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Xu XH, Li YM, Ren LN, Xu XF, Dai YL, Jin CQ, Yang RR. Cluster headache: understandings of current knowledge and directions for whole process management. Front Neurol 2024; 15:1456517. [PMID: 39233684 PMCID: PMC11371566 DOI: 10.3389/fneur.2024.1456517] [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: 06/28/2024] [Accepted: 07/29/2024] [Indexed: 09/06/2024] Open
Abstract
Cluster headache (CH) is a common primary headache that severely impacts patients' quality of life, characterized by recurrent, severe, unilateral headaches often centered around the eyes, temples, or forehead. Distinguishing CH from other headache disorders is challenging, and its pathogenesis remains unclear. Notably, patients with CH often experience high levels of depression and suicidal tendencies, necessitating increased clinical attention. This comprehensive assessment combines various reports and the latest scientific literature to evaluate the current state of CH research. It covers epidemiology, population characteristics, predisposing factors, and treatment strategies. Additionally, we provide strategic insights into the holistic management of CH, which involves continuous, individualized care throughout the prevention, treatment, and rehabilitation stages. Recent advances in the field have revealed new insights into the pathophysiology of CH. While these findings are still evolving, they offer a more detailed understanding of the neurobiological mechanisms underlying this disorder. This growing body of knowledge, alongside ongoing research efforts, promises to lead to the development of more targeted and effective treatments in the future.
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Affiliation(s)
- Xiao-Hu Xu
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong, China
- Medical Laboratory, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Yi-Ming Li
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong, China
- Medical Laboratory, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Li-Na Ren
- Medical Laboratory, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Xiao-Fan Xu
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong, China
- Medical Laboratory, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Yi-Long Dai
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong, China
- Medical Laboratory, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Cheng-Qiang Jin
- Medical Laboratory, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Rui-Rui Yang
- Neurology Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Wen J, Gao Y, Li M, Hu S, Zhao M, Su C, Wang Q, Xi H, Zhan L, Lv Y, Antwi CO, Ren J, Jia X. Regional abnormalities of spontaneous brain activity in migraine: A coordinate‐based meta‐analysis. J Neurosci Res 2023. [DOI: 10.1002/jnr.25191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023]
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Choudhary N, Tewari D, Nabavi SF, Kashani HRK, Lorigooini Z, Filosa R, Khan FB, Masoudian N, Nabavi SM. Plant based food bioactives: A boon or bane for neurological disorders. Crit Rev Food Sci Nutr 2022; 64:3279-3325. [PMID: 36369694 DOI: 10.1080/10408398.2022.2131729] [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] [Indexed: 11/14/2022]
Abstract
Neurological disorders are the foremost occurring diseases across the globe resulting in progressive dysfunction, loss of neuronal structure ultimately cell death. Therefore, attention has been drawn toward the natural resources for the search of neuroprotective agents. Plant-based food bioactives have emerged as potential neuroprotective agents for the treatment of neurodegenerative disorders. This comprehensive review primarily focuses on various plant food bioactive, mechanisms, therapeutic targets, in vitro and in vivo studies in the treatment of neurological disorders to explore whether they are boon or bane for neurological disorders. In addition, the clinical perspective of plant food bioactives in neurological disorders are also highlighted. Scientific evidences point toward the enormous therapeutic efficacy of plant food bioactives in the prevention or treatment of neurological disorders. Nevertheless, identification of food bioactive components accountable for the neuroprotective effects, mechanism, clinical trials, and consolidation of information flow are warranted. Plant food bioactives primarily act by mediating through various pathways including oxidative stress, neuroinflammation, apoptosis, excitotoxicity, specific proteins, mitochondrial dysfunction, and reversing neurodegeneration and can be used for the prevention and therapy of neurodegenerative disorders. In conclusion, the plant based food bioactives are boon for neurological disorders.
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Affiliation(s)
- Neeraj Choudhary
- Department of Pharmacognosy, Adesh Institute of Pharmacy and Biomedical Sciences, Adesh University, Bathinda, Punjab, India
| | - Devesh Tewari
- Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Seyed Fazel Nabavi
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
- Nutringredientes Research Center, Federal Institute of Education, Science and Technology (IFCE), Baturite, Ceara, Brazil
| | - Hamid Reza Khayat Kashani
- Department of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Lorigooini
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rosanna Filosa
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
- Department of Science and Technology, University of Sannio, 82100, Benevento, Italy
| | - Farheen Badrealam Khan
- Department of Biology, College of Science, The United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Nooshin Masoudian
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
| | - Seyed Mohammad Nabavi
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
- Nutringredientes Research Center, Federal Institute of Education, Science and Technology (IFCE), Baturite, Ceara, Brazil
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Yao L, Chen R, Ji H, Wang X, Zhang X, Yuan Y. Preventive and Therapeutic Effects of Low-Intensity Ultrasound Stimulation on Migraine in Rats. IEEE Trans Neural Syst Rehabil Eng 2022; 30:2332-2340. [PMID: 35981071 DOI: 10.1109/tnsre.2022.3199813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study sought to systematically evaluate the prophylactic and therapeutic effects of low-intensity transcranial ultrasound stimulation on migraine in rats. We used video recordings to assess the head scratching behavior and laser speckle contrast imaging to record the changes in cerebral blood flow velocity of freely moving rats in a healthy group, migraine group, migraine group with ultrasound prevention, and migraine group with ultrasound therapy. Results demonstrated that (1) head scratching during migraine attacks in rats was accompanied by an decrease in cerebral blood flow; (2) both ultrasound prevention and therapy significantly reduced the number of head scratches but did not reduce the cerebral blood flow velocity; and (3) the number of head scratches in the ultrasound stimulation groups was not affected by the auditory effect. These results reveal that low-intensity ultrasound has the potential to be used clinically in the prevention and therapeutic treatment of migraine.
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Yang MG, Cai HQ, Wang SS, Liu L, Wang CM. Full recovery from chronic headache and hypopituitarism caused by lymphocytic hypophysitis: A case report. World J Clin Cases 2022; 10:1041-1049. [PMID: 35127918 PMCID: PMC8790444 DOI: 10.12998/wjcc.v10.i3.1041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/05/2021] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Lymphocytic hypophysitis (LYH) is an important condition to consider in the differential diagnosis of patients with a pituitary mass. The main clinical manifestations of LYH include headache, symptoms related to sellar compression, hypopituitarism, diabetes insipidus and hyperprolactinemia. Headache, which is a frequent complaint of patients with LYH, is thought to be related to the occupying effect of the pituitary mass and is rapidly resolved with a good outcome after timely and adequate glucocorticoid treatment or surgery.
CASE SUMMARY Here, we report a patient with LYH whose initial symptom was headache and whose pituitary function assessment showed the presence of secondary hypoadrenalism, central hypothyroidism and hypogonadotropic hypogonadism. Pituitary magnetic resonance imaging showed symmetrical enlargement of the pituitary gland with suprasellar extension in a dumbbell shape with significant homogeneous enhancement after gadolinium enhancement. The size of the gland was approximately 17.7 mm × 14.3 mm × 13.8 mm. The pituitary stalk was thickened without deviation, and there was an elevation of the optimal crossing. The lesion grew bilaterally toward the cavernous sinuses, and the parasternal dural caudal sign was visible. The patient presented with repeatedly worsening and prolonged headaches three times even though the hypopituitarism had fully resolved after glucocorticoid treatment during this course.
CONCLUSION This rare headache regression suggests that patients with chronic headaches should also be alerted to the possibility of LYH.
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Affiliation(s)
- Mao-Guang Yang
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Han-Qing Cai
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Si-Si Wang
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Lin Liu
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Chun-Mei Wang
- Department of Radiology, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
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Varangot-Reille C, Suso-Martí L, Romero-Palau M, Suárez-Pastor P, Cuenca-Martínez F. Effects of Different Therapeutic Exercise Modalities on Migraine or Tension-Type Headache: A Systematic Review and Meta-Analysis with a Replicability Analysis. THE JOURNAL OF PAIN 2021; 23:1099-1122. [PMID: 34929374 DOI: 10.1016/j.jpain.2021.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 09/09/2021] [Accepted: 12/15/2021] [Indexed: 12/11/2022]
Abstract
The primary aim of this study was to review the effect of exercise in comparison with a non-active treatment on pain intensity, frequency of headache episodes, headache duration, quality of life, medication use, and psychological symptoms, in patients with migraine or tension-type headache (TTH). A systematic search was conducted in various electronic databases to identify all relevant studies: Medline (PubMed), PEDro, EBSCO and Google Scholar. Clinical trials assessing the effects of exercise interventions in patients with primary headaches were selected. Methodological quality was evaluated using the Cochrane Risk of Bias Tool and PEDro scale and qualitative analysis was based on classifying the results into levels of evidence according to the GRADE. 19 studies (2776 participants; 85% female) were included. The meta-analysis showed statistically significant differences in pain intensity for aerobic training in patients with migraine (SMD = -0.65; 95% CI = -1.07 to -0.22, very low certainty evidence) and for strength training in patients with TTH (SMD = -0.84; 95% CI = -1.68 to- -0.01, very low certainty evidence). Statistically significant differences were also found in the medication use (SMD = -0.51; 95% CI = -0.85 to -0.17, low certainty evidence). Low transparency, replicability and high risk of bias were found. Aerobic training has a small to moderate clinical effect on pain intensity and medication use on migraine patients, with very low to low certainty of evidence. Strength training showed a moderate clinical effect with very low quality of evidence in patients with TTH. Exercise could be considered as clinically relevant for the management of patients with primary headaches, but the presence of low certainty of evidence and low transparency and replicability limited its clinical application. PERSPECTIVE: This article presents current evidence about exercise interventions in patients with primary headaches, including migraine and tension-type headache. Existing findings are reviewed, and relevant data are provided on the effectiveness of each exercise modality, as well as its certainty of evidence and clinical applicability.
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Affiliation(s)
- Clovis Varangot-Reille
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
| | | | - Pablo Suárez-Pastor
- Deparment of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
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Hammad AB, Elsharkawy RE, Abdel Azim GS. Repetitive transcranial magnetic stimulation as a prophylactic treatment in migraine. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-020-00254-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered.
Objective
To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A).
Methods
Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study.
A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine.
Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once.
Results
There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS (P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS (P < 0.001).
Conclusion
Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.
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Papasavva M, Vikelis M, Siokas V, Katsarou MS, Dermitzakis E, Raptis A, Dardiotis E, Drakoulis N. VDR Gene Polymorphisms and Cluster Headache Susceptibility: Case-Control Study in a Southeastern European Caucasian Population. J Mol Neurosci 2021; 72:382-392. [PMID: 34519950 DOI: 10.1007/s12031-021-01892-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Cluster headache (CH) is a severe primary headache disorder with a genetic component, as indicated by family and twin studies. Diurnal and seasonal rhythmicity are key features of the disease and might be related to vitamin D, as low vitamin D levels have been observed in patients with cluster headache. In addition, the vitamin D receptor (VDR) occurs in brain areas and particularly in the hypothalamus. The aim of the present case-control study was to investigate the association of cluster headache susceptibility and clinical phenotypes with the VDR gene polymorphisms FokI, BsmI and TaqI in a Southeastern European Caucasian population. DNA was extracted from 131 unrelated CH patients and 282 non-headache controls and genotyped using real-time PCR (melting curve analysis). Linkage disequilibrium (LD) analysis confirmed that BsmI and TaqI, both located in the 3'UTR of the VDR gene, are in strong LD. Genotype and allele frequency distribution analysis of the VDR FokI, BsmI, and TaqI polymorphisms showed no statistically significant difference between cases and controls, whereas haplotype analysis indicated that the TAC haplotype might be associated with decreased cluster headache susceptibility. Intra-patient analysis according to diverse clinical phenotypes showed an association of the BsmI GG and TaqI TT genotypes with more frequent occurrence of CH attacks in this cohort. Therefore, a possible association was observed between VDR gene polymorphisms BsmI and TaqI or a linked locus and susceptibility for cluster headache development and altered clinical phenotypes in the Southeastern European Caucasian study population. Further large-scale replication studies are needed to validate these findings.
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Affiliation(s)
- Maria Papasavva
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771, Athens, Greece
| | | | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Martha-Spyridoula Katsarou
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771, Athens, Greece
| | | | - Athanasios Raptis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771, Athens, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771, Athens, Greece.
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Characterization of Headache in COVID-19: a Retrospective Multicenter Study. Mol Neurobiol 2021; 58:4487-4494. [PMID: 34036488 PMCID: PMC8148871 DOI: 10.1007/s12035-021-02430-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/12/2021] [Indexed: 12/15/2022]
Abstract
Headache is the most common neurological symptom in COVID-19, reported in 6.5 to 34% of patients. Few studies have analyzed its characteristics, and some of them included cases without laboratory confirmation or reported only critical patients. We aimed to analyze the clinical characteristics of COVID-19 associated headache in laboratory-confirmed cases. We conducted a retrospective evaluation of patients with COVID-19 and neurological symptoms. Patients who reported headache answered an interview about its clinical characteristics. Twenty-four patients with COVID-19 associated headache completed the interview. Mean age of patients was 53.8 (standard deviation—17.44), and 14 out of 24 (58.3%) were male. The majority (75%) had no previous history of headache. Fever was documented in 19 out of the 24 patients (79.1%). Headache was predominantly bifrontal or holocranial, in pressure, during hours, worsening with cough or physical activity. COVID-19 headache tends to appear in the first days of symptoms, be either frontal or holocranial and last for days. The quality of pain in pressure and the worsening with cough or physical activity were reported in most cases. We have not found any characteristic that could differentiate COVID-19 associated headache from other causes of headache, possibly because of its multifactorial mechanism.
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Urits I, Schwartz R, Smoots D, Koop L, Veeravelli S, Orhurhu V, Cornett EM, Manchikanti L, Kaye AD, Imani F, Varrassi G, Viswanath O. Peripheral Neuromodulation for the Management of Headache. Anesth Pain Med 2020; 10:e110515. [PMID: 34150578 PMCID: PMC8207880 DOI: 10.5812/aapm.110515] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 12/18/2022] Open
Abstract
Context Neuromodulation is an expanding field of study for headache treatment to reduce pain by targeting structures within the nervous system that are commonly involved in headache pathophysiology, such as the vagus nerve (VNS), occipital nerves, or sphenopalatine ganglion (SPG) for stimulation. Pharmaceutical medical therapies for abortive and prophylactic treatment, such as triptans, NSAIDs, beta-blockers, TCAs, and antiepileptics, are effective for some individuals, but the role that technology plays in investigating other therapeutic modalities is essential. Peripheral neuromodulation has gained popularity and FDA approval for use in treating certain headaches and migraine headache conditions, particularly in those who are refractory to treatment. Early trials found FDA approved neurostimulatory implant devices, including Cephaly and SpringTMS, improved patient-oriented outcomes with reductions in headaches per month (frequency) and severity. Evidence Acquisition This was a narrative review. The sources for this review are as follows: Searching on PubMed, Google Scholar, Medline, and ScienceDirect from 1990 - 2019 using keywords: Peripheral Neuromodulation, Headache, vagus nerve, occipital nerves, sphenopalatine ganglion. Results The first noninvasive neurostimulator device approved for migraine treatment was the Cefaly device, an external trigeminal nerve stimulation device (e-TNS) that transcutaneously excites the supratrochlear and supraorbital branches of the ophthalmic nerve. The second noninvasive neurostimulation device receiving FDA approval was the single-pulse transcranial magnetic stimulator, SpringTMS, positioned at the occiput to treat migraine with aura. GammaCore is a handheld transcutaneous vagal nerve stimulator applied directly to the neck at home by the patient for treatment of cluster headache (CH) and migraine. Several other devices are in development for the treatment of headaches and target headache evolution at different levels and inputs. The Scion device is a caloric vestibular stimulator (CVS) which interfaces with the user through a set of small cones resting in the ear canal on either side and held in place by modified over-ear headphones. The pulsante SPG Microstimulator is a patient-controlled device implanted in the patient’s upper jaw via an hour-long oral procedure to target the sphenopalatine ganglion. The occipital nerve stimulator (ONS) is an invasive neuromodulation device for headache treatment that consists of an implanted pulse generator on the chest wall connected to a subcutaneous lead with 4 - 8 electrodes that is tunneled the occiput. Conclusions The aim of this review is to provide a comprehensive overview of the efficacy, preliminary outcomes, and limitations of neurostimulatory implants available for use in the US and those pending further development.
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Affiliation(s)
- Ivan Urits
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA
| | - Ruben Schwartz
- Department of Anesthesiology, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Daniel Smoots
- Department of Anesthesiology, Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ, USA
| | - Lindsey Koop
- Department of Anesthesiology, Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ, USA
| | - Suhitha Veeravelli
- Department of Anesthesia, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Vwaire Orhurhu
- University of Pittsburgh Medical Center, Williamsport, PA, USA
| | - Elyse M. Cornett
- Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA
- Corresponding Author: Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Postal Code: 33932, Shreveport, LA, USA.
| | | | - Alan D. Kaye
- Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA
| | - Farnad Imani
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | | | - Omar Viswanath
- Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA
- Department of Anesthesiology, Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ, USA
- Department of Anesthesia, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
- Valley Anesthesiology and Pain Consultants – Envision Physician Services, Phoenix, AZ, USA
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McGeary DD, Resick PA, Penzien DB, Eapen BC, Jaramillo C, McGeary CA, Nabity PS, Peterson AL, Young-McCaughan S, Keane TM, Reed D, Moring J, Sico JJ, Pangarkar SS, Houle TT. Reason to doubt the ICHD-3 7-day inclusion criterion for mild TBI-related posttraumatic headache: A nested cohort study. Cephalalgia 2020; 40:1155-1167. [DOI: 10.1177/0333102420953109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Posttraumatic headache is difficult to define and there is debate about the specificity of the 7-day headache onset criterion in the current definition. There is limited evidence available to guide decision making about this criterion. Method A nested cohort study of 193 treatment-seeking veterans who met criteria for persistent headache attributed to mild traumatic injury to the head, including some veterans with delayed headache onset up to 90 days post-injury, was undertaken. Survival analysis examined the proportion of participants reporting headache over time and differences in these proportions based on sex, headache phenotype, and mechanism of injury. Result 127 participants (66%; 95% CI: 59–72%) reported headache onset within 7 days of head injury and 65 (34%) reported headache onset between 8 days and 3 months after head injury. Fourteen percent of participants reported pre-existing migraine before head injury, and there was no difference in the proportion of veterans with pre-existing migraine based on headache onset. Headache onset times were not associated with sex, headache phenotype, or mechanism of injury. There were no significant differences in proportion of veterans with headache onset within 7 days of head injury based on headache phenotype (70% migraine onset within 7 days, 70% tension-type headache within 7 days, 56% cluster headache within 7 days; p ≥ .364). Similar findings were observed for head injury (64% blast, 60% blunt; p = .973). There were no significant differences observed between headache onset groups for psychiatric symptoms (Posttraumatic Stress Disorder Checklist for DSM-5 = 1.3, 95% CI = −27.5, 30.1; Patient Health Questionnaire-9 Item = 3.5, 95% CI = −6.3, 3.7; Generalized Anxiety Disorder Screener = 6.5, 95% CI = −2.7, 15.6). Conclusions Although most of the sample reported headache onset within 7 days of head injury, one-third experienced an onset outside of the diagnostic range. Additionally, veterans with headache onset within 7 days of head injury were not meaningfully different from those with later onset based on sex, headache phenotype, or mechanism of head injury. The ICHD-3 diagnostic criteria for 7-day headache onset should be expanded to 3 months. ClinicalTrials.gov Identifier NCT02419131
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Affiliation(s)
- Donald D McGeary
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center San Antonio, San Antonio, TX, USA
- Department of Rehabilitation Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Patricia A Resick
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Donald B Penzien
- Departments of Psychiatry and Behavioral Medicine & Neurology, Wake Forest University, Winston-Salem, NC, USA
| | - Blessen C Eapen
- Greater Los Angeles Veterans Health Care System, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Physical Medicine & Rehabilitation, Los Angeles, CA, USA
| | - Carlos Jaramillo
- Department of Rehabilitation Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Cindy A McGeary
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Paul S Nabity
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Alan L Peterson
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Stacey Young-McCaughan
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Terence M Keane
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - David Reed
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - John Moring
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Jason J Sico
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
- Headache Center of Excellence, VA Connecticut Healthcare System, New Haven, CT, USA
| | - Sanjog S Pangarkar
- Greater Los Angeles Veterans Health Care System, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Physical Medicine & Rehabilitation, Los Angeles, CA, USA
| | - Timothy T Houle
- Department of Anaesthesia, Massachusetts General Hospital, Boston, MA, USA
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12
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Lamsam L, Bhambhvani HP, Thomas A, Ratliff JK, Moore JM. Aneurysmal subarachnoid hemorrhage in patients with migraine and tension headache: A cohort comparison study. J Clin Neurosci 2020; 79:90-94. [PMID: 33070926 DOI: 10.1016/j.jocn.2020.07.017] [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] [Received: 04/09/2020] [Revised: 06/22/2020] [Accepted: 07/06/2020] [Indexed: 12/31/2022]
Abstract
Migraine headache is a common condition with an estimated lifetime prevalence of greater than 20%. While it is a well-established risk factor for cardiovascular disease and ischemic stroke, its association with subarachnoid hemorrhage is largely unexplored. We sought to compare the incidence of aneurysmal subarachnoid hemorrhage in a cohort of migraine patients with a cohort of patients with tension headache. A cohort comparison study utilizing the MarketScan insurance claims database compared patients diagnosed with migraine who were undergoing treatment with abortive or prophylactic pharmacotherapy (treatment cohort) and patients diagnosed with tension headache who had never been diagnosed with a migraine and who were naïve to migraine pharmacotherapy (control cohort). Patients with major pre-existing risk factors for aSAH were excluded from the study, and minor risk factors such as smoking status and hypertension were accounted for using coarsened exact matching (CEM) and subsequent cox proportional-hazards (CPH) regression. More than 679,000 patients (~125,000 treatment and ~ 550,000 control) with an average follow-up of more than three years were analyzed for aneurysmal subarachnoid hemorrhage. CPH regression on matched data showed that treated migraine patients had a significantly lower hazard of aneurysmal subarachnoid hemorrhage compared with tension headache patients (HR = 0.40, 95% CI: 0.19 - 0.86, p = 0.02). This large cohort comparison study, analyzing more than 679,000 patients, demonstrated that migraine patients undergoing pharmacologic treatment had a lower hazard of aneurysmal subarachnoid hemorrhage than patients diagnosed with tension headaches. Future work specifically focusing on migraine medications may identify the mechanisms underlying this association.
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Affiliation(s)
- Layton Lamsam
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Hriday P Bhambhvani
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, USA
| | - Ajith Thomas
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - John K Ratliff
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, USA
| | - Justin M Moore
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, USA; Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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13
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Wu B, Rao H, Yang S, Cai S, Tan L, Feng Z, Mei Z. Efficacy and safety of the classic Chinese herbal prescription Sanpian decoction on migraine: A meta-analysis. Explore (NY) 2020; 16:318-327. [PMID: 32505521 DOI: 10.1016/j.explore.2020.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/13/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To evaluate the efficacy and safety of the classic Chinese herbal prescription Sanpian decoction for curing migraine. METHODS Scopus, PubMed, EMBASE, SPRINGER LINK, China National Knowledge Infrastructure (CNKI), Weipu Database and WanFang Database were searched from inception through January 2019 to identify randomized controlled trials (RCTs) that evaluated the efficacy and safety of Sanpian decoction. RESULTS Fifteen RCTs with a total of 1377 participants were identified. Compared with the control drugs, Sanpian decoction and Sanpian decoction combined with Sibelium significantly improved the clinical efficacy separately (relative risk [RR] 4.19, 95% confidence intervals [CI] 2.91 to 6.04, P < 0.00001; RR 1.29, 95% CI 1.09 to 1.54, P = 0.003 separately); the Sanpian decoction significantly improved the visual analogue scale score (VAS) (mean differences [MD] -1.83, 95% CI -2.69 to -0.97, P < 0.0001), headache score (MD -3.77, 95% CI -7.20 to -0.34, P = 0.03) and reduced the frequency of headache attacks (MD -1.61, 95% CI -2.07 to -1.14, P < 0.00001) and the concentration of endothelin (ET) (MD -11.90, 95% CI -23.22 to -0.58, P = 0.04) when compared with control drugs. There were minor side effects related to Sanpian decoction which were well tolerated. CONCLUSIONS Sanpian decoction is of significant benefits and relative safety in treating migraine. However, more rigorous studies with larger sample sizes are needed due to methodological flaws and low quality of the included trials in this meta-analysis.
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Affiliation(s)
- Bingxin Wu
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei, 443002, China
| | - Hongyin Rao
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei, 443002, China
| | - Songbai Yang
- Yichang Hospital of Traditional Chinese Medicine, Clinical Medical College of Traditional Chinese Medicine, China Three Gorges University, Yichang, Hubei, 443003, China
| | - Sanjin Cai
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei, 443002, China
| | - Lingjing Tan
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei, 443002, China
| | - Zhitao Feng
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei, 443002, China.
| | - Zhigang Mei
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei, 443002, China; Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, Hunan University of Chinese Medicine, Changsha 410208, China.
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Pradhan S, Das A, Ghosh J. Step-Headache: A Distinct Symptom of Migraine. J Neurosci Rural Pract 2020; 11:89-94. [PMID: 32140009 PMCID: PMC7055603 DOI: 10.1055/s-0039-3400197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives
The diagnosis of migraine depends on various characteristics of headache with their associated constitutional symptoms such as nausea, vomiting, photophobia, and phonophobia. Relatively severe intensity, throbbing character, unilaterality, and aggravation with physical activity are the key features of migraine headache. We did this study to describe a new symptom (step-headache) in migraine in which some patients complained of uncomfortable or painful thump over the head with each footstep during walking or running.
Materials and Methods
Self-designed proforma was filled in each clinically diagnosed patient of migraine or tension-type headache in an outpatient clinic setting. The symptom designated here as step-headache was evaluated in 150 patients of migraine including 26 patients with overlapping headache and 244 patients of tension-type headache. Binary logistic regression was used for association analysis of step-headache with subgroups of migraine and with other migraine features.
Statistical Analysis
Frequency distributions were expressed as numbers (percentages) or mean ± standard deviation. Binary logistic regression was used for association analysis of step-headache with subgroups of migraine and with other migraine features.
Results
Step-headache was experienced by 97 (64.67%) migraine patients with nearly equal distribution among the two clinical subtypes (61.5% for migraine with aura and 65.3% for migraine without aura) but with high prevalence among perimenopausal onset migraine. Of all the patients who had this symptom, 77.32% experienced it during all the migraine attacks. The step-headache was differentiable from throbs of migraine and their exacerbation during physical activity by its synchrony with footsteps and its presence during nonpulsatile headaches or nonheadache phases of migraine. Sensitivity of this symptom was 64.67% while specificity was 100%.
Conclusion
Among primary headaches, step-headache is a less well-known but common and distinct symptom of migraine. It has good sensitivity and high specificity for migraine.
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Affiliation(s)
- Sunil Pradhan
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Animesh Das
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Jayashri Ghosh
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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15
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Dima L, Bălan A, Moga MA, Dinu CG, Dimienescu OG, Varga I, Neculau AE. Botulinum Toxin a Valuable Prophylactic Agent for Migraines and a Possible Future Option for the Prevention of Hormonal Variations-Triggered Migraines. Toxins (Basel) 2019; 11:E465. [PMID: 31398813 PMCID: PMC6722780 DOI: 10.3390/toxins11080465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In 1989, Botulinum toxin (BoNT) was accepted by the FDA for the management of some ophthalmic disorders. Although it was initially considered a lethal toxin, in recent times, Botulinum toxin A (BoNT-A), which is the more used serotype, has expanded to cover different clinical conditions, primarily characterized by neuropathic pain, including migraines and headaches. Evidence suggests that migraines are influenced by hormonal factors, particularly by estrogen levels, but very few studies have investigated the prevalence and management strategies for migraines according to the hormonal status. The effects of several therapeutic regimens on migraines have been investigated, but the medications used varied widely in proven efficacies and mechanisms of action. BoNT-A is increasingly used in the management of migraine and several placebo-controlled trials of episodic and chronic migraine are currently underway. This paper is a review of the recently published data concerning the administration of BoNT-A in the prevention of chronic migraines. Considering the lack of population-based studies about the effectiveness of BoNT-A in the alleviation of premenstrual and perimenopausal migraines, this study proposes a new perspective of the therapeutic approach of migraine syndrome associated with menopausal transition and the premenstrual period. METHODS We selected the reviewed papers from CrossRef, PubMed, Medline, and GoogleScholar, and a total of 21 studies met our inclusion criteria. RESULTS To date, no specific preventive measures have been recommended for menopausal women with migraines. BoNT-A often reduces the frequency and intensity of migraine attacks per month; the treatment is well tolerated and does not exhibit a significantly higher rate of treatment-related side effects. No population-based studies were conducted in order to highlight the role of BoNT-A in menopause-related migraines, neither in menstrual migraines. CONCLUSION There is a need for further research in order to quantify the real burden of menstrual and perimenopausal migraines and to clarify if BoNT-A could be used in the treatment of refractory postmenopausal and premenstrual migraines.
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Affiliation(s)
- Lorena Dima
- Department of Fundamental Disciplines and Clinical Prevention, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania
| | - Andreea Bălan
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
| | - Marius Alexandru Moga
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania
| | - Cătălina Georgeta Dinu
- Department of Law, Faculty of Law, Transilvania University of Brasov, 500019 Brasov, Romania
| | - Oana Gabriela Dimienescu
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
| | - Ioana Varga
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania
| | - Andrea Elena Neculau
- Department of Fundamental Disciplines and Clinical Prevention, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania
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Bulboacă AE, Bolboacă SD, Bulboacă AC, Porfire AS, Tefas LR, Suciu ŞM, Dogaru G, Stănescu IC. Liposomal Curcumin Enhances the Effect of Naproxen in a Rat Model of Migraine. Med Sci Monit 2019; 25:5087-5097. [PMID: 31287810 PMCID: PMC6636407 DOI: 10.12659/msm.915607] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 03/13/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Curcumin is an antioxidant that reduces inflammation and pain. This study aimed to assess the effect of pretreatment with naproxen and liposomal curcumin compared with naproxen and curcumin solution on oxidative stress parameters and pain in a rat model of migraine. MATERIAL AND METHODS Sixty-three male Wistar rats included a control group (n=9) and a rat model of migraine (n=54) induced by intraperitoneal injection of nitroglycerin (1 mg/0.1 kg). The rat model group was divided into an untreated control group (n=9), a group pretreated with naproxen alone (2.8 mg/kg) (n=9), a group pretreated with naproxen (2.8 mg/kg) combined with curcumin solution (1 mg/0.1 kg) (n=9), a group pretreated with naproxen (2.8 mg/kg) combined with curcumin solution (2 mg/0.1 kg) (n=9), a group pretreated with naproxen (2.8 mg/kg) combined with liposomal curcumin solution (1 mg/0.1 kg) (n=9) a group pretreated with naproxen (2.8 mg/kg) combined with liposomal curcumin solution (2 mg/0.1 kg) (n=9). Spectroscopy measured biomarkers of total oxidative status and nociception was tested using an injection of 1% of formalin into the rat paw. RESULTS Expression of biomarkers of oxidative stress and enhanced nociception were significantly increased following pretreatment with combined naproxen and liposomal curcumin compared with curcumin solution or naproxen alone (P<0.001). Combined curcumin solution and naproxen were more effective at a concentration of 2 mg/0.1kg for the first nociceptive phase (P<0.005). CONCLUSIONS In a rat model of migraine, combined therapy with liposomal curcumin and naproxen showed an improved antioxidant effect and anti-nociceptive effect.
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Affiliation(s)
- Adriana E. Bulboacă
- Department of Pathophysiology, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Angelo C. Bulboacă
- Department of Neurology and Pediatric Neurology, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Alina S. Porfire
- Department of Pharmaceutical Technology and Biopharmaceutics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Lucia R. Tefas
- Department of Pharmaceutical Technology and Biopharmaceutics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Şoimiţa M. Suciu
- Department of Physiology, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Gabriela Dogaru
- Department of Physical Medicine and Rehabilitation, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ioana C. Stănescu
- Department of Neurology and Pediatric Neurology, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
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17
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Ishida Y, Sugiura Y, Magome T, Kamakura T, Takimoto Y, Hanada Y, Kitayama K, Nakamura Y, Shimada S, Ohta N, Naono-Nakayama R, Kamijo K. Expression Analysis of Serotonin Receptors, Serotonin Transporter and l-Amino Acid Decarboxylase in the Mouse Sphenopalatine Ganglion by RT-PCR, Northern Blot Analysis and In Situ Hybridization. Neuroscience 2019; 411:23-36. [PMID: 31128160 DOI: 10.1016/j.neuroscience.2019.05.028] [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: 01/19/2019] [Revised: 05/03/2019] [Accepted: 05/14/2019] [Indexed: 11/26/2022]
Abstract
The sphenopalatine ganglion (SPG) is a gathering of the cell bodies of parasympathetic fibers that dominate the nasal gland, lacrimal gland and cerebral blood vessels. The SPG controls nasal secretions, tears, and the dilation of cerebral blood vessels. However, it is unclear how serotonin regulates SPG functions. In this study, we investigated the expression of genes involved in the serotonergic system in the mouse SPG. We examined the mRNA expression levels of 5-HT1A, 5-HT1B, 5-HT1D, 5-HT1F, 5-HT2A, 5-HT2B, 5-HT2C, 5-HT3A, 5-HT3B, 5-HT4, 5-HT5A, 5-HT5B, 5-HT6 and 5-HT7 receptors, as well as serotonin transporter, tryptophan hydroxylases 1 and 2, and L-amino acid decarboxylase (AADC) by RT-PCR. It revealed that the 5-HT3A and 5-HT3B ionotropic receptors and AADC were likely to be highly expressed in the SPG, as measured by RT-PCR. We next performed in situ hybridization on the SPG to examine the expression of these three genes at the cellular level after validating the specificity of each cRNA probe by northern blotting. The 5-HT3A receptor, 5-HT3B receptor, and AADC were expressed in 96.5% ± 1.0%, 29.7% ± 10.7%, and 57.4% ± 2.9% of neuronal cell bodies in the SPG, respectively, indicating that the 5-HT3A receptor was virtually expressed in all SPG neurons. Our results on the expression of these critical serotonin system genes in the parasympathetic SPG provide insight into the pathogenetics of rhinitis, conjunctivitis and headache. Furthermore, our findings suggest that targeting the 5-HT3A receptor might have therapeutic potential in the treatment of these ailments.
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Affiliation(s)
- Yusuke Ishida
- Division of Anatomy and Cell Biology, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Japan; Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan; Division of Otorhinolaryngology, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Japan.
| | - Yusuke Sugiura
- Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Takuya Magome
- Department of medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Takefumi Kamakura
- Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yasumitsu Takimoto
- Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yukiko Hanada
- Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Kazuki Kitayama
- Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yukiko Nakamura
- Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Shoichi Shimada
- Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Nobuo Ohta
- Division of Otorhinolaryngology, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Japan
| | - Rumi Naono-Nakayama
- Division of Anatomy and Cell Biology, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Japan
| | - Keiju Kamijo
- Division of Anatomy and Cell Biology, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Japan
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Wu Z, Camargo CA, Sluyter JD, Khaw KT, Malihi Z, Waayer D, Toop L, Lawes CMM, Scragg R. Association between serum 25-hydroxyvitamin D levels and self-reported chronic pain in older adults: A cross-sectional analysis from the ViDA study. J Steroid Biochem Mol Biol 2019; 188:17-22. [PMID: 30508645 DOI: 10.1016/j.jsbmb.2018.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/23/2018] [Accepted: 11/29/2018] [Indexed: 02/07/2023]
Abstract
Chronic pain is a major contributor to the global burden of disability. Prior studies on the association between serum 25-hydroxyvitamin D (25(OH)D) levels and chronic pain have yielded mixed results. The Vitamin D Assessment study, a large randomized controlled trial from New Zealand, offered the opportunity to examine this association in data collected at baseline in all participants, and among those with arthritis or depression. A total of 5110 participants aged 50-84 years were recruited from community general practices. Chronic pain (lasting ≥6 months) and other baseline characteristics were collected at baseline interview. Serum 25(OH)D concentration was measured by liquid chromatography-tandem mass spectrometry. Associations between 25(OH)D levels and chronic pain were explored using multivariable log-binomial regression to estimate relative risks (RRs). Out of 5049 participants with complete data, 871 (17%) reported having this clinical outcome, and 1254 (25%) had a 25(OH)D concentration <50 nmol/L. There was no significant association between 25(OH)D and chronic pain, with vitamin D status categorized in four groups: <25.0, 25.0-49.9, 50.0-74.9, and ≥75.0 nmol/L (the highest group as reference). The unadjusted RRs were 1.09, 1.10, and 1.08, respectively (Ptrend = 0.24). Adjustment for demographics, lifestyle, BMI, medical history, prescription of analgesics and vitamin D supplements did not change this finding. Similar non-significant results were observed in participants with arthritis (n = 1732) or depression (n = 528). In this multi-ethnic, community-selected sample of older adults in New Zealand, serum 25(OH)D levels were not associated with chronic pain. These results do not support a role for low vitamin D status in the prevalence of chronic pain in older adults.
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Affiliation(s)
- Zhenqiang Wu
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John D Sluyter
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Kay-Tee Khaw
- Department of Public Health, University of Cambridge, Cambridge, England, United Kingdom
| | - Zarintaj Malihi
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Debbie Waayer
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Les Toop
- Department of Public Health & General Practice, The University of Otago, Christchurch, New Zealand
| | - Carlene M M Lawes
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand.
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Odell J, Clark C, Hunnisett A, Ahmed OH, Branney J. Manual therapy for chronic migraine: a pragmatic randomised controlled trial study protocol. Chiropr Man Therap 2019; 27:11. [PMID: 30962877 PMCID: PMC6436233 DOI: 10.1186/s12998-019-0232-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/03/2019] [Indexed: 01/02/2023] Open
Abstract
Introduction Chronic migraine is a largely refractory condition affecting between 1 and 2.2% of the overall population worldwide, with females more affected than males. There are also high health and socioeconomic costs associated both for the individual and society. The mainstay of chronic migraine management is pharmacological, but the options available have limited efficacy and there are often unwanted side effects. There is some evidence for manual therapy as a treatment option for migraine, but its effectiveness for chronic migraine is unknown. Therefore, we have designed a pragmatic randomised control trial to investigate whether adding manual therapy to the tertiary specialist treatment of chronic migraine improves patient-reported outcomes. Methods A pragmatic, randomised controlled trial in a hospital tertiary headache clinic. Participants will be randomised into one of two groups: treatment as usual or treatment as usual plus manual therapy. The primary outcome measure will be a change in the Headache Impact Test score. Secondary outcomes will also be measured over the 12-week study period including changes in headache frequency, migraine specific quality of life and reductions in relevant medicine consumption. The manual therapy group will have five treatment sessions each lasting 30 min. The recruitment target of 64 participants will allow power at 80% with p = 0.05 using minimal clinical difference for Headache Impact Test of 3.7 and includes provision for a 10% dropout rate. Recruitment will take place between August 2018 and February 2019. The results will form part of a doctoral study and be published in peer-reviewed journals and presented at national/international conferences. Discussion Current pharmacological approaches have limited effects in the management of chronic migraine and there is a requirement to improve treatment options and reduce the health and economic burden of the condition. Manual therapy has been shown to be effective in other chronic pain conditions as well as other primary headaches. This study will explore the effectiveness of manual therapy as an adjunctive approach to the management of chronic migraine. Trial registration The trial has received a favourable opinion from the UK Health Research Authority (IRAS 228901) and is registered at ClinicalTrials.gov.number NCT03395457. Registered 1st March 2018.
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Affiliation(s)
- Jim Odell
- Bournemouth University, Royal London House, Christchurch Road, Bournemouth, BH1 3LT UK
| | - Carol Clark
- Bournemouth University, Royal London House, Christchurch Road, Bournemouth, BH1 3LT UK
| | - Adrian Hunnisett
- BPP University, McTimoney College, Kimber Road, Abingdon, OX14 1BZ UK
| | - Osman Hassan Ahmed
- Bournemouth University, Royal London House, Christchurch Road, Bournemouth, BH1 3LT UK
| | - Jonathan Branney
- Bournemouth University, Royal London House, Christchurch Road, Bournemouth, BH1 3LT UK
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21
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Chen N, Su W, Cui SH, Guo J, Duan JC, Li HX, He L. A novel large animal model of recurrent migraine established by repeated administration of inflammatory soup into the dura mater of the rhesus monkey. Neural Regen Res 2019; 14:100-106. [PMID: 30531083 PMCID: PMC6262984 DOI: 10.4103/1673-5374.243715] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Several animal models of migraine have been established, and those based on trigeminovascular system activation are widely accepted. However, most of these models have been established on lower animals, such as rodents, and involve only a single administration of a noxious stimulus. In this study, an inflammatory soup (10 μL), consisting of prostaglandin E2 (0.2 mM), serotonin (2 mM), bradykinin (2 mM) and histamine (2 mM), was injected into the dura mater of conscious rhesus monkeys through an indwelling catheter. The infusion started on day 8 and was repeated every 3 days, for a total of six administrations, to induce neurogenic inflammation. We performed behavioral assessments and measured the expression of the oncogene c-fos, neuronal nitric oxide synthase (nNOS) and calcitonin gene related peptide (CGRP) in the trigeminal system and in multiple brain regions involved in pain processing by immunohistochemical staining. Compared with monkeys in the control group, three of the four animals in the inflammatory soup group displayed decreased motor behaviors, and two showed increased ipsilateral nose and mouth secretions during the stimulus period. Higher expression levels of c-fos, nNOS and CGRP were found in various brain areas of experimental animals compared with controls, including the trigeminal nucleus caudalis, thalamus, hypothalamus, midbrain, pons and other areas involved in pain perception. These results suggest that repeated inflammatory soup stimulation of the dura activates the trigeminovascular system and produces migraine-like pathological changes and abnormal behaviors in conscious rhesus monkeys.
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Affiliation(s)
- Ning Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wei Su
- Department of Neurology, West China Hospital; Department of Science & Technology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Shu-Hui Cui
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jian Guo
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jia-Chuan Duan
- National Chengdu Center for Safety Evaluation of Traditional Chinese Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Hong-Xia Li
- National Chengdu Center for Safety Evaluation of Traditional Chinese Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Li He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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McCafferty EH, Lyseng-Williamson KA. Erenumab in the prophylaxis of migraine: a profile of its use. DRUGS & THERAPY PERSPECTIVES 2019. [DOI: 10.1007/s40267-018-0589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ran C, Fourier C, Zinnegger M, Steinberg A, Sjöstrand C, Waldenlind E, Belin AC. Implications for the migraine SNP rs1835740 in a Swedish cluster headache population. J Headache Pain 2018; 19:100. [PMID: 30382894 PMCID: PMC6755538 DOI: 10.1186/s10194-018-0937-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cluster headache is a severe headache disorder with unknown aetiology. The pathophysiology and symptoms present certain common features with migraine. Specifically, activation of the trigeminal vascular system seems to be involved in both disorders, which is hypothesized to result in neurogenic inflammation and vasodilation of the cerebral vessels. In addition, genetic factors have been implicated in both migraine and cluster headache. OBJECTIVE In order to determine whether or not migraine and cluster headache share genetic risk factors, we screened two genetic variants known to increase the risk of migraine in Sweden in a Swedish cluster headache case-control study population. METHODS In all, 541 patients and 581 control subjects were genotyped for rs1835740 in close proximity to MTDH (metadherin) and rs2651899 in the PRDM16 (PR/SET domain 16) gene, using TaqMan® real-time PCR and pyrosequencing. In addition, we analyzed MTDH gene expression in a subset of the material, using reverse transcription real-time PCR to determine relative mRNA levels in primary fibroblast cell lines from patients and controls. RESULTS We found a trend for association between rs1835740, which is reported to affect MTDH mRNA levels, and cluster headache in our Swedish case-control material (p = 0.043, Χ2 = 4.102). This association was stronger in a subgroup of patients suffering from both cluster headache and migraine (p = 0.031, Χ2 = 6.964). We could further confirm that rs1835740 has an effect on the transcriptional activity of MTDH. In this Swedish cluster headache cohort we did not find an association with the rs2651899 variant. CONCLUSIONS We conclude that rs1835740 is a potential risk factor for cluster headache in Sweden. Our data indicates that rs1835740 and MTDH might be involved in neurovascular headaches in general whilst rs2651899 is specifically related to migraine.
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Affiliation(s)
- Caroline Ran
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
| | - Carmen Fourier
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
| | - Margret Zinnegger
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
| | - Anna Steinberg
- Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, Sweden
| | - Christina Sjöstrand
- Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, Sweden
| | - Elisabet Waldenlind
- Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Carmine Belin
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
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Choong CK, Ford JH, Nyhuis AW, Robinson RL, Aurora SK. Health Care Utilization and Direct Costs Among Patients Diagnosed with Cluster Headache in U.S. Health Care Claims Data. J Manag Care Spec Pharm 2018; 24:921-928. [PMID: 30156448 PMCID: PMC10397973 DOI: 10.18553/jmcp.2018.24.9.921] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cluster headache (CH) is a rare trigeminal cephalalgia that is associated with extremely painful unilateral headache attacks and autonomic symptoms. Attacks may be episodic or chronic and associated with substantial suffering due to excruciating pain and limited treatment options. Frequent cluster headaches cause substantial burden for patients, resulting in reduced productivity caused by disability, as well as direct costs in some European countries. Less is known, however, about direct costs of recurring health care resource utilization (HCRU) in the United States. OBJECTIVE To characterize HCRU and direct costs associated with CH in the United States from a third-party payer perspective. METHODS This retrospective observational study analyzed claims data from the Truven Health Analytics MarketScan Research Databases from 2009-2014. Two cohorts were compared: CH (> 2 diagnostic CH claims) and controls (nonheadache patients). All patients were enrolled continuously for ± 12 months from date of first CH claim. HCRU and direct costs were examined during 12 months post-index as all-cause and CH-specific. Cost and HCRU differences were compared using propensity score-adjusted bin bootstrapping. RESULTS CH and control cohorts comprised 6,562 and 143,761 patients (aged ≥ 18 years), respectively. Post-index, 36.9% of CH patients versus 16.2% of controls were admitted to the emergency department (ED), and 14.8% versus 6.1% were hospitalized for any reason, respectively (each P < 0.001). CH patients had a 2- to 3-fold significantly greater number of all-cause mean claims for outpatient visits (26.5 vs. 12.4 visits), hospital visits (0.2 vs. 0.1 visits), and ED visits (1.0 vs. 0.3 visits) versus controls (all P < 0.001). The mean number of all-cause visits with reported radiology and laboratory claims was 1.5- to 2.0-fold greater in CH patients versus controls (each P < 0.001). Mean total direct costs for all-cause claims were more than 2-fold greater in post-index ($16,530) for CH patients versus controls ($7,197, P < 0.0001). Similarly, mean direct all-cause costs attributable to outpatient, inpatient, and pharmacy claims were significantly (2-fold) greater; radiology and ED claims were 3- to 4-fold greater among CH patients versus controls (all P < 0.001). However, CH was cited infrequently as a reason for HCRU, indicating that comorbid conditions may substantially increase HCRU in CH patients. The most common reasons for ED admission in CH patients were gastric ulcer with hemorrhage, sub-arachnoid hemorrhage, and headache symptoms. The most common hospital discharge diagnoses for CH patients not observed in top 10 reasons in controls included cerebral artery occlusion/unspecified with cerebral infarction, headache symptoms, syncope/collapse, and diverticulitis. CONCLUSIONS These findings suggest that, from a payer perspective, CH patients incur significantly higher health care costs versus controls. However, these high costs were not exclusively headache-related. Extrapolating our cost findings to estimated U.S. prevalence rates, approximate total direct cost for CH is greater than $2.8 billion/year. DISCLOSURES Eli Lilly and Company was the sole sponsor and funder for this study and was responsible for the study design, data collection, data analysis, interpretation of data, and decision to publish the findings. All authors are employees and minor stockholders of Eli Lilly and Company.
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Pu S, Chen J, Gu X, Xu Y, Wu J, Lv Y, Du D. Effects of ultrasound-guided stellate ganglion block on cervical vascular blood flow: study protocol for a randomized controlled trial. Trials 2018; 19:426. [PMID: 30086776 PMCID: PMC6081863 DOI: 10.1186/s13063-018-2736-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 06/08/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The stellate ganglion block (SGB) can lead to vasodilation of the head and neck. However, controversy remains concerning the changes in extracerebral blood flow. The objective of this study is to assess the effects of SGB on the blood flow to the neck. METHODS A randomized controlled crossover trial with 38 participants will be conducted. Participants who have primary headaches will be assigned to either group A or B. Patients in group A will receive SGB with 6 ml 1% lidocaine, and after a one-week washout period, they will undergo the second SGB with 6 ml normal saline. In contrast, patients in group B will receive the opposite protocol. Data will be collected at baseline (T0) and at 15 min after the first intervention (T1), 15 min before the second intervention (T2), 15 min after the second intervention (T3) and at a 3-week follow up (T4). T1 is the primary time point for the primary outcome analysis. The primary outcomes include the peak systolic velocity (PSV), the end diastolic velocity (EDV), resistance index (RI) and vessel diameter of the common carotid artery (CCA) and vertebral artery (VA). The secondary outcomes include the rate of ptosis, the rate of conjunctival flushing, and the numerical rating scale (NRS) pain score. Additionally, adverse events (AEs) or serious adverse events (SAEs) will be collected at each assessment point. DISCUSSION This study will comprehensively investigate the efficacy of SGB in extracerebral blood flow. Our research may also suggest that SGB will be effective in reducing pain in patients with primary headaches. TRIAL REGISTRATION Chinese Clinical Trial Registry, identifier ChiCTR-IOR-17011536 . Registered on 1 June 2017.
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Affiliation(s)
- Shaofeng Pu
- Department of Pain Management, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Rd, Shanghai, 200233, People's Republic of China
| | - Jie Chen
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, 200233, China
| | - Xing Gu
- Department of Gynaecology and Obstetrics, the Affiliated Kunshan First People's Hospital, Jiangsu University, Kunshan, 215300, China
| | - Yongming Xu
- Department of Pain Management, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Rd, Shanghai, 200233, People's Republic of China
| | - Junzhen Wu
- Department of Pain Management, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Rd, Shanghai, 200233, People's Republic of China
| | - Yingying Lv
- Department of Pain Management, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Rd, Shanghai, 200233, People's Republic of China
| | - Dongping Du
- Department of Pain Management, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Rd, Shanghai, 200233, People's Republic of China.
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Oral High-Dose Thiamine Improves the Symptoms of Chronic Cluster Headache. Case Rep Neurol Med 2018; 2018:3901619. [PMID: 29850313 PMCID: PMC5932500 DOI: 10.1155/2018/3901619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/03/2018] [Accepted: 02/25/2018] [Indexed: 12/31/2022] Open
Abstract
Cluster headache is a rare painful primary disorder occurring in either episodic or chronic patterns. Several authors found that the hypothalamus, the brain region regulating endocrine function and autonomic system, is involved in the pathophysiology of cluster headache. Some authors have found in patients affected by this disease abnormality in glucose metabolism. Considering the role of thiamine in brain function, in energetic metabolism, and in pain modulation, we treated a patient affected by cluster headache with oral high-dose thiamine. We report a 41-year-old man suffering from primary chronic cluster headache since the age of 15 years. The patient began oral therapy with high-dose thiamine in December 2016. Oral thiamine supplementation led to a dramatic improvement of the symptoms. The therapy was effective in reversing all the symptoms of the disease. Our observation suggests that a thiamine deficiency due to enzymatic abnormalities or to dysfunction of the circulation of thiamine in the intracellular space could cause a neuronal selective impairment in the centers that are involved in this disease and could have an important role in the pathogenesis of the symptoms of cluster headache.
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Singh AK, Tantiwongkosi B, Moise AM, Altmeyer WB. Stroke-like migraine attacks after radiation therapy syndrome: Case report and review of the literature. Neuroradiol J 2017; 30:568-573. [PMID: 28643603 PMCID: PMC5703131 DOI: 10.1177/1971400917690009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 26-year-old female presented with vision loss accompanied by migraine-like headaches. A contrast-enhanced magnetic resonance imaging of the brain was performed which revealed findings suggestive of stroke-like migraine attacks after radiation therapy (SMART) syndrome. SMART syndrome is a delayed complication of brain radiation characterized by neurologic symptoms including migraine-like headaches, seizures, and hemispheric impairment. The purpose of this article is to make the readers aware of this rare complication of brain irradiation. Appropriate diagnosis of SMART syndrome is essential to avoid invasive tests.
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Affiliation(s)
- Achint K Singh
- Department of Radiology, University of Texas Health Science Center, San Antonio, USA
| | - Bundhit Tantiwongkosi
- Department of Radiology, University of Texas Health Science Center, San Antonio, USA
| | | | - Wilson B Altmeyer
- Department of Radiology, University of Texas Health Science Center, San Antonio, USA
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Jay GW, Barkin RL. Primary Headache Disorders Part I- Migraine and the Trigeminal Autonomic Cephalalgias. Dis Mon 2017; 63:308-338. [DOI: 10.1016/j.disamonth.2017.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Sundrum T, Walker CS. Pituitary adenylate cyclase-activating polypeptide receptors in the trigeminovascular system: implications for migraine. Br J Pharmacol 2017; 175:4109-4120. [PMID: 28977676 DOI: 10.1111/bph.14053] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 08/24/2017] [Accepted: 09/11/2017] [Indexed: 12/13/2022] Open
Abstract
The neuropeptide pituitary adenylate cyclase-activating polypeptide (PACAP) has been implicated in a wide range of functions including vasodilatation, neuroprotection, nociception and neurogenic inflammation. PACAP activates three distinct receptors, the PAC1 receptor, which responds to PACAP, and the VPAC1 and VPAC2 receptors, which respond to both PACAP and vasoactive intestinal polypeptide. The trigeminovascular system plays a key role in migraine and contains the trigeminal nerve, which is the major conduit of craniofacial pain. PACAP is expressed throughout the trigeminovascular system and in higher brain regions involved in processing pain. Evidence from human clinical studies suggests that PACAP may act outside the blood-brain barrier in the pathogenesis of migraine. However, the precise mechanisms involved remain unclear. PACAP potentially induces migraine attacks by activating different receptors in different cell types and tissues. This complexity prompted this review of PACAP receptor pharmacology, expression and function in the trigeminovascular system. Current evidence suggests that the PAC1 receptor is the likely pathophysiological target of PACAP in migraine. However, multiple PACAP receptors are expressed in key parts of the trigeminovascular system and further work is required to determine their contribution to PACAP physiology and the pathology of migraine. LINKED ARTICLES This article is part of a themed section on Molecular Pharmacology of GPCRs. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.21/issuetoc.
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Affiliation(s)
- Tahlia Sundrum
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher S Walker
- School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre and Centre for Brain Research, University of Auckland, Auckland, New Zealand
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Deneris A, Rosati Allen P, Hart Hayes E, Latendresse G. Migraines in Women: Current Evidence for Management of Episodic and Chronic Migraines. J Midwifery Womens Health 2017; 62:270-285. [DOI: 10.1111/jmwh.12626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/27/2017] [Accepted: 03/09/2017] [Indexed: 12/17/2022]
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Motte J, Kreitschmann-Andermahr I, Fisse AL, Börnke C, Schroeder C, Pitarokoili K, Müller O, Lukas C, van de Nes J, Buslei R, Gold R, Ayzenberg I. Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2017; 4:e332. [PMID: 28243612 PMCID: PMC5310204 DOI: 10.1212/nxi.0000000000000332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/11/2017] [Indexed: 11/15/2022]
Abstract
Objective: To report a rare case of incipient granulomatous hypophysitis presenting by atypical trigemino-autonomic cephalalgia (TAC) and Horner syndrome. Methods: The patient was investigated with repeated brain MRI, CSF examination, thoracic CT, Doppler and duplex ultrasound of the cerebral arteries, and extensive serologic screening for endocrine and autoimmune markers. Written informed consent was obtained from the patient for access to clinical files for research purposes and for publication. Results: We present a middle-aged woman with a history of an autoimmune pancreatitis type 2 who had therapy-refractory TAC with Horner syndrome. Initial cerebral MRI showed only indistinct and unspecific signs of a pathologic process. A biopsy revealed a granulomatous hypophysitis. The symptoms disappeared after transsphenoidal subtotal resection of the pituitary mass and anti-inflammatory therapy. Conclusions: This case elucidates that inflammatory pituitary diseases must be taken into account in case of atypical and refractory TAC, especially in patients with a history of autoimmune diseases. To our knowledge, the association between TAC accompanied by Horner syndrome and hypophysitis has not yet been described before.
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Affiliation(s)
- Jeremias Motte
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Ilonka Kreitschmann-Andermahr
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Anna Lena Fisse
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Christian Börnke
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Christoph Schroeder
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Kalliopi Pitarokoili
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Oliver Müller
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Carsten Lukas
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Johannes van de Nes
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Rolf Buslei
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Ralf Gold
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Ilya Ayzenberg
- Department of Neurology (J.M., A.L.F., C.B., C.S., K.P., R.G., I.A.), Department of Radiology (C.L.), and Institute of Pathology (J.v.d.N.), Ruhr University Bochum; Department of Neurosurgery (I.K.-A., O.M.), and Institute of Neuropathology (J.v.d.N.), University of Duisburg-Essen; and Department of Neuropathology (R.B.), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
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Zhang J, Su J, Wang M, Zhao Y, Yao Q, Zhang Q, Lu H, Zhang H, Wang S, Li GF, Wu YL, Liu FD, Shi YH, Li J, Liu JR, Du X. Increased default mode network connectivity and increased regional homogeneity in migraineurs without aura. J Headache Pain 2016; 17:98. [PMID: 27771875 PMCID: PMC5075323 DOI: 10.1186/s10194-016-0692-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/15/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The precuneus/posterior cingulate cortex, which has been associated with pain sensitivity, plays a pivotal role in the default mode network. However, information regarding migraine-related alterations in resting-state brain functional connectivity in the default mode network and in local regional spontaneous neuronal activity is not adequate. METHODS This study used functional magnetic resonance imaging to acquire resting-state scans in 22 migraineurs without aura and in 22 healthy matched controls. Independent component analysis, a data-driven method, was used to calculate the resting-state functional connectivity of the default mode network in the patient and healthy control groups. Regional homogeneity (ReHo) was used to analyse the local features of spontaneous resting-state brain activity in the migraineurs without aura. RESULTS Compared with the healthy controls, migraineurs without aura showed increased functional connectivity in the left precuneus/posterior cingulate cortex within the default mode network and significant increase in ReHo values in the bilateral precuneus/posterior cingulate cortex, left pons and trigeminal nerve entry zone. In addition, functional connectivity was decreased between the areas with abnormal ReHo (using the peaks in the precuneus/posterior cingulate cortex) and other brain areas. CONCLUSIONS The abnormalities in the precuneus/posterior cingulate cortex suggest that migraineurs without aura may exhibit information transfer and multimodal integration dysfunction and that pain sensitivity and pian processing may also be affected.
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Affiliation(s)
- Jilei Zhang
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Jingjing Su
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Mengxing Wang
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Ying Zhao
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Qian Yao
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Qiting Zhang
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Haifeng Lu
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Hui Zhang
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Shuo Wang
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Ge-Fei Li
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Yi-Lan Wu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Feng-Di Liu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Yan-Hui Shi
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Jian-Ren Liu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and Clinical Research Center, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
| | - Xiaoxia Du
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China.
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