hearing loss supported its use in the early detection of hearing loss and monitoring disease progression.
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Affiliation(s)
- Zhaoqi Guo
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dan Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - E. Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jingyu Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Union Hospital, Institute of Otorhinolaryngology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sulin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Union Hospital, Institute of Otorhinolaryngology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Sulin Zhang ✉
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Gago-Veiga AB, Camiña Muñiz J, García-Azorín D, González-Quintanilla V, Ordás CM, Torres-Ferrus M, Santos-Lasaosa S, Viguera-Romero J, Pozo-Rosich P. Headache: What to ask, how to examine, and which scales to use. Recommendations of the Spanish Society of Neurology's Headache Study Group. Neurologia 2022; 37:564-574. [PMID: 30929913 DOI: 10.1016/j.nrl.2018.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/05/2018] [Accepted: 12/22/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Headache is the most common neurological complaint at the different levels of the healthcare system, and clinical history and physical examination are essential in the diagnosis and treatment of these patients. With the objective of unifying the care given to patients with headache, the Spanish Society of Neurology's Headache Study Group (GECSEN) has decided to establish a series of consensus recommendations to improve and guarantee adequate care in primary care, emergency services, and neurology departments. METHODS With the aim of creating a practical document, the recommendations follow the dynamics of a medical consultation: clinical history, physical examination, and scales quantifying headache impact and disability. In addition, we provide recommendations for follow-up and managing patients' expectations of the treatment. CONCLUSIONS With this tool, we aim to improve the care given to patients with headache in order to guarantee adequate, homogeneous care across Spain.
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Affiliation(s)
- A B Gago-Veiga
- Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, España.
| | - J Camiña Muñiz
- Servicio de Neurología. Clínica Rotger y Hospital Quirónsalud Palmaplanas, Grupo Quirónsalud, Palma de Mallorca, España
| | - D García-Azorín
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - V González-Quintanilla
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - C M Ordás
- Servicio de Neurología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
| | - M Torres-Ferrus
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma Barcelona, Barcelona, España
| | - S Santos-Lasaosa
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - J Viguera-Romero
- Unidad Gestión Clínica de Neurología, Hospital Virgen Macarena, Sevilla, España
| | - P Pozo-Rosich
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma Barcelona, Barcelona, España
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Gago-Veiga A, Camiña Muñiz J, García-Azorín D, González-Quintanilla V, Ordás C, Torres-Ferrus M, Santos-Lasaosa S, Viguera-Romero J, Pozo-Rosich P. Headache: what to ask, how to examine, and what scales to use. Recommendations of the Spanish society of neurology’s headache study group. NEUROLOGÍA (ENGLISH EDITION) 2022; 37:564-574. [DOI: 10.1016/j.nrleng.2018.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/22/2018] [Indexed: 10/22/2022] Open
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Martami F, Jayedi A, Shab‐Bidar S. Primary headache disorders and body mass index categories: A systematic review and dose–response meta‐analysis. Headache 2022; 62:801-810. [DOI: 10.1111/head.14356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Fahimeh Martami
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran
| | - Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran
- Food Safety Research Center (Salt) Semnan University of Medical Sciences Semnan Iran
| | - Sakineh Shab‐Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran
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Rhee TM, Choi EK, Han KD, Ahn HJ, Lee SR, Oh S, Lip GYH. Type and Severity of Migraine Determines Risk of Atrial Fibrillation in Women. Front Cardiovasc Med 2022; 9:910225. [PMID: 35711356 PMCID: PMC9197451 DOI: 10.3389/fcvm.2022.910225] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate sex differences in the risk of atrial fibrillation (AF) according to the type and severity of migraine. Methods We analyzed the nationwide health screening recipients in 2009 without previous AF diagnosis from the Korean National Health Insurance Service data. The diagnosis, type, and severity of migraine were determined using claims data. Newly developed AF was identified during a 10-year follow-up. Sex-difference in the effect of migraine on AF was evaluated. Results A total of 4,020,488 subjects were enrolled from January 1, to December 31, 2009 and followed-up through December 31, 2018; 4,986 subjects had migraine with aura (age 50.6 ± 14.0 years, men 29.3%); and 105,029 had migraine without aura (age 51.6 ± 14.3 years, men 30.9%). Risk of AF in a mild degree of migraine was similar to that in the control group, regardless of sex or the presence of aura. Severe migraine without aura modestly but significantly increased the risk of AF in both men and women compared to controls, with increase in AF risk being most prominent in women who had severe migraine with aura [incidence rate (IR) = 3.39, hazard ratio (HR)adjust = 1.48, 95% confidence intervals (CI) = 1.18–1.85]. No significant association according to aura was observed in men with severe migraines (p for interaction 0.011). Conclusion Severe migraine with aura significantly increased the risk of incident AF in women, but not in men. Surveillance for incident AF and prompt lifestyle modification may be beneficial, particularly for young women suffering from severe migraine with aura.
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Affiliation(s)
- Tae-Min Rhee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
- *Correspondence: Eue-Keun Choi,
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Hyo-Jeong Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - So-Ryoung Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Gregory Y. H. Lip
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest and Heart Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Tsai CK, Tsai CL, Lin GY, Yang FC, Wang SJ. Sex Differences in Chronic Migraine: Focusing on Clinical Features, Pathophysiology, and Treatments. Curr Pain Headache Rep 2022; 26:347-355. [PMID: 35218478 DOI: 10.1007/s11916-022-01034-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW This review provides an update on sex differences in chronic migraine (CM), with a focus on clinical characteristics, pathophysiology, and treatments. RECENT FINDINGS Approximately 6.8-7.8% of all migraineurs have CM, with an estimated prevalence of 1.4-2.2% in the general population. The economic burden caused by CM, including medical costs and lost working ability, is threefold higher than that caused by episodic migraine (EM). Notably, the prevalence of migraine is affected by age and sex. Female migraineurs with CM experience higher levels of headache-related disability, including longer headache duration, higher frequency of attacks, and more severely impacted efficiency at work. Sex hormones, including estrogen, testosterone, and progesterone, contribute to the sexually dimorphic characteristics and prevalence of migraine in men and women. Recent neuroimaging studies have indicated that migraine may have a greater impact and cause greater dysfunction in the organization of resting-state functional networks in women. Accumulating evidence suggests that topiramate, Onabotulinumtoxin A and calcitonin gene-related peptide (CGRP) monoclonal antibodies are effective as the preventative treatments for CM. Recent evidence highlights a divergence in the characteristics of CM between male and female populations. The data comparing the treatment response for CM regarding sex are lacking.
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Affiliation(s)
- Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Guan-Yu Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.
| | - Shuu-Jiun Wang
- Neurological Institute, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou 112, Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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11
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Tekin H, Edem P. Effects and side effects of migraine prophylaxis in children. Pediatr Int 2022; 64:e15094. [PMID: 34905279 DOI: 10.1111/ped.15094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/29/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Migraine is the primary cause of headache in children. Most patients can be treated with lifestyle changes and acute attack prophylaxis. Prophylaxis should be considered when symptoms cause frequent school absenteeism, poor quality of life, recurring emergency room visits, and frequent analgesic use. We aimed to compare the efficacy and side effects of drugs used in migraine prophylaxis, chosen according to the clinical and/or demographic characteristics of the patients. METHODS One hundred eighty-six patients aged 6-18 years were evaluated and who were diagnosed with migraine according to The International Classification of Headache Disorders, 3rd edition beta version (ICH-3β). Propranolol, topiramate, flunarizine, and cyproheptadine were given as prophylactic treatment. The Pediatric Migraine Disability Assessment Score (PedMIDAS) score, severity, duration, and frequency of the headache attacks were evaluated from the medical records and pre- and post-treatment values were compared. RESULTS The median age of the patients was 14 years (range, 6-18 years) and the mean duration of headache was 29.6 ± 21.02 months. The mean PedMIDAS score was 29.9 ± 21.2 before and 14.9 ± 12.5 after treatment. Most reduction in the frequency of attacks was observed in the topiramate group. All four drugs significantly reduced the PedMIDAS score. The most common side effect was palpitations. CONCLUSIONS Significant improvement was found in PedMIDAS scores in all drug groups. Topiramate was found to be the most effective drug in reducing the frequency of attacks. All four drugs in this study may be utilized for migraine prophylaxis in terms of effectiveness and safety.
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Affiliation(s)
- Hande Tekin
- Division of Pediatric Neurology, Department of Pediatrics, Bakircay University Cigli Training and Research Hospital, Izmir, Turkey
| | - Pınar Edem
- Division of Pediatric Neurology, Department of Pediatrics, Bakircay University Cigli Training and Research Hospital, Izmir, Turkey
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12
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Headache and mental disorders in a nationally representative sample of American youth. Eur Child Adolesc Psychiatry 2022; 31:39-49. [PMID: 33721086 PMCID: PMC8691207 DOI: 10.1007/s00787-020-01599-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/08/2020] [Indexed: 01/03/2023]
Abstract
The objective of this study is to examine the association between headache and mental disorders in a nationally representative sample of American youth. We used the National Comorbidity Survey-Adolescent Supplement to assess sex-specific prevalence of lifetime migraine and non-migraine headache using modified International Headache Society criteria and examine associations between headache subtypes and DSM-IV mental disorders. Adolescent report (n = 10,123) was used to identify headache subtypes and anxiety, mood, eating, and substance use disorders. ADHD and behavior disorder were based on parent report (n = 6483). Multivariate logistic regression analyses controlling for key demographic characteristics were used to examine associations between headache and mental disorders. Headache was endorsed by 26.9% (SE = 0.7) of the total sample and was more prevalent among females. Youth with headache were more than twice as likely (OR 2.74, 95% CI 1.94-3.83) to meet criteria for a DSM-IV disorder. Migraine, particularly with aura, was associated with depression and anxiety (adjusted OR 1.90-2.90) and with multiple classes of disorders. Adolescent headache, particularly migraine, is associated with anxiety, mood, and behavior disorders in a nationally representative sample of US youth. Headache is highly prevalent among youth with mental disorders, and youth with headache should be assessed for comorbid depression and anxiety that may influence treatment, severity, and course of both headache and mental disorders.
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13
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Ohk B, Seong S, Lee J, Gwon M, Kang W, Lee H, Yoon Y, Yoo H. Evaluation of sex differences in the pharmacokinetics of oral sumatriptan in healthy Korean subjects using population pharmacokinetic modeling. Biopharm Drug Dispos 2021; 43:23-32. [PMID: 34923646 PMCID: PMC9306698 DOI: 10.1002/bdd.2307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/05/2021] [Accepted: 12/13/2021] [Indexed: 12/02/2022]
Abstract
Sumatriptan was introduced in 1983, as the first of the triptans, selective 5‐hydroxytryptamine (5‐HT1B/1D) receptor agonists, to treat moderate to severe migraine. Migraine predominates in females. Although there have been reports of sex differences in migraine‐associated features and pharmacokinetics (PKs) of some triptans, sex differences in the PKs of oral sumatriptan have never been evaluated in Korean. We conducted this study of oral sumatriptan to assess the sex differences in Korean population. Thirty‐eight healthy Korean subjects who participated in two separate clinical studies receiving a single oral dose of 50 mg sumatriptan with the same protocols were included in this analysis. A total of 532 sumatriptan concentration observations were used for a population PK modeling. Validation of final population PK model of sumatriptan was performed using bootstrap and visual predictive check. The PK profile of oral sumatriptan was adequately described by a one‐compartmental model with combined transit compartment model and a first‐order absorption. The covariate analysis showed that the clearance of oral sumatriptan was significantly higher in males than in females (male: 444 L/h, female: 281 L/h). Our results showed that there were sex differences in the clearance of oral sumatriptan. These results encourage further studies to establish the sumatriptan pharmacokinetic–pharmacodynamic model considering sex‐related PK differences, which may help to determine optimal dosing regimens for effective treatment of migraine in males and females. Clinical trial registration: CRIS Registration No. KCT0001784.
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Affiliation(s)
- Boram Ohk
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
| | - Sookjin Seong
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
| | - Joomi Lee
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
| | - Miri Gwon
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
| | - Wooyoul Kang
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
| | - Haewon Lee
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
| | - Youngran Yoon
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
| | - Heedoo Yoo
- School of MedicineKyungpook National University and Department of Clinical PharmacologyKyungpook National University HospitalDaeguRepublic of Korea
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14
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Is there any association between migraine headache and polycystic ovary syndrome (PCOS)? A review article. Mol Biol Rep 2021; 49:595-603. [PMID: 34651295 DOI: 10.1007/s11033-021-06799-8] [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: 07/09/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) and migraine headaches are considered to be common health problems that may share some risk factors. This study aimed to discuss the possible association between migraine headache and polycystic ovary syndrome. METHODS AND RESULTS In this narrative review, PubMed, Scopus, Web of Science, and Google Scholar were systematically searched for retrieving and summarizing published studies up to January 2021 to explore the possible interplay between migraine headache and PCOS. We discuss the possible pathways that may explain the association between migraine headaches and PCOS signs/symptoms and complications. While genetic factors have profound effects on the pathogenesis of migraine headaches, sex hormones, including estrogen and progesterone may also play an important role in inducing migraine headaches. Some disorders, such as sleep apnea, amenorrhea, and vascular disease that are more likely to occur in women with PCOS, may cause or exacerbate migraine headaches in women with PCOS. CONCLUSIONS Future comprehensive studies are needed to investigate the exact underlining mechanisms related to the association between PCOS and migraine headaches.
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Abstract
Migraine is considered mostly a woman’s complaint, even if it affects also men. Epidemiological data show a higher incidence of the disease in women, starting from puberty throughout life. The sex-related differences of migraine hold clinical relevance too. The frequency, duration, and disability of attacks tend to be higher in women. Because of this, probably, they also consult specialists more frequently and take more prescription drugs than men. Different mechanisms have been evaluated to explain these differences. Hormonal milieu and its modulation of neuronal and vascular reactivity is probably one of the most important aspects. Estrogens and progesterone regulate a host of biological functions through two mechanisms: nongenomic and genomic. They influence several neuromediators and neurotransmitters, and they may cause functional and structural differences in several brain regions, involved in migraine pathogenesis. In addition to their central action, sex hormones exert rapid modulation of vascular tone. The resulting specific sex phenotype should be considered during clinical management and experimental studies.
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16
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Milošević N, Trajković JZ, Mijajlović M, Milošević J, Podgorac A, Vitošević Z, Novaković T, Pekmezović T. The first prevalence study of primary headaches in adults in a post-conflict area of Serbia. Cephalalgia 2021; 41:959-967. [PMID: 33938250 DOI: 10.1177/03331024211006043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIM The aim of the present study was to establish annual prevalence of primary headaches, migraine, and tension-type headache among adults in a post-conflict area of Serbia. METHODS The data for this cross-sectional study was obtained via face-to-face interviews using questionnaires specifically designed for this purpose, in line with the available guidelines. The study sample included adults aged 18-65 years whose native language is Serbian with residence in six predominantly Serbian communities in Kosovo and Metohija. Relevant diagnoses were established according to the diagnostic criteria of the International Classification of Headache Disorders, 3rd edition. RESULTS The study included 1062 adults. Analyses indicated 47.7% prevalence of primary headaches. The 1-year prevalence of migraine (with aura and without aura) and tension-type headache was established at 15.2% (3.3% and 11.9%), and 32.2%, respectively. One-year prevalence of chronic headache was calculated at 3.5%, while the prevalence of medication overuse headache was slightly lower at 2.9%. Primary headaches were more prevalent among women, participants residing south of the river Ibar, married or cohabiting individuals, as well as among interviewees (persons) who reported feeling unsafe in Kosovo and Metohija. This is the first study of the prevalence of primary headache disorders in Serbia. The obtained data is comparable to the data available for other countries, especially those in the Balkan region.
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Affiliation(s)
- Nenad Milošević
- University of Pristina - Kosovska Mitrovica, Faculty of Medicine, Serbia.,Clinical-Hospital Center Pristina-Gracanica, Kosovska Mitrovica, Serbia
| | - Jasna Zidverc Trajković
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Milija Mijajlović
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Jovana Milošević
- University of Pristina - Kosovska Mitrovica, Faculty of Medicine, Serbia
| | | | - Zdravko Vitošević
- University of Pristina - Kosovska Mitrovica, Faculty of Medicine, Serbia
| | - Tatjana Novaković
- University of Pristina - Kosovska Mitrovica, Faculty of Medicine, Serbia.,Clinical-Hospital Center Pristina-Gracanica, Kosovska Mitrovica, Serbia
| | - Tatjana Pekmezović
- University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia
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17
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Verhaak AMS, Williamson A, Johnson A, Murphy A, Saidel M, Chua AL, Minen M, Grosberg BM. Migraine diagnosis and treatment: A knowledge and needs assessment of women's healthcare providers. Headache 2021; 61:69-79. [PMID: 33377176 PMCID: PMC8771914 DOI: 10.1111/head.14027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Studies suggest that migraine is often underdiagnosed and inadequately treated in the primary care setting, despite many patients relying on their primary care provider (PCP) to manage their migraine. Many women consider their women's healthcare provider to be their PCP, yet very little is known about migraine knowledge and practice patterns in the women's healthcare setting. OBJECTIVE The objective of this study was to assess women's healthcare providers' knowledge and needs regarding migraine diagnosis and treatment. METHODS The comprehensive survey assessing migraine knowledge originally developed for PCPs was used in this study, with the addition of a section regarding the use of hormonal medications in patients impacted by migraine. Surveys were distributed online, and primarily descriptive analyses were performed. RESULTS The online survey was completed by 115 women's healthcare providers (response rate 28.6%; 115/402), who estimated that they serve as PCPs for approximately one-third of their patients. Results suggest that women's healthcare providers generally recognize the prevalence of migraine, but experience some knowledge gaps regarding migraine management. Despite 82.6% (95/115) of survey respondents feeling very comfortable or somewhat comfortable with diagnosing migraine, only 57.9% (66/114) reported routinely asking patients about headaches during annual visits. Very few were familiar with the American Academy of Neurology guidelines on preventative treatment (6.3%; 7/111) and the Choosing Wisely Campaign recommendations on migraine treatment (17.3%; 19/110), and many prescribed medications known to contribute to medication overuse headache. In addition, only 24.3% (28/115) would order imaging for a new type of headache, 35.7% (41/115) for worsening headache, and 47.8% (55/115) for headache with neurologic symptoms; respondents cited greater tendency with sending patients to an emergency department for the same symptoms. Respondents had limited knowledge of evidence-based, non-pharmacological treatments for migraine (i.e., biofeedback or cognitive behavioral therapy), with nearly none placing referrals for these services. Most providers were comfortable prescribing hormonal contraception (mainly progesterone only) to women with migraine without aura (80.9%; 89/110) and with aura (72.5%; 79/109), and followed American College of Obstetricians and Gynecologists (ACOG) guidelines to limit combination hormonal contraception for patients with aura. When queried, 6.3% or less (5/79) of providers would prescribe estrogen-containing contraception for women with migraine with aura. Only 37.3% (41/110) of respondents reported having headache/migraine education. Providers indicated interest in education pertaining to migraine prevention and treatment (96.3%; 105/109), migraine-associated disability (74.3%; 81/109), and diagnostic testing (59.6%; 65/109). CONCLUSION Women's healthcare providers appear to have several knowledge gaps regarding the management of migraine in their patients. These providers would likely benefit from access to a headache-specific educational curriculum to improve provider performance and patient outcomes.
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Affiliation(s)
- Allison M. S. Verhaak
- Hartford Healthcare Headache Center, Ayer Neuroscience Institute, West Hartford, CT, USA
- Division of Health Psychology, The Institute of Living/Hartford Hospital, Hartford, CT, USA
| | - Anne Williamson
- Research Department, Hartford Healthcare, West Hartford, CT, USA
| | - Amy Johnson
- Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, CT, USA
- Department of Obstetrics and Gynecology, Hartford HealthCare, West Hartford, CT, USA
| | - Andrea Murphy
- Hartford Healthcare Headache Center, Ayer Neuroscience Institute, West Hartford, CT, USA
| | | | - Abigail L. Chua
- Hartford Healthcare Headache Center, Ayer Neuroscience Institute, West Hartford, CT, USA
- Department of Neurology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Mia Minen
- Department of Neurology, New York University School of Medicine, New York, NY, USA
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Brian M. Grosberg
- Hartford Healthcare Headache Center, Ayer Neuroscience Institute, West Hartford, CT, USA
- Department of Neurology, University of Connecticut School of Medicine, Farmington, CT, USA
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18
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Personality and Headaches: Findings From Six Prospective Studies. Psychosom Med 2021; 83:118-124. [PMID: 33395215 PMCID: PMC8858382 DOI: 10.1097/psy.0000000000000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The present study examined the association between personality traits and concurrent and incident headaches. METHODS Participants (n = 34,989), aged 16 to 107 years were from the Midlife in the United States study, the Midlife in Japan study, the Health and Retirement Study, the Wisconsin Longitudinal Study Graduate and Siblings samples, and the Longitudinal Internet Studies for the Social Sciences. Demographic factors, personality traits, and headaches were assessed at baseline. Headaches were assessed again 4 to almost 20 years later. RESULTS Across the samples, higher neuroticism was related to a higher likelihood of concurrent (combined odd ratio = 1.41, 95% confidence interval [CI] = 1.28-1.55, p < .001) and incident (combined odd ratio = 1.28, 95% CI = 1.12-1.46, p < .001) headaches, whereas higher extraversion was associated with a lower likelihood of concurrent (combined odd ratio = 0.87, 95% CI = 0.84-0.89, p < .001) and incident (combined odd ratio = 0.90, 95% CI = 0.85-0.96, p = .001) headaches. Higher conscientiousness (combined odd ratio = 0.90, 95% CI = 0.86-0.94, p < .001) and openness (combined odd ratio = 0.95, 95% CI = 0.90-0.99, p = .025) were associated with a lower probability of reporting concurrent headaches. Agreeableness was unrelated to headaches. Sex was not a consistent moderator. CONCLUSIONS The present study provides robust evidence that neuroticism and introversion are risk factors for headaches in concurrent and prospective analyses across multiple cohorts.
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Fuensalida-Novo S, Jiménez-Antona C, Benito-González E, Cigarán-Méndez M, Parás-Bravo P, Fernández-De-Las-Peñas C. Current perspectives on sex differences in tension-type headache. Expert Rev Neurother 2020; 20:659-666. [PMID: 32510251 DOI: 10.1080/14737175.2020.1780121] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Clinical and experimental evidence supports the presence of several gender differences in the pain experience. AREAS COVERED The current paper discusses biological, psychological, emotional, and social differences according to gender and their relevance to TTH. Gender differences have also been observed in men and women with tension-type headache and they should be considered by clinicians managing this condition. It appears that multimodal treatment approaches lead to better outcomes in people with tension-type headache; however, management of tension-type headache should consider these potential gender differences. Different studies have observed the presence of complex interactions between tension-type headache, emotional stress, sleep, and burden and that these interactions are different between men and women. EXPERT OPINION Based on current results, the authors hypothesize that treatment of men with tension-type headache should focus on the improvement of sleep quality and the level of depression whereas treatment of women with TTH should focus on nociceptive mechanisms and emotional/stressful factors. Future trials should investigate the proposed hypotheses.
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Affiliation(s)
- Stella Fuensalida-Novo
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
| | - Carmen Jiménez-Antona
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
| | - Elena Benito-González
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
| | | | - Paula Parás-Bravo
- Department of Nursing, Universidad de Cantabria , Spain.,Nursing Area, Nursing Research Group IDIVAL , Santander, Cantabria, Spain
| | - César Fernández-De-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
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20
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Cooper W, Doty EG, Hochstetler H, Hake A, Martin V. The current state of acute treatment for migraine in adults in the United States. Postgrad Med 2020; 132:581-589. [PMID: 32459561 DOI: 10.1080/00325481.2020.1767402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Migraine is a common and disabling disorder with substantial personal, social, and economic burden that affects 37 million people in the United States. Risk factors for migraine include age, sex, and genetics. The goal of acute treatment of migraine attacks is to stop the pain and associated symptoms of the migraine attack and return the patient to normal function. The acute treatment landscape for migraine has recently expanded beyond the standard nonsteroidal anti-inflammatory drugs, analgesics, triptans, ergotamines, and combination therapies, to include neuromodulation devices, and recently approved calcitonin gene-related peptide receptor antagonists and a serotonin (5-HT1F) receptor agonist. Unmet acute treatment needs still exist due to lack of efficacy, unwanted side effects, or contraindication to treatment. Effective treatment of migraine requires the clinician to assess the patient, make an accurate diagnosis, and then offer appropriate therapy based on the patient's medical history, comorbidities, and preferences, as well as published clinical evidence. The objective of this narrative review is to familiarize primary care clinicians with the variety of acute treatment options available in the United States today based on clinical trial findings, meta-analyses, evidence-based guidelines, and professional society consensus statements.
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Affiliation(s)
- Wade Cooper
- University of Michigan, Department of Neurology, Headache and Neuropathic Pain Program , Ann Arbor, MI, USA
| | | | | | - Ann Hake
- Eli Lilly and Company , Indianapolis, IN, USA
| | - Vincent Martin
- University of Cincinnati, College of Medicine, Department of Internal Medicine , Cincinnati, OH, USA
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21
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Frederiksen SD, Haanes KA, Warfvinge K, Edvinsson L. Perivascular neurotransmitters: Regulation of cerebral blood flow and role in primary headaches. J Cereb Blood Flow Metab 2019; 39:610-632. [PMID: 29251523 PMCID: PMC6446417 DOI: 10.1177/0271678x17747188] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 11/04/2017] [Accepted: 11/06/2017] [Indexed: 12/17/2022]
Abstract
In order to understand the nature of the relationship between cerebral blood flow (CBF) and primary headaches, we have conducted a literature review with particular emphasis on the role of perivascular neurotransmitters. Primary headaches are in general considered complex polygenic disorders (genetic and environmental influence) with pathophysiological neurovascular alterations. Identified candidate headache genes are associated with neuro- and gliogenesis, vascular development and diseases, and regulation of vascular tone. These findings support a role for the vasculature in primary headache disorders. Moreover, neuronal hyperexcitability and other abnormalities have been observed in primary headaches and related to changes in hemodynamic factors. In particular, this relates to migraine aura and spreading depression. During headache attacks, ganglia such as trigeminal and sphenopalatine (located outside the blood-brain barrier) are variably activated and sensitized which gives rise to vasoactive neurotransmitter release. Sympathetic, parasympathetic and sensory nerves to the cerebral vasculature are activated. During migraine attacks, altered CBF has been observed in brain regions such as the somatosensory cortex, brainstem and thalamus. In regulation of CBF, the individual roles of neurotransmitters are partly known, but much needs to be unraveled with respect to headache disorders.
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Affiliation(s)
- Simona D Frederiksen
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Kristian A Haanes
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Karin Warfvinge
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
- Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Lars Edvinsson
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
- Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University, Lund, Sweden
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22
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Song TJ, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Sex Differences in Prevalence, Symptoms, Impact, and Psychiatric Comorbidities in Migraine and Probable Migraine: A Population-Based Study. Headache 2019; 59:215-223. [PMID: 30623976 DOI: 10.1111/head.13470] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study was conducted to investigate sex differences in the prevalence and clinical presentation of migraine and probable migraine in a general population-based sample. BACKGROUND While there is research on sex differences in clinical characteristics and their impact on migraine headache, only few studies have investigated sex differences in probable migraine in population-based settings. Moreover, compared with Western countries, the prevalence of probable migraine in Asia is relatively high. This cross-sectional study was designed to investigate sex differences in the prevalence and clinical presentation of migraine and probable migraine in a general population-based sample. METHODS We used the data of the Korean Headache-Sleep Study, which is a nationwide survey on headache and sleep. RESULTS We interviewed 7430 people, and 3114 of them agreed to participate in our study (rejection rate, 58.1%). Among these people, 419 withdrew their participation during the interview. Ultimately, 2695 people completed our survey (cooperation rate, 36.3%). The prevalence of overall migraine and probable migraine was 350/1350 (25.9%) for women and 172/1345 (12.8%) for men (P < .001, respectively). The prevalence of migraine (107/1350 [7.9%] vs 36/1345 [2.7%], P < .001) and probable migraine (243/1350 [18.0%] vs 136/1345 [10.1%], P < .001) was significantly higher among women than among men. Headache frequency per month (median [interquartile range]) (1.0 [0.3-3.0] vs 0.8 [0.3-2.0], P = .037), the visual analog scale score for headache intensity (5.0 [4.0-7.0] vs 5.0 [3.0-6.0], P = .019), and the impact of headache {Headache Impact Test-6 score (47.0 [42.0-54.0] vs 44.0 [42.0-51.8], P = .013)} were significantly higher among women with probable migraine than men. Headache frequency per month (2.0 [0.4-4.0] vs 1.0 [0.3-2.0], P = .073), headache intensity (6.0 [5.0-8.0] vs 6.0 [4.2-7.0], P = .281), and the impact of headache (55.0 [48.0-61.0] vs 49.0 [46.3-60.8], P = .225) were not significantly different between women and men with migraine. Other comorbidities or associated symptoms, such as anxiety and depression, were not significantly different between women and men with migraine and probable migraine, except for nausea in probable migraine. CONCLUSION Women experience more severe symptoms and a higher impact of headache than men among participants with probable migraine. Our findings suggest that women with PM need a more intensive evaluation and treatment than men with PM.
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Affiliation(s)
- Tae-Jin Song
- Department of Neurology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea
| | - Kwang Ik Yang
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
| | - Chang-Ho Yun
- Bundang Clinical Neuroscience Center, Department of Neurology, Seoul National University Hospital, Seongnam, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Bianchin L, Bozzola M, Battistella Pier A, Bernasconi S, Bona G, Buzi F, De Sanctis C, De Sanctis V, Tonini G, Radetti G, Rigon F, Perissinotto E. Menstrual Cycle and Headache in Teenagers. Indian J Pediatr 2019; 86:25-33. [PMID: 30637681 DOI: 10.1007/s12098-018-2829-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/28/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This population-based study on school-aged girls aimed to estimate the rate of peri-menstrual headache, evaluate headache pain pattern during the menstrual cycle, and verify its relationships with physical, psychosocial and life-style factors. METHODS The students (n = 4973) fulfilled a self-administered questionnaire on demographic and behavioral characteristics, menarche, menstrual pattern and features including headache and dysmenorrhea. The prevalence of headache and the mean pain intensity score at the three menstrual cycle phases (premenstrual, menstrual, in-between period) were estimated, both overall and by gynecological year. Furthermore, the prevalence of three different patterns of headache (peri menstrual/mid-cycle/acyclic) was evaluated, together with the mean pain intensity score. RESULTS The overall prevalence of headache at least once at any time during the menstrual cycle was 64.4%. At multivariable logistic analysis, gynecological age (OR 1.07; 95%CI 1.03-1.12), middle social level (1.24; 1.01-1.55, compared to high social level), physical activity (0.67; 0.51-0.89), oral contraceptive use (1.34; 1.04-1.73) and dysmenorrhea (2.30; 1.54-3.42) were significantly associated with headache. Among girls with headache, 83.4% had peri-menstrual headache (44.6% premenstrual, 38.8% menstrual), 3.5% mid-cycle headache and 13.2% acyclic headache. The gynaecological age and dysmenorrhea were significantly associated with the headache pattern (p = 0.03 and p < 0.0001, respectively). CONCLUSIONS This study suggests that peri-menstrual headache is highly prevalent among adolescents. In girls, the headache rate linearly raises with higher gynecological age; menses-related painful syndromes, such as headache and dysmenorrhea, are strongly interrelated. The anamnesis and monitoring of menstrual health should be mandatory when taking care of girls with headache.
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Affiliation(s)
- Luigi Bianchin
- Child Psychiatric Unit, Local Health and Social Care Services - ULSS 6 Euganea, Padua, Italy
| | - Mauro Bozzola
- Internal Medicine and Therapeutics, Section of Childhood and Adolescence, Foundation IRCCS San Matteo, University of Pavia, Pavia, Italy
| | | | | | - Gianni Bona
- Division of Pediatrics, Department of Mother and Child Health, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Fabio Buzi
- Department of Pediatrics, "Carlo Poma" Hospital, Mantova, Italy
| | - Carlo De Sanctis
- Department of Pediatric Endocrinology, Ospedale Infantile Regina Margherita, Turin, Italy
| | - Vincenzo De Sanctis
- Private Accredited Hospital Quisisana, Pediatric and Adolescent Outpatients Clinic, Ferrara, Italy
| | | | - Giorgio Radetti
- Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - Franco Rigon
- Department of Woman's and Child Health, University of Padua, Padua, Italy
| | - Egle Perissinotto
- Unit of Biostatistics, Epidemiology Public Health, Department of Cardiac, Thoracic, Vascular Science and Public Health, University of Padua, Padua, Italy.
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Gazerani P, Cairns BE, Yassin H, Yousefi JT, Sherzaman AR, Nedergaard BS, Boldsen SK. Amplification of glyceryl trinitrate-induced headache features by noxious craniofacial stimuli in pain-free healthy humans. Pain Manag 2019; 9:17-35. [PMID: 30501556 DOI: 10.2217/pmt-2018-0035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Glyceryl trinitrate (GTN) provokes an immediate migraine-like headache, followed by a delayed migraine attack in migraineurs. In healthy volunteers, only an immediate, less severe and shorter headache occurs. The presence of an already sensitized nervous system in migraineurs may underlie the more intense and prolonged GTN-evoked headaches. We tested if in healthy humans, application of noxious cutaneous and/or mechanical stimulation within craniofacial region would enhance or prolong GTN-evoked headache. MATERIALS & METHODS Noxious stimuli with a capsaicin patch on forehead, a mechanical headband, or both were applied prior to sublingual GTN (0.5 mg) in 20 healthy volunteers. GTN-induced headache characteristics and sensory responsiveness were recorded. RESULTS A more intense GTN-evoked headache was produced following application of headband. CONCLUSION Noxious mechanical stimulation prior to GTN resulted in a more intense GTN-evoked headache.
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Affiliation(s)
- Parisa Gazerani
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Brian Edwin Cairns
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, Denmark.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Hanim Yassin
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Jasmin Tannaz Yousefi
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Asiah Rahi Sherzaman
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, Denmark
| | | | - Søren Kjærgaard Boldsen
- Unit of Clinical Biostatistics and Bioinformatics, Aalborg University Hospital North, Aalborg, Denmark
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Yin JH, Tsai CL, Lee PJ, Chou CH, Chen SY, Chung CH, Chien WC, Lin CC, Sung YF, Yang FC, Tsai CK, Lee JT. Age-specific and gender-dependent impact of primary headache disorders on dementia risk: Population-based longitudinal study. Medicine (Baltimore) 2018; 97:e13789. [PMID: 30593163 PMCID: PMC6314725 DOI: 10.1097/md.0000000000013789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/29/2018] [Indexed: 01/03/2023] Open
Abstract
Dementia is a global burden of public health. Headache disorders are the third most common cause of disability worldwide and common problems in the elderly population. Few studies focused on the relationship between primary headache disorders (PHDs) and cognitive status, and the results remain controversial. The aim of this countrywide, population-based, retrospective study was to investigate potential association between PHDs and dementia risk.We enrolled 1346 cases with PHDs to match the 5384 individuals by age, gender and co-morbidities. The definition of PHDs, dementia, and risk factors of dementia was identified according to The International Classification of Diseases, Ninth Revision, Clinical Modification. Cox regression was administered for estimating hazard ratios (HR) for dementia.During more than 5 years of follow-up, PHDs individuals had 1.52 times (P <.05) greater risk to develop all dementia compared with individuals without PHDs. Elderly (aged ≥65 years) patients with PHDs displayed significantly higher risk to develop all dementia (P <.01) and non-Alzheimer non-vascular dementia (NAVD) P <.01). Female PHDs individuals were at higher risk of suffering from all dementia (P <.05) and NAVD (P <.05). The influence of PHDs on all dementia was highest in the first 2 years of observation.The results indicated PHDs are linked to a temporarily increased risk for dementia, mainly NAVD, with age-specific and gender-dependent characteristics.
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Affiliation(s)
- Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
- Division of Neurology, Department of Medicine, Cheng Hsin General Hospital
| | - Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
| | - Pei-Jung Lee
- Departments of Nursing, Tri-Service General Hospital, National Defense Medical Center
| | - Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei
| | - Shao-Yuan Chen
- Department of Neurology, Cardinal Tien Hospital
- Department of Hyperbaric Medicine, Cardinal Tien Hospital
- School of Medicine, Fu-Jen Catholic University, New Taipei City
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association
- School of Public Health, National Defense Medical Center
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei
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Clinical Characteristics of Benign Recurrent Vestibulopathy: Clearly Distinctive From Vestibular Migraine and Menière's Disease? Otol Neurotol 2018; 38:e357-e363. [PMID: 28834943 DOI: 10.1097/mao.0000000000001553] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We aimed to systematically investigate the clinical characteristics of benign recurrent vestibulopathy (BRV), vestibular migraine (VM), and Menière's disease (MD) and to assess whether clinical symptoms exist that are unique to BRV. STUDY DESIGN Prospective cohort study. SETTING Tertiary referral center. METHODS Between January 2015 and November 2016, patients were prospectively recruited at a specialized dizziness clinic. Patients were included if they met the diagnostic criteria for BRV, VM, or MD which was evaluated by simultaneous consultation of an otorhinolaryngologist and neurologist. All patients received a comprehensive clinical examination that included vestibular tests and pure-tone audiometry. A questionnaire was designed to systematically document symptoms of the three vestibular disorders. RESULTS A total of 122 patients were included in our study, 65 (53%) were females in whom 29 (24%) were postmenopausal. The mean age was 55.5 ± 13.7 years and the mean age of onset of vertigo attacks was 49.2 ± 14.8 years (n = 119). Forty-five (37%) patients had a clinical diagnosis of BRV, 34 (28%) of VM, and 43 (35%) of MD. No symptom could be identified which was specifically linked to BRV. In patients with BRV, similar to those with VM, we found a female preponderance (p = 0.05 in BRV, p = 0.001 in VM). Patients with VM reported significantly more often a positive history of motion sickness (p = 0.01). In addition, canal paresis was most profound in patients with MD (p = 0.001). CONCLUSION We found no clinical characteristics that were distinctive for BRV. However, we did find several distinctive clinical features for VM and MD which may assist the physician in their history taking.
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Li W, Diao X, Chen C, Li C, Zhang Y, Li Y. Changes in hormones of the hypothalamic-pituitary-gonadal axis in migraine patients. J Clin Neurosci 2018; 50:165-171. [DOI: 10.1016/j.jocn.2017.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 10/01/2017] [Accepted: 11/14/2017] [Indexed: 11/28/2022]
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Shala N, Dreshaj S. Association of depression, anxiety and post-traumatic stress disorder with migraine: Data from Kosovo. Neurol Neurochir Pol 2018; 52:490-494. [PMID: 29580567 DOI: 10.1016/j.pjnns.2018.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 03/06/2018] [Accepted: 03/07/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Migraine is ranked as the seventh leading cause of disability worldwide, and it is characterized by a manifestation of combined neurological, gastrointestinal, and autonomic symptoms linked with different provoking factors. AIM OF THE STUDY This study investigates the association between migraine and PTSD, depression and anxiety in the Kosovo population during the post-war period. MATERIAL AND METHODS 273 war survivors with headache were enrolled in the study and were divided into two groups: 153 individuals with confirmed migraine (the study group) and 120 individuals with non-migraine headaches (control group). All individuals were evaluated using the ICHD-II 2004 diagnostic criteria for migraine, as well as the mini-test for PTSD, MMPI (Minnesota Multiphasic Personality Inventory) for psychological evaluation, PAI (Personality Assessment Inventory) and Hamilton Scale for Depression. RESULTS Among migraine patients, depressive disorders were present in 27.5% of patients, anxiety was found in 60.8%, and PTSD was present in 39.2%. While the prominence of depression was not different between groups, anxiety was significantly more common (p<0.05) in women from the control group. PTSD was significantly more common (p<0.001) in migraine patients overall, whereas the difference in PTSD prevalence between women from the migraine and control groups came close to significance (p=0.05). Females in the migraine group had higher incidences of aura (50% vs. 25.5%), whereas the incidence of aura in males in each group was approximately equal (9.8% vs. 7.84%). CONCLUSION Based on our data, we can confirm an association between PTSD and migraine in a sample of patients from Kosovo.
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Affiliation(s)
- Nexhmedin Shala
- University of Prishtina, Faculty of Medicine, Clinic of Neurology, Prishtina University Clinical Centre, Kosovo
| | - Shemsedin Dreshaj
- University of Prishtina, Faculty of Medicine, Clinic of Infectious Diseases, PrishtinaUniversity Clinical Centre, Kosovo.
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Communication of health in experimentally sick men and women: A pilot study. Psychoneuroendocrinology 2018; 87:188-195. [PMID: 29102898 DOI: 10.1016/j.psyneuen.2017.10.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 11/21/2022]
Abstract
The way people communicate their ill-health and the factors involved in ill-health communication remain poorly known. In the present study, we tested how men and women communicate their sickness and assessed whether sickness-related variables (i.e., body temperature, immune response, subjective sickness symptoms) predicted communicative behaviors. Twenty-two participants were filmed during experimentally induced sickness, triggered by lipopolysaccharide administration (2ng/kg body weight), and after placebo administration, in presence of female care providers. Two trained raters scored participants' communicative behaviors (verbal complaints, moaning and sighs/deep breaths). The physiological and subjective sickness responses were similar in both sexes. Participants were more likely to moan and complain when sick, although the frequency of these behaviors remained low and no clear sex differences was observed. Nevertheless, frequency of sighs/deep breaths was increased amongst sick men but not in women. Sickness-related variables did not predict sigh/deep breath frequency. In this setting, sick men appear to display a lower threshold of expressing their malaise as compared to similarly sick women.
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30
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Pavlovic JM, Akcali D, Bolay H, Bernstein C, Maleki N. Sex-related influences in migraine. J Neurosci Res 2017; 95:587-593. [PMID: 27870430 DOI: 10.1002/jnr.23903] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/02/2016] [Accepted: 08/05/2016] [Indexed: 01/04/2023]
Abstract
Migraine is a common neurological disorder with significantly higher incidence and prevalence in women than men. The presentation of the disease in women is modulated by changes in sex hormones from adolescence to pregnancy and menopause. Yet, the effect of sex influences has often been neglected in both basic and clinical and in clinical management of the disease. In this review, evidence from epidemiological, clinical, animal, and neuroimaging studies on the significance of the sex-related influences in migraine is presented, and the unmet needs in each area are discussed. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jelena M Pavlovic
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.,Montefiore Headache Center, Bronx, New York
| | - Didem Akcali
- Department of Neurology and Neuropsychiatry Centre, Gazi University School of Medicine, Ankara, Turkey
| | - Hayrunnisa Bolay
- Department of Neurology and Neuropsychiatry Centre, Gazi University School of Medicine, Ankara, Turkey
| | - Carolyn Bernstein
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nasim Maleki
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
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31
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Sina F, Razmeh S, Habibzadeh N, Zavari A, Nabovvati M. Migraine headache in patients with idiopathic intracranial hypertension. Neurol Int 2017; 9:7280. [PMID: 29071043 PMCID: PMC5641834 DOI: 10.4081/or.2017.7280] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 07/05/2017] [Indexed: 01/03/2023] Open
Abstract
Migraine is a neurological disorder that afflicts many people in the world and can cause severe disability during the attacks. The pathophysiology of migraine is complex and not fully understood. It seems that migraine is common in idiopathic intracranial hypertension (IIH). However, the association between migraine headache and IIH is still unclear. The present study was conducted to assess the prevalence of migraine headache and associated factors in IIH patients. In this cross-sectional study, a total of 68 patients diagnosed with IIH underwent a medical history interview and a neurological examination. The diagnosis of migraine was based on the four diagnostic criteria of the International Classification of Headache Disorders 3rd edition. Forty-five patients (63.2%) met the diagnostic criteria of migraine headache. There was no significant difference between patients with and without migraine headache in respect of their age, gender, body mass. This study revealed high prevalence of migraine headache in IIH patients; appropriate treatment can reduce their headache and prevent unnecessary treatments for IIH.
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Affiliation(s)
- Farzad Sina
- Iran University of Medical sciences, Tehran, Iran
| | - Saeed Razmeh
- Iran University of Medical sciences, Tehran, Iran
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Abstract
PURPOSE OF REVIEW Migraine is a common and highly disabling condition that is particularly prevalent among women and especially women of reproductive age. The tremendous rise in adiposity in the Western world has led to an epidemic of obesity in women. The particular effects of obesity on women with migraine of various ages are the focus of this review. RECENT FINDINGS Conflicting findings from various studies with different approaches and populations have made challenging definitive conclusions about associations between migraine and obesity. While the association between obesity and migraine frequency has been consistently demonstrated and obesity is considered a risk factor for progression from episodic to chronic migraine, the association between obesity and migraine prevalence is still somewhat debated and appears to be dependent on gender and age, with the most consistent effects observed in women younger than 55 years of age. Association between migraine and obesity is most commonly observed in women of reproductive age. The multimodal changes associated with age and hormonal change in women likely play a role in this relationship, as obesity does not appear to be related to migraine in women over 55 years of age. Future studies focusing on the migraine-obesity relationship in women should examine the effects of age, endogenous hormonal state, and exogenous hormones on migraine and obesity.
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Affiliation(s)
- Jelena M Pavlovic
- Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Van Etten 3C9B, Bronx, NY, 10461, USA.
- Montefiore Headache Center, Bronx, NY, USA.
| | - Julio R Vieira
- Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Van Etten 3C9B, Bronx, NY, 10461, USA
- Health Quest Neurology, Kingston, NY, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Van Etten 3C9B, Bronx, NY, 10461, USA
- Montefiore Headache Center, Bronx, NY, USA
| | - Dale S Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
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Yeo NK, Park WJ, Ryu IS, Lim HW, Song YJ. Is Facial or Head Pain Related to the Location of Lesions on Computed Tomography in Chronic Rhinosinusitis? Ann Otol Rhinol Laryngol 2017; 126:589-596. [DOI: 10.1177/0003489417717268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Nam-Kyung Yeo
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Woo Joo Park
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - In Sun Ryu
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Hyun Woo Lim
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Yong Jin Song
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
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Ford L, Goldberg JL, Selan F, Greenberg HE, Shi Y. Comprehensive review of visual defects reported with topiramate. Clin Ophthalmol 2017; 11:983-992. [PMID: 28579749 PMCID: PMC5449165 DOI: 10.2147/opth.s125768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective The objective of this study was to analyze clinical patterns of visual field defects (VFDs) reported with topiramate treatment and assess possible mechanism of action (MOA) for antiepileptic drug (AED) associated VFDs. Methods A comprehensive topiramate database review included preclinical data, sponsor’s clinical trials database, postmarketing spontaneous reports, and medical literature. All treatment-emergent adverse events (TEAEs) suggestive of retinal dysfunction/damage were summarized. Relative risk (RR) was computed from topiramate double-blind, placebo-controlled trials (DBPCTs) data. Results Preclinical studies and medical literature review suggested that despite sharing gamma-aminobutyric acid (GABA)-ergic MOA with other AEDs, topiramate treatment was not associated with VFDs. TEAEs suggestive of retinal dysfunction/damage were observed in 0.3%–0.7% of adults and pediatric patients with topiramate (N=4,679) versus ≤0.1% with placebo (N=1,834) in DBPCTs for approved indications (epilepsy and migraine prophylaxis); open-label trials (OLTs) and DBPCTs for investigational indications had similar incidence. Overall, 88% TEAEs were mild or moderate in severity. Serious TEAEs were very rare (DBPCTs: 0%; OLTs: ≤0.1%), and most were not treatment limiting, and resolved. The most common visual TEAEs (approved indications) were VFD, scotoma, and optic atrophy. The incidence of TEAEs in DBPCTs (approved and investigational indications) was higher in topiramate-treated (N=9,169) versus placebo-treated patients (N=5,023; 0.36% vs 0.24%), but the RR versus placebo-treated patients was not significant (RR: 1.51 [95% confidence interval: 0.78, 2.91]). Conclusion VFDs do not appear to be a class effect for AEDs with GABA-ergic MOA. The RR for VFDs is not significantly different between topiramate and placebo treatment.
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Affiliation(s)
- Lisa Ford
- Janssen Research & Development, LLC, Titusville, NJ
| | | | - Fred Selan
- Janssen Research & Development, LLC, Titusville, NJ
| | | | - Yingqi Shi
- Janssen Research & Development, LLC, Titusville, NJ
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35
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Seifert T, Sufrinko A, Cowan R, Scott Black W, Watson D, Edwards B, Livingston S, Webster K, Akers D, Lively M, Kontos AP. Comprehensive Headache Experience in Collegiate Student-Athletes: An Initial Report From the NCAA Headache Task Force. Headache 2017; 57:877-886. [DOI: 10.1111/head.13104] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2017] [Indexed: 12/25/2022]
Affiliation(s)
| | | | | | - W. Scott Black
- Department of Family and Community Medicine; University of Kentucky
| | - Dave Watson
- Department of Neurology; West Virginia University
| | - Bill Edwards
- Department of Athletics; Western Kentucky University
| | | | | | - David Akers
- Department of Statistics; University of Kentucky
| | - Mathew Lively
- Department of Medicine and Pediatrics; West Virginia University
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Merki-Feld GS, Imthurn B, Dubey R, Sándor PS, Gantenbein AR. Improvement of migraine with change from combined hormonal contraceptives to progestin-only contraception with desogestrel: How strong is the effect of taking women off combined contraceptives? J OBSTET GYNAECOL 2017; 37:338-341. [PMID: 28129717 DOI: 10.1080/01443615.2016.1234438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Migraine is a disabling headache disorder, which affects up to 17% of the female population. Oestrogen withdrawal during the menstrual cycle or the hormone-free interval in users of combined hormonal contraceptives (CHC) plays a pivotal role. Two diary-based studies demonstrated a positive impact of the progestin-only pill (POP) desogestrel 75 μg on the frequency of the migraine attacks and pain intensity. In both studies, CHC users as well as nonusers were included, which makes it difficult to distinguish between the effect of taking women off the CHC and the benefit of the POP itself. With the present study, we compared the therapeutic effect of the POP desogestrel 75 μg on migraine in current CHC users and nonusers. We found a positive influence of desogestrel on migraine not only in women who switched from CHCs to desogestrel, but also in those who had not used hormones over 6 months before starting it. Our findings need to be confirmed in prospectively conducted studies with larger sample size.
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Affiliation(s)
- Gabriele S Merki-Feld
- a Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , University Hospital Zürich , Zurich , Switzerland
| | - Bruno Imthurn
- a Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , University Hospital Zürich , Zurich , Switzerland
| | - Raghvendran Dubey
- a Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , University Hospital Zürich , Zurich , Switzerland
| | - Peter S Sándor
- b Headache outpatient Clinic, Department of Neurorehabilitation , Reha Clinic Bad Zurzach & Baden , Bad Zurzach , Switzerland.,c Headache and Pain Unit, Department for Neurology , University Hospital Zürich , Zurich , Switzerland
| | - Andreas R Gantenbein
- b Headache outpatient Clinic, Department of Neurorehabilitation , Reha Clinic Bad Zurzach & Baden , Bad Zurzach , Switzerland.,c Headache and Pain Unit, Department for Neurology , University Hospital Zürich , Zurich , Switzerland
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Binette A, Howatt K, Waddington A, Reid RL. Ten Challenges in Contraception. J Womens Health (Larchmt) 2017; 26:44-49. [DOI: 10.1089/jwh.2016.5854] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Audrey Binette
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada
| | - Kerry Howatt
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada
| | - Ashley Waddington
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada
| | - Robert L. Reid
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada
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Lima AS, de Araújo RC, Gomes MRDA, de Almeida LR, de Souza GFF, Cunha SB, Pitangui ACR. Prevalence of headache and its interference in the activities of daily living in female adolescent students. ACTA ACUST UNITED AC 2016; 32:256-61. [PMID: 25119759 PMCID: PMC4183010 DOI: 10.1590/0103-0582201432212113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/23/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE: To describe the prevalence of headache and its interference in the activities of
daily living (ADL) in female adolescent students. METHODS: This descriptive cross-sectional study enrolled 228 female adolescents from a
public school in the city of Petrolina, Pernambuco, Northeast Brazil, aged ten to
19 years. A self-administered structured questionnaire about socio-demographic
characteristics, occurrence of headache and its characteristics was employed.
Headaches were classified according to the International Headache Society
criteria. The chi-square test was used to verify possible associations, being
significant p<0.05. RESULTS: After the exclusion of 24 questionnaires that did not met the inclusion criteria,
204 questionnaires were analyzed. The mean age of the adolescents was 14.0±1.4
years. The prevalence of headache was 87.7%. Of the adolescents with headache,
0.5% presented migraine without pure menstrual aura; 6.7%, migraine without aura
related to menstruation; 1.6%, non-menstrual migraine without aura; 11.7%,
tension-type headache and 79.3%, other headaches. Significant associations were
found between pain intensity and the following variables: absenteeism
(p=0.001); interference in ADL (p<0.001);
medication use (p<0.001); age (p=0.045) and
seek for medical care (p<0.022). CONCLUSIONS: The prevalence of headache in female adolescents observed in this study was high,
with a negative impact in ADL and school attendance.
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Squier W, Mack J, Jansen AC. Infants dying suddenly and unexpectedly share demographic features with infants who die with retinal and dural bleeding: a review of neural mechanisms. Dev Med Child Neurol 2016; 58:1223-1234. [PMID: 27435495 DOI: 10.1111/dmcn.13202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2016] [Indexed: 01/01/2023]
Abstract
The cause of death in infants who die suddenly and unexpectedly (sudden unexpected death in infancy [SUDI]) remains a diagnostic challenge. Some infants have identified diseases (explained SUDI); those without explanation are called sudden infant death syndrome (SIDS). Demographic data indicate subgroups among SUDI and SIDS cases, such as unsafe sleeping and apparent life-threatening events. Infants dying suddenly with retinal and dural bleeding are often classified as abused, but in many there is no evidence of trauma. Demographic features suggest that they may represent a further subgroup of SUDI. This review examines the neuropathological hypotheses to explain SIDS and highlights the interaction of infant oxygen-conserving reflexes with the brainstem networks considered responsible for SIDS. We consider sex- and age-specific vulnerabilities related to dural bleeding and how sensitization of the dural innervation by bleeding may influence these reflexes, potentially leading to collapse or even death after otherwise trivial insults.
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Affiliation(s)
- Waney Squier
- Formerly Department of Neuropathology, Oxford University John Radcliffe Hospital, Oxford, UK
| | - Julie Mack
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Anna C Jansen
- Paediatric Neurology Unit, Department of Paediatrics, UZ Brussel, Brussels, Belgium.,Neurogenetics Research Unit, Vrije Universiteit Brussel, Brussels, Belgium
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40
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Davis C, Reno E, Maa E, Roach R. History of Migraine Predicts Headache at High Altitude. High Alt Med Biol 2016; 17:300-304. [DOI: 10.1089/ham.2016.0043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Christopher Davis
- Department of Emergency Medicine, Altitude Research Center, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Elaine Reno
- Department of Emergency Medicine, Altitude Research Center, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Edward Maa
- Division of Neurology, Denver Health and Hospitals, Denver, Colorado
| | - Robert Roach
- Department of Emergency Medicine, Altitude Research Center, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
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41
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Tsai CL, Chou CH, Lee PJ, Yin JH, Chen SY, Lin CC, Sung YF, Yang FC, Chung CH, Chien WC, Tsai CK, Lee JT. The potential impact of primary headache disorders on stroke risk. J Headache Pain 2016; 17:108. [PMID: 27905079 PMCID: PMC5130928 DOI: 10.1186/s10194-016-0701-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 11/22/2016] [Indexed: 01/03/2023] Open
Abstract
Background Headache such as migraine is associated with stroke. Studies focused on primary headache disorders (PHDs) as a risk factor for stroke are limited. The purpose of this population-based cohort study was to explore whether patients with PHDs were at a high risk for developing stroke. Methods A total of 1346 patients with PHDs were enrolled and compared with 5384 age-, gender- and co-morbidity-matched control cohorts. International Classification of Diseases, Clinical Modification codes were administered for the definition of PHDs, stroke, and stroke risk factors. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR). Results PHDs patients exhibited a 1.49 times (95% CI :1.15–1.98, p < 0.01) higher risk for developing ischaemic stroke compared with that of control cohorts. Both migraine (HR = 1.22, 95% CI :1.13–1.97, p < 0.05) and tension-type headache (HR = 2.29, 95% CI :1.22–2.80, p < 0.01) were associated with an increased risk of ischemic stroke. Females with PHDs were at greater risk of developing ischaemic stroke (HR = 1.49, 95% CI :1.13–1.90, p < 0.01) than those without PHDs. PHDs patient aged 45 to 64 years displayed significantly higher risk to develop ischaemic stroke (HR = 1.50, 95% CI: 1.11–2.10, p < 0.05) than the matched controls. The impact of PHDs on ischaemic stroke risk became gradually apparent by different following time intervals beyond 2 years after first diagnosis. Conclusion PHDs is suggestive of an incremental risk for ischaemic stroke with gender-dependent, age-specific and time-dependent characteristics. Electronic supplementary material The online version of this article (doi:10.1186/s10194-016-0701-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Pei-Jung Lee
- Departments of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China.,Division of Neurology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Shao-Yuan Chen
- Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taiwan, ROC.,Department of Hyperbaric Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan, ROC.,School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China. .,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
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42
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Griep RH, Toivanen S, Santos IS, Rotenberg L, Juvanhol LL, Goulart AC, Aquino EM, Benseñor I. Work-family conflict, lack of time for personal care and leisure, and job strain in migraine: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Ind Med 2016; 59:987-1000. [PMID: 27373788 DOI: 10.1002/ajim.22620] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Work-family conflict and time scarcity may affect health. We investigated the association between these issues and migraine, taking into account job strain. METHODS Baseline data from ELSA-Brasil (6,183 women; 5,664 men) included four indicators of work-family conflict: time- and strain-based interference of work with family (TB-WFC, SB-WFC), interference of family with work (FWC) and lack of time for personal care and leisure (LOT). Migraine was classified according to International Headache Society criteria. RESULTS Among women, definite migraine was associated with SB-WFC (odds ratio [OR] = 1.28; 95% confidence interval [CI] 1.06-1.55), FWC (OR = 1.32; 1.00-1.75), and LOT (OR = 1.30; 1.08-1.58). Probable migraine was associated with SB-WFC (OR = 1.17; 1.00-1.36). High psychological job demands and low social support interacted with LOT in association with definite migraine. Among men, probable migraine was associated with LOT (OR = 1.34; 1.09-1.64), and there were interactions between job strain and WFC for probable migraine. CONCLUSIONS Balancing the demands of professional and domestic spheres could be highly relevant in the management of migraines. Am. J. Ind. Med. 59:987-1000, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Rosane Härter Griep
- Laboratory of Health and Environment Education; Oswaldo Cruz Institute; Fundação Oswaldo Cruz; Manguinhos; Rio de Janeiro Brazil
- Centre for Health Equity Studies ∣ CHESS; Stockholm University/KarolinskaInstitutet; Stockholm Sweden
| | - Susanna Toivanen
- Centre for Health Equity Studies ∣ CHESS; Stockholm University/KarolinskaInstitutet; Stockholm Sweden
| | - Itamar S. Santos
- Departamento de Clínica Médica; Faculdade de Medicina da Universidade de São Paulo; Brazil
| | - Lucia Rotenberg
- Laboratory of Health and Environment Education; Oswaldo Cruz Institute; Fundação Oswaldo Cruz; Manguinhos; Rio de Janeiro Brazil
| | | | - Alessandra C. Goulart
- Centre for Clinical and Epidemiological Research; Hospital Universitário da Universidade de São Paulo; Brazil
| | - Estela M. Aquino
- Institute of Collective Health; Federal University of Bahia; Salvador Bahia Brazil
| | - Isabela Benseñor
- Centre for Clinical and Epidemiological Research; Hospital Universitário da Universidade de São Paulo; Brazil
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43
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John D, Ram D, Sundarmurthy H, Rathod H, Rathod S. Study of Barrier to Help Seeking and its Relationships with Disability in Patients with Headache. J Clin Diagn Res 2016; 10:VC01-VC05. [PMID: 27891430 PMCID: PMC5121768 DOI: 10.7860/jcdr/2016/22624.8621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 08/18/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Headache is among the first three most prevalent disorders with a wide treatment gap due to barriers in help seeking. Headache has been associated with disability. However, the relationship of barriers to help-seeking and disability are unexplored. AIM To find out the barriers to help seeking and its relationship with headache related disability in patients with headache. MATERIALS AND METHODS In this hospital based cross-sectional study, 200 consecutive subjects with headache attending a tertiary care centre were recruited as per selection criteria and assessed with Sociodemographic & Clinical Proforma, Mini International Neuropsychiatric Interview (MINI), Barriers to Help Seeking Scale (BHSS), The Henry Ford Hospital Headache Disability Inventory (HDI). RESULTS High mean score was observed on BHSS subscale need for control and self reliance (19.45; SD ±9.66) and minimizing problem and resignation (10.02; SD ±6.98). Mean score on the HDI was 25.65 (SD ± 14.09). Socioeconomic status of the patient was statistically significant and positively associated with need for control and self reliance (p=0.035), concrete barriers and distrust of care givers (p=0.039), emotional control (p=0.005), and privacy (p=0.002). Occupational status had significant association with need for control and self-reliance (p=0.01), minimizing problem and resignation (p=0.033), and emotional control (p=0.006). Score on hospital headache disability inventory significantly predicted the value of score on concrete barriers and distrust of caregivers domain of HDI (p=0.001). CONCLUSION Autonomy and under estimation of seriousness of headache are common barriers to help seeking. Pattern of help seeking barriers may vary with socio-economic status and occupational status, while disability varies with gender and severity of headache. Headache associated disability is positively associated with concrete barriers.
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Affiliation(s)
- Deepa John
- Resident, Department of Neurology, JSS Medical College, Mysore, Karnataka, India
| | - Dushad Ram
- Associate Professor, Department of Psychiatry, JSS Medical College, Mysore, Karnataka, India
| | - Harsha Sundarmurthy
- Professor, Department of Neurology, JSS Medical College, Mysore, Karnataka, India
| | - Harshal Rathod
- Resident, Department of Neurology, JSS Medical College, Mysore, Karnataka, India
| | - Snehal Rathod
- Pathologist, Apollo Hospital, Mysore, Karnataka, India
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44
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Santos L, Azevedo E. Reversible cerebral vasoconstriction syndrome - A narrative revision of the literature. Porto Biomed J 2016; 1:65-71. [PMID: 32258552 DOI: 10.1016/j.pbj.2016.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 07/18/2015] [Indexed: 12/18/2022] Open
Abstract
Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a not very well known clinical-imaging entity; it is characterized by thunderclap headache, which mimics an aneurysmal subarachnoid haemorrhage, and a diffuse and segmental constriction of cerebral arteries, that resolves spontaneously within 3 months. The pathophysiology remains unknown. The female gender is the more affected and more than half of cases occur in the puerperium or after exposure to vasoactive substances. Typically, RCVS is self-limited and has a benign course, although it may have more serious complications with permanent neurologic sequelae and death. Treatment is predominantly supportive and directed to the symptoms.
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Affiliation(s)
- Laura Santos
- Department of Neurology and Neurosurgery, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Elsa Azevedo
- Department of Neurology and Neurosurgery, Faculty of Medicine of University of Porto, Porto, Portugal
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45
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Hoffer ME, Szczupak M, Kiderman A, Crawford J, Murphy S, Marshall K, Pelusso C, Balaban C. Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury. PLoS One 2016; 11:e0146039. [PMID: 26727256 PMCID: PMC4699767 DOI: 10.1371/journal.pone.0146039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/11/2015] [Indexed: 12/02/2022] Open
Abstract
Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.
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Affiliation(s)
- Michael E. Hoffer
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- University of Miami Sports Performance and Wellness Institute, Miami, Florida, United States of America
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- * E-mail:
| | - Mikhaylo Szczupak
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- University of Miami Sports Performance and Wellness Institute, Miami, Florida, United States of America
| | | | - James Crawford
- Department of Otolaryngology, Madigan Army Medical Center, Tacoma, Washington, United States of America
| | - Sara Murphy
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Kathryn Marshall
- Department of Otolaryngology, Madigan Army Medical Center, Tacoma, Washington, United States of America
| | - Constanza Pelusso
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- University of Miami Sports Performance and Wellness Institute, Miami, Florida, United States of America
| | - Carey Balaban
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania United States of America
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46
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Male brain ages faster: the age and gender dependence of subcortical volumes. Brain Imaging Behav 2015; 10:901-10. [DOI: 10.1007/s11682-015-9468-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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47
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Becerra L, Bishop J, Barmettler G, Xie Y, Navratilova E, Porreca F, Borsook D. Triptans disrupt brain networks and promote stress-induced CSD-like responses in cortical and subcortical areas. J Neurophysiol 2015; 115:208-17. [PMID: 26490291 DOI: 10.1152/jn.00632.2015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/18/2015] [Indexed: 12/24/2022] Open
Abstract
A number of drugs, including triptans, promote migraine chronification in susceptible individuals. In rats, a period of triptan administration over 7 days can produce "latent sensitization" (14 days after discontinuation of drug) demonstrated as enhanced sensitivity to presumed migraine triggers such as environmental stress and lowered threshold for electrically induced cortical spreading depression (CSD). Here we have used fMRI to evaluate the early changes in brain networks at day 7 of sumatriptan administration that may induce latent sensitization as well as the potential response to stress. After continuous infusion of sumatriptan, rats were scanned to measure changes in resting state networks and the response to bright light environmental stress. Rats receiving sumatriptan, but not saline infusion, showed significant differences in default mode, autonomic, basal ganglia, salience, and sensorimotor networks. Bright light stress produced CSD-like responses in sumatriptan-treated but not control rats. Our data show the first brain-related changes in a rat model of medication overuse headache and suggest that this approach could be used to evaluate the multiple brain networks involved that may promote this condition.
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Affiliation(s)
- L Becerra
- P.A.I.N. Group, Boston Children's Hospital, Waltham, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; and
| | - J Bishop
- P.A.I.N. Group, Boston Children's Hospital, Waltham, Massachusetts
| | - G Barmettler
- P.A.I.N. Group, Boston Children's Hospital, Waltham, Massachusetts
| | - Y Xie
- Department of Pharmacology, University of Arizona, Tucson, Arizona
| | - E Navratilova
- Department of Pharmacology, University of Arizona, Tucson, Arizona
| | - F Porreca
- Department of Pharmacology, University of Arizona, Tucson, Arizona
| | - D Borsook
- P.A.I.N. Group, Boston Children's Hospital, Waltham, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; and
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48
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One-year prevalence of migraine using a validated extended French version of the ID Migraine™: A Belgian population-based study. Rev Neurol (Paris) 2015; 171:707-14. [DOI: 10.1016/j.neurol.2015.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/23/2015] [Accepted: 04/18/2015] [Indexed: 11/18/2022]
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49
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Lipton RB, Silberstein SD. Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache 2015; 55 Suppl 2:103-22; quiz 123-6. [PMID: 25662743 DOI: 10.1111/head.12505_2] [Citation(s) in RCA: 199] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 02/03/2023]
Abstract
Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as "headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month." However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine.
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Affiliation(s)
- Richard B Lipton
- Department of Psychiatry and Behavioral Sciences, Department of Epidemiology & Population Health, Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, NY, USA
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50
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Cho SJ, Chung YK, Kim JM, Chu MK. Migraine and restless legs syndrome are associated in adults under age fifty but not in adults over fifty: a population-based study. J Headache Pain 2015; 16:554. [PMID: 26272681 PMCID: PMC4536239 DOI: 10.1186/s10194-015-0554-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent studies have shown an association between migraine and restless legs syndrome (RLS). However, migraine prevalence peaks from the 20s to 40s whereas RLS prevalence peaks after the 50s. Despite this, reports on how migraine and RLS may be associated by age is limited. Therefore, the purpose of this study is to investigate the comorbidity between migraine and RLS according to age. METHODS We selected a stratified random population sample of Koreans aged 19 to 69 years and evaluated them with a 60-item semi-structured interview designed to identify RLS, headache type, and clinical characteristics of migraine. To assess the association between migraine and RLS according to age, we divided participants into 5 age groups (19-29, 30-39, 40-49, 50-59, and 60-69 years) and analysed each group. RESULTS Subjects with migraine showed an increased RLS prevalence in the 19-29 (Odds ratio [OR] = 6.6, 95 % confidence interval [CI] = 1.2-36.8) and 40-49 (OR = 6.7, 95 % CI = 1.5-33.5) age groups compared to non-headache controls but failed to showed a significant association in the 50-59 (OR = 1.1, 95 % CI = 0.2-5.6) and 60-69 (OR = 0.4, 95 % CI = 0.1-4.0) age groups. Migraineurs with 1-10 (12.5 %, OR = 2.0, 95 % CI = 1.3-3.2, p = 0.003) and >10 (12.5 %, OR = 2.5, 95 % CI = 1.0-5.6, p = 0.038) attacks per month showed an increased RLS prevalence compared to migraineurs with <1 attack per month (2.1 %). Subjects with non-migraine headaches showed an increased odds for RLS (OR = 1.8, 95 % CI = 1.3-2.7) compared to non-headache controls. There was no significant difference (9.1 % vs. 6.9 %, p = 0.339) in the RLS prevalence between migraineurs and non-migraine headache subjects. CONCLUSIONS Our results suggest that migraine and RLS are differently associated according to age.
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Affiliation(s)
- Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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