The Relationship between Attention Deficit Hyperactivity Disorder and Personality Characteristics in Migrainous Patients

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Abdol Reza Sabahi

2014-08-01

Full Text Available Background: World Health Organization reports described migraine as one of the 4 most disabling chronic medical disorders. A day with migraine is as disabling as a day with quadriplegia, schizophrenia, or dementia in who is view 87% of people with migraine has some degree of disability. Migraine headaches are associated with psychological factors and personality characteristics. This study compares the personality characteristics of migraine patients with Attention Deficit Hyperactivity Disorder (ADHD and without ADHD. Materials and Methods: Eighty patients with migraine were evaluated in this cross sectional study with simple sampling method. All participants were assessed with semi structured clinical interview, adult ADHD self-report scale (ASRS and Millone clinical multiaxial inventory questionnaire. The migraine patients were divided into two groups, with and without ADHD. The correlation of variables was tested by χ2 test and t-test with 0.05 significance with the use of software SPSS-20. Results: Our participants were 80% female, 56% married and 36.2% with at least graduation from high school. Patients with migraine and ADHD were younger and their first headache experience had occurred in lower age compared with non-ADHD patients (p<0.05. In current study, we showed that there is a significant correlation between ADHD and depressive and independent personality traits and dysthymic clinical syndrome in migraine patients (p<0.05. Conclusion: Our results demonstrate that personality characteristics in migraine patients may be affected by some other mental disorders such as ADHD. These findings might be helpful in early treatment and prevention of dysfunctioning in patients with migraine.

Brain structural properties predict psychologically mediated hypoalgesia in an 8-week sham acupuncture treatment for migraine.

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Liu, Jixin; Mu, Junya; Liu, Qianqian; Dun, Wanghuan; Zhang, Ming; Tian, Jie

2017-09-01

Neuroimaging studies described brain structural changes that comprise the mechanisms underlying individual differences in migraine development and maintenance. However, whether such interindividual variability in migraine was observed in a pretreatment scan is a predisposition for subsequent hypoalgesia to placebo treatment that remains largely unclear. Using T1-weighted imaging, we investigated this issue in 50 healthy controls (HC) and 196 patients with migraine without aura (MO). An 8-week double-blinded, randomized, placebo-controlled acupuncture was used, and we only focused on the data from the sham acupuncture group. Eighty patients participated in an 8-weeks sham acupuncture treatment, and were subdivided (50% change in migraine days from baseline) into recovering (MOr) and persisting (MOp) patients. Optimized voxel-based morphometry (VBM) and functional connectivity analysis were performed to evaluate brain structural and functional changes. At baseline, MOp and MOr had similar migraine activity, anxiety and depression; reduced migraine days were accompanied by decreased anxiety in MOr. In our findings, the MOr group showed a smaller volume in the left medial prefrontal cortex (mPFC), and decreased mPFC-related functional connectivity was found in the default mode network. Additionally, the reduction in migraine days after placebo treatment was significantly associated with the baseline gray matter volume of the mPFC which could also predict post-treatment groups with high accuracy. It indicated that individual differences for the brain structure in the pain modulatory system at baseline served as a substrate on how an individual facilitated or diminished hypoalgesia responses to placebo treatment in migraineurs. Hum Brain Mapp 38:4386-4397, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Abnormal rich club organization and impaired correlation between structural and functional connectivity in migraine sufferers.

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Li, Kang; Liu, Lijun; Yin, Qin; Dun, Wanghuan; Xu, Xiaolin; Liu, Jixin; Zhang, Ming

2017-04-01

Because of the unique position of the topologically central role of densely interconnected brain hubs, our study aimed to investigate whether these regions and their related connections would be particularly vulnerable to migraine. In our study, we explored the rich club structure and its role in global functional dynamics in 30 patients with migraine without aura and 30 healthy controls. DTI and resting fMRI were used to construct structural connectivity (SC) and functional connectivity (FC) networks. An independent replication data set of 26 patients and 26 controls was included to replicate and validate significant findings. As compared with the controls, the structural networks of patients exhibited altered rich club organization with higher level of feeder connection density, abnormal small-world organization with increased global efficiency and decreased strength of SC-FC coupling. As these abnormal topological properties and headache attack duration exhibited a significant association with increased density of feeder connections, our results indicated that migraine may be characterized by a selective alteration of the structural connectivity of the rich club regions, tending to have higher 'bridgeness' with non-rich club regions, which may increase the integration among pain-related brain circuits with more excitability but less inhibition for the modulation of migraine.

The relationship with restless legs syndrome, fibromyalgia, and depressive symptoms in migraine patients.

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Akdag Uzun, Zehra; Kurt, Semiha; Karaer Unaldi, Hatice

2018-05-18

In this study, we aimed to investigate restless legs syndrome, depression, frequency of fibromyalgia and possible causes of its frequencies, and the relationships among these synergies and migraine's prodrome, aura, pain, and postdrome symptoms in patients with migraine. The study group included 200 patients previously or recently diagnosed with definite migraine and according to International Headache Society criteria and 200 healthy volunteers. All subjects underwent a medical interview to confirm restless legs syndrome and fibromyalgia, and they were asked to complete Beck Depression and Anxiety Inventory and "severity of restless legs syndrome inventory." The frequencies of depressive symptoms and fibromyalgia in the patients with migraine were higher than those of the control group. The mean age of the migraine patients with restless legs syndrome was also higher, and this group had migraine headache for a longer time. There was a statistically significant difference with regard to only generalized anxiety and traveler's distress, which were features of the migraine, between migraine patients with and without restless legs syndrome. Restless legs syndrome was more common in migraine patients with and without aura and in those with nonspecific white matter lesions in the cranial MRI. In our study, the greater frequency of restless legs syndrome, depressive symptoms, and fibromyalgia in the patients with migraine supports the role of dopamine, which is common to all three disorders. Interviews focused on these problems among migraine patients may help to decide on the best available treatment modality.

Coexisting typical migraine in familial hemiplegic migraine

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Hansen, Jakob Møller; Thomsen, Lise Lykke; Olesen, Jes

2010-01-01

In contrast to patients with migraine with aura (MA) and migraine without aura (MO), most patients with familial hemiplegic migraine (FHM) do not report migraine-like attacks after pharmacologic provocation with glyceryl trinitrate (GTN), a donor of nitric oxide. In the present study, we examined...... patients with FHM without known gene mutations and hypothesized that 1) GTN would cause more migraine-like attacks in patients with FHM compared to controls, and 2) GTN would cause more migraine attacks in patients with FHM with coexisting MA or MO compared to the pure FHM phenotype....

Menstrual migraine

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Simić Svetlana; Slankamenac Petar; Cvijanović Milan; Banić-Horvat Sofija; Jovin Zita; Ilin Miroslav

2007-01-01

Introduction. The prevalence of migraine in childhood and adolescence has not changed to a great extent, but it increases in adolescence, especially in female adolescents. Menstrual migraine – definition. There are two types of menstrual migraine: true menstrual migraine and menstrual related migraine. True menstrual migraine occurs predominantly around menstruation, whereas menstrual related migraine occurs during menstruation, but also at other times during the month. Causes. Exaggerated or...

Migrainous vertigo: prevalence and impact on quality of life.

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Neuhauser, H K; Radtke, A; von Brevern, M; Feldmann, M; Lezius, F; Ziese, T; Lempert, T

2006-09-26

To investigate the epidemiology of migrainous vertigo (MV) in the general population by assessing prevalence, clinical features, comorbid conditions, quality of life, and health care utilization. We screened a representative sample of the adult population in Germany (n = 4,869) for moderate or severe dizziness/vertigo and followed up with validated neurotologic telephone interviews (n = 1,003). Diagnostic criteria for MV were as follows: 1) recurrent vestibular vertigo; 2) migraine according to the International Headache Society; 3) migrainous symptoms during at least two vertiginous attacks (migrainous headache, photophobia, phonophobia, or aura symptoms); and 4) vertigo not attributed to another disorder. In a concurrent validation study (n = 61) the interviews had a sensitivity of 84% and a specificity of 94% for vestibular vertigo and 81% and 100% for migraine. The lifetime prevalence of MV was 0.98% (95% CI 0.70 to 1.37), the 12-month prevalence 0.89% (95% CI 0.62 to 1.27). Spontaneous rotational vertigo was reported by 67% of participants with MV while 24% had positional vertigo. Twenty-four percent always experienced headaches with their vertigo. Logistic regression analysis comparing participants with MV with dizziness-free migraineurs showed an independent association with coronary heart disease but not with sex, age, migrainous aura, education, stroke, hypertension, hyperlipidemia, body mass index, or depression. Age-adjusted health-related quality of life scores (SF-8 Health Survey) were consistently lower in participants with MV compared to dizziness-free controls. Two thirds of participants with MV had consulted a doctor but only 20% of these were diagnosed with MV. Migrainous vertigo is relatively common but underdiagnosed in the general population and has considerable personal and healthcare impact.

Headaches and Migraines: Migraine 101 Quiz

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... Bar Home Current Issue Past Issues Headaches and Migraines Migraine 101 Quiz Past Issues / Spring 2009 Table of ... the facts when it comes to headaches and migraines? Test your knowledge with this quick quiz. True/ ...

Pharmacological migraine provocation: a human model of migraine

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Ashina, Messoud; Hansen, Jakob Møller

2010-01-01

for migraine mechanisms. So far, however, animal models cannot predict the efficacy of new therapies for migraine. Because migraine attacks are fully reversible and can be aborted by therapy, the headache- or migraine-provoking property of naturally occurring signaling molecules can be tested in a human model....... If a naturally occurring substance can provoke migraine in human patients, then it is likely, although not certain, that blocking its effect will be effective in the treatment of acute migraine attacks. To this end, a human in vivo model of experimental headache and migraine in humans has been developed...

Vestibular migraine

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Lempert, Thomas; Olesen, Jes; Furman, Joseph

2012-01-01

This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...... in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms...

A genotype-phenotype analysis of the 8q22.1 variant in migraine with aura

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Esserlind, A-L; Kirchmann, M; Hauge, A W

2012-01-01

-2002 and 2005-2006, and diagnosed according to the International Classification of Headache Disorders (ICHD-II) using a validated physician-conducted semi-structured interview. A large number of clinical characteristics were systematically determined. Caucasians of Danish ancestry diagnosed with MA...... and migraine. The aim of this study is to evaluate the association of clinical characteristics in migraine with aura (MA) with the newly discovered minor allele A of rs1835740 at 8q22.1. Methods: Participants were recruited from the Danish Headache Center and from specialist practices during the periods 1999......-significant tendency towards milder migraine headache characteristics and fewer accompanying symptoms. These tendencies were not increased in homozygote carriers. Conclusion: None of the clinical characteristics of MA were significantly influenced by the common susceptibility variant on 8q22.1....

Psychosocial factors associated with migraine and tension-type headache in medical students.

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Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V; Kislyak, Nadezhda V; Olesen, Jes

2017-11-01

Background In our previous study of workers, blood donors and medical students, students stood out with a higher 1-year prevalence of migraine (28%) and tension-type headache (TTH) (74%). General factors associated with headache were common for all groups except low physical activity. The hypothesis of this study was therefore that a number of psychosocial factors relating to the personal sphere would better explain the high prevalence of migraine and TTH in students. Methods The study population consisted of 1042 students (719 females, 323 males, mean age 20.6, range 17-40). Headache diagnoses and associated factors were identified by direct professional semi-structured interview. We also interviewed about the following psychosocial factors: dissatisfaction with study, dissatisfaction with family life, dissatisfaction for personal reasons, bad financial situation, overwork, stress, not enough sleep, insomnia, depressed mood, anxiety, irritability, tendency towards conflicts and not being married. We report psychosocial factors associated with headache according to diagnosis and sex using univariate and multivariate logistic regression analyses. Results Several factors were significantly associated with migraine and TTH in the univariate analysis. In the multivariate analysis, two psychosocial factors were statistically significantly associated with migraine in all students: irritability (OR 2.2, 95% CI 1.4-3.6) and overwork (OR 2.2, 95% CI 1.4-3.5). Insomnia (2.7, 95% CI 1.1-6.9) and depressed mood (OR 2.1, 95% CI 1.1-4.2) were associated with migraine only in females. Two psychosocial factors were associated with TTH: dissatisfaction with study in males (OR 2.0, 95% CI 1.0-3.8) and depressed mood in females (OR 1.8, 95% CI 1.0-3.5). Conclusion Psychosocial factors from the personal sphere showed significant association with migraine and TTH in students. Such factors should therefore be major targets for preventive efforts to reduce the prevalence of primary

Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey.

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Zhang, Yan; Dennis, Jeff A; Leach, Matthew J; Bishop, Felicity L; Cramer, Holger; Chung, Vincent C H; Moore, Craig; Lauche, Romy; Cook, Ron; Sibbritt, David; Adams, Jon

2017-09-01

Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17

Migraine aura

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Charles, Andrew; Hansen, Jakob Møller

2015-01-01

classification of migraine aura is becoming both broader and more detailed. Traditionally viewed as a primary event that triggers a migraine attack, studies regarding the timing of aura relative to other symptoms of migraine indicate that it may not in fact play a primary role in initiating an attack. Careful....... SUMMARY: There has been significant evolution of concepts regarding the causes of migraine aura, how it is best defined, and how it fits into the picture of the migraine disorder as a whole. Regardless of its exact role in the genesis of migraine, an increased understanding of aura has the potential...

The impacts of migraine and anxiety disorders on painful physical symptoms among patients with major depressive disorder.

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Hung, Ching-I; Liu, Chia-Yih; Chen, Ching-Yen; Yang, Ching-Hui; Wang, Shuu-Jiun

2014-11-10

No study has simultaneously investigated the impacts of migraine and anxiety disorders on painful physical symptoms (PPS) among patients with major depressive disorder (MDD). The study aimed to investigate this issue. This open-label study enrolled 155 outpatients with MDD, who were then treated with venlafaxine 75 mg per day for four weeks. Eighty-five participants with good compliance completed the treatment. Migraine was diagnosed according to the International Classification of Headache Disorders. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale (VAS) was used to evaluate the severity of eight PPS. Multiple linear and logistic regressions were used to investigate the impacts of migraine and anxiety disorders on PPS. Compared with patients without migraine, patients with migraine had a greater severity of PPS at baseline and post-treatment. After controlling for demographic variables and depressive severity, migraine independently predicted the intensities of eight PPS at baseline and four PPS post-treatment. Moreover, migraine independently predicted poorer treatment responses of chest pain and full remission of pains in the head, chest, neck and/or shoulder. Anxiety disorders predicted less full remission of pains in the abdomen and limbs. Migraine and anxiety disorders have negative impacts on PPS among patients with MDD. Integrating the treatment of migraine and anxiety disorders into the management of depression might help to improve PPS and the prognosis of MDD.

Menstrual migraine

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Moschiano, Franca; Grazzi, Licia; D?Amico, Domenico; Schieroni, Ferdinando; Bussone, Gennaro

2001-01-01

An association between migraine and menstruation can be ascertained by use of a diary for a minimum of three cycles. The pathophysiological and clinical peculiarities of menstrual migraine indicate that its management should differ from that of non?menstrual migraine. NSAIDS or migraine-specific medications (e.g. triptans) are often effective for the acute management of menstrual migraine. Preventive treatment is indicated when the attacks are long?lasting, severe and disabling and do not res...

Stress and Migraine

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... Spotlight On News Content Capsule Contact Understanding Migraine Stress and Migraine Doctor Q&A Managing Migraine Migraine ... of Headache Disorders Cluster Headache Post-Traumatic Headache Stress and Migraine March 16, 2017 How to cope ...

Responsiveness of migraine-ACT and MIDAS questionnaires for assessing migraine therapy.

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García, María Luisa; Baos, Vicente; Láinez, Miguel; Pascual, Julio; López-Gil, Arturo

2008-10-01

Migraine is frequently undertreated. The 4-item Migraine Assessment of Current Therapy (Migraine-ACT) questionnaire is a simple and reliable tool to identify patients requiring a change in current acute migraine treatment. To investigate the responsiveness of the Migraine-ACT tool, and compare it with that of the Migraine Disability Assessment (MIDAS) questionnaire, for patients with migraine at 1100 primary care sites in Spain. Patients eligible for this open-label, 2-visit prospective study reported migraine for >1 year and >or=1 migraine attack per month and were new to the clinic or on follow-up care for MIDAS questionnaires were administered, and patient satisfaction with treatment was recorded, at baseline and at 3 months. A total of 3272 patients, 78% female, were enrolled, and 2877 (88%) returned for the 3-month visit. Investigators changed baseline migraine treatment for 72% of returning patients; 85% and 80% of these patients had improved Migraine-ACT and MIDAS scores at 3 months, respectively. Patients who reported being completely or very satisfied with migraine treatment numbered 492 (15%) at baseline and 1406 (49%) at 3 months. Migraine-ACT and MIDAS score agreement for improvement at 3 months was poor (kappa = 0.339). Both the mean MIDAS score and the distribution of Migraine-ACT scores improved over the course of 3 months; however, Migraine-ACT scores were significantly (P MIDAS scores. The area under the curve in the receiver-operating characteristic analysis was significantly (P MIDAS (0.70) questionnaire. These results suggest that the Migraine-ACT questionnaire can be used more reliably than the MIDAS questionnaire for detecting improvements in treatment of new and follow-up patients with migraine.

Migraine vestibulaire 

DEFF Research Database (Denmark)

Lempert, T; Olesen, J; Furman, J

2014-01-01

This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...... in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms...

Accurate Classification of Chronic Migraine via Brain Magnetic Resonance Imaging

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Schwedt, Todd J.; Chong, Catherine D.; Wu, Teresa; Gaw, Nathan; Fu, Yinlin; Li, Jing

2015-01-01

Background The International Classification of Headache Disorders provides criteria for the diagnosis and subclassification of migraine. Since there is no objective gold standard by which to test these diagnostic criteria, the criteria are based on the consensus opinion of content experts. Accurate migraine classifiers consisting of brain structural measures could serve as an objective gold standard by which to test and revise diagnostic criteria. The objectives of this study were to utilize magnetic resonance imaging measures of brain structure for constructing classifiers: 1) that accurately identify individuals as having chronic vs. episodic migraine vs. being a healthy control; and 2) that test the currently used threshold of 15 headache days/month for differentiating chronic migraine from episodic migraine. Methods Study participants underwent magnetic resonance imaging for determination of regional cortical thickness, cortical surface area, and volume. Principal components analysis combined structural measurements into principal components accounting for 85% of variability in brain structure. Models consisting of these principal components were developed to achieve the classification objectives. Ten-fold cross validation assessed classification accuracy within each of the ten runs, with data from 90% of participants randomly selected for classifier development and data from the remaining 10% of participants used to test classification performance. Headache frequency thresholds ranging from 5–15 headache days/month were evaluated to determine the threshold allowing for the most accurate subclassification of individuals into lower and higher frequency subgroups. Results Participants were 66 migraineurs and 54 healthy controls, 75.8% female, with an average age of 36 +/− 11 years. Average classifier accuracies were: a) 68% for migraine (episodic + chronic) vs. healthy controls; b) 67.2% for episodic migraine vs. healthy controls; c) 86.3% for chronic

Vomiting and migraine-related clinical parameters in pediatric migraine.

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Eidlitz-Markus, Tal; Haimi-Cohen, Yishai; Zeharia, Avraham

2017-06-01

To investigate the characteristics of vomiting in pediatric migraineurs and the relationship of vomiting with other migraine-related parameters. The cohort included children and adolescents with migraine attending a headache clinic of a tertiary pediatric medical center from 2010 to 2016. Patients were identified by a retrospective database search. Data were collected from medical files. The presence of vomiting was associated with background and headache-related parameters. The study group included 453 patients, 210 boys (46.4%) and 243 girls (53.6%), of mean age 11.3 ± 3.7 years. Vomiting was reported by 161 patients (35.5%). On comparison of patients with and without vomiting, vomiting was found to be significantly associated with male gender (54% vs 42.1%, P migraine onset (8.0 ± 3. years vs 9.6 ± 3.7 years, P migraine (67% vs 58.7%, P migraine (24.1% vs 10.1%, P migraine in both parents (9.3% vs 3.1%, P = .007), and migraine in either parent (57.5% vs 45.5%, P = .02). The higher rate of vomiting in the younger patients and the patients with awakening pain may be explained by a common underlying pathogenetic mechanism of vomiting and migraine involving autonomic nerve dysfunction/immaturity. The association of vomiting with parental migraine points to a genetic component of vomiting and migraine. It should be noted that some of the findings may simply reflect referral patterns in the tertiary clinic. © 2017 American Headache Society.

The impacts of migraine, anxiety disorders, and chronic depression on quality of life in psychiatric outpatients with major depressive disorder.

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Hung, Ching-I; Wang, Shuu-Jiun; Yang, Ching-Hui; Liu, Chia-Yih

2008-08-01

Our purpose was to determine if migraine, anxiety comorbidities, and chronic depression were independently related to health-related quality of life (HRQoL) in outpatients with major depressive disorder (MDD). Consecutive psychiatric outpatients with MDD in a medical center were enrolled. MDD, chronic depression, and seven anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. Migraine was diagnosed based on the International Classification of Headache Disorders, 2nd edition. The acute version of the Short-Form 36 and the Hamilton Depression Rating Scale (HAMD) were used to evaluate the HRQoL and the severity of depression, respectively. Multiple linear regressions were used to determine the independent factors related to HRQoL. There were 135 participants (34 men, 101 women) with MDD. Subjects with migraine, anxiety comorbidities, or chronic depression had higher HAMD scores and poor HRQoL. Migraine, specific phobia, and panic disorder were important and independent comorbidities predicting HRQoL. The impact of migraine on HRQoL, especially on bodily pain, was not inferior to those of some anxiety comorbidities or chronic depression. Future studies related to HRQoL of MDD should consider migraine and anxiety comorbidities simultaneously.

Dipyridamole may induce migraine in patients with migraine without aura

DEFF Research Database (Denmark)

Kruuse, C; Lassen, L H; Iversen, Helle Klingenberg

2006-01-01

Dipyridamole inhibits phosphodiesterase 5 (PDE5) and adenosine re-uptake. The most prominent side-effect is headache. We examined the migraine-generating effects of dipyridamole as well as the cerebral blood velocity response in a single-blind study, including 10 patients with migraine without aura...... repeatedly. Headache was induced in all migraine patients and in eight of 10 healthy subjects (P = 0.47) with no significant difference in headache intensity (P = 0.53). However, five patients but only one healthy subject experienced the symptoms of migraine without aura, according to ICHD-2 criteria, within....... Thus, dipyridamole induces symptoms of migraine and an initial decrease in V(mca) in migraine patients, but not significantly more than in healthy subjects. This relatively low frequency of migraine induction, compared with nitric oxide donors and sildenafil, is probably due to the less specific action...

Migrainous infarction

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Laurell, K; Artto, V; Bendtsen, L

2011-01-01

Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included......Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included...

Migraine and ischemia

NARCIS (Netherlands)

van der Wammes-van der Heijden, E.A.

2009-01-01

An association between migraine and ischemic events, especially ischemic stroke, has been debated for many years. Whether migraine is a risk factor for ischemic events or ischemia triggers migraine, or both, is still unclear. This thesis explores different relationships between migraine and

Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain

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Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda

2017-01-01

where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension......-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons...... well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition...

Migraine

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... headache Migraine cause CT scan of the brain Central nervous system and peripheral nervous system References Becker WJ. Acute migraine treatment in adults. Headache . 2015;55(6):778-793. PMID: 25877672 ...

Comorbidity of Migraine

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Shuu-Jiun Wang

2010-08-01

Full Text Available Migraine is a common neurological disorder and can cause severely disabling during attacks. The highest prevalence occurs between the ages of 25 and 55 years, potentially the most productive period of life. Migraine leads to a burden not only to the individual, but also to the family and society. Prior studies have found migraine occurs with some illness at a greater than coincidental rate than is seen in the general population. These occurrences are called “comorbidity”, which means that these disorders are interrelated with migraine. To delineate migraine comorbidity is important because it can help improve treatment strategies and understand the possible pathophysiology of migraine. The comorbid illnesses in patients with migraine include stroke, sub-clinical vascular brain lesions, coronary heart disease, hypertension, patent foramen ovale, psychiatric diseases (depression, anxiety, bipolar disorder, panic disorder, and suicide, restless legs syndrome, epilepsy, and asthma. In this paper, we review the existing epidemiological and hospital based studies and illustrate the connections between these illness and migraine.

Association between migraine and suicidal behavior among Ethiopian adults.

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Berhane, Hanna Y; Jamerson-Dowlen, Bethannie; Friedman, Lauren E; Berhane, Yemane; Williams, Michelle A; Gelaye, Bizu

2018-02-12

Despite the significant impact of migraine on patients and societies, few studies in low- and middle-income countries (LMICs) have investigated the association between migraine and suicidal behavior. The objective of our study is to examine the extent to which migraines are associated with suicidal behavior (including suicidal ideation, plans, and attempts) in a well-characterized study of urban dwelling Ethiopian adults. We enrolled 1060 outpatient adults attending St. Paul hospital in Addis Ababa, Ethiopia. Standardized questionnaires were used to collect data on socio-demographics, and lifestyle characteristics. Migraine classification was based on the International Classification of Headache Disorders-2 diagnostic criteria. The Composite International Diagnostic Interview (CIDI) was used to assess depression and suicidal behaviors (i.e. ideation, plans and attempts). Multivariable logistic regression models were used to estimate adjusted odds ratio (AOR) and 95% confidence intervals (95% CIs). The prevalence of suicidal behavior was 15.1%, with a higher suicidal behavior among those who had migraines (61.9%). After adjusting for confounders including substance use and socio-demographic factors, migraine was associated with a 2.7-fold increased odds of suicidal behavior (AOR = 2.7; 95% CI 1.88-3.89). When stratified by their history of depression in the past year, migraine without depression was significantly associated with suicidal behavior (AOR: 2.27, 95% Cl: 1.49-3.46). The odds of suicidal behavior did not reach statistical significance in migraineurs with depression (AOR: 1.64, 95% CI: 0.40-6.69). Our study indicates that migraine is associated with increased odds of suicidal behavior in this population. Given the serious public health implications this has, attention should be given to the treatment and management of migraine at a community level.

Association between eating disorders and migraine may be explained by major depression.

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Mustelin, Linda; Raevuori, Anu; Kaprio, Jaakko; Keski-Rahkonen, Anna

2014-12-01

The association between eating disorders and migraine remains unclear. We identified women with lifetime diagnoses of anorexia nervosa (AN) (N = 55) and bulimia nervosa (BN) (N = 60) and their co-twins from the FinnTwin16 cohort born in 1975-1979 (N = 2,825 women). Eating disorder and major depressive disorder (MDD) diagnoses were obtained from clinical interviews and data on migraine by self-report questionnaire. The women with eating disorders were compared with their unaffected co-twins and with unrelated women from the same birth cohorts. The prevalence of migraine was 12% in the general female population, but 22% for both AN and BN (odds ratio 2.0, p = .04). The prevalence of MDD was high in women with an eating disorder (42%). MDD was strongly associated with migraine (odds ratio 3.0, p eating disorders and migraine. The highest migraine prevalence (36%) was found in women with both an eating disorder and MDD. Pairwise twin analyses also supported the clustering of migraine, MDD and eating disorders. Women with a lifetime diagnosis of an eating disorder were twice as likely to report a history of migraine as unrelated women from the same cohort; this relationship was explained by comorbid MDD. © 2014 Wiley Periodicals, Inc.

Morphological Abnormalities of Thalamic Subnuclei in Migraine

DEFF Research Database (Denmark)

Magon, Stefano; May, Arne; Stankewitz, Anne

2015-01-01

UNLABELLED: The thalamus contains third-order relay neurons of the trigeminal system, and animal models as well as preliminary imaging studies in small cohorts of migraine patients have suggested a role of the thalamus in headache pathophysiology. However, larger studies using advanced imaging te...... is a disorder of the CNS in which not only is brain function abnormal, but also brain structure is undergoing significant remodeling....... a fully automated multiatlas approach. Deformation-based shape analysis was performed to localize surface abnormalities. Differences between patients with migraine and healthy subjects were assessed using an ANCOVA model. After correction for multiple comparisons, performed using the false discovery rate.......9) was observed in patients. This large-scale study indicates structural thalamic abnormalities in patients with migraine. The thalamic nuclei with abnormal volumes are densely connected to the limbic system. The data hence lend support to the view that higher-order integration systems are altered in migraine...

Migraine

Science.gov (United States)

... processed foods may trigger migraines. Skipping meals or fasting also can trigger attacks. Food additives. The sweetener ... weight or maintain a healthy body weight, and obesity is thought to be a factor in migraines. ...

Managing migraine by patient profile: role of frovatriptan.

Science.gov (United States)

Cady, Roger K; Farmer, Kathleen

2016-01-01

For the last quarter of a century, triptans have been available for acute treatment of migraine but with little guidance on which of the different triptan products to use for which patient or which attack of migraine. In this article, we propose a structured approach to analysis of individual migraine attacks and patient characteristics as a means of defining and optimizing acute intervention. Assessment of patient and attack profiles includes the "5-Ps": pattern, phenotype, patient, pharmacology, and precipitants. Attending to these five components of information can assist in developing an individualized behavioral, pharmacological, and nonpharmacological comprehensive treatment plan for most migraine patients. This clinical approach is then focused on frovatriptan because of its unique molecular signature and potential novel clinical applications. Frovatriptan like all triptans is indicated for acute treatment of migraine but its role has been explored in management of several unique migraine phenotypes. Frovatriptan has the longest half-life of any triptan and consequently is often promoted for acute treatment of migraine of longer duration. It has also been studied as a short-term preventive treatment in women with menstrual-related migraine. Given that 60% of female migraineurs suffer from menstrual-related migraine, this population is the obvious group for continued study. Small studies have also explored frovatriptan's use in treating migraine predicted by premonitory symptoms as a preventive for the headache phase of migraine. By identifying patient and attack profiles, clinicians may effectively determine the viability of frovatriptan as an effective pharmacological intervention for migraine.

Topiramate-induced paresthesia is more frequently reported by migraine than epileptic patients.

Science.gov (United States)

Sedighi, Behnaz; Shafiei, Kaveh; Azizpour, Iman

2016-04-01

Topiramate is an approved and effective drug in migraine prophylaxis. Paresthesia is the most commonly reported side effect. The primary objective of this study was to compare the frequency of topiramate-induced paresthesia in migraine headache to epileptic patients. Patients with migraine without aura and epilepsy were enrolled in this observational study. All cases were interviewed by telephone about their history of paresthesia. Confounding factors were controlled through logistic regression. The odds ratio of developing topiramate-induced paresthesia in migraine compared to epilepsy patients was 3.4. Three factors were independent contributors to developing topiramate-induced paresthesia: female sex (odds ratio 2.1), topiramate dosage (odds ratio 0.3) and duration of therapy. Our findings indicate an independent association between migraine and development of paresthesia. Migraineurs were more likely than epileptic patients to report paresthesia as topiramate adverse effects. Female sex, treatment duration and topiramate dosage contribute significantly to subsequent development of paresthesia.

Emerging Role of (EndoCannabinoids in Migraine

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Pinja Leimuranta

2018-04-01

Full Text Available In this mini-review, we summarize recent discoveries and present new hypotheses on the role of cannabinoids in controlling trigeminal nociceptive system underlying migraine pain. Individual sections of this review cover key aspects of this topic, such as: (i the current knowledge on the endocannabinoid system (ECS with emphasis on expression of its components in migraine related structures; (ii distinguishing peripheral from central site of action of cannabinoids, (iii proposed mechanisms of migraine pain and control of nociceptive traffic by cannabinoids at the level of meninges and in brainstem, (iv therapeutic targeting in migraine of monoacylglycerol lipase and fatty acid amide hydrolase, enzymes which control the level of endocannabinoids; (v dual (possibly opposing actions of cannabinoids via anti-nociceptive CB1 and CB2 and pro-nociceptive TRPV1 receptors. We explore the cannabinoid-mediated mechanisms in the frame of the Clinical Endocannabinoid Deficiency (CECD hypothesis, which implies reduced tone of endocannabinoids in migraine patients. We further discuss the control of cortical excitability by cannabinoids via inhibition of cortical spreading depression (CSD underlying the migraine aura. Finally, we present our view on perspectives of Cannabis-derived (extracted or synthetized marijuana components or novel endocannabinoid therapeutics in migraine treatment.

Prevalence of migraine in persons with the 3243A>G mutation in mitochondrial DNA

DEFF Research Database (Denmark)

Guo, S.; Esserlind, A-L; Andersson, Z

2016-01-01

% vs. 6%; P persons with the mDNA 3243A>G mutation was found. This finding suggests a clinical association between a monogenetically inherited disorder......BACKGROUND AND PURPOSE: Over the last three decades mitochondrial dysfunction has been postulated to be a potential mechanism in migraine pathogenesis. The lifetime prevalence of migraine in persons carrying the 3243A>G mutation in mitochondrial DNA was investigated. METHODS: In this cross......-sectional study, 57 mDNA 3243A>G mutation carriers between May 2012 and October 2014 were included. As a control group, a population-based cohort from our epidemiological studies on migraine in Danes was used. History of headache and migraine was obtained by telephone interview, based on a validated semi...

Structured Interviews: Developing Interviewing Skills in Human Resource Management Courses

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Doll, Jessica L.

2018-01-01

Structured interviews are widely used in the employment process; however, students often have little experience asking and responding to structured interview questions. In a format similar to "speed dating," this exercise actively engages students in the interview process. Students pair off to gain experience as an interviewer by asking…

The stigma of migraine.

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William B Young

Full Text Available BACKGROUND: People who have a disease often experience stigma, a socially and culturally embedded process through which individuals experience stereotyping, devaluation, and discrimination. Stigma has great impact on quality of life, behavior, and life chances. We do not know whether or not migraine is stigmatizing. METHODS: We studied 123 episodic migraine patients, 123 chronic migraine patients, and 62 epilepsy patients in a clinical setting to investigate the extent to which stigma attaches to migraine, using epilepsy as a comparison. We used the stigma scale for chronic illness, a 24-item questionnaire suitable for studying chronic neurologic diseases, and various disease impact measures. RESULTS: Patients with chronic migraine had higher scores (54.0±20.2 on the stigma scale for chronic illness than either episodic migraine (41.7±14.8 or epilepsy patients (44.6±16.3 (p<0.001. Subjects with migraine reported greater inability to work than epilepsy subjects. Stigma correlated most strongly with the mental component score of the short form of the medical outcomes health survey (SF-12, then with ability to work and migraine disability score for chronic and episodic migraine and the Liverpool impact on epilepsy scale for epilepsy. Analysis of covariance showed adjusted scores for the stigma scale for chronic illness were similar for chronic migraine (49.3; 95% confidence interval, 46.2 to 52.4 and epilepsy (46.5; 95% confidence interval, 41.6 to 51.6, and lower for episodic migraine (43.7; 95% confidence interval, 40.9 to 46.6. Ability to work was the strongest predictor of stigma as measured by the stigma scale for chronic illness. CONCLUSION: In our model, adjusted stigma was similar for chronic migraine and epilepsy, which were greater than for episodic migraine. Stigma correlated most strongly with inability to work, and was greater for chronic migraine than epilepsy or episodic migraine because chronic migraine patients had less ability

Premonitory symptoms in migraine

DEFF Research Database (Denmark)

Laurell, Katarina; Artto, Ville; Bendtsen, Lars

2016-01-01

AIM: To describe the frequency and number of premonitory symptoms (PS) in migraine, the co-occurrence of different PS, and their association with migraine-related factors. METHODS: In this cross-sectional study, a validated questionnaire was sent to Finnish migraine families between 2002 and 2013...... to obtain data on 14 predefined PS, migraine diagnoses, demographic factors, and migraine characteristics. The estimated response rate was 80%. RESULTS: Out of 2714 persons, 2223 were diagnosed with migraine. Among these, 77% reported PS, with a mean number of 3.0 symptoms compared to 30% (p ....5 symptoms (p migraine headaches. Yawning was the most commonly reported symptom (34%) among migraineurs. Females reported PS more frequently than males (81 versus 64%, p 

Prevalence of neck pain in migraine and tension-type headache

DEFF Research Database (Denmark)

Ashina, Sait; Bendtsen, Lars; Lyngberg, Ann C

2015-01-01

BACKGROUND: We assessed the prevalence of neck pain in the population in relation to headache. METHODS: In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M......+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. RESULTS: The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted...... OR 3.0, 95% CI 2.0-4.4, pneck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) (p

MIDAS (Migraine Disability Assessment: a valuable tool for work-site identification of migraine in workers in Brazil

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Yara Dadalti Fragoso

Full Text Available CONTEXT: MIDAS was developed as a fast and efficient method for identification of migraine in need of medical evaluation and treatment. It was necessary to translate MIDAS, originally written in English, so as to apply it in Brazil and make it usable by individuals from a variety of social-economic-cultural backgrounds. OBJECTIVE: To translate and to apply MIDAS in Brazil. SETTING: Assessment of a sample of workers regularly employed by an oil refinery. SETTING: Refinaria Presidente Bernardes, Cubatão, São Paulo, Brazil. PARTICIPANTS: 404 workers of the company who correctly answered a questionnaire for the identification and evaluation of headache. When the individual considered it to be pertinent to his own needs, there was the option to answer MIDAS as well. METHODS: MIDAS, originally written in English, was translated into Brazilian Portuguese by a neurologist and by a translator specializing in medical texts. The final version of the translation was obtained when, for ten patients to whom it was applied, the text seemed clear and the results were consistent over three sessions. MAIN MEASUREMENTS: Prevalence and types of primary headaches, evaluation of MIDAS as a tool for identification of more severe cases. RESULTS: From the total of 419 questionnaires given to the employees, 404 were returned correctly completed. From these, 160 persons were identified as presenting headaches, 44 of whom considered it worthwhile answering MIDAS. Nine of these individuals who answered MIDAS were identified as severe cases of migraine due to disability caused by the condition. An interview on a later date confirmed these results. Three were cases of chronic daily headache (transformed migraine and six were cases of migraine. CONCLUSIONS: MIDAS translated to Brazilian Portuguese was a useful tool for identifying severe cases of migraine and of transformed migraine in a working environment. The workers did not consider MIDAS to be difficult to answer. Their

Molecular factors in migraine

Science.gov (United States)

Kowalska, Marta; Prendecki, Michał; Kozubski, Wojciech; Lianeri, Margarita; Dorszewska, Jolanta

2016-01-01

Migraine is a common neurological disorder that affects 11% of adults worldwide. This disease most likely has a neurovascular origin. Migraine with aura (MA) and more common form - migraine without aura (MO) – are the two main clinical subtypes of disease. The exact pathomechanism of migraine is still unknown, but it is thought that both genetic and environmental factors are involved in this pathological process. The first genetic studies of migraine were focused on the rare subtype of MA: familial hemiplegic migraine (FHM). The genes analysed in familial and sporadic migraine are: MTHFR, KCNK18, HCRTR1, SLC6A4, STX1A, GRIA1 and GRIA3. It is possible that migraine is a multifactorial disease with polygenic influence. Recent studies have shown that the pathomechanisms of migraine involves both factors responsible for immune response and oxidative stress such as: cytokines, tyrosine metabolism, homocysteine; and factors associated with pain transmission and emotions e.g.: serotonin, hypocretin-1, calcitonin gene-related peptide, glutamate. The correlations between genetic variants of the HCRTR1 gene, the polymorphism 5-HTTLPR and hypocretin-1, and serotonin were observed. It is known that serotonin inhibits the activity of hypocretin neurons and may affect the appearance of the aura during migraine attack. The understanding of the molecular mechanisms of migraine, including genotype-phenotype correlations, may contribute to finding markers important for the diagnosis and treatment of this disease. PMID:27191890

[Is childhood migraine an immature form of adult migraine?].

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Ozge, Aynur

2007-01-01

Childhood migraine is a common problem among the primary complaints of the pediatric population. But for the general practitioners there are little known about clinical characteristics and management strategies. Headache practitioners commonly notice the age related differences of headache characteristics and management schedules. This paper primarily aimed to answer the question if pediatric migraine is an unmaturated form of adult migraine, by discussing the pathophysiological basis, clinical forms and management strategies.

Understanding migraine and psychiatric comorbidity.

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Seng, Elizabeth K; Seng, Cynthia D

2016-06-01

This article describes recent trends in our understanding of the role of psychiatric disorders in the experience and treatment of migraine, and the role of migraine in the experience and treatment of psychiatric disorders. Although the majority of studies evaluating psychiatric comorbidity in migraine have focused on depression, anxiety, and bipolar disorders are highly associated with migraine and relevant for prognosis and treatment planning. Comorbid psychiatric disorders may be associated with poorer treatment response for some acute pharmacotherapies; however, people with comorbid migraine and mood or anxiety disorders can achieve large responses to preventive pharmacologic and behavioral therapies. Emerging research is developing and evaluating behavioral treatments designed to manage cooccurring migraine and mood or anxiety disorders. Stigma related to psychiatric disorders has been well characterized, and could exacerbate extant migraine-related stigma. Anxiety and mood disorders are prevalent in people with migraine, although not ubiquitous. Psychiatric comorbidity is associated with greater migraine symptoms and disability; however, people with comorbid depression or anxiety are amenable to preventive migraine treatment. Research regarding migraine treatment strategies optimized for people with comorbid psychiatric disorders is critical to advancing care and reducing stigma for this important subpopulation of people with migraine.

Epigone migraine vertigo (EMV): a late migraine equivalent.

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Pagnini, P; Vannucchi, P; Giannoni, B; Pecci, R

2014-02-01

Migrainous headache is determined by pathogenetic mechanisms that are also able to affect the peripheral and/or central vestibular system, so that vestibular symptoms may substitute and/or present with headache. We are convinced that there can be many different manifestations of vestibular disorders in migrainous patients, representing true different clinical entities due to their different characteristics and temporal relashionship with headache. Based on such considerations, we proposed a classification of vertigo and other vestibular disorders related to migraine, and believe that a particular variant of migraine-related vertigo should be introduced, namely "epigone migraine vertigo" (EMV): this could be a kind of late migraine equivalent, i.e. a kind of vertigo, migrainous in origin, starting late in the lifetime that substitutes, as an equivalent, pre-existing migraine headache. To clarify this particular clinical picture, we report three illustrative clinical cases among 28 patients collected during an observation period of 13 years (November 1991 - November 2004). For all patients, we collected complete personal clinical history. All patients underwent standard neurotological examination, looking for spontaneous-positional, gaze-evoked and caloric induced nystagmus, using an infrared video camera. We also performed a head shaking test (HST) and an head thrust test (HTT). Ocular motility was tested looking at saccades and smooth pursuit. To exclude other significant neurological pathologies, a brain magnetic resonance imaging (MRI) with gadolinium was performed. During the three months after the first visit, patients were invited to keep a diary noting frequency, intensity and duration of vertigo attacks. After that period, we suggested that they use prophylactic treatment with flunarizine (5 mg per day) and/or acetylsalicylic acid (100 mg per day), or propranolol (40 mg twice a day). All patients were again recommended to note in their diary the frequency

Contact lenses, migraine, and allodynia

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Ozgur Bulent Timucin

2016-01-01

Full Text Available Clinical trials and electrophysiologic studies demonstrated increased perceptual sensitivity in patients suffering from migraines. At least, one triggering factor is described in 85% of migraine patients. The aim of this report was to investigate the relationship between contact lens (CL usage and migraine attacks in two cases. Two patients who were diagnosed with migraine reported that the frequency of migraine attacks increased after they switched to using CL with different base curves (BCs. These two patients, who began using CL with different BCs experienced discomfort and dryness of the eye. The ocular complaints were followed by migraine attacks. CL intolerance was also developed during migraine attack in one of the cases. The frequency of migraine attacks decreased and allodynia relieved significantly when flatter BCs were selected. CL related stimulus could have triggered the migraine attack. CLs should be well fitted in migraine patients with allodynia.

Travelling along a road with obstacles: Experiences of managing life to feel well while living with migraine

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Catrine Kostenius

2013-02-01

Full Text Available Living a life with migraine can impair one's sense of feeling well, and migraine is a disorder that is associated with substantial disability. Earlier research on how people manage their migraine has given important insight into these people's preventive actions and how they handle their attacks, but there is still a lack of knowledge of how persons with migraine manage their lives to feel well from a more holistic viewpoint. Therefore, the aim of this study was to explore lived experiences of managing life to feel well while living with migraine. Nineteen persons with migraine were interviewed. A hermeneutic-phenomenological approach was used to explore their lived experiences. The findings reveal that persons with migraine not only used preventive strategies to abort and ease the consequences of migraine but also tried to amplify the good in life through increasing their energy and joy and through reaching peace with being afflicted with migraine. The findings of this study can encourage healthcare providers, as well as persons with migraine, to consider channeling their efforts into strategies aiming to amplify the good in life, including reaching peace of mind despite being afflicted.

Migraine and risk of stroke: a national population-based twin study.

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Lantz, Maria; Sieurin, Johanna; Sjölander, Arvid; Waldenlind, Elisabet; Sjöstrand, Christina; Wirdefeldt, Karin

2017-10-01

Numerous studies have indicated an increased risk for stroke in patients with migraine, especially migraine with aura; however, many studies used self-reported migraine and only a few controlled for familial factors. We aimed to investigate migraine as a risk factor for stroke in a Swedish population-based twin cohort, and whether familial factors contribute to an increased risk. The study population included twins without prior cerebrovascular disease who answered a headache questionnaire during 1998 and 2002 for twins born 1935-58 and during 2005-06 for twins born between 1959 and 1985. Migraine with and without aura and probable migraine was defined by an algorithm mapping on to clinical diagnostic criteria according to the International Classification of Headache Disorders. Stroke diagnoses were obtained from the national patient and cause of death registers. Twins were followed longitudinally, by linkage of national registers, from date of interview until date of first stroke, death, or end of study on 31 Dec 2014. In total, 8635 twins had any migraineous headache, whereof 3553 had migraine with aura and 5082 had non-aura migraineous headache (including migraine without aura and probable migraine), and 44 769 twins had no migraine. During a mean follow-up time of 11.9 years we observed 1297 incident cases of stroke. The Cox proportional hazards model with attained age as underlying time scale was used to estimate hazard ratios with 95% confidence intervals for stroke including ischaemic and haemorrhagic subtypes related to migraine with aura, non-aura migraineous headache, and any migraineous headache. Analyses were adjusted for gender and cardiovascular risk factors. Where appropriate; within-pair analyses were performed to control for confounding by familial factors. The age- and gender-adjusted hazard ratio for stroke related to migraine with aura was 1.27 (95% confidence interval 1.00-1.62), P = 0.05, and 1.07 (95% confidence interval 0.91-1.26), P = 0

The NRP1 migraine risk variant shows evidence of association with menstrual migraine.

Science.gov (United States)

Pollock, Charmaine E; Sutherland, Heidi G; Maher, Bridget H; Lea, Rodney A; Haupt, Larisa M; Frith, Alison; Anne MacGregor, E; Griffiths, Lyn R

2018-04-18

In 2016, a large meta-analysis brought the number of susceptibility loci for migraine to 38. While sub-type analysis for migraine without aura (MO) and migraine with aura (MA) found some loci showed specificity to MO, the study did not test the loci with respect to other subtypes of migraine. This study aimed to test the hypothesis that single nucleotide polymorphisms (SNPs) robustly associated with migraine are individually or collectively associated with menstrual migraine (MM). Genotyping of migraine susceptibility SNPs was conducted using the Agena MassARRAY platform on DNA samples from 235 women diagnosed with menstrual migraine as per International Classification for Headache Disorders II (ICHD-II) criteria and 140 controls. Alternative genotyping methods including restriction fragment length polymorphism, pyrosequencing and Sanger sequencing were used for validation. Statistical analysis was performed using PLINK and SPSS. Genotypes of 34 SNPs were obtained and investigated for their potential association with menstrual migraine. Of these SNPs, rs2506142 located near the neuropilin 1 gene (NRP1), was found to be significantly associated with menstrual migraine (p = 0.003). Genomic risk scores were calculated for all 34 SNPs as well as a subset of 7 SNPs that were nearing individual significance. Overall, this analysis suggested these SNPs to be weakly predictive of MM, but of no prognostic or diagnostic value. Our results suggest that NRP1 may be important in the etiology of MM. It also suggests some genetic commonality between common migraine subtypes (MA and MO) and MM. The identification of associated SNPs may be the starting point to a better understanding of how genetic factors may contribute to the menstrual migraine sub-type.

Why does sleep stop migraine?

Science.gov (United States)

Bigal, Marcelo E; Hargreaves, Richard J

2013-10-01

The relationship between sleep and migraine headaches is complex. Changes in sleep patterns can trigger migraine attacks, and sleep disorders may be associated with increased migraine frequency. Furthermore, migraine patients and their doctors very consistently report that sleep relieves already established migraine attacks. Herein we will try to answer the question, "Why does sleep stop migraine?" Since evidence for this relationship is largely based on empirical clinical observation, we will not provide a clinical review of the association. Instead, we will focus on the pathophysiology of migraine attacks and its intersections with sleep biology.

Basilar migraine.

Science.gov (United States)

Kuhn, W F; Kuhn, S C; Daylida, L

1997-03-01

Basilar migraine is a complicated headache which the International Headache Society describes as 'migraine with aura symptoms clearly originating from the brainstem or from both occipital lobes'. For years this headache was thought to originate from a transient disturbance in the vertebrobasilar circulation, but more recent studies suggest that a central neuronal disorder may be the source of migraine. Basilar migraines may have certain symptoms which are similar to other neurologic, vascular, psychiatric and metabolic diseases, yet there are specific criteria which can help differentiate it from other diagnoses. It is characterized by a throbbing occipital headache which may be preceded by an aura. The unusual symptoms of basilar migraine, which may precede and continue throughout the duration of the headache and even after it, include bilateral visual symptoms, altered mental status, vertigo, gait ataxia, bilateral paresthesia, bilateral paralysis and dysarthria. We describe a 29-year-old black female whose husband brought her to the emergency department complaining of confusion, headache, and left-sided weakness for 2 h prior to arrival.

Risk of placental abruption in relation to migraines and headaches

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Ananth Cande V

2010-10-01

Full Text Available Abstract Background Migraine, a common chronic-intermittent disorder of idiopathic origin characterized by severe debilitating headaches and autonomic nervous system dysfunction, and placental abruption, the premature separation of the placenta, share many common pathophysiological characteristics. Moreover, endothelial dysfunction, platelet activation, hypercoagulation, and inflammation are common to both disorders. We assessed risk of placental abruption in relation to maternal history of migraine before and during pregnancy in Peruvian women. Methods Cases were 375 women with pregnancies complicated by placental abruption, and controls were 368 women without an abruption. During in-person interviews conducted following delivery, women were asked if they had physician-diagnosed migraine, and they were asked questions that allowed headaches and migraine to be classified according to criteria established by the International Headache Society. Logistic regression procedures were used to calculate odds ratios (aOR and 95% confidence intervals (CI adjusted for confounders. Results Overall, a lifetime history of any headaches or migraine was associated with an increased odds of placental abruption (aOR = 1.60; 95% CI 1.16-2.20. A lifetime history of migraine was associated with a 2.14-fold increased odds of placental abruption (aOR = 2.14; 95% CI 1.22-3.75. The odds of placental abruption was 2.11 (95% CI 1.00-4.45 for migraineurs without aura; and 1.59 (95% 0.70-3.62 for migraineurs with aura. A lifetime history of tension-type headache was also increased with placental abruption (aOR = 1.61; 95% CI 1.01-2.57. Conclusions This study adds placental abruption to a growing list of pregnancy complications associated with maternal headache/migraine disorders. Nevertheless, prospective cohort studies are needed to more rigorously evaluate the extent to which migraines and/or its treatments are associated with the occurrence of placental abruption.

Managing migraine by patient profile: role of frovatriptan

Directory of Open Access Journals (Sweden)

Cady RK

2016-04-01

Full Text Available Roger K Cady, Kathleen Farmer Headache Care Center, Springfield, MO, USA Abstract: For the last quarter of a century, triptans have been available for acute treatment of migraine but with little guidance on which of the different triptan products to use for which patient or which attack of migraine. In this article, we propose a structured approach to analysis of individual migraine attacks and patient characteristics as a means of defining and optimizing acute intervention. Assessment of patient and attack profiles includes the “5-Ps”: pattern, phenotype, patient, pharmacology, and precipitants. Attending to these five components of information can assist in developing an individualized behavioral, pharmacological, and nonpharmacological comprehensive treatment plan for most migraine patients. This clinical approach is then focused on frovatriptan because of its unique molecular signature and potential novel clinical applications. Frovatriptan like all triptans is indicated for acute treatment of migraine but its role has been explored in management of several unique migraine phenotypes. Frovatriptan has the longest half-life of any triptan and consequently is often promoted for acute treatment of migraine of longer duration. It has also been studied as a short-term preventive treatment in women with menstrual-related migraine. Given that 60% of female migraineurs suffer from menstrual-related migraine, this population is the obvious group for continued study. Small studies have also explored frovatriptan’s use in treating migraine predicted by premonitory symptoms as a preventive for the headache phase of migraine. By identifying patient and attack profiles, clinicians may effectively determine the viability of frovatriptan as an effective pharmacological intervention for migraine. Keywords: frovatriptan, acute treatment, preventive therapy, early intervention

Association between Body Mass Index and Migraine: A Survey of Adult Population in China

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Qingqing Huang

2018-01-01

Full Text Available Both migraine and obesity are prevalent disorders in the general population, which are characterized by disability and impaired quality of life. Although so many researches had studied the association between migraine and obesity, there are still no full knowledge of the relationship between body mass index (BMI and migraine, especially chronic migraine (CM. In this study, we analyzed a previous epidemiological survey data of primary headache patients in Chongqing, which surveyed consecutive neurological outpatients through face-to-face interview with physicians using a headache questionnaire. 166 episodic migraine (EM patients and 134 chronic migraine (CM patients were included in the study out of 1327 primary headache patients. And 200 healthy adults from the physical examination center were included as a control group. Finally, we found that the patients with migraine (EM and CM were more likely to be overweight, obese, or morbidly obese compared to those in the healthy group. Significant difference was found between BMI and frequency of migraine attacks but not severity or duration of headache onset. And no significant difference was found in severity and duration of headache onset between episodic and chronic migraine among different BMI classifications. Such may update our knowledge about the clinical features of migraine and BMI, revealing that the frequency of attacks may be associated with being overweight, obese, or morbidly obese in patients with migraine and that the extent of being overweight, obese, or morbidly obese in CM patients was lower than that in EM patients.

The KATP channel in migraine pathophysiology: a novel therapeutic target for migraine.

Science.gov (United States)

Al-Karagholi, Mohammad Al-Mahdi; Hansen, Jakob Møller; Severinsen, Johanne; Jansen-Olesen, Inger; Ashina, Messoud

2017-08-23

To review the distribution and function of K ATP channels, describe the use of K ATP channels openers in clinical trials and make the case that these channels may play a role in headache and migraine. K ATP channels are widely present in the trigeminovascular system and play an important role in the regulation of tone in cerebral and meningeal arteries. Clinical trials using synthetic K ATP channel openers report headache as a prevalent-side effect in non-migraine sufferers, indicating that K ATP channel opening may cause headache, possibly due to vascular mechanisms. Whether K ATP channel openers can provoke migraine in migraine sufferers is not known. We suggest that K ATP channels may play an important role in migraine pathogenesis and could be a potential novel therapeutic anti-migraine target.

Migraine is the most prevalent primary headache in individuals with temporomandibular disorders.

Science.gov (United States)

Franco, Ana L; Gonçalves, Daniela A G; Castanharo, Sabrina M; Speciali, José G; Bigal, Marcelo E; Camparis, Cinara M

2010-01-01

To assess the prevalence of primary headaches (HA) in adults with temporomandibular disorders (TMD) who were assessed in a specialty orofacial pain clinic, as well as in controls without TMD. The sample consisted of 158 individuals with TMD seen at a university-based specialty clinic, as well as 68 controls. The Research Diagnostic Criteria for TMD were used to diagnose the TMD patients. HAs were assessed using a structured interview and classified according to the Second Edition of the International Classification for Headache Disorders. Data were analyzed by chi-square tests with a significance level of 5% and odds ratio (OR) tests with a 95% confidence interval (CI). HAs occurred in 45.6% of the control group (30.9% had migraine and 14.7% had tension-type headache [TTH]) and in 85.5% of individuals with TMD. Among individuals with TMD, migraine was the most prevalent primary HA (55.3%), followed by TTH (30.2%); 14.5% had no HA. In contrast to controls, the odds ratio (OR) for HA in those with TMD was 7.05 (95% confidence interval [CI] = 3.65-13.61; P = .000), for migraine, the OR was 2.76 (95% CI = 1.50-5.06; P = .001), and for TTH, the OR was 2.51 (95% CI = 1.18-5.35; P = .014). Myofascial pain/arthralgia was the most common TMD diagnosis (53.2%). The presence of HA or specific HAs was not associated with the time since the onset of TMD (P = .714). However, migraine frequency was positively associated with TMD pain severity (P = .000). TMD was associated with increased primary HA prevalence rates. Migraine was the most common primary HA diagnosis in individuals with TMD.

Optimizing prophylactic treatment of migraine: Subtypes and patient matching

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Michel Dib

2008-09-01

Full Text Available Michel DibFédération du système nerveux central, Hôpital de la Salpêtrière, Assistance Publique- Hôpitaux de Paris, FranceAbstract: Advances in our understanding of the pathophysiology of migraine have resulted in important breakthroughs in treatment. For example, understanding of the role of serotonin in the cerebrovascular circulation has led to the development of triptans for the acute relief of migraine headaches, and the identification of cortical spreading depression as an early central event associated wih migraine has brought renewed interest in antiepileptic drugs for migraine prophylaxis. However, migraine still remains inadequately treated. Indeed, it is apparent that migraine is not a single disease but rather a syndrome that can manifest itself in a variety of pathological conditions. The consequences of this may be that treatment needs to be matched to particular patients. Clinical research needs to be devoted to identifying which sort of patients benefit best from which treatments, particularly in the field of prophylaxis. We propose four patterns of precipitating factors (adrenergic, serotoninergic, menstrual, and muscular which may be used to structure migraine prophylaxis. Finally, little is known about long-term outcome in treated migraine. It is possible that appropriate early prophylaxis may modify the long-term course of the disease and avoid late complications.Keywords: migraine, diagnosis, treatment, prophylaxis, subtypes

Studies on the Pathophysiology and Genetic Basis of Migraine

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Gasparini, Claudia F; Sutherland, Heidi G.; Griffiths, Lyn R

2013-01-01

Migraine is a neurological disorder that affects the central nervous system causing painful attacks of headache. A genetic vulnerability and exposure to environmental triggers can influence the migraine phenotype. Migraine interferes in many facets of people’s daily life including employment commitments and their ability to look after their families resulting in a reduced quality of life. Identification of the biological processes that underlie this relatively common affliction has been difficult because migraine does not have any clearly identifiable pathology or structural lesion detectable by current medical technology. Theories to explain the symptoms of migraine have focused on the physiological mechanisms involved in the various phases of headache and include the vascular and neurogenic theories. In relation to migraine pathophysiology the trigeminovascular system and cortical spreading depression have also been implicated with supporting evidence from imaging studies and animal models. The objective of current research is to better understand the pathways and mechanisms involved in causing pain and headache to be able to target interventions. The genetic component of migraine has been teased apart using linkage studies and both candidate gene and genome-wide association studies, in family and case-control cohorts. Genomic regions that increase individual risk to migraine have been identified in neurological, vascular and hormonal pathways. This review discusses knowledge of the pathophysiology and genetic basis of migraine with the latest scientific evidence from genetic studies. PMID:24403849

High frequency migraine is associated with lower acute pain sensitivity and abnormal insula activity related to migraine pain intensity, attack frequency, and pain catastrophizing

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Vani A Mathur

2016-09-01

Full Text Available Migraine is a pain disorder associated with abnormal brain structure and function, yet the effect of migraine on acute pain processing remains unclear. It also remains unclear whether altered pain-related brain responses and related structural changes are associated with clinical migraine characteristics. Using fMRI and three levels of thermal stimuli (non-painful, mildly painful, and moderately painful, we compared whole-brain activity between 14 migraine patients and 14 matched controls. Although, there were no significant differences in pain thresholds and pre-scan pain ratings to mildly painful thermal stimuli, patients had aberrant suprathreshold nociceptive processing. Compared to controls, patients had reduced activity in pain modulatory regions including left dorsolateral prefrontal, posterior parietal, and middle temporal cortices and, at a lower-threshold, greater activation in the right mid-insula to moderate pain versus mild pain. We also found that pain-related activity in the insula was associated with clinical variables in patients, including associations between: bilateral anterior insula and pain catastrophizing (PCS; bilateral anterior insula and contralateral posterior insula and migraine pain intensity; and bilateral posterior insula and migraine frequency at a lower-threshold. PCS and migraine pain intensity were also negatively associated with activity in midline regions including posterior cingulate and medial prefrontal cortices. Diffusion tensor imaging revealed a negative correlation between fractional anisotropy (a measure of white matter integrity; FA and migraine duration in the right mid-insula and a positive correlation between left mid-insula FA and PCS. In sum, while patients showed lower sensitivity to acute noxious stimuli, the neuroimaging findings suggest enhanced nociceptive processing and significantly disrupted modulatory networks, particularly involving the insula cortex, associated with indices of

Migraine accompagnee: Clinical and neutroradiological findings. Migraine Accompagnee: Klinische und neutroradiologische Befunde

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Schaefer, E M

1981-01-01

This study analyses clinical data, EEC and X-ray findings of 102 stationary examined migraine patients, 62 of whom suffered from migraine accompagnee. Sex distribution, age at onset of disease, hereditary disease disposition and EEC findings largely correspond to the data given in literature. As it had been expected, the X-ray images of the skull and the cerebral angiographies performed in 46 patients suffering from migraine accompagnee did not show any pathological findings. The X-ray images were compared with those taken of patients without migraine anamnesis in order to detect non-pathologic variations. Neither differences in the intensity of vascular and diplovenous marking could be found in the native images of the skull nor any variations of the circle of Willis. The dependency of the posterior cerebral artery on the carotid circulation existing in 41% of the migraine accompagnee does not lead to any particular alteration of the accompanying symptoms and signs. The idea is discussed to divide the migraine syndrome into simple, focal and complicated migraine on the basis of a uniform pathogenesis. (orig./MG).

Migraine accompagnee: Clinical and neutroradiological findings. Migraine Accompagnee: Klinische und neutroradiologische Befunde

Energy Technology Data Exchange (ETDEWEB)

Schaefer, E M

1981-01-01

This study analyses clinical data, EEC and X-ray findings of 102 stationary examined migraine patients, 62 of whom suffered from migraine accompagnee. Sex distribution, age at onset of disease, hereditary disease disposition and EEC findings largely correspond to the data given in literature. As it had been expected, the X-ray images of the skull and the cerebral angiographies performed in 46 patients suffering from migraine accompagnee did not show any pathological findings. The X-ray images were compared with those taken of patients without migraine anamnesis in order to detect non-pathologic variations. Neither differences in the intensity of vascular and diplovenous marking could be found in the native images of the skull nor any variations of the circle of Willis. The dependency of the posterior cerebral artery on the carotid circulation existing in 41% of the migraine accompagnee does not lead to any particular alteration of the accompanying symptoms and signs. The idea is discussed to divide the migraine syndrome into simple, focal and complicated migraine on the basis of a uniform pathogenesis.

The stress and migraine interaction.

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Sauro, Khara M; Becker, Werner J

2009-10-01

There are several ways in which stress may interact with migraine in those predisposed to migraine attacks. These interactions may result from biochemical changes related to the physiological stress response, as, for example, the release of corticotrophin releasing hormone, or from changes induced by the psychological response to stressors. Stress is the factor listed most often by migraine sufferers as a trigger for their attacks, but in addition there is evidence that stress can help initiate migraine in those predisposed to the disorder, and may also contribute to migraine chronification. Migraine attacks themselves can act as a stressor, thereby potentially leading to a vicious circle of increasing migraine frequency. Since the important factor in the stress-migraine interaction is likely the individual's responses to stressors, rather than the stressors themselves, the acquisition of effective stress management skills has the potential to reduce the impact of stressors on those with migraine.

Migraine with visual aura associated with thicker visual cortex

DEFF Research Database (Denmark)

Gaist, David; Hougaard, Anders; Garde, Ellen

2018-01-01

Until recent years it was believed that migraine with aura was a disorder causing intermittent neurological symptoms, with no impact on brain structure. However, recent MRI studies have reported increased cortical thickness of visual and somatosensory areas in patients with migraine with aura...... number of subjects. In this cross-sectional study, we recruited females aged 30-60 years from the nationwide Danish Twin Registry. Brain MRI of females with migraine with aura (patients), their co-twins, and unrelated migraine-free twins (controls) were performed at a single centre and assessed...... for cortical thickness in predefined cortical areas (V1, V2, V3A, MT, somatosensory cortex), blinded to headache diagnoses. The difference in cortical thickness between patients and controls adjusted for age, and other potential confounders was assessed. Comparisons of twin pairs discordant for migraine...

Ischaemia-induced (symptomatic) migraine attacks may be more frequent than migraine-induced ischaemic insults

DEFF Research Database (Denmark)

Olesen, Jes; Friberg, L; Olsen, T S

1993-01-01

deficits after the very first migraine attack, severe atherosclerosis, risk factors for stroke, high age and no family history of migraine. In these cases the evidence indicates that thromboembolic ischaemia had triggered an attack of migraine with aura (likely symptomatic migraine). Three young females...

What Is an Ocular Migraine?

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... When to seek help What is an ocular migraine? Is it a sign of something serious? Answers ... and retinal migraine, which could signal something serious. Migraine aura affecting your vision Ocular migraine sometimes describes ...

Ophthalmoplegic migraine.

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Bek, Semai; Genc, Gencer; Demirkaya, Seref; Eroglu, Erdal; Odabasi, Zeki

2009-05-01

According to the International Headache Society, ophthalmoplegic migraine is recurrent attacks of headache with migrainous characteristics associated with paresis of one or more ocular cranial nerves (commonly the third nerve) in the absence of any demonstrable intracranial lesion. We report a patient with typical clinical features of ophthalmoplegic migraine. A 21-year-old man had right frontal throbbing headaches recurring twice a year. His headache lasted for 1 to 5 days and was followed by slight drooping of his eyelid and double vision that lasted for approximately 3 months. On examination he had ptosis and adduction paralysis of the right eye. Brain MRI revealed a thickened, enhancing right oculomotor nerve. He was treated with methylprednisolone 1000 mg/d IV for 5 days. Only 2 weeks later, clinical improvement was observed and 3 months later the oculomotor nerve enhancement resolved. Ophthalmoplegic migraine has been considered to have a microvascular, ischemic etiology, but more recently it has been reclassified as a demyelinating condition affecting the oculomotor. To our knowledge, this is the first ophthalmoplegic migraine case presented pretreatment and post-treatment with clinical photographic documentation and an MRI showing enduring thickening of the oculomotor nerve although symptoms and contrast enhancement resolved.

Menstrual Migraine

OpenAIRE

J Gordon Millichap

2004-01-01

The association between migraine and menstruation was determined using diary data from 155 women of median age 44 years (range, 15 to 58 years) who were not using hormonal contraception and attended the City of London Migraine Clinic, UK.

Acute migraine medication adherence, migraine disability and patient satisfaction: A naturalistic daily diary study.

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Seng, Elizabeth K; Robbins, Matthew S; Nicholson, Robert A

2017-09-01

Objective To examine the influence of acute migraine medication adherence on migraine disability and acute medication satisfaction. Methods Adults with migraine completed three months of daily electronic diaries assessing headache symptoms, acute medication taken, acute medication satisfaction, and daily migraine disability. Repeated measures mixed-effects models examined the effect of initial medication type [migraine-specific medication (MSM) vs. over-the-counter analgesic (OTC) vs. an opiate/barbiturate], the severity of pain at dosing, and their interaction with daily migraine disability and satisfaction with acute medication. Results Participants (N = 337; 92.5% female; 91.1% Caucasian, non-Hispanic; 84.0% with episodic migraine) recorded 29,722 diary days. Participants took acute medication on 96.5% of 8090 migraine days. MSM was most frequently taken first (58%), followed by OTC (29.9%) and an opiate/barbiturate (12.1%). Acute medication was most frequently taken when pain was mild (41.2%), followed by moderate (37.7%) and severe pain (11.4%). Initially dosing with MSM while pain was mild was associated with the lowest daily disability [medication × pain at dosing F (4, 6336.12) = 58.73, p migraine disability and highest acute medication satisfaction.

Migraine and Common Morbidities

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... routine eating and drinking habits. Prolonged periods of fasting, dehydration, or hyperglycemia (too much sugar) may all ... More › Related Articles Retinal Migraine Tinnitus and Headache Obesity and Migraine Abdominal Migraine Opioid Narcotics and Headache ...

Genetics Home Reference: sporadic hemiplegic migraine

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... Home Health Conditions Sporadic hemiplegic migraine Sporadic hemiplegic migraine Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Sporadic hemiplegic migraine is a rare form of migraine headache. Migraines ...

Acceptance of a structured diagnostic interview in children, parents, and interviewers.

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Neuschwander, Murielle; In-Albon, Tina; Meyer, Andrea H; Schneider, Silvia

2017-09-01

The objective of this study was to investigate the satisfaction and acceptance of a structured diagnostic interview in clinical practice and in a research setting. Using the Structured Diagnostic Interview for Mental Disorders in Children and Adolescents (Kinder-DIPS), 28 certified interviewers conducted 202 interviews (115 with parents, 87 with children). After each interview, children, parents, and interviewers completed a questionnaire assessing the overall satisfaction (0 = not at all satisfied to 100 = totally satisfied) and acceptance (0 = completely disagree to 3 = completely agree) with the interview. Satisfaction ratings were highly positive, all means >82. The mean of the overall acceptance for children was 2.43 (standard deviation [SD] = 0.41), 2.54 (SD = 0.33) of the parents, 2.30 (SD = 0.43) of the children's interviewers, and 2.46 (SD = 0.32) of the parents' interviewers. Using separate univariate regression models, significant predictors for higher satisfaction and acceptance with the interview are higher children's Global Assessment of Functioning, fewer number of children's diagnoses, shorter duration of the interview, a research setting, female sex of the interviewer, and older age of the interviewer. Results indicate that structured diagnostic interviews are highly accepted by children, parents, and interviewers. Importantly, this is true for different treatment settings. Copyright © 2017 John Wiley & Sons, Ltd.

Osler on migraine.

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Boes, Christopher J

2015-03-01

William Osler's 1892 textbook The Principles and Practice of Medicine became the dominant medical text in the English-speaking world. Osler was labeled a therapeutic nihilist by some. The topic of migraine, including treatment, was succinctly covered in his text. The objectives of this study were to review Osler's thoughts on migraine, and outline his therapeutic recommendations. Preventively Osler mentioned bromides, iron, arsenic, nitroglycerin, and cannabis. Acutely he recommended coffee, chloroform, cannabis, antipyrin, antifebrin, phenacetin, caffeine citrate, nux vomica, or ergot. He thought cannabis was the most satisfactory remedy. Osler was not a therapeutic nihilist when it came to migraine, and his treatment recommendations were similar to other writers of his time. Osler did not draw upon his personal experience to contribute new knowledge about migraine. Regardless, given the popularity and clarity of his text, Osler's well-summarized migraine chapter had a great influence on practicing physicians.

Migraine Variants in Children

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... Headaches in Children FAQ Migraine Variants In Children Children Get Migraines Too! Learn More Migraine Information Find Help Doctors & Resources Get Connected Join the Conversation Follow Us on Social Media Company About News Resources Privacy Policy Contact Phone: ...

Migraine and Mental Health in a Population-Based Sample of Adolescents.

Science.gov (United States)

Orr, Serena L; Potter, Beth K; Ma, Jinhui; Colman, Ian

2017-01-01

To explore the relationship between migraine and anxiety disorders, mood disorders and perceived mental health in a population-based sample of adolescents. The Canadian Community Health Survey (CCHS) is a cross-sectional health survey sampling a nationally representative group of Canadians. In this observational study, data on all 61,375 participants aged 12-19 years from six survey cycles were analyzed. The relationships between self-reported migraine, perceived mental health, and mood/anxiety disorders were modeled using univariate and multivariate logistic regression. The migraine-depression association was also explored in a subset of participants using the Composite International Diagnostic Interview-Short Form (CIDI-SF) depression scale. The odds of migraine were higher among those with mood disorders, with the strongest association in 2011-2 (adjusted odds ratio [aOR]=4.59; 95% confidence interval [CI 95%]=3.44-6.12), and the weakest in 2009-10 (aOR=3.06, CI 95%=2.06-4.55). The migraine-mood disorders association was also significant throughout all cycles, other than 2011-2, when the CIDI-SF depression scale was employed. The odds of migraine were higher among those with anxiety disorders, with the strongest association in 2011-2 (aOR=4.21, CI 95%=3.31-5.35) and the weakest in 2010 (aOR=1.87, CI 95%=1.10-3.37). The inverse association between high perceived mental health and the odds of migraine was observed in all CCHS cycles, with the strongest association in 2011-2 (aOR=0.58, CI 95%=0.48-0.69) and the weakest in 2003-4 (aOR=0.75, CI 95%=0.62-0.91). This study provides evidence, derived from a large population-based sample of adolescents, for a link between migraine and mood/anxiety disorders.

Positron emission tomography and migraine. Tomographie par emission de positons et migraine

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Chabriat, H. (CEA, 91 - Orsay (France). Service Hospitalier Frederic Joliot)

1992-04-01

Positron emission tomography (PET) is a brain imaging technique that allows in vivo studies of numerous physiological parameters. There have been few PET studies in migraine patients. Cerebral blood flow changes with no variations in brain oxygen consumption have been reported in patients with prolonged neurologic manifestations during migraine attacks. Parenteral administration of reserpine during migraine headache has been followed by a fall in the overall cerebral uptake of glucose. The small sample sizes and a number of methodologic problems complicate the interpretation of these results. Recent technical advances and the development of new PET tracers can be expected to provide further insight into the pathophysiology of migraine. Today cerebral cortex 5 HT{sub 2} serotonin receptors can be studied in migraine patients with PET.

Energy Metabolism Impairment in Migraine.

Science.gov (United States)

Cevoli, Sabina; Favoni, Valentina; Cortelli, Pietro

2018-06-22

Migraine is a common disabling neurological disorder which is characterised by recurring headache associated with a variety of sensory and autonomic symptoms. The pathophysiology of migraine remains not entirely understood, although many mechanisms involving the central and peripheral nervous system are now becoming clear. In particular, it is widely accepted that migraine is associated with energy metabolic impairment of the brain. The purpose of this review is to present an update overview of the energy metabolism involvement in the migraine pathophysiology. Several biochemical, morphological and magnetic resonance spectroscopy studies have confirmed the presence of energy production deficiency together with an increment of energy consumption in migraine patients. An increment of energy demand over a certain threshold create metabolic and biochemical preconditions for the onset of the migraine attack. The defect of oxidative energy metabolism in migraine is generalized. It remains to be determined if the mitochondrial deficit in migraine is primary or secondary. Riboflavin and Co-Enzyme Q10, both physiologically implicated in mitochondrial respiratory chain functioning, are effective in migraine prophylaxis, supporting the hypothesis that improving brain energy metabolism may reduce the susceptibility to migraine. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Origin of pain in migraine: evidence for peripheral sensitisation

DEFF Research Database (Denmark)

Olesen, Jes; Burstein, Rami; Ashina, Messoud

2009-01-01

, in our view, neuronal hyperexcitability depends on activation of peripheral nociceptors. Although the onset of a migraine attack might take place in deep-brain structures, some evidence indicates that the headache phase depends on nociceptive input from perivascular sensory nerve terminals. The input......Migraine is the most common neurological disorder, and much has been learned about its mechanisms in recent years. However, the origin of painful impulses in the trigeminal nerve is still uncertain. Despite the attention paid recently to the role of central sensitisation in migraine pathophysiology...

Migraine and its psychiatric comorbidities.

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Minen, Mia Tova; Begasse De Dhaem, Olivia; Kroon Van Diest, Ashley; Powers, Scott; Schwedt, Todd J; Lipton, Richard; Silbersweig, David

2016-07-01

Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Preventive Migraine Treatment

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Silberstein, Stephen D.

2015-01-01

Purpose of Review: This article reviews the evidence base for the preventive treatment of migraine. Recent Findings: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS. Summary: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence. PMID:26252585

Behavioural management of migraine

OpenAIRE

Brown, Helen; Newman, Craig; Noad, Rupert; Weatherby, Stuart

2012-01-01

It is important to recognise that migraine is a ′biological′ and not a ′psychological′ entity. However, psychological factors can be involved in migraine in 4 different ways:- 1) Migraines can be triggered by psychological stressors; 2) Severe migraine can itself be a cause of significant psychological stress which can, in turn, exacerbate the problem; 3) Even if psychological stress is not significantly involved in the genesis of the headache, pain management techniques can help people cope ...

Sensory migraine aura is not associated with structural grey matter abnormalities

DEFF Research Database (Denmark)

Hougaard, Anders; Amin, Faisal Mohammad; Arngrim, Nanna

2016-01-01

Migraine with aura (MA) is characterized by cortical dysfunction. Frequent aura attacks may alter cerebral cortical structure in patients, or structural grey matter abnormalities may predispose MA patients to aura attacks. In the present study we aimed to investigate cerebral grey matter structure...... sensory aura regularly. We analysed high-resolution structural MR images using two complimentary approaches and compared patients with and without sensory aura. Patients were also compared to controls. We found no differences of grey matter density or cortical thickness between patients with and without...... sensory aura and no differences for the cortical visual areas between patients and controls. The somatosensory cortex was thinner in patients (1.92 mm vs. 1.96 mm, P = 0.043) and the anterior cingulate cortex of patients had a decreased grey matter density (P = 0.039) compared to controls...

Food and migraine in adolescents

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Magda Bouhairet

2011-08-01

Full Text Available Background Migraine headaches are a common problem worldwide, especially in adolescents. They are usually chronic, with frequent relapses. Therefore, any dietary risk factor for headaches has important implications on migraineurs. However, the association between migraine and diet needs to be examined further. Objective To investigate the association between diet and migraine in adolescents. Methods We conducted a cross-sectional study in August to September 2009 on 13 - 18 year old adolescents in a senior high school in Medan, North Sumatera. We included subjects diagnosed with migraine, according to the International Headache Society (IHS criteria. Ninety participants completed the questionnaire. Foods we observed for a link to migraine included milk, chocolate, ice cream, cheese, bread, instant noodles, meatballs, chili sauce, sweetener, yoghurt, pizza, and other foods and beverages. Results Of the 90 participants with migraines, there were more females (61.1% than males. There were statistically significant associations between migraine and triggering foods (P = 0.045, 95% CI 0.59 to 0.79 as well as between migraine and family history of migraine (P = 0.043, 95% CI 0.46 to 0.66. Stress (P = 0.164, menstruation (P = 0.369, and sound or light (P= 0.577 had no significant association with migraine. A wide variety of foods and beverages were implicated as migraine precipitants. The most common were chili sauce (75.8%, ice cream (71.0%, milk (67.7%, instant noodles (67.7%, chocolate (61.3%, peanuts (59.7%, cheese (54.8% and meatballs (54.8%. Conclusion Food and family history have a significant association with the occurrence of migraine in adolescents.

Migraine management in community pharmacies: practice patterns and knowledge of pharmacy personnel in Thailand.

Science.gov (United States)

Saengcharoen, Woranuch; Lerkiatbundit, Sanguan

2013-10-01

To describe practice behavior and understanding among pharmacy personnel, both pharmacists and non-pharmacist staff, in the management of mild and moderate migraines. Migraine is recognized as a prevalent and chronic neurological disorder. In developing countries, such as Thailand, community pharmacies are a widely used source of health care for various illnesses including migraine. However, the quality of migraine management and knowledge among pharmacy personnel is unclear. Cross-sectional study. The sample comprised 142 randomly selected community pharmacies in a city in the south of Thailand. Simulated clients visited the pharmacies twice, at least 1 month apart, to ask for the treatment of mild and moderate migraines. After the encounters, question asking, drug dispensing, and advice giving by pharmacy staff were recorded. Subsequently, the providers in 135 pharmacies participated in the interview to evaluate their knowledge in migraine management. The majority of pharmacy personnel were less likely to ask questions in cases of mild migraine when compared with moderate attack (mean score [full score = 12] 1.8 ± 1.6 vs 2.6 ± 1.5, respectively, P knowledge on migraine management. Pharmacists had better knowledge on question asking (mild migraine 5.1 ± 2.1 vs 3.1 ± 1.3, respectively, P knowledge on advice giving but poorer drug dispensing in moderate migraine according to the guidelines, relative to non-pharmacists (20.5% vs 40.3%, P = .014). A large number of community pharmacists and non-pharmacist staff had inappropriate practice behavior and understanding. Continuing education and interventions are important to improve the practice and knowledge of pharmacy personnel, particularly the pharmacists. © 2013 American Headache Society.

Prevalence of Migraine Among Medical Students in Zahedan Faculty of Medicine (Southeast of Iran

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Mohammad R. Shahrakai

2011-09-01

Full Text Available  Introduction: Migraine is a refer pain which is common in adults and children. Migraine and its frequently limits the daily life activities. Since medical students are subjected to stresses regarding lots of tests and the implicit responsibility to the courses, the purpose of the present study carried out to evaluate the prevalence of migraine among medical students in Zahedan University. Methods: This cross-sectional, questionnaire-based study was performed on 210 (male 94 and female 116 medical students in Zahedan faculty of Medicine during an academic year (2005 to 2006. The questionnaire was specified on demographic data and headache questions based on International Headache Society (IHS. Students’ Migraine was confirmed by clinical interviews, general physical and neurological examinations then the data obtained were analyzed using v 11 of SPSS, Chi square. Afterward the percentage and the mean (±SD along with the statistical difference (P<0.05 of the T-tests were calculated. Results and Discussion: The present study showed that the rate of headache during recent academic years was 90.5% in males and 88.8 % in females. The prevalence of migraine was 7.14 % in both sex (migraine without aura 4.29% and migraine with aura 2.86%. The most common of migraine triggers was stress, (73% sleeplessness (52.5%, too much reading (39.25% and fasting (39.55%. In this sense the moderate light and severe incidence were 52.27%, 38.18% and 9.09%. The prevalence of migraine did not have any relations with gender but there was a relation between having migraine and number of studying years.

Neurovascular pharmacology of migraine

NARCIS (Netherlands)

MaassenVanDenBrink, Antoinette; Chan, Kayi Y.

2008-01-01

Migraine is a paroxysmal neurovascular disorder, which affects a significant proportion of the population. Since dilation of cranial blood vessels is likely to be responsible for the headache experienced in migraine, many experimental models for the study of migraine have focussed on this feature.

Stress as a major determinant of migraine in women aged 25-65 years

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Woro Riyadina

2014-08-01

Full Text Available Background Migraine is a primary headache causing substantial disability in patients. The prevalence of migraine in women is still high. Menarche, menstruation, pregnancy, menopause, and the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence. The aim of this study was to determine the major determinants of migraine in adult women aged 25-65 years. Methods A cross-sectional study of 2,747 women from the baseline study “Cohort Study of Risk Factors for Non-Communicable Diseases”. The dependent variable was migraine based on the diagnosis of health providers or symptoms. Independent variables were demographic (age, marital status, education and behavioral (smoking, diet, and stress characteristics, metabolic disorders (obesity, hypertension, dyslipidemia, and hormonal factors (contraception and hormone therapy. Data were collected through interviews (characteristics, health and hormonal status, diet, measurement (anthropometrics, blood pressure, and health examination (blood specimens, neurology. Data were analyzed by chi-square test and multiple logistic regression. Results Migraine in adult women was found in 710 cases (25.8% with symptoms of worsening with activity (15%, nausea and vomiting (13%, and photophobia/phonophobia (4.1%. The main determinant of migraine in adult women was stress with a 2.47-fold risk [95% CI = 2.07 to 2.95] as compared with no stress, after controlling for smoking, menstruation and hormonal drug consumption. Conclusion Stress is a major determinant of migraine in adult women, therefore health programs should be instituted through health promotion, prevention and education to control stress.

Behavioural management of migraine

Science.gov (United States)

Brown, Helen; Newman, Craig; Noad, Rupert; Weatherby, Stuart

2012-01-01

It is important to recognise that migraine is a ‘biological’ and not a ‘psychological’ entity. However, psychological factors can be involved in migraine in 4 different ways:- 1) Migraines can be triggered by psychological stressors; 2) Severe migraine can itself be a cause of significant psychological stress which can, in turn, exacerbate the problem; 3) Even if psychological stress is not significantly involved in the genesis of the headache, pain management techniques can help people cope with their pain more effectively; 4) Longitudinal data demonstrate a complex bidirectional association between mood disorders and migraine. Treatment of a co-existing mood disorder, for example with cognitive behavioural techniques, may therefore reduce the impact of migraine. It would thus appear logical to view medical and psychological approaches as potentially synergistic rather than mutually exclusive. Functional imaging indicates that cognition, emotions, and pain experiences change the way the brain processes pain inputs. This may provide a physiological rationale for psychological interventions in pain management. As most studies of psychological management of migraine have been relatively small and the approach often varies between clinicians, the magnitude of benefit, optimum method of delivery, and the length of intervention are uncertain. PMID:23024569

Quality of Life and Migraine Disability among Female Migraine Patients in a Tertiary Hospital in Malaysia

Science.gov (United States)

Shaik, Munvar Miya; Hassan, Norul Badriah; Gan, Siew Hua

2015-01-01

Background. Disability caused by migraine may be one of the main causes of burden contributing to poor quality of life (QOL) among migraine patients. Thus, this study aimed to measure QOL among migraine sufferers in comparison with healthy controls. Methods. Female diagnosed migraine patients (n= 100) and healthy controls (n=100) completed the Malay version of the World Health Organization QOL Brief (WHOQOL-BREF) questionnaire. Only migraine patients completed the Malay version of the Migraine Disability Assessment questionnaire. Results. Females with migraines had significantly lower total WHOQOL-BREF scores (84.3) than did healthy controls (91.9, Pmigraine patients with lower total QOL scores had 1.2 times higher odds of having disability than patients with higher total QOL scores. Conclusions. The present study showed that migraine sufferers experienced significantly lower QOL than the control group from a similar population. Disability was severe and frequent and was associated with lower QOL among the migraine patients. PMID:25632394

Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain.

Science.gov (United States)

Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda; Nielsen, Trine; Sloth, Louise Bönsdorff; Jensen, Rigmor Højland; Gard, Gunvor

2017-12-01

The prevalence of migraine with co-existing tension-type headache and neck pain is high in the general population. However, there is very little literature on the characteristics of these combined conditions. The aim of this study was to investigate a) the prevalence of migraine with co-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons with migraine and co-existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition. The study was conducted at a tertiary referral specialised headache centre where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension-type headache and neck pain. Out of 148 persons with migraine, 100 (67%) suffered from co-existing tension-type headache and neck pain. Only 11% suffered from migraine only. Persons with migraine and co-existing tension-type headache and neck pain had lower level of physical activity and psychological well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition was migraine, followed by tension-type headache and neck pain. Migraine with co-existing tension-type headache and neck pain was highly prevalent in a clinic-based sample. Persons with migraine and co

Trigger factors in migraine patients Fatores desencadeantes de enxaqueca

Directory of Open Access Journals (Sweden)

Patrícia Timy Fukui

2008-09-01

Full Text Available BACKGROUND: Migraine is a chronic neurological disease with several trigger factors, including dietary, hormonal and environmental factors. PURPOSE: To analyse precipitating factors in a sample of migraine patients. METHOD: Two hundred consecutive migraine patients were interviewed about possible trigger factors for migraine attacks. RESULTS: Most patients showed at least one dietary trigger, fasting was the most frequent one, followed by alcohol and chocolate. Hormonal factors appeared in 53% , being the pre-menstrual period the most frequent trigger. Physical activities caused migraine in 13%, sexual activities in 2.5% and 64% reported emotional stress a trigger factor. 81% related some sleep problem as a trigger factor. Regarding environmental factors, smells were reported by 36.5%. CONCLUSION: Trigger factors are frequent in migraine patients, its avoidance may decrease headache frequency and also improve patients' quality of life.INTRODUÇÃO: A enxaqueca é uma doença neurológica crônica que apresenta diversos desencadeantes como fatores alimentares, hormonais e ambientais. OBJETIVO: Analisar os fatores desencadeantes em uma amostra de pacientes com enxaqueca. MÉTODO: Duzentos pacientes com diagnóstico de enxaqueca foram questionados sobre fatores que pudessem desencadear suas crises. RESULTADOS: 83,5% apresentaram algum fator alimentar, jejum foi o fator mais freqüente, seguido de álcool e chocolate. Dos fatores hormonais, o período pré-menstrual foi o mais freqüente. Atividade física causou enxaquecas em 13%, atividade sexual em 2,5%, estresse em 64% e 81% relataram o sono como fator desencadeante. Em relação aos fatores ambientais, odores foram desencadeantes em 36,5%. CONCLUSÃO: Os fatores desencadeantes são freqüentes em enxaqueca e a sua detecção deve ser pormenorizada para que se reduza a freqüência de crises e melhore a qualidade de vida do paciente.

The migraine postdrome

DEFF Research Database (Denmark)

Giffin, Nicola J; Lipton, Richard B; Silberstein, Stephen D

2016-01-01

OBJECTIVE: To report migraine postdrome symptoms in patients who report nonheadache symptoms as part of their attacks. METHODS: A prospective daily electronic diary study was conducted over 3 months in 120 patients with migraine. Nonheadache symptoms before, during, and after headache were...... pain resolved. There was no relationship between medication taken for the headache and the duration of the postdrome. The severity of the migraine was not associated with the duration of the postdrome. Overall state of health scores remained low during the postdrome. CONCLUSION: Nonheadache symptoms...... in the postdrome were common and may contribute to the distress and disability in the patients studied. Postdrome symptoms merit larger observational studies and careful recording in clinical trials of acute and preventive migraine treatments....

The migraine postdrome

DEFF Research Database (Denmark)

Giffin, Nicola J.; Lipton, Richard B; Silberstein, Stephen D

2016-01-01

Objective: To report migraine postdrome symptoms in patients who report nonheadache symptoms as part of their attacks.  Methods: A prospective daily electronic diary study was conducted over 3 months in 120 patients with migraine. Nonheadache symptoms before, during, and after headache were...... pain resolved. There was no relationship between medication taken for the headache and the duration of the postdrome. The severity of the migraine was not associated with the duration of the postdrome. Overall state of health scores remained low during the postdrome.  Conclusion: Nonheadache symptoms...... in the postdrome were common and may contribute to the distress and disability in the patients studied. Postdrome symptoms merit larger observational studies and careful recording in clinical trials of acute and preventive migraine treatments....

Psychological Factors Associated with Chronic Migraine and Severe Migraine-Related Disability: an Observational Study in a Tertiary Headache Center

Science.gov (United States)

Seng, Elizabeth K.; Buse, Dawn C.; Klepper, Jaclyn E.; Mayson, Sarah Jo; Grinberg, Amy S.; Grosberg, Brian M.; Pavlovic, Jelena M.; Robbins, Matthew S.; Vollbracht, Sarah E.; Lipton, Richard B.

2016-01-01

Objective To evaluate relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score ≥ 21), and modifiable psychological factors [depressive symptoms (Patient Health Questionnaire-9), anxious symptoms (Generalized Anxiety Disorder-7), Pain Catastrophizing Scale and Headache Specific Locus of Control]. Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results Among 90 eligible participants the mean age was 45.0 (SD = 12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR = 1.99, 95% CI = 1,11, 3.55) and chance HSLC (OR = 1.85, 95% CI = 1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR = 3.54, 95%CI = 1.49, 8.41), anxiety symptoms (OR = 3.65, 95% CI = 1.65, 8.06), and pain catastrophizing (OR = 1.95, 95% CI = 1.14, 3.35), were associated with severe migraine-related disability. Conclusions Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate relationships among naturalistic

Comorbidity of Migraine

OpenAIRE

Shuu-Jiun Wang; Shuu-Jiun Wang; Jong-Ling Fuh; Jong-Ling Fuh; Ping-Kun Chen; Ping-Kun Chen

2010-01-01

Migraine is a common neurological disorder and can cause severely disabling during attacks. The highest prevalence occurs between the ages of 25 and 55 years, potentially the most productive period of life. Migraine leads to a burden not only to the individual, but also to the family and society. Prior studies have found migraine occurs with some illness at a greater than coincidental rate than is seen in the general population. These occurrences are called “comorbidity”, which me...

Migraine - Prophylactic Treatment

Directory of Open Access Journals (Sweden)

Chowdhury Debashish

2002-01-01

Full Text Available Preventive therapy in migraine constitutes an important aspect of migraine management especially in patients who are not controlled or have significant disability despite taking drugs for acute management. In spite of te recent advances in understanding of the pathophysiology of migraine, the mechanisms of action of many preventive drugs are largely unknown. Further, these provide only about 50% reduction in frequency in about 2/3rds of migraine sufferers. Hence, risk-benefit ratio must be considered while prescribing these agents. Recent efforts to undertake large-scale meta-analysis to assess the efficacy of these agents have been rewarding and consensus guidelines have evolved. Propanolol, metoprolol, amitriptyline, sodium valproate, flunarizine and lisuride have emerged as first line drugs. The role of newer anti-convulsants and botox injections in refractory cases are being investigated. Availability, co-morbidities, medical contraindications, concomitant acute therapy and costs are important determinants for choosing a particular agent. This article reviews the guidelines to be followed in choosing the prophylactic treatment options for migraine.

The prevalence of bad headaches including migraine in a multiethnic community.

Science.gov (United States)

Thomson, A N; White, G E; West, R

1993-11-10

Overall and ethnic specific prevalences of bad headache including migraine, for the New Zealand population, are unknown. A study was carried out in South Auckland to estimate prevalence and to explore ethnic differences in doctor attendance for the diagnosis and management of bad headaches. Telephone interviews were administered to respondents selected by random digit dialing of households. 40.6% of the respondents suffered from bad headaches. 54.5% of these had the characteristics of bad headache with features symptomatic of migraine. Trends in the prevalence of bad headache with features symptomatic of common migraine, peaked between the ages of 30-49 years in both men and women. A difference was seen in the prevalence of bad headache with aura, with or without common migraine features, when ethnic groups and gender were examined. The difference in prevalence of aura was particularly noticeable between Pacific Island men and women. Although there was no difference between ethnic groups in doctor attendance, headaches were more likely to be labelled as migraine in Europeans than in the Polynesian groups. Ways in which people perceive and report their bad headaches have a bearing on management by general practitioners. Although no overall ethnic predominance was seen, there was a gender difference amongst Pacific Island people in reporting bad headaches with aura. The labelling process, and thus the management by general practitioners does demonstrate likely ethnic differences.

Behavioural management of migraine

Directory of Open Access Journals (Sweden)

Helen Brown

2012-01-01

Full Text Available It is important to recognise that migraine is a ′biological′ and not a ′psychological′ entity. However, psychological factors can be involved in migraine in 4 different ways:- 1 Migraines can be triggered by psychological stressors; 2 Severe migraine can itself be a cause of significant psychological stress which can, in turn, exacerbate the problem; 3 Even if psychological stress is not significantly involved in the genesis of the headache, pain management techniques can help people cope with their pain more effectively; 4 Longitudinal data demonstrate a complex bidirectional association between mood disorders and migraine. Treatment of a co-existing mood disorder, for example with cognitive behavioural techniques, may therefore reduce the impact of migraine. It would thus appear logical to view medical and psychological approaches as potentially synergistic rather than mutually exclusive. Functional imaging indicates that cognition, emotions, and pain experiences change the way the brain processes pain inputs. This may provide a physiological rationale for psychological interventions in pain management. As most studies of psychological management of migraine have been relatively small and the approach often varies between clinicians, the magnitude of benefit, optimum method of delivery, and the length of intervention are uncertain.

Ischemic strokes and migraine

Energy Technology Data Exchange (ETDEWEB)

Bousser, M.G.; Baron, J.C.; Chiras, J.

1985-11-01

Lasting neurological deficits, though most infrequent, do occur in migrainous subjects and are well documented by clinical angiographic computed tomographic (CT scan) and even pathological studies. However the mechanism of cerebral ischemia in migraine remains widely unknown and the precise role of migraine in the pathogenesis of ischemic strokes is still debated. (orig./MG).

Vestibular migraine: who is the patient?

Science.gov (United States)

Colombo, Bruno; Teggi, Roberto

2017-05-01

Vestibular migraine has been classified as a specific entity in which vestibular symptomatology is defined as part of the migrainous disorder. New and appropriate diagnostic criteria have been proposed by the Barany and International Headache Societies. The diagnosis of vestibular migraine mainly depends on the patient history. The NIVE project is a prospectic multicentric study on vestibular migraine. The aim of this project is to evaluate demographics, epidemiology, clinical manifestations of migraine and vertigo in a large cohort of Caucasian patients affected by vestibular migraine.

Cognitive functioning in adolescents with migraine

Directory of Open Access Journals (Sweden)

Melissa Andréia Costa-Silva

Full Text Available Although migraine is highly prevalent in children and teenagers, it often goes undetected in these patients, resulting in underdiagnosis and inadequate treatment. Several studies have investigated cognitive changes in adults with migraine. However, there are few studies focusing on children and adolescents. Objective : To investigate cognitive performance of adolescents with migraine. Methods : Twenty-eight adolescents diagnosed with migraine and twenty-six individuals without a history of headache were recruited for the study. All participants were evaluated using standardized neuropsychological tests. Results : Adolescents with migraine had worse performance on tests evaluating short- and long-term verbal memory, attention, executive function, and speed of processing information than controls. Conclusion : Cognitive dysfunction is common in adolescents with migraine. Since the cognitive deficits found in adolescents with migraine are similar to those reported in adults with migraine, cognitive impairment seems to persist throughout life.

Serotonergic mechanisms in the migraine brain

DEFF Research Database (Denmark)

Christensen, Marie Deen; Christensen, Casper Emil; Hougaard, Anders

2017-01-01

role of brain serotonergic mechanisms remains a matter of controversy. Methods We systematically searched PubMed for studies investigating the serotonergic system in the migraine brain by either molecular neuroimaging or electrophysiological methods. Results The literature search resulted in 59 papers......, of which 13 were eligible for review. The reviewed papers collectively support the notion that migraine patients have alterations in serotonergic neurotransmission. Most likely, migraine patients have a low cerebral serotonin level between attacks, which elevates during a migraine attack. Conclusion...... This review suggests that novel methods of investigating the serotonergic system in the migraine brain are warranted. Uncovering the serotonergic mechanisms in migraine pathophysiology could prove useful for the development of future migraine drugs....

One hundred years of migraine research

DEFF Research Database (Denmark)

Tfelt-Hansen, Peer C; Koehler, Peter J

2011-01-01

); oligemia in the wake of CSD in rats (1982); neurogenic inflammation theory of migraine (1987); a new headache classification (1988); the discovery of sumatriptan (1988); migraine and calcitonin gene-related peptide (1990); the brainstem "migraine generator" and PET studies (1995); migraine...

Cerebral hemodynamics in migraine

DEFF Research Database (Denmark)

Hachinski, V C; Olesen, Jes; Norris, J W

1977-01-01

Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...... prodromal symptoms, a decrease in cerebral blood flow has been demonstrated during the aura. Occasionally, this flow decrease persists during the headache phase. In common migraine, where such prodromata are not seen, a flow decrease has not been demonstrated. During the headache phase of both types...... of migraine, rCBF has usually been found to be normal or in the high range of normal values. The high values may represent postischemic hyperemia, but are probably more frequently secondary to arousal caused by pain. Thus, during the headache phase rCBF may be subnormal, normal or high. These findings do...

Genetics of migraine and related syndromes

NARCIS (Netherlands)

Stam, Anine Henrike

2014-01-01

In this dissertation clinical genetic investigations on migraine, related syndromes and comorbid conditions are described. The first migraine syndrome studied is Familial Hemiplegic Migraine (FHM), a monogenic migraine variant. The clinical spectrum of FHM1-3 and the relation with closely related

Trigger factors for familial hemiplegic migraine

DEFF Research Database (Denmark)

Hansen, Jakob Møller; Hauge, Anne Werner; Ashina, Messoud

2011-01-01

The aim was to identify and describe migraine trigger factors in patients with familial hemiplegic migraine (FHM) from a population-based sample.......The aim was to identify and describe migraine trigger factors in patients with familial hemiplegic migraine (FHM) from a population-based sample....

Migraine generator network and spreading depression dynamics as neuromodulation targets in episodic migraine

Science.gov (United States)

Dahlem, Markus A.

2013-12-01

Migraine is a common disabling headache disorder characterized by recurrent episodes sometimes preceded or accompanied by focal neurological symptoms called aura. The relation between two subtypes, migraine without aura (MWoA) and migraine with aura (MWA), is explored with the aim to identify targets for neuromodulation techniques. To this end, a dynamically regulated control system is schematically reduced to a network of the trigeminal nerve, which innervates the cranial circulation, an associated descending modulatory network of brainstem nuclei, and parasympathetic vasomotor efferents. This extends the idea of a migraine generator region in the brainstem to a larger network and is still simple and explicit enough to open up possibilities for mathematical modeling in the future. In this study, it is suggested that the migraine generator network (MGN) is driven and may therefore respond differently to different spatio-temporal noxious input in the migraine subtypes MWA and MWoA. The noxious input is caused by a cortical perturbation of homeostasis, known as spreading depression (SD). The MGN might even trigger SD in the first place by a failure in vasomotor control. As a consequence, migraine is considered as an inherently dynamical disease to which a linear course from upstream to downstream events would not do justice. Minimally invasive and noninvasive neuromodulation techniques are briefly reviewed and their rational is discussed in the context of the proposed mechanism.

Sexual Dysfunction in Women With Migraine and Overweight/Obesity: Relative Frequency and Association With Migraine Severity.

Science.gov (United States)

Bond, Dale S; Pavlović, Jelena M; Lipton, Richard B; Graham Thomas, J; Digre, Kathleen B; Roth, Julie; Rathier, Lucille; O'Leary, Kevin C; Evans, E Whitney; Wing, Rena R

2017-03-01

Previous studies suggest that migraine might be associated with female sexual dysfunction (FSD), although this association may be complicated by overweight/obesity. To disentangle relationships of migraine and obesity with FSD, we examined: (1) FSD rates in women who had migraine and obesity with a matched sample of women with obesity who were free of migraine and (2) associations between indices of migraine severity and FSD in a larger sample of participants with migraine and overweight/obesity, controlling for important confounders. Women with migraine and obesity seeking behavioral weight loss treatment to decrease headaches (n = 37) and nonmigraine controls (n = 37) with obesity seeking weight loss via bariatric surgery were matched on age (±5 years), body mass index (BMI; ±3 kg/m 2 ), and reported sexual activity during the past month. Both groups completed the Female Sexual Function Index (FSFI), with a validated FSFI-total cutoff score used to define FSD. In participants with migraine and overweight/obesity (n = 105), separate logistic regression models evaluated associations of migraine attack frequency, intensity, and duration with odds of having FSD, controlling for age, BMI, depression, and anxiety. On average, participants and matched controls had severe obesity (BMI = 42.4 ± 3.8 kg/m 2 ; range = 35-49.9) and were 37.3 ± 7.2 years of age (range = 22-50). FSD rate did not differ between migraine participants and controls (56.8% vs. 54.1%, P = .82). In the larger sample of participants with migraine and overweight/obesity (38.2 ± 7.8 years of age; BMI = 34.8 ± 6.4 [range = 25-50 kg/m 2 ]; 8.0 ± 4.3 migraine days/month, maximum pain intensity = 5.9 ± 1.4 on 0-10 scale; average attack duration = 18.3 ± 9.7 hours), FSD was not associated with attack frequency (P = .31), pain intensity (P = .92), or attack duration (P = .35) but was associated with more severe anxiety

Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American Migraine Prevalence and Prevention (AMPP) Study.

Science.gov (United States)

Buse, Dawn C; Loder, Elizabeth W; Gorman, Jennifer A; Stewart, Walter F; Reed, Michael L; Fanning, Kristina M; Serrano, Daniel; Lipton, Richard B

2013-09-01

The strikingly higher prevalence of migraine in females compared with males is one of the hallmarks of migraine. A large global body of evidence exists on the sex differences in the prevalence of migraine with female to male ratios ranging from 2:1 to 3:1 and peaking in midlife. Some data are available on sex differences in associated symptoms, headache-related disability and impairment, and healthcare resource utilization in migraine. Few data are available on corresponding sex differences in probable migraine (PM) and other severe headache (ie, nonmigraine-spectrum severe headache). Gaining a clear understanding of sex differences in a range of severe headache disorders may help differentiate the range of headache types. Herein, we compare sexes on prevalence and a range of clinical variables for migraine, PM, and other severe headache in a large sample from the US population. This study analyzed data from the 2004 American Migraine Prevalence and Prevention Study. Total and demographic-stratified sex-specific, prevalence estimates of headache subtypes (migraine, PM, and other severe headache) are reported. Log-binomial models are used to calculate sex-specific adjusted prevalence ratios and 95% confidence intervals for each across demographic strata. A smoothed sex prevalence ratio (female to male) figure is presented for migraine and PM. One hundred sixty-two thousand seven hundred fifty-six individuals aged 12 and older responded to the 2004 American Migraine Prevalence and Prevention Study survey (64.9% response rate). Twenty-eight thousand two hundred sixty-one (17.4%) reported "severe headache" in the preceding year (23.5% of females and 10.6% of males), 11.8% met International Classification of Headache Disorders-2 criteria for migraine (17.3% of females and 5.7% of males), 4.6% met criteria for PM (5.3% of females and 3.9% of males), and 1.0% were categorized with other severe headache (0.9% of females and 1.0% of males). Sex differences were observed in

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

International Nuclear Information System (INIS)

Castro Lopes, Sergio Lucio Pereira; Ferreira Costa, Andre Luiz; Oliveira Gamba, Thiago; Flores, Isadora Luana; Cruz, Adriana Dibo; Min, Li Li

2015-01-01

Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

Energy Technology Data Exchange (ETDEWEB)

Castro Lopes, Sergio Lucio Pereira [Dept. of Diagnosis and Surgery, Sao Jose dos Campos Dental School, Sao Paulo (Brazil); Ferreira Costa, Andre Luiz [Dept. of Pediatric Dentistry and Orthodontics, University of Sao Paulo, Sao Paulo (Brazil); Oliveira Gamba, Thiago; Flores, Isadora Luana [Dept. of ral Diagnosis, School of Dentistry, Sao Paulo (Brazil); Cruz, Adriana Dibo [Dept. of Specific Formation, Area of Radiology, Nova Friburgo Dental School, Fluminense Federal University, Rio de Janeiro (Brazil); Min, Li Li [Laboratory of Neuroimaging, Dept. of Neurology, Faculty of Medical Sciences, Sao Paulo (Brazil)

2015-03-15

Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

Migraine as a risk factor for young patients with ischemic stroke: a case-control study.

Science.gov (United States)

Abanoz, Yasin; Gülen Abanoz, Yeşim; Gündüz, Ayşegül; Uludüz, Derya; İnce, Birsen; Yavuz, Burcu; Göksan, Baki

2017-04-01

Studies have suggested a possible association of migraine and increased risk of ischemic stroke in young adults, particularly in smokers and in women who use oral contraceptive drugs. We aimed to analyze the association between migraine and ischemic stroke in young population in a hospital-based cohort. We included 202 consecutive patients with the diagnosis of ischemic stroke who were between 15 and 50 years and age- and gender-matched 250 volunteers with no history of stroke. All participants were interviewed using a questionnaire for migraine. Localization of ischemic lesion was classified as anterior and posterior circulation according to neuroimaging findings. The cause of ischemic lesion and all risk factors were recorded. Undetermined etiology was the most frequent (43.1%) and the most common determined cause was cardioembolism (22.3%) in young stroke patients. Frequency of migraine was 30.2% among patients with stroke whereas 16.8% of healthy subjects had migraine (p = 0.001). Migraine with aura was significantly more common among patients with stroke compared to healthy subjects (18.3 vs 4.4%; p = 0.000) whereas the frequency of migraine without aura was similar in both groups (11.9 vs 12.4%). Using logistic regression, migraine with aura was shown to be an independent risk factor for ischemic stroke in young population (p = 0.000) and separate analysis for gender demonstrated that it was only a risk factor for women (p = 0.009) but not for men (p = 0.107). Migraine with aura was found to be more common in ischemic stroke in young patients. It was an independent risk factor in women.

Unilateral nasal pain with migraine features.

Science.gov (United States)

Alvarez, Mónica; Montojo, Teresa; de la Casa, Beatriz; Vela, Lydia; Pareja, Juan A

2013-09-01

Migraine attacks exclusively felt in the face are very rare, the pain involving the territories supplied by the second and third branches of the trigeminal nerve. Two patients suffering from heminasal pain attacks accompanied with typical migrainous features and responsive to oral or intranasal triptans - but not to intranasal lidocaine or oxymetazoline. In one patient, the attacks could be precipitated upon slight touching on the tip of the nose, in the other attacks were preceded by the nasal sensation typically heralding sneezing. Migraine pain mostly develops within the innervation territory of the first branch of the trigeminal nerve, which includes the nose. Therefore, episodes of unilateral nasal pain with migrainous features could be considered a migraine with unusual topography (nasal migraine). Painful nasal attacks occasionally preceded by stimulation of trigeminal afferents in the nose, could be conceived of as migraine-tic syndrome.

Neurotrophins and Migraine.

Science.gov (United States)

Martins, L B; Teixeira, A L; Domingues, R B

2017-01-01

Neurotrophins (NTs) have been implicated in generation and modulation of nociceptive pathways. Change in NTs levels is associated with painful conditions and neurological diseases such as migraine. Currently, it is generally recognized that migraine headaches result from the activation and sensitization of trigeminal sensory afferent fibers leading to neuropeptides release such as calcitonin gene-related peptide (CGRP) and substance P (SP). This triggers an inflammatory cascade causing a neurogenic inflammation. The agents responsible for trigeminal activation and release of neuropeptides are still unclear. It is known that the transient receptor potential vanilloid receptor-1 (TRPV1) is an important mediator of CGRP and SP release. TRPV1 is closely associated with tyrosine receptors kinases (Trk), which are NTs receptors. NTs can act on TRPV1 increasing its sensitivity to painful stimuli, therefore predisposing to hyperalgesia. Upregulation of ion channels and pain receptors in dorsal root ganglion neurons may be alternative mechanisms by which NTs contribute to pain development. Only a few studies have been performed to investigate the role of NTs in migraine. These studies have reported changes in NTs levels in migraine patients either during the migraine attack or in free-headache periods. © 2017 Elsevier Inc. All rights reserved.

Bipolar Affective Disorder and Migraine

Directory of Open Access Journals (Sweden)

Birk Engmann

2012-01-01

Full Text Available This paper consists of a case history and an overview of the relationship, aetiology, and treatment of comorbid bipolar disorder migraine patients. A MEDLINE literature search was used. Terms for the search were bipolar disorder bipolar depression, mania, migraine, mood stabilizer. Bipolar disorder and migraine cooccur at a relatively high rate. Bipolar II patients seem to have a higher risk of comorbid migraine than bipolar I patients have. The literature on the common roots of migraine and bipolar disorder, including both genetic and neuropathological approaches, is broadly discussed. Moreover, bipolar disorder and migraine are often combined with a variety of other affective disorders, and, furthermore, behavioural factors also play a role in the origin and course of the diseases. Approach to treatment options is also difficult. Several papers point out possible remedies, for example, valproate, topiramate, which acts on both diseases, but no first-choice treatments have been agreed upon yet.

Positron emission tomography and migraine

International Nuclear Information System (INIS)

Chabriat, H.

1992-01-01

Positron emission tomography (PET) is a brain imaging technique that allows in vivo studies of numerous physiological parameters. There have been few PET studies in migraine patients. Cerebral blood flow changes with no variations in brain oxygen consumption have been reported in patients with prolonged neurologic manifestations during migraine attacks. Parenteral administration of reserpine during migraine headache has been followed by a fall in the overall cerebral uptake of glucose. The small sample sizes and a number of methodologic problems complicate the interpretation of these results. Recent technical advances and the development of new PET tracers can be expected to provide further insight into the pathophysiology of migraine. Today cerebral cortex 5 HT 2 serotonin receptors can be studied in migraine patients with PET

Acute Confusional Migraine: Distinct Clinical Entity or Spectrum of Migraine Biology?

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Ashar M. Farooqi

2018-02-01

Full Text Available The goal of this review is to explore the literature reports of acute confusional migraine (ACM including patient characteristics, migraine symptomatology, and proposed diagnostic criteria. A literature review was conducted using PubMed, Scopus and Web of Science using the terms “confusional migraine” and “confusional state in migraine”. All the relevant articles from 1970 to 2016 were included. A total of 120 patients were found in the literature. Most of the cases were seen in the pediatric population with a slight male predominance. Personal or family history of migraine was common. Most patients had a headache prior to the confusional state. In addition to confusion and agitation, some developed visual (32.5% and/or sensory symptoms (19% and/or speech problems (39% either prior to or during the confusional state. Data on treatment outcomes is lacking. Patients with most common forms of migraine report attention and cognitive disturbances but awareness remains intact as opposed to patients with ACM. ACM is a distinct entity and should be included as part of the appendix of International Classification of Headache Disoders-3 beta version (ICHD-3β criteria. Prospective studies are needed to further study this disorder and its association with other migraine forms.

Understanding Menstrual Migraine.

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Calhoun, Anne H

2018-04-01

Menstrual-related migraine is very prevalent, very disabling, yet very easy to manage given a good understanding of its cause. This article is intended to help with that understanding and to enable headache specialists to prescribe or create effective hormonal preventives of menstrual-related migraine. © 2018 American Headache Society.

Migraine & paediatric obesity: a plausible link?

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Sarit Ravid

2014-01-01

Full Text Available Obesity and migraine are both highly prevalent disorders in the general population, influenced by genetic and environmental risk factors. In recent studies, obesity was found to be a strong risk factor for transformed migraine and, among migraineurs, obesity was associated with frequent headaches and higher disability scores. Suggested mechanisms included: (i obesity as a pro-inflammatory state may be associated with neurovascular inflammation in patients with migraine; (ii elevated levels of plasma calcitonin gene-related peptide (CGRP in obese individuals may play a role as an important post-synaptic mediator of trigeminovascular inflammation in migraine; (iii dismodulation in the hypothalamic neuropeptide, orexin, in obese persons may be associated with increased susceptibility to neurogenic inflammation causing migraine attacks; and (iv leptin and adiponectin can activate proinflammatory cytokine release that is involved in the pathogenesis of migraine. In addition, both conditions are associated with psychiatric co-morbidities, such as depression and anxiety, that can further increase headache frequency and disability. Therefore, the effect of obesity on migraine outcome is important. Weight and BMI should be measured and calculated in all children presenting with migraine, and weight control should be a part of the treatment.

Functional Imaging and Migraine: New Connections?

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Schwedt, Todd J.; Chong, Catherine D.

2015-01-01

Purpose of Review Over the last several years, a growing number of brain functional imaging studies have provided insights into mechanisms underlying migraine. This manuscript reviews the recent migraine functional neuroimaging literature and provides recommendations for future studies that will help fill knowledge gaps. Recent Findings Positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) studies have identified brain regions that might be responsible for mediating the onset of a migraine attack and those associated with migraine symptoms. Enhanced activation of brain regions that facilitate processing of sensory stimuli suggests a mechanism by which migraineurs are hypersensitive to visual, olfactory, and cutaneous stimuli. Resting state functional connectivity MRI studies have identified numerous brain regions and functional networks with atypical functional connectivity in migraineurs, suggesting that migraine is associated with aberrant brain functional organization. Summary fMRI and PET studies that have identified brain regions and brain networks that are atypical in migraine have helped to describe the neurofunctional basis for migraine symptoms. Future studies should compare functional imaging findings in migraine to other headache and pain disorders and should explore the utility of functional imaging data as biomarkers for diagnostic and treatment purposes. PMID:25887764

The Relationship between Migraine and Nutrition

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Ayçıl Özturan

2016-06-01

Full Text Available Migraine is a kind of headache accompanied by neurologic, gastrointestinal, and autonomous variations. The roles of factors that trigger migraine, especially nutrition triggers, have become much more questionable with the increase in the rate of migraine occurrence. Some patients with migraine have stated that their headache attacks start without any reason. However, inner triggers such as hormonal changes or external triggers such as air exchange, some smells or the association of both triggers can start the headache. Each patient may not have same sensitivity to these triggers. A single factor might become prominent in some patients, but more than one factor may need to be required in other patients. Although the connection between migraine and the factors such as stress, environmental factors, chronic diseases, and nutritional and sleep status has been known, their mechanisms are still not clear. Nutritional status and the effects of nutrition play an important role being pain triggers in everybody, especially children and young people who suffer from migraine headache. Considering the migraine triggers generally, it has been suggested in studies that there is at least one nutrition-related trigger and hunger is the most frequently reported trigger in terms of diet. Moreover it is known that chocolate, tea, coffee, cheese, and alcohol may trigger migraine because of some specific elements within them. In recently conducted studies, using some functional foods have raised on the treatment of migraine. For this reason, the relationship between migraine and triggering factors as food and nutrition are examined in this study.

Migraine and magnetic resonance spectroscopy

DEFF Research Database (Denmark)

Younis, Samaira; Hougaard, Anders; Vestergaard, Mark B.

2017-01-01

Purpose of review: To present an updated and streamlined overview of the metabolic and biochemical aspect of the migraine pathophysiology based on findings from phosphorous (31P) and hydrogen (1H) magnetic resonance spectroscopy (MRS) studies. Recent findings: Despite of the variation in the meth......Purpose of review: To present an updated and streamlined overview of the metabolic and biochemical aspect of the migraine pathophysiology based on findings from phosphorous (31P) and hydrogen (1H) magnetic resonance spectroscopy (MRS) studies. Recent findings: Despite of the variation...... in the methodology and quality of the MRS migraine studies over time, some results were consistent and reproducible. 31P-MRS studies suggested reduced availability of neuronal energy and implied a mitochondrial dysfunction in the migraine brain. 1H-MRS studies reported interictal abnormalities in the excitatory...... and inhibitory neurotransmitters, glutamate and g-aminobutyric acid (GABA), suggesting persistent altered excitability in migraine patients. N-Acetylaspartate levels were decreased in migraine, probably due to a mitochondrial dysfunction and abnormal energy metabolism. The reported abnormalities may increase...

Depression and Anxiety in Migraine Patients

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... Spotlight On News Content Capsule Contact Understanding Migraine Depression and Anxiety in Migraine Patients Doctor Q&A ... of Headache Disorders Cluster Headache Post-Traumatic Headache Depression and Anxiety in Migraine Patients August 13, 2015 ...

What is Migraine? | NIH MedlinePlus the Magazine

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... of this page please turn JavaScript on. Feature: Migraine Headaches What is Migraine? Past Issues / Fall 2015 Table of Contents If ... exhausted or weak following a migraine. Who Gets Migraines? Migraines occur in both children and adults, but ...

The KATP channel in migraine pathophysiology

DEFF Research Database (Denmark)

Al-Karagholi, Mohammad Al-Mahdi; Hansen, Jakob Møller; Severinsen, Johanne

2017-01-01

BACKGROUND: To review the distribution and function of KATP channels, describe the use of KATP channels openers in clinical trials and make the case that these channels may play a role in headache and migraine. DISCUSSION: KATP channels are widely present in the trigeminovascular system and play...... an important role in the regulation of tone in cerebral and meningeal arteries. Clinical trials using synthetic KATP channel openers report headache as a prevalent-side effect in non-migraine sufferers, indicating that KATP channel opening may cause headache, possibly due to vascular mechanisms. Whether KATP...... channel openers can provoke migraine in migraine sufferers is not known. CONCLUSION: We suggest that KATP channels may play an important role in migraine pathogenesis and could be a potential novel therapeutic anti-migraine target....

Toward a rational understanding of migraine trigger factors.

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Martin, V T; Behbehani, M M

2001-07-01

The typical migraine patient is exposed to a myriad of migraine triggers on a daily basis. These triggers potentially can act at various sites within the cerebral vasculature and the central nervous system to promote the development of migraine headache. The challenge to the physician is in the identification and avoidance of migraine trigger factors within patients suffering from migraine headache. Only through a rational approach to migraine trigger factors can physicians develop an appropriate treatment strategy for migraine patients.

Future possibilities in migraine genetics

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Rudkjøbing, Laura Aviaja; Esserlind, Ann-Louise; Olesen, Jes

2012-01-01

Migraine with and without aura (MA and MO, respectively) have a strong genetic basis. Different approaches using linkage-, candidate gene- and genome-wide association studies have been explored, yielding limited results. This may indicate that the genetic component in migraine is due to rare...... variants; capturing these will require more detailed sequencing in order to be discovered. Next-generation sequencing (NGS) techniques such as whole exome and whole genome sequencing have been successful in finding genes in especially monogenic disorders. As the molecular genetics research progresses......, the technology will follow, rendering these approaches more applicable in the search for causative migraine genes in MO and MA. To date, no studies using NGS in migraine genetics have been published. In order to gain insight into the future possibilities of migraine genetics, we have looked at NGS studies...

Association Between Obesity and Migraine in Women.

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Pavlovic, Jelena M; Vieira, Julio R; Lipton, Richard B; Bond, Dale S

2017-08-25

Migraine is a common and highly disabling condition that is particularly prevalent among women and especially women of reproductive age. The tremendous rise in adiposity in the Western world has led to an epidemic of obesity in women. The particular effects of obesity on women with migraine of various ages are the focus of this review. Conflicting findings from various studies with different approaches and populations have made challenging definitive conclusions about associations between migraine and obesity. While the association between obesity and migraine frequency has been consistently demonstrated and obesity is considered a risk factor for progression from episodic to chronic migraine, the association between obesity and migraine prevalence is still somewhat debated and appears to be dependent on gender and age, with the most consistent effects observed in women younger than 55 years of age. Association between migraine and obesity is most commonly observed in women of reproductive age. The multimodal changes associated with age and hormonal change in women likely play a role in this relationship, as obesity does not appear to be related to migraine in women over 55 years of age. Future studies focusing on the migraine-obesity relationship in women should examine the effects of age, endogenous hormonal state, and exogenous hormones on migraine and obesity.

Sleep in Patients with Chronic Migraine.

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Yang, Chun-Pai; Wang, Shuu-Jiun

2017-09-01

The biological and pathophysiological interaction between sleep and chronic migraine (CM) remains to be fully elucidated. In this article, we provide a narrative review of the literature on sleep disturbance and CM, highlighting recent advances in sleep research and insights into mechanisms that could mediate a role of sleep disturbances in migraine chronification. We discuss the potential for cognitive-behavioral insomnia therapy (CBTi) as an intervention for CM with comorbid insomnia. Finally, we propose a model of the mechanisms underlying the interactions among sleep physiology, maladaptive migraine-coping behaviors, and coexisting factors which contribute to sleep disturbances in CM based on conceptual models used in sleep research. Insomnia is the most common sleep complaint among patients with CM. CM patients experience more frequent and severe insomnia symptoms than patients with episodic migraine (EM). It has been suggested that sleep disturbances may predispose individuals to migraine attacks, which may affect the pain-processing trigeminovascular system and thus play a role in migraine progression. Encouraging but limited evidence suggests that management of insomnia via behavioral sleep therapy may reverse CM to EM and possibly prevent migraine chronification. Migraine has a complex relationship with sleep. The use of objective sleep study such as polysomnographic microstructural sleep analysis and actigraphy could help connect sleep disturbances and processes related to CM. Future longitudinal studies should examine whether effective behavioral treatments such as CBTi can reverse migraine chronification.

Migraine Management During Menstruation and Menopause.

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MacGregor, E Anne

2015-08-01

Migraine is most prevalent in women during their reproductive years. An understanding of the effects of menstruation and menopause on migraine can enable neurologists to provide targeted and appropriate medical and hormonal strategies, enabling their patients to achieve better control of migraine and reduced disability. This article reviews the effects of hormonal events on migraine and summarizes the evidence-based options available for management. Estrogen "withdrawal" during the late luteal phase of the natural menstrual cycle and the hormone-free interval of combined hormonal contraceptives has long been implicated in the pathophysiology of menstrual migraine. However, more recent research suggests that other independent mechanisms may be relevant. Prostaglandin inhibitors used for management of dysmenorrhea are effective for associated menstrual migraine, suggesting a common pathophysiology. The interplay between serotonin and estrogen also deserves further research. Menstrual and perimenopausal migraine can be managed effectively using a variety of strategies, the choice of which depends on the efficacy of acute treatment, predictability and regularity of menstruation, use of contraception, and presence of menstrual disorders or perimenopausal vasomotor symptoms.

Migraine accompagnee: Clinical and neutroradiological findings

International Nuclear Information System (INIS)

Schaefer, E.M.

1981-01-01

This study analyses clinical data, EEC and X-ray findings of 102 stationary examined migraine patients, 62 of whom suffered from migraine accompagnee. Sex distribution, age at onset of disease, hereditary disease disposition and EEC findings largely correspond to the data given in literature. As it had been expected, the X-ray images of the skull and the cerebral angiographies performed in 46 patients suffering from migraine accompagnee did not show any pathological findings. The X-ray images were compared with those taken of patients without migraine anamnesis in order to detect non-pathologic variations. Neither differences in the intensity of vascular and diplovenous marking could be found in the native images of the skull nor any variations of the circle of Willisi. The dependency of the posterior cerebral artery on the carotid circulation existing in 41% of the migraine accompagnee does not lead to any particular alteration of the accompanying symptoms and signs. The idea is discussed to divide the migraine syndrome into simple, focal and complicated migraine on the basis of a uniform pathogenesis. (orig./MG) [de

Migraine pain location in adult patients from eastern India

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Chakravarty Ambar

2008-01-01

Full Text Available Background: Sparse literature documenting the location of pain at the onset of migraine attacks and during established headaches is available. Objectives: A prospective study (2003-05 on 800 adult migraine patients (International Classifications of Headache Disorders (ICHD, 2:1.1, 1.2.1 and 1.6.1 was conducted to document (a sites of onset of pain and (b location of pain during established attacks (in> 50% occasions through semistructured interviews. Results: Demography: N = 800; M:F = 144:656 (1:4.56; age, 16-42 years (mean, 26 years; duration of migraine, 1-18 years (mean, 6.8 years. 87% of the subjects were ethnic Bengalis from the eastern Indian state of West Bengal, Calcutta being the capital city. Migraine types (on the basis of> 50% headache spells: N = 800; 1.1:668 (83.5%; 1.2.1:18 (2.25%; 1.6.1:114 (14.25%. Location of pain at onset: Unilateral onset was present in 41.38% of the patients; of these, 53.17% had eye pain; 8.16%, frontal pain and 38.67%, temporal pain. In 32.25% of the patients, bilateral/central location of pain, mostly bitemporal or at vertex was noted. Cervico-occipital pain onset was noted in 26.43% patients (predominantly occipital, 14.68%; predominantly cervical, 11.75%. Location of established headaches: In 47.4% of the patients, with unilateral ocular or temporal onset, pain remained at the same site. Pain became hemicranial in 32.9%. In most patients, unilateral frontal onset pain (55.5% became bilateral or holocranial. Most bilateral ocular (69.4% and temporal onset (69.7% pains remained at the same location. However, most bifrontal (55.6% and vertex onset (56.9% pains subsequently became holocranial. Most occipital pains at onset became holocranial (45.3%, but cervical pains subsequently became either hemicranial (38.3% or holocranial (36.2%. Conclusions: This study documents location of pain at the onset and during established headaches in migraine patients largely from a specific ethnic group. Migraine with

Establishment of an Italian chronic migraine database: a multicenter pilot study.

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Barbanti, Piero; Fofi, L; Cevoli, S; Torelli, P; Aurilia, C; Egeo, G; Grazzi, L; D'Amico, D; Manzoni, G C; Cortelli, P; Infarinato, F; Vanacore, N

2018-05-01

To optimize chronic migraine (CM) ascertainment and phenotype definition, provide adequate clinical management and health care procedures, and rationalize economic resources allocation, we performed an exploratory multicenter pilot study aimed at establishing a CM database, the first step for developing a future Italian CM registry. We enrolled 63 consecutive CM patients in four tertiary headache centers screened with face-to-face interviews using an ad hoc dedicated semi-structured questionnaire gathering detailed information on life-style, behavioral and socio-demographic factors, comorbidities, and migraine features before and after chronicization and healthcare resource use. Our pilot study provided useful insights revealing that CM patients (1) presented in most cases symptoms of peripheral trigeminal sensitization, a relatively unexpected feature which could be useful to unravel different CM endophenotypes and to predict trigeminal-targeted treatments' responsiveness; (2) had been frequently admitted to emergency departments; (3) had undergone, sometime repeatedly, unnecessary or inappropriate investigations; (4) got rarely illness benefit exemption or disability allowance only. We deem that the expansion of the database-shortly including many other Italian headache centers-will contribute to more precisely outline CM endophenotypes, hence improving management, treatment, and economic resource allocation, ultimately reducing CM burden on both patients and health system.

Migraine, cerebrovascular disease and the metabolic syndrome

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Alexandra J Sinclair

2012-01-01

Full Text Available Evidence is emerging that migraine is not solely a headache disorder. Observations that ischemic stroke could occur in the setting of a migraine attack, and that migraine headaches could be precipitated by cerebral ischemia, initially highlighted a possibly association between migraine and cerebrovascular disease. More recently, large population-based studies that have demonstrated that migraineurs are at increased risk of stroke outside the setting of a migraine attack have prompted the concept that migraine and cerebrovascular disease are comorbid conditions. Explanations for this association are numerous and widely debated, particularly as the comorbid association does not appear to be confined to the cerebral circulation as cardiovascular and peripheral vascular disease also appear to be comorbid with migraine. A growing body of evidence has also suggested that migraineurs are more likely to be obese, hypertensive, hyperlipidemic and have impaired insulin sensitivity, all features of the metabolic syndrome. The comorbid association between migraine and cerebrovascular disease may consequently be explained by migraineurs having the metabolic syndrome and consequently being at increased risk of cerebrovascular disease. This review will summarise the salient evidence suggesting a comorbid association between migraine, cerebrovascular disease and the metabolic syndrome.

Brain stimulation in migraine.

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Brighina, Filippo; Cosentino, Giuseppe; Fierro, Brigida

2013-01-01

Migraine is a very prevalent disease with great individual disability and socioeconomic burden. Despite intensive research effort in recent years, the etiopathogenesis of the disease remains to be elucidated. Recently, much importance has been given to mechanisms underlying the cortical excitability that has been suggested to be dysfunctional in migraine. In recent years, noninvasive brain stimulation techniques based on magnetic fields (transcranial magnetic stimulation, TMS) and on direct electrical currents (transcranial direct current stimulation, tDCS) have been shown to be safe and effective tools to explore the issue of cortical excitability, activation, and plasticity in migraine. Moreover, TMS, repetitive TMS (rTMS), and tDCS, thanks to their ability to interfere with and/or modulate cortical activity inducing plastic, persistent effects, have been also explored as potential therapeutic approaches, opening an interesting perspective for noninvasive neurostimulation for both symptomatic and preventive treatment of migraine and other types of headache. In this chapter we critically review evidence regarding the role of noninvasive brain stimulation in the pathophysiology and treatment of migraine, delineating the advantages and limits of these techniques together with potential development and future application. © 2013 Elsevier B.V. All rights reserved.

Acute treatment of migraine headaches.

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Taylor, Frederick R

2010-04-01

Optimum acute treatment of migraine requires prevention of headache as a top priority. Recognition of the multitude of migraine presentations, the frequency of total headache attacks, and number of days of headache disability are critical. Successful treatment requires excellent patient-clinician communication enhancing confidence and mutual trust based on patient needs and preferences. Optimum management of acute migraine nearly always requires pharmacologic treatment for rapid resolution. Migraine-specific triptans, dihydroergotamine, and several antiinflammatories have substantial empirical clinical efficacy. Older nonspecific drugs, particularly butalbital and opioids, contribute to medication overuse headache and are to be avoided. Clinicians should utilize evidence-based acute migraine-specific therapy stressing the imperative acute treatment goal of early intervention, but not too often with the correct drug, formulation, and dose. This therapy needs to provide cost-effective fast results, meaningful to the patient while minimizing the need for additional drugs. Migraine-ACT evaluates 2-hour pain freedom with return to normal function, comfort with treatment, and consistency of response. Employ a thoroughly educated patient, formulary, testimonials, stratification, and rational cotherapy against the race to central sensitization for optimum outcomes. Thieme Medical Publishers.

Bariatric Surgery Promising in Migraine Control: a Controlled Trial on Weight Loss and Its Effect on Migraine Headache.

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Razeghi Jahromi, Soodeh; Abolhasani, Maryam; Ghorbani, Zeinab; Sadre-Jahani, Solmaz; Alizadeh, Zahra; Talebpour, Mohammad; Meysamie, Alipasha; Togha, Mansoureh

2018-01-01

There is evidence that substantial weight loss through bariatric surgery (BS) may result in short-term improvement of migraine severity. However, it still remains to be seen whether smaller amounts of weight loss have a similar effect on migraine headache. This study has been designed to compare the effects of weight reduction through BS and non-surgical modifications. Migraine characteristics were assessed at 1 month before (T0), 1 month (T1), and 6 months (T2) after BS (vertical sleeve gastrectomy (VSG) (n = 25) or behavioral therapy (BT) (n = 26) in obese women (aged 18-60 years) with migraine headache. Migraine was diagnosed using the International Classification of Headache Disorders (ICHDIIβ) criteria. There was significant reduction in the visual analog scale (VAS) from the baseline to T1 and T2 in both groups. The number of migraine-free days showed a significant increase within each group (p migraine characteristics, age, changes in weight, BMI, body fat, and fat-free mass from T0 to T2, the BS group showed statistically significant lower VAS and duration of migraine attacks and a significantly higher number of migraine-free days than the BT group at T1 and T2 (p ≤ 0.028). Our results indicated that far before significant weight reduction after BS (VSG), there was marked alleviation in the severity and duration of migraine and a significant increase in the number of migraine-free days in obese female migraineurs. However, the effects in the BT group were not comparable with the effects in the BS group.

Experience of Surgical Treatment for Occipital Migraine in Taiwan.

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Lin, Shang-Hsi; Lin, Huwang-Chi; Jeng, Chu-Hsu; Hsieh, Cheng-Han; Lin, Yu-Hsien; Chen, Cha-Chun

2016-03-01

Refractory migraine surgery developed since 2003 has excellent results over the past 10 years. According to the pioneer of migraine surgery, Dr. Bahman Guyuron, 5 major surgical classifications of migraines are described in the field of plastic surgery, namely, frontal migraine, temporal migraine, rhinogenic migraine, occipital migraine, and auriculotemporal migraine. In this study, we present the preliminary surgical results of the occipital migraine surgery. A total of 22 patients with simple occipital migraines came to our outpatient clinic for help from June 2014 to February 2015. Thirteen cases were excluded owing to ineligibility for operation or other reasons. The patients who concurrently experienced other types of migraines were precluded even if they received combined migraine surgery. Therefore, 9 simple occipital migraine cases were enrolled in this study. Migraine severity was evaluated by uniform questionnaires to identify the source of migraine. Neurolysis was performed under general anesthesia, with the patient in a prone position. Postoperative conditions were evaluated at the second, fourth, sixth, and eighth weeks by posttreatment questionnaires. Of all the 9 patients, 5 experienced single-sided migraines of greater occipital nerve origin (2 left-sided and 3 right-sided cases). Two patients had bilateral migraines of greater occipital nerve origin, and unilateral right lesser occipital nerve origin was noted in one patient. The last patient had right-sided migraines of greater and lesser occipital nerve origin. As a result in the follow-up, a response rate greater than 90% was documented, and complete resolution was observed in 2 patients. Drug doses were reduced more than 50% in the remaining patients. The overall efficacy of occipital migraine surgery in this study was 88.8% (8/9 cases). Some patients with migraine are good candidates for surgical resolution with appropriate and meticulous selection. Similar to what is observed in Western

Synesthesia and Migraine: Case Report

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Alstadhaug Karl B

2010-12-01

Full Text Available Abstract Background Synesthesia is, as visual migraine aura, a common and fascinating perceptual phenomenon. Here we present a unique case with synesthesias exclusively during visual migraine auras. Case presentation A 40-year-old woman with a cyclic mood disorder had suffered from migraine with visual aura for several years. On several occasions she had experienced "mixing of senses" during the aura phase. Staring at strong bright light she could experience intense taste of lemon with flow from the salivary glands. Conclusion Acquired synesthesia, exclusively coincident with migraine aura, gives support to the idea of an anomalous cortical processing underlying the phenomenon.

Prevention for Pediatric and Adolescent Migraine.

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Hickman, Carolyn; Lewis, Kara Stuart; Little, Robert; Rastogi, Reena Gogia; Yonker, Marcy

2015-01-01

Children and adolescents can experience significant disability from frequent migraine. A number of tools have been developed to help quantify the impact of migraine in this population. Many preventative medications used in adults are routinely used to prevent migraines in children, although there has been less rigorous study. This article reviews the indications and evidence for the use of migraine preventatives, such as antidepressants, antihypertensives, anticonvulsants, antihistamines, and botulinum toxin, in this population. © 2015 American Headache Society.

Migraine headaches among university students using id migraine test as a screening tool

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Caylan Ayse

2011-08-01

Full Text Available Abstract Background Migraine is a significant health problem, especially for the young people, due to its frequency and accompanying morbidity, causing disability and loss of performance. In this study, our aim was to determine the prevalence of migraine headaches among university students in Edirne, a Turkish city. Methods In this cross-sectional and descriptive study, study population was composed of students registered to Trakya University in the academic year of 2008-2009. Out of these, 3694 of them accepted to participate. Participants who had two or more headaches in the last 3 months formed the headache group. Afterwards, two preliminary questions were applied to the headache group and participants with at least one affirmative response were asked to perform the validated ID-Migraine™ test. Results The mean age of 3694 students participated in the study was 19.23 ± 1.84 (17-39 years, with adolescents:adult ratio being 2.5:1. 1613 students (43.7% did have at least two headaches in the last three months. Migraine-type headache was detected in 266 subjects (7.2% based on the ID-Migraine™ test. Of the migraine group, 72 were male (27.1% and 194 were female (72.9%. There was no significant difference in migraine prevalence between adolescent and adult age groups. Conclusions With a prevalence similar to adults, primary care physicians should be aware of the probability of migraine headaches in university students in order to maintain a successful school performance.

Migraine symptomatology and major depressive disorder

NARCIS (Netherlands)

Ligthart, Lannie; Penninx, Brenda; Nyholt, Dale R.; Distel, Marijn A.; de Geus, Eco J. C.; Willemsen, Gonneke; Smit, Johannes H.; Boomsma, Dorret I.

Introduction and objective: Migraine and major depressive disorder (MDD) frequently co-occur, but it is unclear whether depression is associated with a specific subtype of migraine. The objective of this study was to investigate whether migraine is qualitatively different in MDD patients (N = 1816)

Food insecurity and migraine in Canada.

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Dooley, Joseph M; Gordon, Kevin E; Kuhle, Stefan

2016-09-01

The aim of this study was to examine the prevalence of household food insecurity in individuals reporting migraine within a large population-based sample of Canadians. The Canadian Community Health Survey (CCHS) uses a stratified cluster sample design to obtain information on Canadians ≥12 years of age. Data on household food insecurity were assessed for individuals who reported having migraine or not, providing a current point prevalence. This was assessed for stability in two CCHS datasets from four and eight years earlier. Factors associated with food insecurity among those reporting migraine were examined and a logistic regression model of food insecurity was developed. We also examined whether food insecurity was associated with other reported chronic health conditions. Of 48,645 eligible survey respondents, 4614 reported having migraine (weighted point prevalence 10.2%). Food insecurity was reported by 14.8% who reported migraine compared with 6.8% of those not reporting migraine, giving an odds ratio of 2.4 (95% confidence interval 2.0-2.8%). This risk estimate was stable over the previous eight years. The higher risk for food insecurity was not unique to migraine and was seen with some, but not all, chronic health conditions reported in the CCHS. Food insecurity is more frequent among individuals reporting migraine in Canada. © International Headache Society 2015.

Optical Coherence Tomography in Patients with Chronic Migraine: Literature Review and Update

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Francisco J. Ascaso

2017-12-01

Full Text Available Migraine is a chronic disease characterized by unilateral, pulsating, and often moderate-to-severe recurrent episodes of headache with nausea and vomiting. It affects approximately 15% of the general population, yet the underlying pathophysiological mechanisms are not fully understood. Optical coherence tomography (OCT is a safe and reproducible diagnostic technique that utilizes infrared wavelengths and has a sensitivity of 8–10 μm. It can be used to measure thinning of the retinal nerve fiber layer (RNFL in some neurological disorders. Although ophthalmologists are often the first specialists to examine patients with migraine, few studies have addressed the involvement of the optic nerve and retino-choroidal structures in this group. We reviewed the literature on the etiological and pathological mechanisms of migraine and the relationship between recurrent constriction of cerebral and retrobulbar vessels and ischemic damage to the optic nerve, retina, and choroid. We also assessed the role of OCT for measuring peripapillary RNFL thickness and macular and choroidal changes in migraine patients. There is considerable evidence of cerebral and retrobulbar vascular involvement in the etiology of migraine. Transitory and recurrent constriction of the retinal and ciliary arteries may cause ischemic damage to the optic nerve, retina, and choroid in patients with migraine. OCT to assess the thickness of the peripapillary RNFL, macula, and choroid might increase our understanding of the pathophysiology of migraine and facilitate diagnosis of retino-choroidal compromise and follow-up of therapy in migraine patients. Future studies should determine the usefulness of OCT findings as a biomarker of migraine.

Migraine: Clinical pattern and psychiatric comorbidity

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Manjeet Singh Bhatia

2012-01-01

Full Text Available Background: Migraine is a common disorder which has psychiatric sequelae. Objective: The objective of this study was to determine the clinical pattern and psychiatric comorbidity of migraine. Materials and Methods: 100 cases of migraine seen over a period of one year were analysed to know the sociodemographic characteristics, clinical pattern and psychiatric morbidity. Results: Maximum patients were between 31-40 years of age group (40%, females (78.0%, married (76% and housewives (56.0%. Family history of migraine was present in 12% cases. Average age of onset was 22 years. Unilateral and throbbing type of headache was most common. The commonest frequency was one to two per week. Migraine without aura was commonest sub-type (80%. Generalized anxiety disorder (F41.1 was the most common psychiatric disorder (34%, followed by mixed anxiety and depressive disorder (F41.2 (18% and depressive episode (F32 (14%. In 22% cases, no psychiatric disorder could be elicited. Conclusion: The present study confirms that majority patients with migraine had psychiatric disorders. This needs timely detection and appropriate intervention to treat and control the migraine effectively.

Patients' preference in migraine

NARCIS (Netherlands)

Dekker, François (Frans)

2014-01-01

This thesis is about migraine. Three elements are discussed. First element is preventive treatment, second element is attack treatment and the third part focuses on medication overuse headache. The preventive treatment of migraine is a valuable intervention in primary care. If preventive treatment

Migraine and brain changes

NARCIS (Netherlands)

Meinders, I.H.

2018-01-01

This thesis describes the longitudinal population-based CAMERA-study on the association between migraine and brain changes (e.g. white matter hyperintensities, infarct-like and other lesions) and possible causes and consequences of those brain changes. Women with migraine showed higher incidence of

Management of Pediatric Migraine: Current Therapies.

Science.gov (United States)

Khrizman, Marina; Pakalnis, Ann

2018-02-01

Migraine is one of the most common neurologic conditions in pediatrics. It can be a significant stressor, causing absences from school and interruption of parents' work and family schedules. The mainstay of treatment remains educating patients about healthy lifestyle practices and the influences of sleep, stressors, and hydration on triggering migraine attacks. Psychological therapies such as biofeedback or cognitive-behavioral therapy may be beneficial in some patients, especially those with prominent psychological comorbidities. New advances in the pathophysiology of migraine and additional pediatric approval of abortive therapy with triptans have led to significant advances in the management of migraine in children. Some challenges to preventive therapy were recently noted with the negative results obtained in the Childhood and Adolescent Migraine Prevention Study, which compared prescription drugs to placebo. Inherent differences between adult and pediatric headaches, with shorter duration of pediatric migraine and prominent placebo effect, present recurring challenges for clinicians. [Pediatr Ann. 2018;47(2):e55-e60.]. Copyright 2018, SLACK Incorporated.

Migraine among medical students in Kuwait University.

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Al-Hashel, Jasem Y; Ahmed, Samar Farouk; Alroughani, Raed; Goadsby, Peter J

2014-05-10

Medical students routinely have triggers, notably stress and irregular sleep, which are typically associated with migraine. We hypothesized that they may be at higher risk to manifest migraine. We aimed to determine the prevalence of migraine among medical students in Kuwait University. This is cross-sectional, questionnaire-based study. Participants who had two or more headaches in the last 3 months were subjected to two preliminary questions and participants with at least one positive response were asked to perform the validated Identification of Migraine (ID Migraine™) test. Frequency of headache per month and its severity were also reported. Migraine headache was suggested in 27.9% subjects based on ID-Migraine™. Migraine prevalence (35.5% and 44%, versus 31.1%, 25%, 21.1%, 14.8%, 26.5%, p Kuwait University compared to other published studies. The migraine prevalence, frequency and headache severity, all increased in the final two years of education.

Arterial responses during migraine headache

DEFF Research Database (Denmark)

Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J

1990-01-01

The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed...... that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than between attacks. The generalised vasoconstriction was not shared by the temporal artery on the affected...... side, which suggests a local vasodilatory response. The findings suggest that cephalic arteries may play a role in migraine pathogenesis....

Migraine, vertigo and migrainous vertigo: Links between vestibular and pain mechanisms.

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Balaban, Carey D

2011-01-01

This review develops the hypothesis that co-morbid balance disorders and migraine can be understood as additive effects of processing afferent vestibular and pain information in pre-parabrachial and pre-thalamic pathways, that have consequences on cortical mechanisms influencing perception, interoception and affect. There are remarkable parallel neurochemical phenotypes for inner ear and trigeminal ganglion cells and these afferent channels appear to converge in shared central pathways for vestibular and nociceptive information processing. These pathways share expression of receptors targeted by anti-migraine drugs. New evidence is also presented regarding the distribution of serotonin receptors in the planum semilunatum of the primate cristae ampullaris, which may indicate involvement of inner ear ionic homeostatic mechanisms in audiovestibular symptoms that can accompany migraine.

CBT for Pediatric Migraine: A Qualitative Study of Patient and Parent Experience.

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Kroon Van Diest, Ashley M; Ernst, Michelle M; Vaughn, Lisa; Slater, Shalonda; Powers, Scott W

2018-03-08

The goal of this study was to determine which cognitive behavioral therapy (CBT-HA) treatment components pediatric headache patient stakeholders would report to be most helpful and essential to reducing headache frequency and related disability to develop a streamlined, less burdensome treatment package that would be more accessible to patients and families. Pediatric migraine is a prevalent and disabling condition. CBT-HA has been shown to reduce headache frequency and related disability, but may not be readily available or accepted by many migraine sufferers due to treatment burden entailed. Research is needed to determine systematic ways of reducing barriers to CBT-HA. Qualitative interviews were conducted with 10 patients and 9 of their parents who had undergone CBT-HA. Interviews were analyzed using an inductive thematic analysis approach based upon modified grounded theory. Patients were 13-17.5 years of age (M = 15.4, SD = 1.63) and had undergone CBT-HA ∼1-2 years prior to participating in the study. Overall, patients and their parents reported that CBT-HA was helpful in reducing headache frequency and related disability. Although patients provided mixed reports on the effectiveness of different CBT-HA skills, the majority of patients indicated that the mind and body relaxation skills of CBT-HA (deep breathing, progressive muscle relaxation, and activity pacing in particular) were the most helpful and most frequently used skills. Patients and parents also generally reported that treatment was easy to learn, and noted at least some aspect of treatment was enjoyable. Results from these qualitative interviews indicate that mind and body CBT-HA relaxation skills emerged as popular and effective based on patient and parent report. Future research examining the effectiveness of streamlined pediatric migraine nonpharmacological interventions should include these patient-preferred skills. © 2018 American Headache Society.

Hair Transplantation in Migraine Headache Patients.

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Ors, Safvet

2017-09-01

Migraine headache is a primary neurologic disease affecting millions of people worldwide. As a consequence, quality of life is diminished, productivity suffers (through loss of work force), and treatment costs are substantial. The occurrence rate in the general population is quite high, with women accounting for 3 of every 4 cases. Between January 2011 and May 2012, a total of 221 patients received hair transplants. Another 590 patients underwent hair transplantation between June 2012 and December 2016. Initially (first interval), patients were not questioned on migraine headaches in preoperative visits, but questioning was regularly done thereafter. Overall, 150 patients given transplants in the first period were surveyed by phone regarding preoperative migraine headaches. Aside from the 1 incidental discovery, no other instances of migraine emerged. Headache origins were occipital-frontal in 2 patients, occipital-temporal in 2 patients, and occipital-temporal-frontal in the 2 others. Donor/receiver areas in hair transplantation and migraine trigger zones shared locations. Headache frequencies ranged from 4 to 8 days per month (average, 6 days), and pain scores were 5-8 (10 being highest). Duration of pain was 3-5 hours (average, 4 hours). All six patients had used various medications, such as triptans, ergot, and nonsteroidal anti-inflammatory drugs, before hair transplantation. The 1 female patient was a 32-year-old seeking treatment for alopecia, with a 6-year history of migraine headaches. The male patients presenting with androgenetic alopecia (grade 4-5 by Norwood classification) had 6- to 20-year migrainous histories. After hair transplantation, each migraine sufferer was checked once in the first month and then once every 3 months. Those who could not appear in person after the first year were evaluated by phone every 3 months. Migraine headaches had ceased in all 6 patients, none of whom used medical treatments for migraines thereafter. The postoperative

Acid-sensing ion channels and migraine

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Yu-qi KANG

2015-09-01

Full Text Available Acid-sensing ion channels (ASICs are ligand-gated ion channels that are activated by extracellular protons (H+, which belong to epithelial sodium channels/degenerin (ENaC/DEG superfamily. ASICs are widely distributed in central nervous system, peripheral nervous system, digestive system and some tumor tissues. Different ASIC subunits play important roles in various pathophysiological processes such as touch, sour taste, learning and memory, including inflammation, ischemic stroke, pain, learning and memory decline, epilepsy, multiple sclerosis (MS, migraine, irritable bowel syndrome and tumor. Research over the last 2 decades has achieved substantial advances in migraine pathophysiology. It is now largely accepted that inflammatory pathways play a key role and three main events seem to take place: cortical spreading depression (CSD, activation of the trigeminovascular system (i.e. dural nociceptors, peripheral and central sensitization of this pain pathway. However, the exact mechanisms that link these three events to each other and to inflammation have so far remained to be studied. This article takes an overview of newly research advances in structure, distribution and the relationship with migraine of ASICs.  DOI: 10.3969/j.issn.1672-6731.2015.09.013

The quality of diagnosis and management of migraine and tension-type headache in three social groups in Russia.

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Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V; Olesen, Jes

2017-03-01

Background Three successive editions of the International Classification of Headache Disorders and multiple guideline papers on headache care have described evidence based diagnosis and treatment of headache disorders. It remains unknown, however, to which extent this has improved the diagnosis and management of headache. That was the aim of our study in which we also analysed differences between three social groups in Russia. Methods We studied 1042 students (719 females, 323 males, mean age 20.6, age range 17-40), 1075 workers (146 females, 929 males, mean age 40.4, age range 21-67) and 1007 blood donors (484 females, 523 males, mean age 34.1, age range 18-64). We conducted a semi-structured, validated, face-to-face professional interview. Data on prevalence and associated factors have previously been published. A section of the interview focused on previous diagnosis and treatment, the topic of this paper. Results Only 496 of 2110 participants (23%) with headache in Russia had consulted because of headache. Students consulted more frequently (35%), workers and blood donors less often (13% and 14%). Only 12% of the patients with ICHD-3beta diagnosis of migraine and 11.7% with ICHD-3beta diagnosis of tension-type headache (TTH) had previously been correctly diagnosed. Triptans were used by only 6% of migraine patients. Only 0.4% of migraine patients and no TTH patients had received prophylactic treatment. Conclusion Despite existing guidelines about diagnosis and treatment, both remain poor in Russia. According to the literature this is only slightly better in Europe and America. Dissemination of existing knowledge should have higher priority in the future.

Magnetic resonance spectroscopy studies in migraine

Energy Technology Data Exchange (ETDEWEB)

Montagna, P.; Cortelli, P.; Barbiroli, B. (Inst. of Medical Pathology, Univ. of Bologna (Italy))

1994-06-01

The authors describe the method of [sup 31]phosphorus magnetic resonance spectroscopy and review the results when it is applied to the study of brain and muscle energy metabolism in migraine subjects. Brain energy metabolism appears to be abnormal in all major subtypes of migraine when measured both during and between attacks. Impaired energy metabolism is also documented in skeletal muscle. It is suggested that migraine is associated with a generalized disorder of mitochondrial oxidative phosphorylation and that this may constitute a threshold for the triggering of migraine attacks. 47 refs., 10 figs., 3 tabs.

Selectivity in Genetic Association with Sub-classified Migraine in Women

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Chasman, Daniel I.; Anttila, Verneri; Buring, Julie E.; Ridker, Paul M.; Schürks, Markus; Kurth, Tobias

2014-01-01

Migraine can be sub-classified not only according to presence of migraine aura (MA) or absence of migraine aura (MO), but also by additional features accompanying migraine attacks, e.g. photophobia, phonophobia, nausea, etc. all of which are formally recognized by the International Classification of Headache Disorders. It remains unclear how aura status and the other migraine features may be related to underlying migraine pathophysiology. Recent genome-wide association studies (GWAS) have identified 12 independent loci at which single nucleotide polymorphisms (SNPs) are associated with migraine. Using a likelihood framework, we explored the selective association of these SNPs with migraine, sub-classified according to aura status and the other features in a large population-based cohort of women including 3,003 active migraineurs and 18,108 free of migraine. Five loci met stringent significance for association with migraine, among which four were selective for sub-classified migraine, including rs11172113 (LRP1) for MO. The number of loci associated with migraine increased to 11 at suggestive significance thresholds, including five additional selective associations for MO but none for MA. No two SNPs showed similar patterns of selective association with migraine characteristics. At one extreme, SNPs rs6790925 (near TGFBR2) and rs2274316 (MEF2D) were not associated with migraine overall, MA, or MO but were selective for migraine sub-classified by the presence of one or more of the additional migraine features. In contrast, SNP rs7577262 (TRPM8) was associated with migraine overall and showed little or no selectivity for any of the migraine characteristics. The results emphasize the multivalent nature of migraine pathophysiology and suggest that a complete understanding of the genetic influence on migraine may benefit from analyses that stratify migraine according to both aura status and the additional diagnostic features used for clinical characterization of

Prevalence of neck pain in migraine and tension-type headache: a population study.

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Ashina, Sait; Bendtsen, Lars; Lyngberg, Ann C; Lipton, Richard B; Hajiyeva, Nazrin; Jensen, Rigmor

2015-03-01

We assessed the prevalence of neck pain in the population in relation to headache. In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted OR 3.0, 95% CI 2.0-4.4, pneck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) (pneck pain had higher TTS than individuals without neck pain (15.1±10.5 vs. 8.4±8.0, pNeck pain is highly prevalent in the general population and even more prevalent in individuals with primary headaches. Prevalence is highest in coexistent M+TTH, followed by pure TTH and migraine. Myofascial tenderness is significantly increased in individuals with neck pain. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Management of migraine in adolescents

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Marielle A Kabbouche

2008-06-01

Full Text Available Marielle A Kabbouche1,2, Deborah K Gilman31Department of Pediatrics, Department of 2Neurology, Cincinnati Children’s Hospital Medical Center; 3Department of Psychology, Columbus Children’s Hospital, OH, USAAbstract: Headaches in children and adolescents are still under-diagnosed. 75% of children are affected by primary headache by the age of 15 with 28% fitting the ICHD2 criteria of migraine. Migraine is considered a chronic disorder that can severely impact a child’s daily activities, including schooling and socializing. Early recognition and aggressive therapy, with acute and prophylactic treatments, as well as intensive biobehavioral interventions, are essential to control the migraine attacks and reverse the progression into intractable disabling headache.Keywords: migraine, children, adolescents, headache, biofeedback

Neurophysiology of visual aura in migraine

International Nuclear Information System (INIS)

Shibata, Koichi

2007-01-01

Visual processing in migraine has been targeted because the visual symptoms that are commonly associated with attack, either in the form of aura or other more subtle symptoms, indicate that the visual pathways are involved in migrainous pathophysiology. The visual aura of the migraine attack has been explained by the cortical spreading depression (CSD) of Leao, neuroelectric event beginning in the occipital cortex and propagating into contiguous brain region. Clinical observations suggest that hyperexcitability occurs not only during the attack, typically in the form of photophobia, but also between attacks. Numerous human neuroimaging, neurophysiological and psychophysical studies have identified differences in cortical visual processing in migraine. The possibility of imaging the typical visual aura with BOLD functional MRI has revealed multiple neurovascular events in the occipital cortex within a single attack that closely resemble CSD. As transient synchronized neuronal excitation precedes CSD, changes in cortical excitability underlie the migraine attack. Independent evidence for altered neuronal excitability in migraineurs between attacks emerges from visual evoked potentials (VEPs) and transcranial magnetic stimulation (TMS), recordings of cortical potentials and psychophysics. Recently, both TMS and psychophysical studies measuring visual performance in migraineurs have used measures which presumably measure primary visual (V1) and visual association cortex. Our VEP and blink reflex study showed that migraine patients exhibiting allodynia might show central sensitization of braistem trigeminal neuron and had contrast modulation dysfunction during the cortical visual processing of V1 and visual association cortex in-between attacks. In pathophysiology of migraine, these neurophysiological and psychophysical studies indicate that abnormal visual and trigeminal hyperexcitability might persist between migraine attacks. The influence of migraine on cortical

Evaluation of a Workplace-Based Migraine Education Program.

Science.gov (United States)

Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; McCluskey, Maureen; Erickson, Denise; Schultz, Alyssa B

2016-08-01

Migraine affects approximately 10% of working-age adults and is associated with increased health care costs, absenteeism, and presenteeism in the workplace. A migraine education program was offered to United States employees of a global financial services organization. Two hundred forty three employees (46% response rate) completed both a baseline and 6-month follow-up migraine questionnaire. The program included webinars, E-mailed educational tips, and intranet-based resources. No change was found in the frequency of migraines but improvements were observed in the severity, workdays missed, effectiveness at work during migraine, and work/activity limitations. Participants reported taking action to identify and reduce migraine triggers. A worksite disease education program for migraine headache has the potential to significantly impact lost productivity and absenteeism for migraineurs.

Symptom dimensions of affective disorders in migraine patients.

Science.gov (United States)

Louter, M A; Pijpers, J A; Wardenaar, K J; van Zwet, E W; van Hemert, A M; Zitman, F G; Ferrari, M D; Penninx, B W; Terwindt, G M

2015-11-01

A strong association has been established between migraine and depression. However, this is the first study to differentiate in a large sample of migraine patients for symptom dimensions of the affective disorder spectrum. Migraine patients (n=3174) from the LUMINA (Leiden University Medical Centre Migraine Neuro-analysis Program) study and patients with current psychopathology (n=1129), past psychopathology (n=477), and healthy controls (n=561) from the NESDA (Netherlands Study of Depression and Anxiety) study, were compared for three symptom dimensions of depression and anxiety. The dimensions -lack of positive affect (depression specific); negative affect (nonspecific); and somatic arousal (anxiety specific)- were assessed by a shortened adaptation of the Mood and Anxiety Symptom Questionnaire (MASQ-D30). Within the migraine group, the association with migraine specific determinants was established. Multivariate regression analyses were conducted. Migraine patients differed significantly (pmigraine patients were predominantly similar to the past psychopathology group. For the somatic arousal dimension, migraine patients scores were more comparable with the current psychopathology group. Migraine specific determinants for high scores on all dimensions were high frequency of attacks and cutaneous allodynia during attacks. This study shows that affective symptoms in migraine patients are especially associated with the somatic arousal component. Copyright © 2015 Elsevier Inc. All rights reserved.

Migraine induced by hypoxia

DEFF Research Database (Denmark)

Arngrim, Nanna; Schytz, Henrik Winther; Britze, Josefine

2016-01-01

in the visual cortex were measured by proton magnetic resonance spectroscopy. The circumference of cranial arteries was measured by 3 T high-resolution magnetic resonance angiography. Hypoxia induced migraine-like attacks in eight patients compared to one patient after sham (P = 0.039), aura in three...... and possible aura in 4 of 15 patients. Hypoxia did not change glutamate concentration in the visual cortex compared to sham, but increased lactate concentration (P = 0.028) and circumference of the cranial arteries (P ... suggests that hypoxia may provoke migraine headache and aura symptoms in some patients. The mechanisms behind the migraine-inducing effect of hypoxia should be further investigated....

Migraine attacks the Basal Ganglia

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Bigal Marcelo

2011-09-01

Full Text Available Abstract Background With time, episodes of migraine headache afflict patients with increased frequency, longer duration and more intense pain. While episodic migraine may be defined as 1-14 attacks per month, there are no clear-cut phases defined, and those patients with low frequency may progress to high frequency episodic migraine and the latter may progress into chronic daily headache (> 15 attacks per month. The pathophysiology of this progression is completely unknown. Attempting to unravel this phenomenon, we used high field (human brain imaging to compare functional responses, functional connectivity and brain morphology in patients whose migraine episodes did not progress (LF to a matched (gender, age, age of onset and type of medication group of patients whose migraine episodes progressed (HF. Results In comparison to LF patients, responses to pain in HF patients were significantly lower in the caudate, putamen and pallidum. Paradoxically, associated with these lower responses in HF patients, gray matter volume of the right and left caudate nuclei were significantly larger than in the LF patients. Functional connectivity analysis revealed additional differences between the two groups in regard to response to pain. Conclusions Supported by current understanding of basal ganglia role in pain processing, the findings suggest a significant role of the basal ganglia in the pathophysiology of the episodic migraine.

Epidemiologic and Clinical Characteristics of Migraine and Tension-Type Headaches among Hospitals Staffs of Shiraz (Iran

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Ayatollahi Seyyed Mohammad Taghi

2009-05-01

Full Text Available Headache is a common symptom that constitutes a major health problem to all countries in the world. This study was conducted to estimate the prevalence of migraine and tension -type headaches(TTH, its associated occupational risk factors among Shiraz hospitals staffs, and to report on clinical characteristics of migraine and TTH with using the International Headache Society (IHS diagnosis criteria. A random sample of 1023 staffs constituting a 20% sample of the hospitals staff population was selected. Sampling method was categorical random sampling. Within each group sampling was carried out systematically. Data were collected by screening questionnaire followed by clinical interviews, general physical and neurological examination, and diagnostic criteria of IHS. Prevalence of migraine, TTH and coexisting migraine and TTH were estimated as 11.2% (115 cases, 19.5% (199 subjects and 3.2% (33 subjects respectively. In this study , clinical characteristics of headache including type, site, number , intensity ,concomitant symptom of headaches had been surveyed. TTH and migraine headaches were significantly associated with self reported abnormal sleep pattern and female gender (P < 0.001. Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly (P<0.026. The average of prevalence of migraine and TTH were lower than their counter parts in western countries but higher than previous studies conducted in other Asian countries. Clinical characteristics were almost parallel with IHS criteria, headache- related missed work rates were higher for subjects with migraine headache, and also TTH and migraine were separate disorders and were not as a part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.

Prednisolone reduces nitric oxide-induced migraine

DEFF Research Database (Denmark)

Tfelt-Hansen, P; Daugaard, D; Lassen, L H

2009-01-01

BACKGROUND AND PURPOSE: Glyceryl trinitrate (GTN) induces delayed migraine attacks in migraine patients. The purpose of this study was to investigate whether pre-treatment with prednisolon could decrease this effect of GTN. METHODS: In this double-blind, randomized and placebo-controlled, crossover...... study 15 migraineurs with migraine without aura were pre-treated with 150 mg of prednisolone or placebo followed by a 20-min infusion of GTN (0.5 ug/kg/min). One hour after the GTN-infusion, the participants were sent home, but continued to rate headache and possible associated symptoms by filling out...... a headache diary every hour for 12 h. There were two equal primary efficacy end-points: frequency of delayed migraine and intensity of delayed headache. RESULTS: Nine patients experienced a GTN headache fulfilling the diagnostic criteria for migraine without aura on the placebo day compared with four...

Prostaglandins and prostaglandin receptor antagonism in migraine

DEFF Research Database (Denmark)

Antonova, Maria

2013-01-01

Human models of headache may contribute to understanding of prostaglandins' role in migraine pathogenesis. The current thesis investigated the migraine triggering effect of prostaglandin E2 (PGE2) in migraine patients without aura, the efficacy of a novel EP4 receptor antagonist, BGC20....... The infusion of PGE2 caused the immediate migraine-like attacks and vasodilatation of the middle cerebral artery in migraine patients without aura. The highly specific and potent EP4 receptor antagonist, BGC20-1531, was not able to attenuate PGE2-induced headache and vasodilatation of both intra- and extra......-cerebral arteries. The intravenous infusion of PGF2α did not induce headache or statistically significant vasoconstriction of cerebral arteries in healthy volunteers. Novel data on PGE2-provoked immediate migraine-like attacks suggest that PGE2 may be one of the important final products in the pathogenesis...

Association between migraine, lifestyle and socioeconomic factors

DEFF Research Database (Denmark)

Le, Han; Tfelt-Hansen, Peer; Skytthe, Axel

2011-01-01

or studying. The risk was increased for men compared to women in subjects with heavy physical exercise, intake of alcohol, and body mass index >25. Migraine was associated with several lifestyle and socioeconomic factors. Most associations such as low education and employment status were probably due......To investigate whether sex-specific associations exist between migraine, lifestyle or socioeconomic factors. We distinguished between the subtypes migraine with aura (MA) and migraine without aura (MO). In 2002, a questionnaire containing validated questions to diagnose migraine and questions...... on lifestyle and socioeconomic factors was sent to 46,418 twin individuals residing in Denmark. 31,865 twin individuals aged 20-71 were included. The twins are representative of the Danish population with regard to migraine and other somatic diseases and were used as such in the present study. An increased...

Commonly Used Acute Migraine Treatments

Science.gov (United States)

... impact during MHAM What is Migraine and Headache Awareness Month? June is Migraine and Headache Awareness Month, ... approved last week, which is called erenumab, the brand name of which is Aimovig, is a monoclonal ...

Migraine

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... Certain foods and food additives such as Alcohol Chocolate Aged cheeses Monosodium glutamate (MSG) Some fruits and ... consistent sleep schedule and eating regular meals. Hormone therapy may help some women whose migraines seem to ...

Self- Reported Comorbid Pains in Severe Headaches or Migraines in a US National Sample

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Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

2012-01-01

Aims To compare prevalence of self-reported comorbid temporomandibular joint muscle disorder (TMJMD)-type, neck, back and joint pains in people with severe headache or migraine; analyze these self-reported pains in the 2000–2005 US National Health Interview Survey (NHIS) by gender and age for Non-Hispanic Whites, Hispanics and Non-Hispanic Blacks (African Americans). Methods NHIS data included information on gender, age, race, ethnicity, health status, and common pain types: severe headache or migraine, TMJMD-type, neck, and low back in the last 3 months, as well as prior month joint pains. Analyses included survey prevalence estimation and survey logistic regression to obtain odds ratios and 95% confidence intervals. Results 189,967 adults, 48% males, 52% females; 73% White, 12% Hispanic, and 11% Black were included. 29,712 (15%) of the entire sample reported severe headache or migraine, 19,228 (64%) had severe headache or migraine with at least one comorbid pain. 10,200 (33%) reported 2 or more comorbid pains, with no gender difference, and with Hispanics (n=1,847 or 32%) and Blacks (n=1,301 or 30%) less likely to report 2 or more comorbid pains than Whites (n=6,747 or 34%) (OR=0.91, p=0.032; OR=0.82, pheadache or migraine is often associated with other common pains, seldom existing alone. Two or more comorbid pains are common, similarly affecting gender and racial/ethnic groups. PMID:22553936

The pathophysiology of migraine: implications for clinical management.

Science.gov (United States)

Charles, Andrew

2018-02-01

The understanding of migraine pathophysiology is advancing rapidly. Improved characterisation and diagnosis of its clinical features have led to the view of migraine as a complex, variable disorder of nervous system function rather than simply a vascular headache. Recent studies have provided important new insights into its genetic causes, anatomical and physiological features, and pharmacological mechanisms. The identification of new migraine-associated genes, the visualisation of brain regions that are activated at the earliest stages of a migraine attack, a greater appreciation of the potential role of the cervical nerves, and the recognition of the crucial role for neuropeptides are among the advances that have led to novel targets for migraine therapy. Future management of migraine will have the capacity to tailor treatments based on the distinct mechanisms of migraine that affect individual patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

Reduction in perceived stress as a migraine trigger

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Lipton, Richard B.; Hall, Charles B.; Tennen, Howard; DeFreitas, Tiffani A.; Borkowski, Thomas M.; Grosberg, Brian M.; Haut, Sheryl R.

2014-01-01

Objective: To test whether level of perceived stress and reductions in levels of perceived stress (i.e., “let-down”) are associated with the onset of migraine attacks in persons with migraine. Methods: Patients with migraine from a tertiary headache center were invited to participate in a 3-month electronic diary study. Participants entered data daily regarding migraine attack experience, subjective stress ratings, and other data. Stress was assessed using 2 measures: the Perceived Stress Scale and the Self-Reported Stress Scale. Logit-normal, random-effects models were used to estimate the odds ratio for migraine occurrence as a function of level of stress over several time frames. Results: Of 22 enrolled participants, 17 (median age 43.8 years) completed >30 days of diaries, yielding 2,011 diary entries including 110 eligible migraine attacks (median 5 attacks per person). Level of stress was not generally associated with migraine occurrence. However, decline in stress from one evening diary to the next was associated with increased migraine onset over the subsequent 6, 12, and 18 hours, with odds ratios ranging from 1.5 to 1.9 (all p values < 0.05) for the Perceived Stress Scale. Decline in stress was associated with migraine onset after controlling for level of stress for all time points. Findings were similar using the Self-Reported Stress Scale. Conclusions: Reduction in stress from one day to the next is associated with migraine onset the next day. Decline in stress may be a marker for an impending migraine attack and may create opportunities for preemptive pharmacologic or behavioral interventions. PMID:24670889

Risk of preterm delivery and hypertensive disorders of pregnancy in relation to maternal co-morbid mood and migraine disorders during pregnancy.

Science.gov (United States)

Cripe, Swee May; Frederick, Ihunnaya O; Qiu, Chunfang; Williams, Michelle A

2011-03-01

We evaluated the risks of preterm delivery and hypertensive disorders of pregnancy among pregnant women with mood and migraine disorders, using a cohort study of 3432 pregnant women. Maternal pre-pregnancy or early pregnancy (migraine diagnoses were ascertained from interview and medical record review. We fitted generalised linear models to derive risk ratios (RR) and 95% confidence intervals (CI) of preterm delivery and hypertensive disorders of pregnancy for women with isolated mood, isolated migraine and co-morbid mood-migraine disorders, respectively. Reported RR were adjusted for maternal age, race/ethnicity, marital status, parity, smoking status, chronic hypertension or pre-existing diabetes mellitus, and pre-pregnancy body mass index. Women without mood or migraine disorders were defined as the reference group. The risks for preterm delivery and hypertensive disorders of pregnancy were more consistently elevated among women with co-morbid mood-migraine disorders than among women with isolated mood or migraine disorder. Women with co-morbid disorders were almost twice as likely to deliver preterm (adjusted RR=1.87, 95% CI 1.05, 3.34) compared with the reference group. There was no clear evidence of increased risks of preterm delivery and its subtypes with isolated migraine disorder. Women with mood disorder had elevated risks of pre-eclampsia (adjusted RR=3.57, 95% CI 1.83, 6.99). Our results suggest an association between isolated migraine disorder and pregnancy-induced hypertension (adjusted RR=1.42, 95% CI 1.00, 2.01). This is the first study examining perinatal outcomes in women with co-morbid mood-migraine disorders. Pregnant women with a history of migraine may benefit from screening for depression during prenatal care and vigilant monitoring, especially for women with co-morbid mood and migraine disorders. © 2011 Blackwell Publishing Ltd.

Factors contributing to migraine headache surgery failure and success.

Science.gov (United States)

Larson, Kelsey; Lee, Michelle; Davis, Janine; Guyuron, Bahman

2011-11-01

The purpose of this study was to identify factors that contribute to migraine headache surgery failure and success. A retrospective chart review was conducted of patients who underwent surgery for migraine headaches performed by the senior author (B.G.) and had at least 11 months of follow-up. The study population included three groups: migraine surgery success, improvement, and failure. Thirty-six unique data points were collected for each patient. A total of 169 patients met inclusion criteria. Of these, 66 patients comprised the migraine surgery success group (S, complete elimination of migraine headaches); 67 comprised the migraine surgery improvement group (I, >50 percent reduction in migraine frequency, intensity, or duration); and 36 comprised the migraine surgery failure group (F, I, p=0.02), migraine frequency (SI, p=0.003; S>F, p=0.04), history of head or neck injury (SI, p=0.02), increased intraoperative bleeding (SF, p=0.0006; I>F, p=0.0004), site II (S>F, p=0.015), single operative site (SI, p=0.05; S>F, p=0.04). Factors associated with migraine surgery failure include increased intraoperative bleeding and surgery on fewer trigger sites. Factors associated with migraine surgery success are older age of migraine onset, higher rate of visual symptoms versus improvement group, surgery at site I or II, and deactivating all four operative sites. Risk, III.

Altered functional connectivity of amygdala underlying the neuromechanism of migraine pathogenesis.

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Chen, Zhiye; Chen, Xiaoyan; Liu, Mengqi; Dong, Zhao; Ma, Lin; Yu, Shengyuan

2017-12-01

The amygdala is a large grey matter complex in the limbic system, and it may contribute in the neurolimbic pain network in migraine. However, the detailed neuromechanism remained to be elucidated. The objective of this study is to investigate the amygdala structural and functional changes in migraine and to elucidate the mechanism of neurolimbic pain-modulating in the migraine pathogenesis. Conventional MRI, 3D structure images and resting state functional MRI were performed in 18 normal controls (NC), 18 patients with episodic migraine (EM), and 16 patients with chronic migraine (CM). The amygdala volume was measured using FreeSurfer software and the functional connectivity (FC) of bilateral amygdala was computed over the whole brain. Analysis of covariance was performed on the individual FC maps among groups. The increased FC of left amygdala was observed in EM compared with NC, and the decreased of right amygdala was revealed in CM compared with NC. The increased FC of bilateral amygdala was observed in CM compared with EM. The correlation analysis showed a negative correlation between the score of sleep quality (0, normal; 1, mild sleep disturbance; 2, moderate sleep disturbance; 3, serious sleep disturbance) and the increased FC strength of left amygdala in EM compared with NC, and a positive correlation between the score of sleep quality and the increased FC strength of left amygdala in CM compared with EM, and other clinical variables showed no significant correlation with altered FC of amygdala. The altered functional connectivity of amygdala demonstrated that neurolimbic pain network contribute in the EM pathogenesis and CM chronicization.

Temporomandibular disorder-type pain and migraine headache in women: a preliminary twin study.

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Plesh, Octavia; Noonan, Carolyn; Buchwald, Dedra S; Goldberg, Jack; Afari, Niloo

2012-01-01

To determine whether shared genetic influences are responsible for the association between pain from temporomandibular disorders (TMD) and migraine headache. Data were obtained from 1,236 monozygotic and 570 dizygotic female twin pairs from the University of Washington Twin Registry. TMD pain was assessed with a question about persistent or recurrent pain in the jaw, temple, in front of the ear, or in the ear. The presence of migraine headache was determined by self-report of doctor-diagnosed migraine. Univariate and bivariate structural equation models estimated the components of variance attributable to genetic and environmental influences. The best fitting univariate models indicated that additive genetic effects contributed 27% of the variance in TMD pain (95% confidence interval = 15% to 38%) and 49% of the variance in migraine headache (95% confidence interval = 40% to 57%). The best-fitting bivariate model revealed that 12% of the genetic component of TMD pain is shared with migraine headache. These preliminary findings suggest that the association between TMD pain and migraine headache in women may be partially due to a modest shared genetic risk for both conditions. Future studies can focus on replicating these findings with symptom- and diagnosis-based instruments.

The impact of migraine on health status

NARCIS (Netherlands)

Essink-Bot, M L; van Royen, L; Krabbe, P; Bonsel, G J; Rutten, F F

PROBLEMS: What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

Exploring genes and pathways involved in migraine

NARCIS (Netherlands)

Eising, E.

2017-01-01

The research in this thesis was aimed at identifying genes and molecular pathways involved in migraine. To this end, two gene expression analyses were performed in brain tissue obtained from transgenic mouse models for familial hemiplegic migraine (FHM), a monogenic subtype of migraine with aura.

The impact of migraine on health status

NARCIS (Netherlands)

Essink-Bot, M. L.; van Royen, L.; Krabbe, P.; Bonsel, G. J.; Rutten, F. F.

1995-01-01

PROBLEMS--What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

Migraine

Science.gov (United States)

... SEARCH Definition Treatment ... is often described as an intense pulsing or throbbing pain in one area of the head. However, it is much more; the International Headache Society diagnoses a migraine by its pain and number ...

[The migraine of Immanual Kant].

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Podoll, K; Hoff, P; Sass, H

2000-07-01

The German philosopher Immanuel Kant (1724-1804) suffered, since his forties, from a migraine with aura which showed a significant exacerbation in his seventies, coinciding with the onset of symptoms of a senile dementia of Alzheimer's type. Recorded symptoms of Kant's migraine include recurrent scintillating scotomas, one episode of diplopia, two episodes of complete amaurosis and frequent headaches described as oppressions of the head. The said symptoms of Kant's migraine can be traced not only in his letters and in accounts of his contemporary biographers, but also in the philosopher's published work.

Examination of fluctuations in atmospheric pressure related to migraine.

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Okuma, Hirohisa; Okuma, Yumiko; Kitagawa, Yasuhisa

2015-01-01

Japan has four seasons and many chances of low atmospheric pressure or approaches of typhoon, therefore it has been empirically known that the fluctuation of weather induces migraine in people. Generally, its mechanism has been interpreted as follows: physical loading, attributed by atmospheric pressure to human bodies, compresses or dilates human blood vessels, which leads to abnormality in blood flow and induces migraine. We report our examination of the stage in which migraine tends to be induced focusing on the variation of atmospheric pressure. Subjects were 34 patients with migraine, who were treated in our hospital. The patients included 31 females and three males, whose mean age was 32 ± 6.7. 22 patients had migraine with aura and 12 patients had migraine without aura. All of patients with migraine maintained a headache diary to record atmospheric pressures when they developed a migraine. The standard atmospheric pressure was defined as 1013 hPa, and with this value as the criterion, we investigated slight fluctuations in the atmospheric pressure when they developed a migraine. It was found that the atmospheric pressure when the patients developed a migraine was within 1003-1007 hPa in the approach of low atmospheric pressure and that the patients developed a migraine when the atmospheric pressure decreased by 6-10 hPa, slightly less than the standard atmospheric pressure. Small decreases of 6-10 hPa relative to the standard atmospheric pressure of 1013 hPa induced migraine attacks most frequently in patients with migraine.

Sphenopalatine ganglion neuromodulation in migraine

DEFF Research Database (Denmark)

Khan, Sabrina; Schoenen, Jean; Ashina, Messoud

2014-01-01

OBJECTIVE: The objective of this article is to review the prospect of treating migraine with sphenopalatine ganglion (SPG) neurostimulation. BACKGROUND: Fuelled by preliminary studies showing a beneficial effect in cluster headache patients, the potential of treating migraine with neurostimulation...

Investigation of the pathophysiological mechanisms of migraine attacks induced by pituitary adenylate cyclase-activating polypeptide-38

DEFF Research Database (Denmark)

Amin, Faisal Mohammad; Hougaard, Anders; Schytz, Henrik W

2014-01-01

Pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) and vasoactive intestinal polypeptide are structurally and functionally closely related but show differences in migraine-inducing properties. Mechanisms responsible for the difference in migraine induction are unknown. Here, for the ...

Treatment in chronic migraine: choice of reabilitation strategies

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Ioana STANESCU

2015-12-01

Full Text Available Migraine is a disabling neurologic condition with a spontaneous clinical evolution into a chronic form. Migraine progression from an episodic into a chronic form is realized through a period of time involving several months or years, during which an increase attack frequency occurs. .According to the International Classification of Headache Disorders (ICHD-3 chronic migraine is a type of primary headache occurring on 15 or more days per month for more than 3 months, in which more than 8 days per month headache meet criteria for migraine with or without aura or respond to specific migraine treatment. The prevalence of chronic migraine is estimated between 1- 3% of general population. Persons with chronic migraine are more likely to suffer from severe disability; chronic migraine has an important socio-economic impact. Diagnostic approach in chronic migraine includes exclusion of a secondary headache disorder and confirmation of a primary episodic headache. When a patient is found to overuse pain medication, diagnosis of both chronic migraine and MOH should be considered. Treating episodic migraine early and managing attack frequency using preventive medication and behavioural interventions will be benefic in reducing the risk of chronicisation. Lifestyle changes are important for avoiding triggers for migraine attacks; treatment of comorbidities is equally important because these conditions exacerbate patient’s tendency to have headaches. The initial relief step for drug abusers always relies in drug withdrawal. For migraine attacks treatment begins with non-pharmacologic interventions (staying in a quiet, dark room, pressure on painful areas, applying cold compresses , simple OTC analgetics (NSAIDs, paracetamol, aspirin, acetaminophen. If these are not effective, triptans are the drugs of choice. Preventive treatment is always recommended in patients with chronic migraine because the high frequency of headache attacks. Treatment should be

Tetra-ataxiometric Posturography in Patients with Migrainous Vertigo.

Science.gov (United States)

Ongun, Nedim; Atalay, Nilgun S; Degirmenci, Eylem; Sahin, Fusun; Bir, Levent Sinan

2016-01-01

Migraine is a common disorder characterized by headache attacks frequently accompanied by vestibular symptoms like dizziness, vertigo, and balance disorders. Clinical studies support a strong link between migraine and vertigo rather than between other headache types and vertigo or nonvertiginous dizziness. There is a lack of consensus regarding the pathophysiology of migrainous vertigo. Activation of central vestibular processing during migraine attacks and vasospasm-induced ischemia of the labyrinth are reported as the probable responsible mechanisms. Because vestibular examination alone does not provide enough information for diagnosis of migrainous vertigo, posturography systems which provide objective assessment of somatosensory, vestibular, and visual information would be very helpful to show concomitant involvement of the vestibular and somato-sensorial systems. There are few posturographic studies on patients with migraine but it seems that how balance is affected in patients with migraine and/or migrainous vertigo is still not clear. We want to investigate balance function in migraineurs with and without vertigo with a tetra-ataxiometric posturography system and our study is the first study in which tetra-ataxiometric static posturography was used to evaluate postural abnormalities in a well-defined population of patients with migrainous vertigo. To investigate balance functions in migraineurs with and without vertigo with a tetra-ataxiometric posturography system. Prospective, nonrandomized, controlled study. Pamukkale University Hospital, Neurology and Physical Therapy and Rehabilitation outpatient clinics. Sixteen patients with migrainous vertigo, 16 patients with migraine without aura and no vestibular symptoms, and 16 controls were included in the study. Computerized static posturography system was performed and statistical analyses of fall, Fourier, Stability, and Weight distribution indexes were performed. The tetra-ataxiometric posturography device

Gendering the migraine market: do representations of illness matter?

Science.gov (United States)

Kempner, Joanna

2006-10-01

Migraine is a common, debilitating and costly disorder. Yet help-seeking for and rates of diagnosis of migraine are low. Drawing on ethnographic observations of pharmaceutical marketing practices at professional headache conferences and a content analysis of migraine advertising, principally in the USA, this paper demonstrates: (1) that the pharmaceutical industry directs its marketing of migraine medication to women; and (2) as part of this strategy, pharmaceutical advertisements portray women as the prototypical migraine sufferer, through representations that elicit hegemonic femininity. This strategy creates the impression that migraine is a "women's disorder", which, in turn, exacerbates gender bias in help seeking and diagnosis of migraine and reifies presumptions about the epidemiology of the disorder. I conclude that these pharmaceutical marketing practices have a paradoxical effect: even as they educate and raise awareness about migraine, they also create barriers to help seeking and diagnosis.

Magnetic resonance image abnormality in migraine with aura

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Ziegler, D.K.; Batnitzky, S.; Barter, R.; McMillan, J.H. (Kansas Univ., Kansas City, KS (United States). Medical Center)

1991-07-01

Cerebral magnetic resonance imaging (MRI) was performed on 18 patients with migraine characterized by aura consisting of both visual symtoms and parasthesias. 15 headache-free individuals of the same age range were used as controls. Records were radomized and read in blind fashion by two neuroradiologists. Small subcortical white matter lesions were seen in three migraine cases and two controls. In one migraine case cortical infarctions were seen. In two controls, small areas of increased density similar to those in migraine were seen. No consistent correlation of migraine or its duration with cerebral atrophy was found. It is concluded that identification of both these MRI findings (small subcortical white lesions and cerebral atrophy) as significantly associated with migraine is doubtful. 21 refs., 2 figs.

Magnetic resonance image abnormality in migraine with aura

International Nuclear Information System (INIS)

Ziegler, D.K.; Batnitzky, S.; Barter, R.; McMillan, J.H.

1991-01-01

Cerebral magnetic resonance imaging (MRI) was performed on 18 patients with migraine characterized by aura consisting of both visual symtoms and parasthesias. 15 headache-free individuals of the same age range were used as controls. Records were radomized and read in blind fashion by two neuroradiologists. Small subcortical white matter lesions were seen in three migraine cases and two controls. In one migraine case cortical infarctions were seen. In two controls, small areas of increased density similar to those in migraine were seen. No consistent correlation of migraine or its duration with cerebral atrophy was found. It is concluded that identification of both these MRI findings (small subcortical white lesions and cerebral atrophy) as significantly associated with migraine is doubtful. 21 refs., 2 figs

The Migraine-Ischemic Stroke Relation in Young Adults

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Alessandro Pezzini

2011-01-01

Full Text Available In spite of the strong epidemiologic evidence linking migraine and ischemic stroke in young adults, the mechanisms explaining this association remain poorly understood. The observation that stroke occurs more frequently during the interictal phase of migraine prompts to speculation that an indirect relation between the two diseases might exist. In this regard, four major issues might be considered which may be summarized as follows: (1 the migraine-ischemic stroke relation is influenced by specific risk factors such as patent foramen ovale or endothelial dysfunction and more frequent in particular conditions like spontaneous cervical artery dissection; (2 migraine is associated with an increased prevalence of cardiovascular risk factors; (3 the link is caused by migraine-specific drugs; (4 migraine and ischemic vascular events are linked via a genetic component. In the present paper, we will review epidemiological studies, discuss potential mechanisms of migraine-induced stroke and comorbid ischemic stroke, and pose new research questions.

The Migraine-Ischemic Stroke Relation in Young Adults

Science.gov (United States)

Pezzini, Alessandro; Del Zotto, Elisabetta; Giossi, Alessia; Volonghi, Irene; Costa, Paolo; Dalla Volta, Giorgio; Padovani, Alessandro

2011-01-01

In spite of the strong epidemiologic evidence linking migraine and ischemic stroke in young adults, the mechanisms explaining this association remain poorly understood. The observation that stroke occurs more frequently during the interictal phase of migraine prompts to speculation that an indirect relation between the two diseases might exist. In this regard, four major issues might be considered which may be summarized as follows: (1) the migraine-ischemic stroke relation is influenced by specific risk factors such as patent foramen ovale or endothelial dysfunction and more frequent in particular conditions like spontaneous cervical artery dissection; (2) migraine is associated with an increased prevalence of cardiovascular risk factors; (3) the link is caused by migraine-specific drugs; (4) migraine and ischemic vascular events are linked via a genetic component. In the present paper, we will review epidemiological studies, discuss potential mechanisms of migraine-induced stroke and comorbid ischemic stroke, and pose new research questions. PMID:21197470

Prevalence of migraine in the Canadian household population.

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Ramage-Morin, Pamela L; Gilmour, Heather

2014-06-01

Based on data from the 2010 and 2011 Canadian Community Health Surveys and the 2011 Survey of Living with Neurological Conditions in Canada, this article provides information about migraine among people living in private households. In 2010/2011, an estimated 8.3% of Canadians (2.7 million) reported that they had been diagnosed with migraine by a health professional. Females were more likely than males to report migraine: 11.8% versus 4.7%. Migraine prevalence was highest among people in their 30s and 40s: 17.0% for women and 6.5% for men. Compared with the national figure, the prevalence of migraine was lower in Quebec (6.8%) and higher in Manitoba (9.5%), Nova Scotia (9.1%) and Ontario (8.8%). Among people who reported a migraine diagnosis, 42% took prescription medication for their condition, and 56% incurred medication-related out-of-pocket expenses. Migraine was highly comorbid with depression and affected many aspects of daily life including education, work, sleep, and driving.

PS2-5: Prevalence of Migraine in a Diverse Community – Electronic Methods for Migraine Ascertainment in a Large Integrated Health Plan

Science.gov (United States)

Pressman, Alice; Jacobson, Alice; Avins, Andy

2013-01-01

Background/Aims Migraine, a common neurological disorder, is among the top 20 causes of disability worldwide. One-year prevalence of migraine in the US is estimated to range from 8–15%, with women affected at approximately three times the rate of men. Current methods for migraine ascertainment from headache clinics and surveys are costly, affected by clinic-ascertainment bias, and do not work in situations where patient contact is not feasible. With the growing use of electronic medical records (EMR), new methods must be developed for identifying and tracking migraine prevalence over time. We sought to develop an EMR algorithm, to identify migraine, and to characterize its prevalence in Kaiser Permanente Northern California (KPNC). Methods From EMRs of all KPNC members, we collected all outpatient migraine diagnoses (ICD9 code 346.xx) and migraine-specific prescriptions (ergots, triptans, and acetaminophen with caffeine) for 2006–2010. We chart-reviewed a random sample to develop an electronic Migraine Probability Algorithm (score 0–100). We tested the algorithm in a second independent chart review. Using membership data, we calculated prevalences by age, race, and gender. Results We identified 313,174 KPNC members with evidence of migraine - 233,620 women and 79,554 men. The 5-year period-prevalence of migraine among KPNC adults was 17.1% for women and 5.9% for men. Among children, rates did not differ by gender (<2%) until the age of 10, when prevalences were higher - 5.8% for girls and 3.5% for boys. For women, prevalence peaked at ages 25–29. In contrast, males experienced flat prevalence with age (range 5%–6%). Overall, Whites had higher prevalence than Asians, but Blacks did not differ appreciably. Conclusions We used EMR data to capture migraine diagnoses and show prevalence patterns similar to those reported in the literature. Prevalence of diagnosed migraine in KPNC was 2.5–3 times higher in women than men; migraine peaked with age in women

Why is migraine so common?

Science.gov (United States)

Edmeads, J

1998-08-01

Migraine is clearly a very common biological disorder, but this knowledge has not been sufficient as yet to ensure completely effective treatment strategies. There appears to be discrepancy between what migraine patients desire as the outcome of consultations and what doctors think patients want. Patients seem, from Packard's selective study (11), to want explanation and reassurance before they get pain relief, whereas doctors view pain relief as the most important aim of management. It is possible that doctors still have underlying assumptions about psychological elements of migraine which color their perceptions of their patients. Communicating the relevance of scientific progress in migraine to neurologists and PCPs is an important challenge, as is calling attention to the patient's expectations from treatment. To be effective in improving education in this area, perhaps we should first ascertain the level of knowledge about the biology and treatment of headache among general neurologists.

Migraines

Science.gov (United States)

... may trigger migraines: Aged, canned, cured or processed meat, including bologna, game, ham, herring, hot dogs, pepperoni and sausage Aged cheese Alcoholic beverages, especially red wine Aspartame Avocados Beans, ... Lentils Meat tenderizer Monosodium glutamate (MSG) Nuts and peanut butter ...

Perceived stress in patients with migraine: a case-control study.

Science.gov (United States)

Moon, Hye-Jin; Seo, Jong-Geun; Park, Sung-Pa

2017-12-01

Perceived stress is the most common trigger for migraine. The objective of this study was to examine the clinical significance of perceived stress in migraine patients. This is a case-control study. Consecutive migraine patients who visited a tertiary care hospital were enrolled for this study. They completed self-reported questionnaires including Perceived Stress Scale (PSS), 12-item Allodynia Symptom Checklist (ASC-12), Migraine Disability Assessment Scale (MIDAS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and Migraine-Specific Quality of Life Questionnaire (MSQ). Degree of perceived stress in migraine patients was measured and compared to that in healthy controls. Predictors for perceived stress and their impact on quality of life (QOL) of migraine patients were also determined. A total of 227 migraine patients were eligible for this study, including 103 (45.4%) who had chronic migraine (CM). Mean PSS score was significantly (p migraine is a critical factor for perceived stress. Perceived stress affects QOL of migraine patients.

MIGRAINE: BASIC PRINCIPLES OF TREATMENT AND PREVENTION

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O. R. Esin

2011-01-01

Full Text Available Modern recommendations for the migraine attack treatment and it's prophylaxis are analyzed in this review. Established, that acetylsalicylic acid, diclofenac potassium, ibuprofen, naproxen, paracetamol, metamizol and their combination with caffeine are drugs of the first choice for migraine attack treatment. Metoclopramide and domperidone are used to reduce nausea and vomiting. Also triptans are high effective drugs for migraine attack treatment. Metoprolol, propranolol, flunarizine, valproic acid can be used for migraine prophylaxis. Drugs of the second choice are: amitriptyline, venlafaxine, naproxen and bisoprolol.

Using Search Engines to Investigate Shared Migraine Experiences.

Science.gov (United States)

Burns, Sara M; Turner, Dana P; Sexton, Katherine E; Deng, Hao; Houle, Timothy T

2017-09-01

To investigate migraine patterns in the United States using Google search data and utilize this information to better understand societal-level trends. Additionally, we aimed to evaluate time-series relationships between migraines and social factors. Extensive research has been done on clinical factors associated with migraines, yet population-level social factors have not been widely explored. Migraine internet search data may provide insight into migraine trends beyond information that can be gleaned from other sources. In this longitudinal analysis of open access data, we performed a time-series analysis in which about 12 years of Google Trends data (January 1, 2004 to August 15, 2016) were assessed. Data points were captured at a daily level and Google's 0-100 adjusted scale was used as the primary outcome to enable the comparison of relative popularity in the migraine search term. We hypothesized that the volume of relative migraine Google searches would be affected by societal aspects such as day of the week, holidays, and novel social events. Several recurrent social factors that drive migraine searches were identified. Of these, day of the week had the most significant impact on the volume of Google migraine searches. On average, Mondays accumulated 13.31 higher relative search volume than Fridays (95% CI: 11.12-15.51, P ≤ .001). Surprisingly, holidays were associated with lower relative migraine search volumes. Christmas Day had 13.84 lower relative search volumes (95% CI: 6.26-21.43, P ≤ .001) and Thanks giving had 20.18 lower relative search volumes (95% CI: 12.55-27.82, P ≤ .001) than days that were not holidays. Certain novel social events and extreme weather also appear to be associated with relative migraine Google search volume. Social factors play a crucial role in explaining population level migraine patterns, and thus, warrant further exploration. © 2017 American Headache Society.

Harnessing migraines for neural regeneration

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Jonathan M Borkum

2018-01-01

Full Text Available The success of naturalistic or therapeutic neuroregeneration likely depends on an internal milieu that facilitates the survival, proliferation, migration, and differentiation of stem cells and their assimilation into neural networks. Migraine attacks are an integrated sequence of physiological processes that may protect the brain from oxidative stress by releasing growth factors, suppressing apoptosis, stimulating neurogenesis, encouraging mitochondrial biogenesis, reducing the production of oxidants, and upregulating antioxidant defenses. Thus, the migraine attack may constitute a physiologic environment conducive to stem cells. In this paper, key components of migraine are reviewed – neurogenic inflammation with release of calcitonin gene-related peptide (CGRP and substance P, plasma protein extravasation, platelet activation, release of serotonin by platelets and likely by the dorsal raphe nucleus, activation of endothelial nitric oxide synthase (eNOS, production of brain-derived neurotrophic factor (BDNF and, in migraine aura, cortical spreading depression – along with their potential neurorestorative aspects. The possibility is considered of using these components to facilitate successful stem cell transplantation. Potential methods for doing so are discussed, including chemical stimulation of the TRPA1 ion channel, conjoint activation of a subset of migraine components, invasive and noninvasive deep brain stimulation of the dorsal raphe nucleus, transcranial focused ultrasound, and stimulation of the Zusanli (ST36 acupuncture point.

Hemiplegic Migraine Presenting with Prolonged Somnolence: A Case Report

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Christian Saleh

2016-10-01

Full Text Available Hemiplegic migraine is a rare and complex disease, characterized by migraine with a reversible motor aura. Hemiplegic migraine can be easily misdiagnosed at its first presentation with an atypical severe form of migraine, a stroke, multiple sclerosis, metabolic disorders, conversion disorder or an epilepsy. We present the case of a young 24-year-old male patient, who since the age of 4 years had been having multiple episodes of migraine associated with hemiparesis, paraesthesia, prolonged somnolence, aphasia and confusion. We review the literature and discuss important diagnostic findings in hemiplegic migraine to help establishing a prompt diagnosis.

Professional tools and a personal touch - experiences of physical therapy of persons with migraine.

Science.gov (United States)

Rutberg, Stina; Kostenius, Catrine; Öhrling, Kerstin

2013-09-01

The aim was to explore the lived experience of physical therapy of persons with migraine. Data were collected by conducting narrative interviews with 11 persons with migraine. Inspired by van Manen, a hermeneutic phenomenological method was used to analyse the experiences of physical therapy which these persons had. Physical therapy for persons with migraine meant making an effort in terms of time and energy to improve their health by meeting a person who was utilising his or her knowledge and skill to help. Being respected and treated as an individual and having confidence in the physical therapist were highlighted aspects. The analysis revealed a main theme, "meeting a physical therapist with professional tools and a personal touch". The main theme included four sub-themes, "investing time and energy to feel better", "relying on the competence of the physical therapist", "wanting to be treated and to become involved as an individual" and "being respected in a trustful relationship". The therapeutic relationship with the physical therapist is important and the findings of this study can increase awareness about relational aspects of physical therapy and encourage thoughtfulness among physical therapists and other healthcare professionals interacting with persons with migraine. Physical therapists use both professional tools and a personal touch in their interaction with persons with migraine and this article can increase physical therapists' awareness and encourage thoughtfulness in their professional practice. Being respected and treated as an individual and having confidence in the physical therapist are important aspects of the therapeutic relationship and indicate a need for patient-centred care. By making the effort of spending the time and energy required, physical therapy could be a complement or an alternative to medication to ease the consequences of migraine.

Chronic migraine is associated with reduced corneal nerve fiber density and symptoms of dry eye.

Science.gov (United States)

Kinard, Krista I; Smith, A Gordon; Singleton, J Robinson; Lessard, Margaret K; Katz, Bradley J; Warner, Judith E A; Crum, Alison V; Mifflin, Mark D; Brennan, Kevin C; Digre, Kathleen B

2015-04-01

We used in vivo corneal confocal microscopy to investigate structural differences in the sub-basal corneal nerve plexus in chronic migraine patients and a normal population. We used a validated questionnaire and tests of lacrimal function to determine the prevalence of dry eye in the same group of chronic migraine patients. Activation of the trigeminal system is involved in migraine. Corneal nociceptive sensation is mediated by trigeminal axons that synapse in the gasserian ganglion and the brainstem, and serve nociceptive, protective, and trophic functions. Noninvasive imaging of the corneal sub-basal nerve plexus is possible with in vivo corneal confocal microscopy. For this case-control study, we recruited chronic migraine patients and compared them with a sex- and age-similar group of control subjects. Patients with peripheral neuropathy, a disease known to be associated with a peripheral neuropathy, or prior corneal or intraocular surgery were excluded. Participants underwent in vivo corneal confocal microscopy using a Heidelberg Retinal Tomography III confocal microscope with a Rostock Cornea Module. Nerve fiber length, nerve branch density, nerve fiber density, and tortuosity coefficient were measured using established methodologies. Migraine participants underwent testing of basal tear production with proparacaine, corneal sensitivity assessment with a cotton-tip applicator, measurement of tear break-up time, and completion of a validated dry eye questionnaire. A total of 19 chronic migraine patients and 30 control participants completed the study. There were no significant differences in age or sex. Nerve fiber density was significantly lower in migraine patients compared with controls (48.4 ± 23.5 vs. 71.0 ± 15.0 fibers/mm2 , P dry eye syndrome. We found that in the sample used in this study, the presence of structural changes in nociceptive corneal axons lends further support to the hypothesis that the trigeminal system plays a critical role

Abdominal migraine in childhood: a review

Directory of Open Access Journals (Sweden)

Scicchitano B

2014-08-01

Full Text Available Beatrice Scicchitano,1 Gareth Humphreys,1 Sally G Mitton,2 Thiagarajan Jaiganesh1 1Children's Emergency Department, 2Department of Paediatric Gastroenterology, St Georges Hospital, St Georges Healthcare NHS Trust, Tooting, London, United Kingdom Abstract: The childhood condition of abdominal migraine has been described under many different synonyms, including "abdominal epilepsy", "recurrent abdominal pain", "cyclical vomiting syndrome", and "functional gastrointestinal disorder". In the early literature, abdominal migraine is included in the "childhood periodic syndrome", first described by Wyllie and Schlesinger in 1933. Abdominal migraine has emerged over the last century as a diagnostic entity in its own right thanks to the development of well defined diagnostic criteria and its recent inclusion in the International Headache Society's Classification of Headache disorders. Despite this progress, little is known about the pathophysiology of the condition, and the treatment options are poorly defined. Here we summarize the recent literature, with particular focus on establishing the diagnosis of abdominal migraine and its pathophysiology, and suggest an approach to management. Keywords: abdominal migraine, recurrent abdominal pain, abdominal epilepsy, cyclical vomiting

Anatomical alterations of the visual motion processing network in migraine with and without aura.

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Cristina Granziera

2006-10-01

Full Text Available Patients suffering from migraine with aura (MWA and migraine without aura (MWoA show abnormalities in visual motion perception during and between attacks. Whether this represents the consequences of structural changes in motion-processing networks in migraineurs is unknown. Moreover, the diagnosis of migraine relies on patient's history, and finding differences in the brain of migraineurs might help to contribute to basic research aimed at better understanding the pathophysiology of migraine.To investigate a common potential anatomical basis for these disturbances, we used high-resolution cortical thickness measurement and diffusion tensor imaging (DTI to examine the motion-processing network in 24 migraine patients (12 with MWA and 12 MWoA and 15 age-matched healthy controls (HCs. We found increased cortical thickness of motion-processing visual areas MT+ and V3A in migraineurs compared to HCs. Cortical thickness increases were accompanied by abnormalities of the subjacent white matter. In addition, DTI revealed that migraineurs have alterations in superior colliculus and the lateral geniculate nucleus, which are also involved in visual processing.A structural abnormality in the network of motion-processing areas could account for, or be the result of, the cortical hyperexcitability observed in migraineurs. The finding in patients with both MWA and MWoA of thickness abnormalities in area V3A, previously described as a source in spreading changes involved in visual aura, raises the question as to whether a "silent" cortical spreading depression develops as well in MWoA. In addition, these experimental data may provide clinicians and researchers with a noninvasively acquirable migraine biomarker.

Migraine headaches and mood/anxiety disorders in the ELSA Brazil.

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Goulart, Alessandra C; Santos, Itamar S; Brunoni, André R; Nunes, Maria Angélica; Passos, Valéria M; Griep, Rosane H; Lotufo, Paulo A; Benseñor, Isabela M

2014-09-01

To describe the relationship between mood/anxiety disorders and migraine headaches emphasizing the frequency of episodes based in a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health. It has been suggested that frequency of migraine headaches can be directly associated with the presence of psychiatric disorders. Migraine headaches (International Headache Society criteria) was classified as migraine and 10,531 without migraine headaches (reference). Our main result was an increase in the strength of association between migraine and MDD as frequency of migraine increased for all sample: odds ratio of 2.14 (95% confidence interval [CI] 1.33-3.43) for migraine/month to 6.94 (95% CI 4.20-11.49) for daily headaches for all sample. Significant associations with migraine were also found for GAD, OCD, MADD, and CMD for total sample: MDD, GAD, OCD, MADD, and CMD for women, and MADD and CMD for men. Among men with daily migraine complaint, we found a significant association between migraine and OCD after correction for multiple comparisons (odds ratio 29.86 [95% CI 4.66-191.43]). Analyzing probable and definite migraine cases together, we replicated the findings in a lower magnitude. The increase in migraine frequency was associated with progressively higher frequencies of having mood/anxiety disorders in all samples suggesting for some psychiatric disorders a likely dose-response effect especially for women. © 2014 American Headache Society.

Professional tools and a personal touch – experiences of physical therapy of persons with migraine

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Kostenius, Catrine; Öhrling, Kerstin

2013-01-01

Purpose: The aim was to explore the lived experience of physical therapy of persons with migraine. Method: Data were collected by conducting narrative interviews with 11 persons with migraine. Inspired by van Manen, a hermeneutic phenomenological method was used to analyse the experiences of physical therapy which these persons had. Results: Physical therapy for persons with migraine meant making an effort in terms of time and energy to improve their health by meeting a person who was utilising his or her knowledge and skill to help. Being respected and treated as an individual and having confidence in the physical therapist were highlighted aspects. The analysis revealed a main theme, “meeting a physical therapist with professional tools and a personal touch”. The main theme included four sub-themes, “investing time and energy to feel better”, “relying on the competence of the physical therapist”, “wanting to be treated and to become involved as an individual” and “being respected in a trustful relationship”. Conclusions: The therapeutic relationship with the physical therapist is important and the findings of this study can increase awareness about relational aspects of physical therapy and encourage thoughtfulness among physical therapists and other healthcare professionals interacting with persons with migraine. PMID:23311671

Hair Transplantation in Migraine Headache Patients

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Safvet Ors, MD

2017-09-01

Conclusions:. This report details 6 patients who experienced abatement of migraine headache symptoms following hair transplantation. The positive effects of hair transplantation on migraine headache and potential mechanisms of action are also discussed.

The PACAP receptor: a novel target for migraine treatment

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Schytz, Henrik W; Olesen, Jes; Ashina, Messoud

2010-01-01

The origin of migraine pain has not yet been clarified, but accumulating data point to neuropeptides present in the perivascular space of cranial vessels as important mediators of nociceptive input during migraine attacks. Pituitary adenylate cyclase-activating polypeptide (PACAP) is present in s......) receptor, which suggests a possible signaling pathway implicated in migraine pain. This review summarizes the current evidence supporting the involvement of PACAP in migraine pathophysiology and the PAC(1) receptor as a possible novel target for migraine treatment....

A STUDY ON EEG ABNORMALITIES IN CHILDREN WITH MIGRAINE

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Subinay Mandal

2017-04-01

Full Text Available BACKGROUND Migraine is one of the common causes of headache in children. Migraine and epilepsy are both common episodic neurological disorders. The comorbidity of these two conditions is well known. Many researcher have pointed out that neuronal hyperexcitability is the initiating event for occurrence of migraine attack. The aim of the paper was to evaluate the EEG in children with migraine. MATERIALS AND METHODS We retrospectively analysed records of children who attended our paediatric outpatient department with diagnoses as suffering from migraine based on International Headache Society (IHS diagnostic criteria. Apart from detailed clinical history, EEG of every patient was collected and analysed. EEG was performed interictally at least 24 hours after the last episode of headache attack in all the cases. RESULTS 56 children (age range, 4-14 years constituted our study group. 64.3% children had migraine without aura (common type and in 23.2% cases had migraine with aura (classic type other were with migraine variants. Abnormal EEG was reported in 30.3% children. 17% of children with migraine without history of seizure had abnormal EEG. Sixty one percent of patients with aura had abnormal EEG. History of either febrile fits or afebrile fits was present in total 17.1% of cases. The type of paroxysmal discharges we came across was- a Sharp waves, b Spikes and c Spike and slow wave complexes. Abnormal paroxysmal sharp and spike-wave complexes (also called spike-and-slow-wave complexes were the most common EEG abnormality. CONCLUSION EEG abnormality was found in significant number of children with migraine both with and without history of seizure in our study. This indicates neuronal hyperexcitability during episodes of migraine. So, EEG should be considered in patients with clinical diagnoses of migraine to exclude association of any seizure activity.

Friendships and social interactions of school-aged children with migraine.

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Vannatta, K; Getzoff, E A; Gilman, D K; Noll, R B; Gerhardt, C A; Powers, S W; Hershey, A D

2008-07-01

We set out to evaluate the friendships and social behaviour of school-aged children with migraine. Concern exists regarding the impact of paediatric migraine on daily activities and quality of life. We hypothesized that children with migraine would have fewer friends and be identified as more socially sensitive and isolated than comparison peers. Sixty-nine children with migraine participated in a school-based study of social functioning. A comparison sample without migraine included classmates matched for gender, race and age. Children with migraine had fewer friends at school; however, this effect was limited to those in elementary school. Behavioural difficulties were not found. Middle-school students with migraine were identified by peers as displaying higher levels of leadership and popularity than comparison peers. Concern may be warranted about the social functioning of pre-adolescent children with migraine; however, older children with migraine may function as well as or better than their peers.

Psychiatric comorbidities and photophobia in patients with migraine.

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Seidel, Stefan; Beisteiner, Roland; Manecke, Maike; Aslan, Tuna Stefan; Wöber, Christian

2017-12-01

Based on recent findings and our own impressions we took a closer look at the relationship between (inter)ictal photophobia and psychometric variables in migraine patients with photophobia. For this study we included 29 (27 female) migraine patients and 31 (18 female) controls with a mean age of 31.6 ± 12.5 years and 24.0 ± 4.1 years, respectively. All participants filled out the Depression Anxiety Stress Scale (DASS). Interictal photophobia in patients was significantly higher than photophobia in controls (p = .001). Patients showed statistically significantly higher levels of depressive symptoms (p migraine and depression, it might be possible that depression contributes to interictal photophobia in patients with migraine. The same may be true for anxiety and stress. Both are also related to migraine and their possible impact on photophobia in migraine may be explained by pupillary dysfunction.

Migraine, the heart and the brain

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Koppen, H.

2018-01-01

The association between migraine and silent ischemic brain lesions was investigated. Also the occurence of right-to-left shunts in different migraine groups and controls. The functional consequences of silent ischemic brain lesions were investigated.

Effects of migraine disease on the vestibulocochlear system

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Murat Zaim

2015-03-01

Full Text Available Objective: Migraine patients have tendency to have vestibular and auditory system problems. The aim of this study is to evaluate vestibule cochlear system of patients with migraine with Transient-evoked otoacoustic emissions (TEOAE video-nystagmography (VNG and caloric test. Methods:39 patients diagnosed with migraine and control group of 21 healthy volunteers were included in this study. Before they were included in the study, all of them were examined and those who has acute otitis media, chronic otitis media, tympanic membrane perforation, external otitis, ear surgery history and head trauma were excluded from the study. All patients and volunteers were tested by TEOAE, VNG and caloric tests. In evaluating the statistical data, SPSS 15.0 was utilized. Results: When TEOAE values for the migraine group and for the control group are compared, it is found statistically significant that the TEOAE values for the migraine group is lower than those for the control group. This result shows that there can be a pathology that is able to affect cochlear functions in migraine disease. As for VNG test results, a statistically significant difference cannot be determined between migraine and control groups. More over, the identification of canal paresis in caloric test indicates that peripheral vestibular problems accompany migraine disease. Conclusion:Evaluating vestibulocochlear system of migraine patients with TEOAE, VNG and caloric tests has been an important task for identifying vestibular imperfections accompanying these patients and for predicting potential auricular pathologies. J Clin Exp Invest 2015; 6(1: 1-4

Can We Get Faculty Interviewers on the Same Page? An Examination of a Structured Interview Course for Surgeons.

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Gardner, Aimee K; D'Onofrio, Brenna C; Dunkin, Brian J

Guidance on how to train faculty to conduct structured interviews and implement them into current screening processes is lacking. The goal of this study is to describe a structured interview training program designed specifically for surgeons and examine its effectiveness. Faculty involved in advanced surgical fellowship interviews completed a 20-item knowledge assessment and video-based applicant interview ratings before taking a half-day course on conducting structured interviews. The course consisted of evidence-based strategies and methods for conducting structured interviews, asking questions, and rating applicants in a highly interactive format. After the course, faculty again completed the knowledge assessment and provided ratings for 3 video-based applicant interviews. All faculty members (N = 5) responsible for selecting fellows in minimally invasive and bariatric surgery completed the training. Faculty had an average of 15.8 ± 9.12 years in practice. Average performance on the precourse knowledge assessment was 35% ± 6.12% and the group was unable to achieve acceptable agreement for applicant interview scores for any of the competencies assessed. After the course, faculty demonstrated significant improvements (p interview ratings within 2 points of each other. Implementation of a half-day course designed to teach principles and skills around structured interviewing and assessment demonstrated significant improvements in both interviewing knowledge and interrater agreement. These findings support the time and resources required to develop and implement a structured interview training program for surgeons for the postgraduate admissions process. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[The importance of chronic migraine in a general neurology service].

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Gracia-Naya, M; Alarcia-Alejos, R; Modrego-Pardo, P J

Chronic migraine is a primary headache that is difficult to treat and has an important impact on the patient's quality of life. The international headache classification recently modified the criteria for chronic migraine and therefore few studies have been conducted that analyse groups according to these new criteria. AIM. To analyse a group of patients with chronic migraine who were referred to a general neurology service. The first 100 patients with migraine were selected. Researchers established and analysed a number of subgroups of patients with episodic, chronic or chronic migraine with probable headache due to medication abuse, in accordance with the International Headache Society (IHS) headache classification and its revised version from 2006. Of the total sample of 738 new patients, 100 (13.5%) suffered from migraines and of these 100 new patients with migraine 42 (5.6% of the total series) satisfied criteria for chronic migraine and 15 patients with chronic migraine met the criteria for probable headache due to medication abuse. Before visiting the neurology service, only 41% had been diagnosed as suffering from migraine, 38% had received no information about this condition, only 17% took triptans for symptomatic relief and 23% had followed some kind of preventive treatment. One notable finding was the importance of episodic and chronic migraine in a general neurology service, on applying the recent IHS criteria. A high percentage of patients with chronic migraine who were referred to the neurology service have not been diagnosed or given any information or proper treatment; an elevated degree of self-medication and medication abuse also exists. Preventive treatment and triptans in cases of intense migraines are still not commonly used in primary care.

Emerging migraine treatments and drug targets

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Olesen, Jes; Ashina, Messoud

2011-01-01

Migraine has a 1-year prevalence of 10% and high socioeconomic costs. Despite recent drug developments, there is a huge unmet need for better pharmacotherapy. In this review we discuss promising anti-migraine strategies such as calcitonin gene-related peptide (CGRP) receptor antagonists and 5......-hydroxytrypamine (5-HT)(1F) receptor agonists, which are in late-stage development. Nitric oxide antagonists are also in development. New forms of administration of sumatriptan might improve efficacy and reduce side effects. Botulinum toxin A has recently been approved for the prophylaxis of chronic migraine....... Tonabersat, a cortical spreading depression inhibitor, has shown efficacy in the prophylaxis of migraine with aura. Several new drug targets such as nitric oxide synthase, the 5-HT(1D) receptor, the prostanoid receptors EP(2) and EP(4), and the pituitary adenylate cyclase receptor PAC1 await development...

Spinal Cord Injury and Migraine Headache: A Population-Based Study.

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Warner, Freda M; Cragg, Jacquelyn J; Weisskopf, Marc G; Kramer, John K

2015-01-01

Migraine headaches are a common neurological condition, negatively impacting health and quality of life. The association between migraines and spinal cord injury (SCI) is intriguing to consider from the perspective that migraine headaches may be acquired in response to damage in the spinal cord [corrected].The primary objective of this study was to further examine the association between SCI and migraine headache, controlling for potential confounding variables. A secondary objective was to determine the impact of migraine headaches on self-perceived health. Data from a sample of 61,047 participants were obtained from the cross-sectional Canadian Community Health Survey. Multivariable logistic regression was used to explore the association between SCI and migraine headache using probability weights and adjusting for confounders. The multivariable age- and sex-adjusted model revealed a strong association between SCI and migraine headache, with an adjusted odds ratio for migraine of 4.82 (95% confidence interval [3.02, 7.67]) among those with SCI compared to those without SCI. Further, individuals who experienced both SCI and migraine tended to report poorer perceived general health compared with the other groups (i.e., SCI and no migraine). In conclusion, this study established a strong association between SCI and migraine headache. Further research is needed to explore the possible mechanisms underlying this relationship. Improvements in clinical practice to minimize this issue could result in significant improvements in quality of life.

Familial Hemiplegic Migraine and Recurrent Episodes of Psychosis

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LaBianca, Sonja; Jensen, Rigmor; van den Maagdenberg, Arn M J M

2015-01-01

Familial hemiplegic migraine (FHM) is a rare autosomal dominant form of migraine with motor aura. We present a case report of a father and son with very similar attacks of hemiplegic migraine and recurrent episodes of accompanying psychoses. Previously, such episodes led to hospitalization...... and extended clinical examinations, which further worsened the psychoses. Since the episodes were recognized as related to the hemiplegic migraine, a treatment strategy combining sleep and sedation was initiated and progression onto psychosis was almost completely avoided in both father and son. Genetic...

Migraine and risk of perioperative ischemic stroke and hospital readmission

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Timm, Fanny P; Houle, Timothy T; Grabitz, Stephanie D

2017-01-01

OBJECTIVE: To evaluate whether patients with migraine are at increased risk of perioperative ischemic stroke and whether this may lead to an increased hospital readmission rate. DESIGN: Prospective hospital registry study. SETTING: Massachusetts General Hospital and two satellite campuses between...... was hospital readmission within 30 days of surgery. Exploratory outcomes included post-discharge stroke and strata of neuroanatomical stroke location. RESULTS: 10 179 (8.2%) patients had any migraine diagnosis, of whom 1278 (12.6%) had migraine with aura and 8901 (87.4%) had migraine without aura. 771 (0.......9 (2.9 to 5.0) for migraine without aura, and 6.3 (3.2 to 9.5) for migraine with aura. : Patients with migraine had a higher rate of readmission to hospital within 30 days of discharge (adjusted odds ratio 1.31, 1.22 to 1.41). CONCLUSIONS: Surgical patients with a history of migraine are at increased...

The relationship between migraine headache and asthma features.

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Dirican, Nigar; Demirci, Seden; Cakir, Munire

2017-06-01

Migraine and asthma are comorbid chronic disorders with episodic attacks thought to involve inflammatory and neurological mechanisms. The objective of the present study is to investigate the relationship of asthma features between the asthma patients with migraine and those without migraine headache. A cross-sectional study was conducted from October 2015 to June 2016. Physician-diagnosed asthma patients aged 18 years and above were included. Demographic data, pulmonary function test and treatment of asthma were recorded. Asthma control was assessed using the asthma control test (ACT) and asthma control questionnaire (ACQ). The diagnosis of migraine was made by the neurologist with face-to face examinations based on the International Classification of Headache Disorders, third edition beta (ICHD-III-beta) criteria. Data about the age at onset, frequency of headache attacks, duration of headache attack, the presence of aura, and severity of headache were recorded. The severity of headache was evaluated using visual analogue scale (VAS). Overall 121 asthma patients were included in this study. Migraine was found to be present in 32 (26.4%) of patients. No statistically significant difference was found between asthma group and asthma with migraine groups in terms of pulmonary function test parameters. The mean ACT score in asthma with migraine patients group was significantly lower than the asthma groups. Morever, in the group asthma with migraine, a negative significant correlations were found between ACT scores with VAS scores. This study demonstrates that migraine headache may be associated with poor asthma control. On the other hand, it should not be forgotten that ACT is a subjective test and can be affected from by many clinical parameters.

Genetics Home Reference: familial hemiplegic migraine

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... features of an aura can include difficulty with speech, confusion, and drowsiness. An aura typically develops gradually over a few minutes and lasts about an hour. Unusually severe migraine episodes have been reported in some people with familial hemiplegic migraine . These ...

Effects of a training in the Disability Assessment Structured Interview on the interviews of Dutch insurance physicians

NARCIS (Netherlands)

Spanjer, Jerry; Mei, van der Sijrike; Cornelius, Bert; Brouwer, Sandra; Klink, van der Jac

PURPOSE: The Disability Assessment Structured Interview (DASI) is a semi-structured interview for assessing functional limitations of claimants in a work disability evaluation. The aim of this study is to evaluate the effect of a 3-day DASI training course on the quality of assessment interviews of

Migraine Headache Treatment & Research | NIH MedlinePlus the Magazine

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... of this page please turn JavaScript on. Feature: Migraine Headaches Treatment & Research Past Issues / Fall 2015 Table of Contents Nondrug Options to Manage Migraine Pain Dr. Josephine P. Briggs discusses complementary migraine ...

Angiotensin Converting Enzyme Gene Insertion/Deletion Polymorphism in Migraine Patients

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Belgin Alaşehirli

2009-12-01

Full Text Available OBJECTIVE: The beneficial effects of angiotensin converting enzyme inhibitor drugs on migraine attack frequency have been shown. We aimed to study the relationship between the angiotensin converting enzyme gene and migraine pathophysiology. METHODS: In the present study, to assess whether the angiotensin converting enzyme insertion/deletion (I/D gene polymorphisms have an effect on migraine attacks, we studied the angiotensin converting enzyme genotypes of 102 migraine patients (35 cases of migraine with aura and 67 of migraine without aura and 75 age-and sex-matched normal volunteers. Frequency and age of onset of migraine attacks were also assessed according to angiotensin converting enzyme genotypes. RESULTS: Patients with migraine with and without aura were comparable with each other and the control group with respect to angiotensin converting enzyme genotypes (respectively; p= 0.88 and p= 0.76, p= 0.624. We could not determine a relationship between angiotensin converting enzyme genotypes and attack frequency (p= 0.125, but cases with angiotensin converting enzyme-II genotype showed a significantly younger age for onset of migraine attacks in comparison with the I/D genotype patients (p= 0.021. CONCLUSION: We believe that further angiotensin converting enzyme gene studies are warranted in younger age groups of patients with migraine and also in different populations

Frequency of Migraine as a Chief Complaint in Otolaryngology Outpatient Practice

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Muhammad Ali, Maria; Al Zayer, Maha

2015-01-01

Objective. To identify the frequency of typical (headache and dizziness) and common atypical (ear fullness, pressure, pain, tinnitus, facial fullness, and nasal congestion) migraine symptoms as chief complaints among patients presenting to otolaryngology clinic. Methods. This is a descriptive study of prospectively collected data from a general otolaryngology practice. Typical migraine presentations were diagnosed by applying international headache society (IHS) criteria for migraine headache and Neuhauser's criteria for migrainous vertigo. Atypical otologic and rhinologic migraine symptoms were diagnosed using individualized criteria. Charts were reviewed at 6-month interval from the first presentation. Results. Out of 1002 consecutive patients, 10.8% presented with “migrainous chief complaint.” All migrainous chief complaint patients had a history of headache but not all of them presented with headache. Corrected female to male ratio in the migraine group was 3 to 1; age distributions were significantly different between the migraine and nonmigraine groups by applying t-test. Out of the atypical complaints, 86% of the patients had a history of concomitant typical presentation. Conclusion. Actual diagnostic criteria for migraine do not satisfy the diversity of its presentation. Investigating the history of migraine is enough to diagnose most atypical presentations. Sound knowledge about migraine seems essential for any ENT practitioner. PMID:25695049

Relationship between MIDAS, depression, anxiety and alexithymia in migraine patients.

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Yalınay Dikmen, Pınar; Onur Aysevener, Elif; Kosak, Seda; Ilgaz Aydınlar, Elif; Sağduyu Kocaman, Ayşe

2017-11-16

The co-existence of psychiatric comorbidities with migraine is well known; however, the relationship between alexithymia and migraine has not been persuasively shown yet. The aim of the study was to assess the relationships between migraine-related disability, depression, anxiety and alexithymia. One hundred and forty-five migraine patients (33.18 ± 8.6; 111 females, 34 males), and 50 control subjects (29.06 ± 7.6; 34 females, 16 males) were prospectively enrolled for the study. The participants completed a demographic data form and Migraine Disability Assessment Scale, Beck Depression Inventory, Beck Anxiety Inventory and Toronto Alexithymia Score-20 (TAS-20). All migraine patients were more depressive (p = 0.01) and anxious (p = 0.001) than the healthy subjects. TAS-20 scores of the migraine sufferers and the control group did not indicate alexithymia. The migraine-related disability of all migraine patients was severe (27.84 ± 29.22). Depression and anxiety scores in the migraine patients were highly correlated with each other and TAS-20 (r = 0.485, p = 0.001) and all its subscales in turn: difficulty in identifying (r = 0.435, p < 0.001) and describing feelings (r = 0.451, p = 0.001) and externally oriented thinking (r = 0.302, p = 0.001). Moreover, logistic regression analysis revealed that depression and anxiety predicted alexithymia. Our findings showed a complex relationship between migraine, depression, anxiety and alexithymia. On the other hand, alexithymia apparently was not directly connected to migraine, but its presence could be predicted in migraine patients because of co-morbid depression and anxiety.

The pathophysiology of the migraine attack

NARCIS (Netherlands)

E.L.H. Spierings

1980-01-01

textabstractMigraine, a word of French origin, is a mediaeval corruption of the Greek hemicrania". Its etymological meaning, half-headache, indicates two important features of the disorder, the headache and its onesidedness. In classical migraine, the headache is preceded by an 'aura' of

Spinal Cord Injury and Migraine Headache: A Population-Based Study.

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Freda M Warner

Full Text Available Migraine headaches are a common neurological condition, negatively impacting health and quality of life. The association between migraines and spinal cord injury (SCI is intriguing to consider from the perspective that migraine headaches may be acquired in response to damage in the spinal cord [corrected].The primary objective of this study was to further examine the association between SCI and migraine headache, controlling for potential confounding variables. A secondary objective was to determine the impact of migraine headaches on self-perceived health. Data from a sample of 61,047 participants were obtained from the cross-sectional Canadian Community Health Survey. Multivariable logistic regression was used to explore the association between SCI and migraine headache using probability weights and adjusting for confounders. The multivariable age- and sex-adjusted model revealed a strong association between SCI and migraine headache, with an adjusted odds ratio for migraine of 4.82 (95% confidence interval [3.02, 7.67] among those with SCI compared to those without SCI. Further, individuals who experienced both SCI and migraine tended to report poorer perceived general health compared with the other groups (i.e., SCI and no migraine. In conclusion, this study established a strong association between SCI and migraine headache. Further research is needed to explore the possible mechanisms underlying this relationship. Improvements in clinical practice to minimize this issue could result in significant improvements in quality of life.

Is migraine a risk factor for pediatric stroke?

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Gelfand, Amy A; Fullerton, Heather J; Jacobson, Alice; Sidney, Stephen; Goadsby, Peter J; Kurth, Tobias; Pressman, Alice

2015-12-01

Our understanding of risk factors for childhood stroke is incomplete. In adults, migraine with aura is associated with a two-fold increase in ischemic stroke risk. In this cohort study we examine the association between migraine and stroke among children in Kaiser Permanente Northern California (KPNC). Children ages 2-17 years who were members of KPNC for ≥6 months between 1997 and 2007 were included. Migraine cohort members had one or more of: an ICD-9 code for migraine, migraine listed as a significant health problem, or a prescription for a migraine-specific medication. The comparison group was children with no evidence of headache. Main outcome measures included stroke incidence rates and incidence rate ratios (IR). Among the 1,566,952 children within KPNC during the study period, 88,164 had migraine, and 1,323,142 had no evidence of headache. Eight migraineurs had a stroke (three (38%) hemorrhagic; five (63%) ischemic). Eighty strokes occurred in children without headache (53 (66%) hemorrhagic; 27 (34%) ischemic). The ischemic stroke incidence rate was 0.9/100,000 person-years in migraineurs vs. 0.4/100,000 person-years in those without headache; IR 2.0 (95% CI 0.8-5.2). A post-hoc analysis of adolescents (12-17 years) showed an increased risk of ischemic stroke among those with migraine; IR 3.4 (95% CI 1.2-9.5). The hemorrhagic stroke incidence rate was 0.5/100,000 person-years in migraineurs and 0.9/100,000 person-years in those without headache; IR 0.6 (95% CI 0.2-2.0). There was no statistically significant increase in hemorrhagic or ischemic stroke risk in pediatric migraineurs in this cohort study. A post-hoc analysis found that ischemic stroke risk was significantly elevated in adolescents with migraine. Future studies should focus on identifying risk factors for ischemic stroke among adolescent migraineurs. Based on adult data, we recommend that migraine aura status should be studied as a possible risk factor for ischemic stroke among adolescent

The prevalence of vestibular symptoms in migraine or tension-type headache.

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Akdal, Gülden; Ozge, Aynur; Ergör, Gül

2013-01-01

We assessed frequency of vestibular symptoms in Headache Clinic patients over 10 years. A descriptive study of 5111 consecutive patients with tension-type headache or migraine, analyzed for dizziness/ vertigo accompanying headache and for a lifetime history of motion-sickness, cyclic vomiting, recurrent abdominal pain or atopy. Migraine patients were re-grouped as those with vestibular symptoms (dizziness/vertigo or motion sickness) and those without and their data then re-analyzed. There were 1880 migraine patients and 3231 tension-type headache patients. Significantly more migraine patients than tension-type headache patients experienced vestibular symptoms (p< 0.0001). The migraine with vestibular symptoms group was significantly younger (p< 0.05) had more aura, more phonophobia with migraine attacks (p< 0.0001). Menstruation and reported sleep problems impacted on headaches. While past history of cyclical vomiting, recurrent abdominal pain or atopy was about twice as common in migraine with aura and it was also more common in migraine with vestibular symptoms than migraine without vestibular symptoms. Vestibular symptoms are common in migraine patients. Migraine with vestibular symptoms might constitute a special group, one more likely to have had cyclic vomiting, recurrent abdominal pain or atopy.

Migraine Pathophysiology - Evolution Of Our Knowledge

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Sinha K.K

2002-01-01

Full Text Available The biologic basis of migraine had remained unclear until about 15 years, but current migraine research has made some major advances to explain its mechanism. Migraine is currently conceived to originate in the brain. The trigger of an attack starts a depolarising event very similar to "spreading depression" of Leao in a brain that is already hyperexcitable. Hyperexcitability of cell membrane is perhaps genetically determined. Cortical depolarising events drive the trigeminovascular system through mechanisms that are largely hypothetical but might include a migraine generating centre in the brainstem to produce changes in the vessels of the cranium and meninges. Pain sensations carrying impulses are relayed back, first reaching the trigeminal ganglion caudalis and the trigeminal cervical complex in upper cervical cord from where they are relayed further up through various transmitting pathways to the brainstem, thalamus and the cortex where pain is finally perceived and registered.

Fisiopatologia da enxaqueca Migraine pathophysiology

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MAURICE B. VINCENT

1998-12-01

Full Text Available A fisiopatologia da enxaqueca ainda não foi completamente elucidada. As principais estruturas envolvidas parecem ser o sistema nervoso central (córtex e tronco cerebral, o sistema trigeminovascular e os vasos correspondentes, outras fibras autonômicas que inervam estes vasos, e os vários agentes vasoativos locais, como a SP, CGRP, NO, VIP, NPY, ACh, NA, NKA, entre outros. A depressão alastrante é o fenômeno neurológico que provavelmente justifica achados experimenais e clínicos na enxaqueca. Ela tem velocidade de propagação semelhante à aura, ativa o núcleo espinhal do trigêmeo e está relacionada à liberação de CGRP e NO. Alterações circulatórias detectadas por métodos complementares reforçam o papel da depressão alastrante. A identificação de anormalidades em pelo menos três loci (cromossomas 19 e 1 na enxaqueca hemiplégica familiar ocorreu recentemente. Elas estão relacionadas a anormalidades nos canais de cálcio voltagem dependentes tipo P/Q, específicos do sistema nervoso central, que regulam a liberação de vários neurotransmissores, incluindo possivelmente a serotonina. A exemplo de outras anormalidades neurológicas paroxísticas que resultam da hiperexcitabilidade da membrana plasmática, é possível que a enxaqueca ocorra devido a uma desordem de canais iônicos.The pathophysiology of migraine is not yet fully understood. The most important structures involved seem to be the central nervous system (cortex and brain stem, the trigeminovascular system and related cranial arteries, other autonomic fibres innervating such vessels, and various local vasoactive agents, including SP, CGRP, NO, VIP, NPY, ACh, NA, NKA, among others. The spreading depression phenomenon may explain clinical as well experimental findings in migraine. Its propagation velocity mirrors what is found in clinical aura, it may activate the spinal trigeminal nucleus and may induce CGRP and NO release. Circulatory changes detected with

The role of exercise in migraine treatment.

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Koseoglu, E; Yetkin, M F; Ugur, F; Bilgen, M

2015-09-01

This review aims to provide a comprehensive overview of the literature on the use of exercise for migraine treatment with regard to its efficacy, mechanism of action and role in practice. Many randomized studies have reported the efficacy of prophylactic treatment of migrane with medications such as beta blockers or antiepileptic drugs. Studies on alternative approaches, like aerobic exercise and biofeedback, are however limited but also considered to be effective. Scientific databases were searched with keywords "exercise" and "migraine". The resulting publications were gathered, examined and discussed throughly. Past studies had limitations and were few in number, but more recent randomized controlled studies have concretely provided level of evidence about the effectiveness of exercise in prophylactic treatment of migraine. Core properties of exercise like intensity, duration, frequency, type and warming up period are required to be monitored while treating migraine to increase the beneficial effects and, also to prevent injuries and side effects which may include exertional headache. Isometric neck exercise is helpful when the migraine is accompanied by neck pain. Patient population with low beta endorphin level in blood, high physical fitness and high motivation receives significant benefits from the exercise treatment. The action of exercise on migraine is in general related to neurochemical factors, psychological states and increase in cardivascular and cerebrovascular fitness. Considering its effectiveness and minimal side effects, migraine patients should often be encouraged to practice physical exercise with intensity, frequency and duration that should be carefully instituted to achieve the most beneficial outcome while preventing potential injuries and side effects.

Stress and psychological factors before a migraine attack: A time-based analysis

Directory of Open Access Journals (Sweden)

Makino Mariko

2008-09-01

Full Text Available Abstract Background The objective of this study is to examine the stress and mood changes of Japanese subjects over the 1–3 days before a migraine headache. Methods The study participants were 16 patients with migraines who consented to participate in this study. Each subject kept a headache diary four times a day for two weeks. They evaluated the number of stressful events, daily hassles, domestic and non-domestic stress, anxiety, depressive tendency and irritability by visual analog scales. The days were classified into migraine days, pre-migraine days, buffer days and control days based on the intensity of the headaches and accompanying symptoms, and a comparative study was conducted for each factor on the migraine days, pre-migraine days and control days. Results The stressful event value of pre-migraine days showed no significant difference compared to other days. The daily hassle value of pre-migraine days was the highest and was significantly higher than that of buffer days. In non-domestic stress, values on migraine days were significantly higher than on other days, and there was no significant difference between pre-migraine days and buffer days or between pre-migraine days and control days. There was no significant difference in the values of domestic stress between the categories. In non-domestic stress, values on migraine days were significantly higher than other days, and there was no significant difference between pre-migraine days and buffer days or between pre-migraine days and control days. There was little difference in sleep quality on migraine and pre-migraine days, but other psychological factors were higher on migraine days than on pre-migraine days. Conclusion Psychosocial stress preceding the onset of migraines by several days was suggested to play an important role in the occurrence of migraines. However, stress 2–3 days before a migraine attack was not so high as it has been reported to be in the United States and

Weight change associated with the use of migraine-preventive medications.

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Taylor, Frederick R

2008-06-01

Medications administered long term, such as those used for migraine prophylaxis, are often associated with weight change as a side effect. Such effects may compromise general health status, exacerbate coexisting medical conditions, and affect medication adherence. Weight gain should be of particular concern in patients with migraine, as there is evidence that overweight and obese patients with migraine are at risk for an increased frequency and severity of migraine attacks. This article reviews weight-change data from recent clinical studies of migraine-preventive medications in children, adolescents, and adults with migraine. A PubMed search was conducted for English-language articles published between January 1970 and November 2007. Among the search terms were migraine prevention, migraine prophylaxis, migraine treatment, antidepressant drug, beta-adrenergic-receptor blockers, antiepileptic drug, anticonvulsant drug, weight gain, and weight loss. Studies that reported weight-change data (gain, loss, or neutral) were included. When available, double-blind, placebo-controlled studies were selected for review. Open-label, retrospective or prospective trials may also have been included. Most of the migraine-preventive medications classified by the United States Headache Consortium as group 1 based on the high level of evidence for their efficacy--for instance, amitriptyline, propranolol, and divalproex sodium-have been associated with varying degrees of weight gain. The exceptions are timolol, which is weight neutral, and topiramate, which is associated with weight loss. Among the drugs that have been associated with weight gain, a higher incidence of weight gain was observed with amitriptyline and divalproex sodium than with propranolol. Weight-change effects require careful consideration when selecting migraine-preventive medications, and weight should be monitored carefully over the course of any migraine treatment plan.

Migraine: A look down the nose.

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Muehlberger, Thomas; Wormald, Justin C R; Hachach-Haram, Nadine; Mosahebi, Afshin

2017-07-01

Studies have suggested that contact between opposing mucosal surfaces in the nasal wall and cavity can be a target of the surgical treatment of migraines. Unfortunately, not enough is known about the role of nasal pathology in the pathogenesis of this condition. The co-existence of further rhinological disorders can be an impediment to defining the cause and effect of anatomical variants. The authors compared the MRI scans of migraine- and non-migraine patients (MPs and NMPs, respectively) to determine the prevalence of such mucosal contact points in order to extrapolate whether there is a significant association with migraines. Coronal and axial MRI brain scans of 522 patients (412 migraineurs and 110 non-migraineurs) were analysed for the prevalence of anatomical variations of the nasal cavity, e.g. concha bullosa, septal deviations, mucosal swelling and contact points. The results showed no significant difference between MPs and NMPs patients for any of the parameters examined. Moreover, 87% MPs and 79% NMPs had at least one contact point. The most frequent contact point was between the middle turbinate and the septum, observed in 54% of MPs and 45% of NMPs. Contact points with the nasal mucosa are highly prevalent in both MPs and NMPs. Although a contact point does not cause a migraine in the absence of the disease, the concomitant presence of migraine and contact points can trigger an attack, and therefore, it is necessary to differentiate or exclude a rhinological disorder in these patients. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Periodontal disease as a potential factor of migraine chronification.

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Ameijeira, Pablo; Leira, Yago; Blanco, Juan; Leira, Rogelio

2017-05-01

Migraine is a hereditary constitutional base disorder, which is characterized by recurrent episodes of headache pulsatile characteristics associated with photophobia/phonophobia, nausea and/or vomiting. The main complication in migraine is the chronicity of the process, now recognized as a chronic migraine. Although pathogenic mechanisms that may influence the pathophysiology of migraine and its possible chronicity are not fully understood, previous studies have shown in patients with migraine molecular alterations of systemic inflammation, neurogenic inflammation, endothelial dysfunction, innate immunity, dysfunction of matrix proteases and blood-brain barrier. Periodontal disease is an inflammatory lesion caused by bacteria. After the bacterial infection begins, an immune response that will be responsible for individual susceptibility appears. More advanced forms of periodontitis have demonstrated molecular alterations of inflammation, endothelial dysfunction, dysfunction of matrix proteases and innate immunity, similar to those observed in migraine. Furthermore, the main molecular mediators of neurogenic inflammation related to activation of the trigeminovascular system, which are characteristic of migraine, are overexpressed in gingival crevicular fluid and mucosa in patients with periodontal disease. Hypertension, hypercholesterolemia, insulin resistance, stroke or coronary artery disease are comorbidities that periodontal disease and migraine could share. Therefore, several mechanisms and hypotheses could explain the possible association between both diseases. However, epidemiological and molecular studies will be necessary to provide a better understanding of this potential association, which could be implicated in the chronification of migraine. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pearls and pitfalls in human pharmacological models of migraine

DEFF Research Database (Denmark)

Ashina, Messoud; Hansen, Jakob Møller; Olesen, Jes

2013-01-01

In vitro studies have contributed to the characterization of receptors in cranial blood vessels and the identification of new possible anti-migraine agents. In vivo animal models enable the study of vascular responses, neurogenic inflammation, peptide release and genetic predisposition and thus......- or migraine-provoking property of naturally occurring signaling molecules can be tested in a human model. If such an endogenous substance can provoke migraine in human patients, then it is likely, although not certain, that blocking its effect will be effective in the treatment of acute migraine attacks...... an important role in translational migraine research leading to the identification of three new principally different targets in the treatment of acute migraine attacks and has been used to examine other endogenous signaling molecules as well as genetic susceptibility factors. New additions to the model...

C-reactive protein and migraine. Facts or speculations?

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Lippi, Giuseppe; Mattiuzzi, Camilla; Cervellin, Gianfranco

2014-09-01

Abstract Migraine is a highly prevalent and frequently disabling disorder. Since the pathogenesis of this condition has a strong inflammatory component and migraine is significantly associated with cardiovascular disease, we assess whether C-reactive protein (CRP) may be epidemiologically or casually linked with migraine. An electronic search on Medline, Scopus and Web of Science produced 17 studies reporting original data about the epidemiological association between CRP and migraine (1 retrospective, 1 interventional, 14 cross-sectional and 1 both interventional and cross-sectional). When all studies reporting sufficient data about CRP values were pooled (n=12; 6980 cases and 38,975 controls), the concentration of CRP was found to be significantly higher in patients with migraine than in controls (weighted mean difference 1.12 mg/L; 95% CI 1.01-1.25 mg/L; p<0.001). In further analysis of studies containing separate data for migraine with and without aura (n=7), CRP values remained significantly higher in both migraineur patients with aura (n=1939; weighted mean difference 0.88 mg/L; 95% CI 0.63-1.14 mg/L; p<0.001) or without aura (n=2483; weighted mean difference 1.04 mg/L; 95% CI 0.78-1.30 mg/L; p<0.001) when compared with controls (n=29,354). Despite a large inter-study heterogeneity (99.3%), our analysis provides evidence of a potential epidemiological association between increased concentration of CRP and migraine, thus paving the way for further clinical investigations about therapeutic agents that may contextually decrease the risk of cardiovascular disease and reduce the burden of migraine.

Pharmacological synergy: the next frontier on therapeutic advancement for migraine.

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Blumenfeld, Andrew; Gennings, Chris; Cady, Roger

2012-04-01

The burden of migraine significantly impacts the individual sufferer, their families, the workplace, and society. The World Health Organization has identified migraine as an urgent public health priority and has initiated a global initiative to reduce the burden of migraine. Underlying the World Health Organization initiative is the need to discover means of optimizing migraine treatments and make them accessible to the broader portion of the world population. Development of acute migraine medications over the past several decades has largely centered on engineering highly specific receptor molecules that alter migraine pathophysiological mechanisms to abort or reverse the acute attack of migraine. The first product of this line of discovery was sumatriptan and heralded as a landmark therapeutic breakthrough. Sumatriptan is a 5-HT-1B/D receptor agonist considered to activate receptors involved in the pathophysiology specific to migraine. Large-scale regulatory/clinical studies demonstrated statistical superiority for sumatriptan over placebo in reduction or elimination of headache, nausea, photophobia, and phonophobia. Since the introduction of sumatriptan, 6 other triptan products have been released in the United States as acute treatments for migraine, all having the same mechanism of action and similar efficacy. Despite their utility as migraine abortive medications, the triptans do not successfully treat all attacks of migraine or necessarily treat all migraine associated symptoms. In fact, in less than 25% of attacks do subjects obtain and maintain a migraine-free response to treatment for at least beyond 24 hours. A wide range of non-triptan medications also have demonstrated efficacy in acute migraine. These include non-steroidal anti-inflammatory drugs (NSAIDs), opioids, phenothiazines, and valproic acid to name a few. Given the distinctly different mechanisms of actions of these various medications, it is likely that several unique pathophysiological

Towards a reliable animal model of migraine

DEFF Research Database (Denmark)

Olesen, Jes; Jansen-Olesen, Inger

2012-01-01

The pharmaceutical industry shows a decreasing interest in the development of drugs for migraine. One of the reasons for this could be the lack of reliable animal models for studying the effect of acute and prophylactic migraine drugs. The infusion of glyceryl trinitrate (GTN) is the best validated...... and most studied human migraine model. Several attempts have been made to transfer this model to animals. The different variants of this model are discussed as well as other recent models....

Temporomandibular disorders and migraine headache

OpenAIRE

Demarin, Vida; Bašić Kes, Vanja

2010-01-01

Migraine headache and temporomandibular disorders show significant overlap in the area or distribution of pain, the gender prevalence and age distribution. Temporomandibular disorders may cause headaches per se, worsen existent primary headaches, and add to the burden of headache disorders. The patients with combined migraine and tension-type headaches had a higher prevelance of temporomandibular disorders. Evidence supporting a close relationship include the increased masticatory...

Calcitonin gene-related peptide does not cause the familial hemiplegic migraine phenotype

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Hansen, J.M.; Thomsen, L.L.; Olesen, J.

2008-01-01

Objective: The neuropeptide calcitonin gene-related peptide (CGRP) is a migraine trigger that plays a crucial role in migraine pathophysiology, and CGRP antagonism is efficient in the treatment of migraine attacks. Familial hemiplegic migraine (FHM) is a dominantly inherited subtype of migraine w...... without aura. This indicates that the pathophysiologic pathways underlying migraine headache in FHM may be different from the common types of migraine and questions whether CGRP antagonists would be effective in the treatment of FHM patients Udgivelsesdato: 2008/9/9...

Refractory migraine in a headache clinic population

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Fernandez-Torron Roberto

2011-08-01

Full Text Available Abstract Background Many migraineurs who seek care in headache clinics are refractory to treatment, despite advances in headache therapies. Epidemiology is poorly characterized, because diagnostic criteria for refractory migraine were not available until recently. We aimed to determine the frequency of refractory migraine in patients attended in the Headache Unit in a tertiary care center, according to recently proposed criteria. Methods The study population consisted of a consecutive sample of 370 patients (60.8% females with a mean age of 43 years (range 14-86 evaluated for the first time in our headache unit over a one-year period (between October 2008 and October 2009. We recorded information on clinical features, previous treatments, Migraine Disability Assessment Score (MIDAS, and final diagnosis. Results Overall migraine and tension-type headache were found in 46.4% and 20.5% of patients, respectively. Refractory migraine was found in 5.1% of patients. In refractory migraineurs, the mean MIDAS score was 96, and 36.8% were medication-overusers. Conclusions Refractory migraine is a relatively common and very disabling condition between the patients attended in a headache unit. The proposed operational criteria may be useful in identifying those patients who require care in headache units, the selection of candidates for combinations of prophylactic drugs or invasive treatments such as neurostimulation, but also to facilitate clinical studies in this patient group.

Dietary patterns according to headache and migraine status: a cross-sectional study.

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Rist, Pamela M; Buring, Julie E; Kurth, Tobias

2015-08-01

Several potential dietary trigger factors for migraine have been proposed. However, few studies have examined the intake pattern of these dietary items compared to adequate control populations and whether intake levels may vary by migraine aura status or attack frequency. We conducted a cross-sectional study among participants in the Women's Health Study. We used logistic regression to evaluate the association between migraine and headache status and low intake of foods commonly reported to affect migraine. A total of 25,755 women reported no history of migraine or headache, 5573 reported non-migraine headache and 7042 reported any migraine. Those with non-migraine headache or any migraine were more likely to have low intake of total alcohol (OR = 1.22, 95% CI:1.14-1.29 and OR = 1.17, 95% CI:1.11-1.24, respectively). Migraineurs with aura were more likely to have low intake of chocolate, ice cream, hot dogs, and processed meats. Those who experience migraine at least once per week were more likely to have low intake of skim/low-fat milk and white and red wine. Intake of most suggested migraine dietary triggers differs by migraine aura status and attack frequency, a pattern not found for non-migraine headache. © International Headache Society 2014.

Patent foramen ovale and migraine attacks: a systematic review.

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Lip, Philomena Z Y; Lip, Gregory Y H

2014-05-01

Migraine headache and the presence of a patent foramen ovale have been associated with each other, although the precise pathophysiological mechanism(s) are uncertain. The purpose of this systematic review was to identify the extent of patent foramen ovale prevalence in migraineurs and to determine whether closure of a patent foramen ovale would improve migraine headache. An electronic literature search was performed to select studies between January 1980 and February 2013 that were relevant to the prevalence of patent foramen ovale and migraine, and the effects of intervention(s) on migraine attacks. Of the initial 368 articles presented by the initial search, 20 satisfied the inclusion criteria assessing patent foramen ovale prevalence in migraineurs and 21 presented data on patent foramen ovale closure. In case series and cohort studies, patent foramen ovale prevalence in migraineurs ranged from 14.6% to 66.5%. Case-control studies reported a prevalence ranging from 16.0% to 25.7% in controls, compared with 26.8% to 96.0% for migraine with aura. The extent of improvement or resolution of migraine headache attack symptoms was variable. In case series, intervention ameliorated migraine headache attack in 13.6% to 92.3% of cases. One single randomized trial did not show any benefit from patent foramen ovale closure. The data overall do not exclude the possibility of a placebo effect for resolving migraine following patent foramen ovale closure. This systematic review demonstrates firstly that migraine headache attack is associated with a higher prevalence of patent foramen ovale than among the general population. Observational data suggest that some improvement of migraine would be observed if the patent foramen ovale were to be closed. A proper assessment of any interventions for patent foramen ovale closure would require further large randomized trials to be conducted given uncertainties from existing trial data. Copyright © 2014 Elsevier Inc. All rights reserved.

Prophylaxis of migraine headaches with riboflavin: A systematic review.

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Thompson, D F; Saluja, H S

2017-08-01

Migraine headache is a relatively common, debilitating condition that costs our healthcare system over 78 billion dollars per year. Riboflavin has been advocated as a safe, effective prophylactic therapy for the prevention of migraines. The purpose of this study was to provide a systematic review of the current role of riboflavin in the prophylaxis of migraine headache. A MEDLINE literature search inclusive of the dates 1966-2016 was performed using the search terms: riboflavin and migraine disorders. Excerpta Medica was searched from 1980 to 2016 using the search terms: riboflavin and migraine. Additionally, Web of Science was searched using the terms riboflavin and migraine inclusive of 1945-2016. Bibliographies of all relevant papers were reviewed for additional citations. We utilized the PRISMA guidelines to select English language, human, clinical trials of riboflavin as a single entity or in combination, review articles, and supporting pharmacokinetic and pharmacogenomic data assessing the efficacy and mechanism of riboflavin therapy in the prophylactic treatment of migraine headache. A total of 11 clinical trials reveal a mixed effect of riboflavin in the prophylaxis of migraine headache. Five clinical trials show a consistent positive therapeutic effect in adults; four clinical trials show a mixed effect in paediatric and adolescent patients, and two clinical trials of combination therapy have not shown benefit. Adverse reactions with riboflavin have generally been mild. Riboflavin is well tolerated, inexpensive and has demonstrated efficacy in the reduction of adult patient's migraine headache frequency. Additional data are needed, however, to resolve questions involving pharmacokinetic issues and pharmacogenomic implications of therapy. © 2017 John Wiley & Sons Ltd.

Brain imaging with 123I-IMP-SPECT in migraine between attacks

International Nuclear Information System (INIS)

Schlake, H.P.; Boettger, I.G.G.; Grotemeyer, K.H.; Husstedt, I.W.

1989-01-01

123 I-IMP-SPECT brain imaging was performed in patients with classic migraine (n = 5) and migraine accompagnee (n = 18) during the headache-free interval. A regional reduction of tracer uptake into brain was observed in all patients with migraine accompagnee, while in patients with classic migraine only one case showed an area of decreased activity. The most marked alteration was found in a patient with persisting neurological symptoms (complicated migraine). In most cases the areas of decreased tracer uptake corresponded to headache localization as well as to topography of neurologic symptoms during migraine attacks. It may be concluded that migraine attacks occur in connection with exacerbations of preexisting changes of cerebral autoregulation due to endogenous or exogenous factors

Migraine and pregnancy: an internet survey.

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Allais, Gianni; Rolando, Sara; De Lorenzo, Cristina; Manzoni, Gian Camillo; Messina, Paolo; Benedetto, Chiara; d'Onofrio, Florindo; Bonavita, Vincenzo; Bussone, Gennaro

2013-05-01

Data in the literature show that migraine tends to improve during pregnancy in most migrainous women. The aim of this Internet survey was to obtain the most likely cross section of the situation in the general population with respect to the presence and course of migraine in pregnancy. All women who participated were asked to answer questions pertaining to their history of pregnancy and headache. One thousand and eighteen women participated in the survey; only 775 met the eligibility criteria for inclusion. One hundred and ninety-five women (25.2 %) reported having had a headache only before pregnancy, 425 (54.8 %) before and during pregnancy, and 155 (20.0 %) only during pregnancy. Women suffering from headache before and/or during pregnancy were much more likely to have headaches with more migrainous features at the ID Migraine Screener test when compared to women whose headache began during pregnancy. "Definite migraines" were 277/620 (44.7 %) and 26/155 (16.8 %), respectively, in the two groups (p < 0.0001). Among the 620 females that suffered from headache before pregnancy, 375 (60.5 %) improved, 195 (31.5 %) showed complete resolution of the disorder, and 180 (29.0 %) had a reduction in headache frequency. Moreover, the multinomial logistic model (with headache pattern as dependent variable) proved fetal presentation as significant (p = 0.0042). Women with "new headache" (No/Yes pattern) had an OR (95 % CI) of 1.9 (1.2-3.0) of breech presentation at delivery versus those with a stable pattern of headache (Yes/Yes). Finally, women with not recent pregnancy stated they suffered from headache less than the women with recent pregnancy.

Blocking CGRP in migraine patients - a review of pros and cons

DEFF Research Database (Denmark)

Deen, Marie; Correnti, Edvige; Kamm, Katharina

2017-01-01

Migraine is the most prevalent neurological disorder worldwide and it has immense socioeconomic impact. Currently, preventative treatment options for migraine include drugs developed for diseases other than migraine such as hypertension, depression and epilepsy. During the last decade, however......, blocking calcitonin gene-related peptide (CGRP) has emerged as a possible mechanism for prevention of migraine attacks. CGRP has been shown to be released during migraine attacks and it may play a causative role in induction of migraine attacks. Here, we review the pros and cons of blocking CGRP...

Visual Disturbances: Related to Migraine or Not?

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... impact during MHAM What is Migraine and Headache Awareness Month? June is Migraine and Headache Awareness Month, ... approved last week, which is called erenumab, the brand name of which is Aimovig, is a monoclonal ...

Fatores desencadeantes de crises de migrânea em pacientes com migrânea sem aura Precipitating factors of migraine attacks in patients with migraine without aura

Directory of Open Access Journals (Sweden)

Ricardo Ierusalimschy

2002-09-01

Full Text Available Com o objetivo de estudar a distribuição de fatores desencadeantes de migrânea em uma população determinada, foram avaliados, através de entrevista pessoal, 100 pacientes que preenchiam os critérios diagnósticos para migrânea sem aura propostos pela Sociedade Internacional de Cefaléia. O estresse foi o desencadeante mais citado, respondendo pelo surgimento de crises de migrânea em 76% dos pacientes. Em seguida, em ordem de frequência decrescente, foram citados: estímulos sensoriais (75%, privação do sono (49%, jejum (48%, fatores ambientais (47%, alimentos (46%, menstruação (39%, fadiga (35%, bebidas alcoólicas (28%, sono prolongado (27%, cafeína (22%, esforço físico (20%, trauma craniano (20%, viagens (4%, atividade sexual (3%, medicamentos (2%, os movimentos do pescoço (2%, tabagismo (1% e uso de travesseiro baixo (1%. Conclui-se que determinados fatores parecem desempenhar papel importante na precipitação da migrânea.To study the distribution of triggers of migraine in a selected population, 100 patients who fulfilled the diagnostic criteria for migraine without aura as proposed by the International Headache Societywere evaluated by means of a personal interview. Stress was the most cited trigger, triggering migraine in 76%. Afterwards, in descending order of frequency, were cited sensorial stimuli (75%, sleep deprivation (49%, hunger (48%, environmental factors (47%, food (46%, menses (39%, fatigue (35%, alcohol (28%, sleep excess (27%, cafeine (22%, physical exertion (20%, head trauma (20%, trips (4%, sexual activity (3%, medications (2%, neck movements (2%, smoking (1% and the use of a low pillow (1%. It is concluded that certain factors seem to play an important role in the triggering of migraine.

Eyewitness performance in cognitive and structured interviews.

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Memon, A; Wark, L; Holley, A; Bull, R; Koehnken, G

1997-09-01

This paper addresses two methodological and theoretical questions relating to the Cognitive Interview (CI), which previous research has found to increase witness recall in interviews. (1) What are the effects of the CI mnemonic techniques when communication techniques are held constant? (2) How do trained interviewers compare with untrained interviewers? In this study, witnesses (college students) viewed a short film clip of a shooting and were questioned by interviewers (research assistants) trained in conducting the CI or a Structured Interview (SI)--similar to the CI except for the "cognitive" components--or by untrained interviewers (UI). The CI and SI groups recalled significantly more correct information compared to the UI group. However they also reported more errors and confabulated details. Theoretical and practical implications of the results are discussed in terms of precisely identifying the CI facilitatory effects and consequent good practice in the forensic setting.

Genetic bases of the nutritional approach to migraine.

Science.gov (United States)

De Marchis, Maria Laura; Guadagni, Fiorella; Silvestris, Erica; Lovero, Domenica; Della-Morte, David; Ferroni, Patrizia; Barbanti, Piero; Palmirotta, Raffaele

2018-03-08

Migraine is a common multifactorial and polygenic neurological disabling disorder characterized by a genetic background and associated to environmental, hormonal and food stimulations. A large series of evidence suggest a strong correlation between nutrition and migraine and indicates several commonly foods, food additives and beverages that may be involved in the mechanisms triggering the headache attack in migraine-susceptible persons. There are foods and drinks, or ingredients of the same, that can trigger the migraine crisis as well as some foods play a protective function depending on the specific genetic sensitivity of the subject. The recent biotechnological advances have enhanced the identification of some genetic factors involved in onset diseases and the identification of sequence variants of genes responsible for the individual sensitivity to migraine trigger-foods. Therefore many studies are aimed at the analysis of polymorphisms of genes coding for the enzymes involved in the metabolism of food factors in order to clarify the different ways in which people respond to foods based on their genetic constitution. This review discusses the latest knowledge and scientific evidence of the role of gene variants and nutrients, food additives and nutraceuticals interactions in migraine.

Patients with migraine correctly estimate the visual verticality.

Science.gov (United States)

Crevits, Luc; Vanacker, Leen; Verraes, Anouk

2012-05-01

We wanted to study otolith function by measuring the static subjective visual vertical (SVV) in migraine patients and in controls with and without kinetosis (motion sickness). Forty-seven patients with moderately severe migraine and 96 healthy controls were enrolled. Using a questionnaire, persons with kinetosis were identified. The SVV test was performed in a totally dark room. Subjects wore a stiffneck to stabilize the head in an erect position. They were required to adjust an infrared line to the gravitational vertical with a hand-held infrared remote controlled potentiometer. The deviation of SVV in the group of migraine patients was not significantly different from that of controls, regardless of whether an aura was associated. SVV was not significantly influenced by the presence of dizziness/non specific vertigo or kinetosis. Patients with moderately severe migraine under prophylactic medication correctly estimate the visual verticality in the headache-free period. It is suggested that a deviation of SVV in a headache-free migraine patient may not be attributed to his migraine disorder as such regardless whether kinetosis is associated. Copyright © 2011 Elsevier B.V. All rights reserved.

Migraine Medications and Antidepressants: A Risky Mix?

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... What are the health risks associated with taking migraine medications and antidepressants at the same time? Answers ... W. Swanson, M.D. Reports suggest that combining migraine medications called triptans with certain antidepressants — including selective ...

Variability of clinical features in attacks of migraine with aura

DEFF Research Database (Denmark)

Hansen, Jakob M; Goadsby, Peter J; Charles, Andrew C

2016-01-01

. CONCLUSION: These findings are consistent with variable involvement of different brain regions during a migraine attack. The variable occurrence of nausea, and phonophobia in conjunction with photophobia, both defining features of migraine, may be an important consideration in designing clinical studies......BACKGROUND: There is significant variability in the clinical presentation of migraine, both among patients, and between attacks in an individual patient. We examined clinical features of migraine with aura in a large group of patients enrolled in a clinical trial, and compared retrospective...... a detailed retrospective description of the clinical features of their attacks of migraine. During the trial, clinical symptoms in migraine attacks starting with aura were recorded prospectively in 861 attacks. RESULTS: Retrospectively reported visual aura symptoms were variable and often overlapping...

Sleep terrors antecedent is common in adolescents with migraine

Directory of Open Access Journals (Sweden)

Libânia Melo Nunes Fialho

2013-02-01

Full Text Available Migraines and sleep terrors (STs are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. METHODS: All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to the International Classification of Sleep Disorders. RESULTS: A total of 158 participants were evaluated. Of these participants, 50 suffered from episodic migraines (EMs, 57 had chronic migraines (CMs and 51 were control subjects (CG. Participants who had a history of STs had significantly more migraines than participants who did not. CONCLUSIONS: Migraine is strongly associated with a history of STs in the adolescent population independent of demographics and pain intensity.

Migraine Headaches

Science.gov (United States)

... migraine triggers include: stress menstruation (periods) skipping meals dehydration too much caffeine (more than 200 mg a day, such as the amount of caffeine in energy drinks) some foods (alcohol, cheese, citrus fruits, pizza, chocolate, ice cream, lunch meats and hot ...

The borderland of migraine and epilepsy in children.

Science.gov (United States)

Rajapakse, Thilinie; Buchhalter, Jeffrey

2016-06-01

To provide a review on the spectrum of migraine-epilepsy disorders in children. The migraine-epilepsy continuum covers a fascinating array of disorders that share many clinical similarities but also differ fundamentally in pathophysiology. In the pediatric population, its study can be complicated by the young age of those affected and the lack of clear understanding of the neurobiology of these disorders within the developing brain. This review serves to discuss the borderland of migraine and epilepsy in children. It will focus on epidemiology and comorbidity of the two disorders, possible mechanisms for shared pathophysiology informed by basic and translational science, and an overview of clinical similarities and differences. It will also discuss differentiation of migraine aura from childhood occipital epilepsies. Finally, the review concludes with a discussion of current classification methods for capturing cases on the migraine-epilepsy spectrum and a call for a united approach towards a better definition of this spectrum of disorders. Recent advances examining the migraine-epilepsy spectrum show clinicopathological similarities between the two disorders in children. Epidemiology demonstrates reciprocally increased incidences of epilepsy in migraineurs and of migraines in children with epilepsy, however, prospective longitudinal in children are currently lacking. Clinically, the two disorders show similarity in preictal, ictal, and postictal phenomena, with close temporal association of the two conditions described by the controversial term of "migralepsy." Basic science research has contributed significant improvements in understanding the generation of both of these episodic neurological conditions, with common links seen at a cellular level involving synaptic glutamate release and the provocation of varying propagation methods including cortical spreading depression in migraine and the paroxysmal depolarizing shift in epilepsy. Despite these significant

Migraine: is it related to hormonal disturbances or stress?

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Parashar R

2014-10-01

Full Text Available Rachna Parashar,1 Payal Bhalla,2 Nirendra K Rai,3 Abhijit Pakhare,4 Rashmi Babbar5 1Department of Physiology, All India Institute of Medical Sciences, Bhopal, 2Department of Physiology, Vardhaman Mahavir Medical College, New Delhi, 3Department of Neurology, 4Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, 5Department of Physiology, Maulana Azad Medical College, New Delhi, India Background: Common neurological syndrome (migraine without aura is more common among women than men. Migraine is among the top 20 causes of disability. Menstruation is known to be a powerful trigger for migraine, and so is stress, but the presentation of headache is similar in both. Also, women are more vulnerable to stress as well as migraine, and this makes a complex relationship of menstruation, stress, and migraine. Objective: This study was done to understand the association of hormonal fluctuation in menstruation and stress with common migraine. Materials and methods: A cross-sectional comparative study was conducted in 40 young adult females, of whom 20 participants were cases of migraine without aura (18–35 years old, and the remaining 20 participants were age-matched controls. The study was done in Maulana Azad Medical College, New Delhi. Study participants were selected on the basis of International Headache Society (ICHD-IIA1.1 (2004 classification. Study participants with neurological disorders, chronic diseases, and disease suggestive of any hormonal disturbances were excluded. Clinically diagnosed migraine cases were asked to maintain a headache diary and to fill in the Depression Anxiety Stress Scales questionnaire. Biochemical assessment of hormonal status for thyroid-stimulating hormone, triiodothyronine, thyroxine, estrogen, follicle-stimulating hormone, luteinizing hormone, and prolactin was also done on the second day of their menstrual cycle. We used the Mann–Whitney U test to compare hormonal levels

Headache Characteristics and Clinical Features of Elderly Migraine Patients.

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de Rijk, Pablo; Resseguier, Noémie; Donnet, Anne

2018-04-01

To investigate the headache characteristics and clinical features of elderly migraine patients at a tertiary headache center. We retrospectively reviewed 239 records of migraine patients, over the age of 64 at the first visit, who had migraine as defined by the International Classification of Headache Disorders 3rd edition (beta version) from 2006 to 2015 based on the Marseille registry at Timone Hospital. 13.8% (33/239) patients had migraine with aura only, 13.0% (31/239) had both diagnoses. Of the patients who presented with migraine with aura, 13.4% (32/239) presented with aura without headache. Unilateral pain location was reported by 58.6% (140/239) of patients and the throbbing type of pain was present in 50.2% (120/239) of our study group. Photo- and phonophobia were observed in 77.4% (185/239) and 79.5% (190/239) of patients. Seventy-nine out of 239 (30.1%) patients were found to have probable medication overuse. Within this group, 31.65% (25/79) overused triptan and 70.9% (56/79) overused combination analgesics. We found higher frequencies of migraine for patients whose age at onset of migraine was younger than 18 years, and low frequency migraine was reported more frequently in the later onset group (P = .0357). We assess the headache characteristics of elderly migraine patients who were seen at our tertiary headache center and report the high frequency of probable medication overuse headache in this study group. Finally, we suggest that age of onset is an important factor in the clinical profile of these patients. © 2017 American Headache Society.

High brain serotonin levels in migraine between attacks

DEFF Research Database (Denmark)

Deen, Marie; Hansen, Hanne D.; Hougaard, Anders

2017-01-01

Objectives To investigate brain 5-HT4-receptor binding with positron emission tomography (PET) as a proxy of serotonin (5-hydroxytryptamine, 5-HT) levels in migraine patients between attacks. Methods Brain 5-HT4-receptor binding, assessed with PET imaging of the specific 5-HT4-receptor radioligand......, [11C]SB207145, is inversely related to long-term changes in brain 5-HT-levels. Eighteen migraine patients without aura (≥48 hours migraine free) and 16 age- and sex-matched controls underwent PET-scanning after injection of [11C]SB207145. Patients who reported a migraine attack ≤48 hours after...... the scan were excluded. The mean neocortical [11C]SB207145 binding potential (BPND) was calculated in a blinded manner. Results Fifteen patients (age 29.6 ± 10.2 years, 2 men) and 16 controls (28.9 ± 10.2 years, 3 men) completed the study. Migraine patients had significantly lower neocortical 5-HT4...

Chocolate and migraine: the history of an ambiguous association.

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Lippi, Giuseppe; Mattiuzzi, Camilla; Cervellin, Gianfranco

2014-12-17

Migraine is a highly prevalent condition and an important cause of disability. Although the pathogenesis of this condition is complex and multifaceted, several environmental factors have been associated with development and aggravation of headache attacks. Among the various foods that have been implicated in migraine, chocolate has been regarded as detrimental on the basis of old and mostly anecdotal evidence. Therefore, this article is aimed to provide an overview on the current scientific evidence about the relationship between chocolate and migraine. Taken together, the information gathered from epidemiological and provocative studies attests that the potential causal association between chocolate and migraine remains largely enigmatic. The analysis of epidemiological surveys reveals a highly heterogeneous picture, with frequency of migraine episodes attributable to chocolate ranging from 0 to 22.5%. Even in those studies reporting a more convincing association, the risk of migraine after chocolate ingestion was found to be 2- to 3-fold lower than that reported for exposure to other conventional triggers such as stress, fasting, lack of sleep and alcohol beverages. The results of the double-blind studies are instead unequivocal, and clearly demonstrate that the risk of developing a headache attack after ingestion of chocolate is as likely as administering placebo in patients with migraine. It can hence be concluded that the widespread belief that chocolate and cocoacontaining foods should be absolutely avoided by migraine patients lacks of a reliable scientific basis.

Prevalence and clinical symptoms of migrainous vertigo in Germany - a population based study

OpenAIRE

Feldmann, Maria

2010-01-01

Objective: To investigate the epidemiology of migrainous vertigo (MV) in the general population by assessing the prevalence, clinical features, co morbid conditions, quality of life, and health care utilization. Methods: We screened a representative sample of the adult population in Germany (n=4,869) for moderate or severe dizziness/vertigo and followed up with validated neurotologic telephone interviews (n=1003). Diagnostic criteria for MV were as follows: 1. recurrent vestibular vertigo, 2....

Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day.

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Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K

2017-12-01

Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year

[Migraine type childhood headache aggravated by sexual abuse: case report].

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Kaleağasi, Hakan; Ozge, Aynur; Toros, Fevziye; Kar, Hakan

2009-04-01

Although the vast majority of chronic headache is idiopathic in origin, child abuse can be a very rare cause of paroxysmal headaches in children. The aim of this report was to present a case of migraine headache aggravated after sexual abuse, which did not respond to treatment. An 11-year-old girl admitted to the outpatient department of the Neurology Clinic with headache complaint for the past two years. Neurological examination, neuroimaging and laboratory tests were normal. According to the International Classification of Headache Disorders (ICHD)-II criteria, the headache was diagnosed as migraine without aura and treatment as prophylaxis was planned. Her headache did not respond to treatment, so she was consulted with the Department of Child and Adolescent Psychiatry and diagnosed as major depressive disorder. During one of the psychological interviews, she confessed that she had been sexually abused by her mother's boyfriend for two years. After this confession and punishment of the abuser, her headache improved dramatically. The prevalence of physical, sexual, and emotional abuse during childhood has been estimated between 13% and 27%, and these children may suffer chronic pain, headache or depression. Sexual abuse has been strongly associated with the migraine-depression phenotype when abuse first occurred before the age of 12 years. Despite the high prevalence of abuse, many physicians do not routinely ask about abuse history. In conclusion, child abuse must be kept in mind in intractable childhood headache. A multidisciplinary approach with the Departments of Forensic Sciences and Child and Adolescent Psychiatry and detailed psychiatric evaluation should be useful in these cases.

A nitric oxide donor (nitroglycerin) triggers genuine migraine attacks

DEFF Research Database (Denmark)

Thomsen, L L; Kruuse, C; Iversen, Helle Klingenberg

1994-01-01

Supersensitivity to induction of headache and arterial dilatation by a donor of nitric oxide (nitroglycerin) has recently been demonstrated in migraine sufferers. The aims of the present study were to examine whether the nitric oxide donor nitroglycerin may induce a typical migraine attack......, to exclude placebo-related effects and to describe the relation between middle cerebral artery dilatation and provoked migraine. Nitroglycerin (0.5 μg/kg/min for 20 min) or placebo was infused into 12 migraine patients in a double-blind cross-over trial. Blood velocity in the middle cerebral artery...

Treatment of Chronic Migraine with Focus on Botulinum Neurotoxins

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Sara M. Schaefer

2015-07-01

Full Text Available Migraine is the most common neurological disorder, and contributes to disability and large healthcare costs in the United States and the world. The treatment of migraine until recently has focused on medications, both abortive and prophylactic, but treatment of chronic migraine has been revolutionized with the introduction of botulinum toxin injection therapy. In this review, we explore the current understanding of migraine pathophysiology, and the evolution of the use of botulinum toxin therapy including proposed pathophysiological mechanisms through animal data. We also discuss the similarities and differences between three injection techniques.

Emerging migraine treatments and drug targets

DEFF Research Database (Denmark)

Olesen, Jes; Ashina, Messoud

2011-01-01

Migraine has a 1-year prevalence of 10% and high socioeconomic costs. Despite recent drug developments, there is a huge unmet need for better pharmacotherapy. In this review we discuss promising anti-migraine strategies such as calcitonin gene-related peptide (CGRP) receptor antagonists and 5....... Tonabersat, a cortical spreading depression inhibitor, has shown efficacy in the prophylaxis of migraine with aura. Several new drug targets such as nitric oxide synthase, the 5-HT(1D) receptor, the prostanoid receptors EP(2) and EP(4), and the pituitary adenylate cyclase receptor PAC1 await development....... The greatest need is for new prophylactic drugs, and it seems likely that such compounds will be developed in the coming decade....

Acupuncture for migraine prophylaxis

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Klaus Linde

Full Text Available ABSTRACT BACKGROUND: Acupuncture is often used for migraine prophylaxis but its effectiveness is still controversial. This review (along with a companion review on 'Acupuncture for tension-type headache' represents an updated version of a Cochrane review originally published in Issue 1, 2001, of The Cochrane Library. OBJECTIVES: To investigate whether acupuncture is a more effective than no prophylactic treatment/routine care only; b more effective than 'sham' (placebo acupuncture; and c as effective as other interventions in reducing headache frequency in patients with migraine. METHODS: Search methods: The Cochrane Pain, Palliative & Supportive Care Trials Register, CENTRAL, MEDLINE, EMBASE and the Cochrane Complementary Medicine Field Trials Register were searched to January 2008. Selection criteria: We included randomized trials with a post-randomization observation period of at least 8 weeks that compared the clinical effects of an acupuncture intervention with a control (no prophylactic treatment or routine care only, a sham acupuncture intervention or another intervention in patients with migraine. Data collection and analysis: Two reviewers checked eligibility; extracted information on patients, interventions, methods and results; and assessed risk of bias and quality of the acupuncture intervention. Outcomes extracted included response (outcome of primary interest, migraine attacks, migraine days, headache days and analgesic use. Pooled effect size estimates were calculated using a random-effects model. MAIN RESULTS: Twenty-two trials with 4419 participants (mean 201, median 42, range 27 to 1715 met the inclusion criteria. Six trials (including two large trials with 401 and 1715 patients compared acupuncture to no prophylactic treatment or routine care only. After 3 to 4 months patients receiving acupuncture had higher response rates and fewer headaches. The only study with long-term follow up saw no evidence that effects dissipated up

Prophylactic treatment of migraine; the patient's view, a qualitative study

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Dekker Frans

2012-03-01

Full Text Available Abstract Background Prophylactic treatment is an important but under-utilised option for the management of migraine. Patients and physicians appear to have reservations about initiating this treatment option. This paper explores the opinions, motives and expectations of patients regarding prophylactic migraine therapy. Methods A qualitative focus group study in general practice in the Netherlands with twenty patients recruited from urban and rural general practices. Three focus group meetings were held with 6-7 migraine patients per group (2 female and 1 male group. All participants were migraine patients according to the IHS (International Headache Society; 9 had experience with prophylactic medication. The focus group meetings were analysed using a general thematic analysis. Results For patients several distinguished factors count when making a decision on prophylactic treatment. The decision of a patient on prophylactic medication is depending on experience and perspectives, grouped into five categories, namely the context of being active or passive in taking the initiative to start prophylaxis; assessing the advantages and disadvantages of prophylaxis; satisfaction with current migraine treatment; the relationship with the physician and the feeling to be heard; and previous steps taken to prevent migraine. Conclusion In addition to the functional impact of migraine, the decision to start prophylaxis is based on a complex of considerations from the patient's perspective (e.g. perceived burden of migraine, expected benefits or disadvantages, interaction with relatives, colleagues and physician. Therefore, when advising migraine patients about prophylaxis, their opinions should be taken into account. Patients need to be open to advice and information and intervention have to be offered at an appropriate moment in the course of migraine.

Multilocus analysis reveals three candidate genes for Chinese migraine susceptibility.

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An, X-K; Fang, J; Yu, Z-Z; Lin, Q; Lu, C-X; Qu, H-L; Ma, Q-L

2017-08-01

Several genome-wide association studies (GWASs) in Caucasian populations have identified 12 loci that are significantly associated with migraine. More evidence suggests that serotonin receptors are also involved in migraine pathophysiology. In the present study, a case-control study was conducted in a cohort of 581 migraine cases and 533 ethnically matched controls among a Chinese population. Eighteen polymorphisms from serotonin receptors and GWASs were selected, and genotyping was performed using a Sequenom MALDI-TOF mass spectrometry iPLEX platform. The genotypic and allelic distributions of MEF2D rs2274316 and ASTN2 rs6478241 were significantly different between migraine patients and controls. Univariate and multivariate analysis revealed significant associations of polymorphisms in the MEF2D and ASTN2 genes with migraine susceptibility. MEF2D, PRDM16 and ASTN2 were also found to be associated with migraine without aura (MO) and migraine with family history. And, MEF2D and ASTN2 also served as genetic risk factors for the migraine without family history. The generalized multifactor dimensionality reduction analysis identified that MEF2D and HTR2E constituted the two-factor interaction model. Our study suggests that the MEF2D, PRDM16 and ASTN2 genes from GWAS are associated with migraine susceptibility, especially MO, among Chinese patients. It appears that there is no association with serotonin receptor related genes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Odors as triggering and worsening factors for migraine in men

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A M Lima

2011-01-01

Full Text Available OBJECTIVE: To assess the role of odors in triggering or worsening migraine in men. METHOD: Ninety-eight male migraineurs from the general population were assessed individually through questionnaires. Environmental factors relating to their migraine were reported, with special focus on the role of odors. RESULTS: Odors were the second most frequent triggering factor for migraine attacks (48%, behind stressful situations (59%. Likewise, odors were the second most frequent worsening factor (73%, just behind excessive light (74%. Thirty-three individuals (33.4% stated that odors were both triggering and worsening factors for their migraine attacks. Perfume, cigarette smoke and cleaning products were the most frequent migraine-related odors reported by these male migraineurs. CONCLUSION: This was the first study to assess the role of odors in migraine exclusively in men. There was a high degree of odor-related migraine among these men, thus suggesting that patient education could alert such individuals to gender-related factors, since different triggering and worsening factors have been reported by males and females.

The Migraine-Ischemic Stroke Relation in Young Adults

OpenAIRE

Pezzini, Alessandro; Del Zotto, Elisabetta; Giossi, Alessia; Volonghi, Irene; Costa, Paolo; Dalla Volta, Giorgio; Padovani, Alessandro

2010-01-01

In spite of the strong epidemiologic evidence linking migraine and ischemic stroke in young adults, the mechanisms explaining this association remain poorly understood. The observation that stroke occurs more frequently during the interictal phase of migraine prompts to speculation that an indirect relation between the two diseases might exist. In this regard, four major issues might be considered which may be summarized as follows: (1) the migraine-ischemic stroke relation is influenced by s...

Low levels of serum serotonin and amino acids identified in migraine patients.

Science.gov (United States)

Ren, Caixia; Liu, Jia; Zhou, Juntuo; Liang, Hui; Wang, Yayun; Sun, Yinping; Ma, Bin; Yin, Yuxin

2018-02-05

Migraine is a highly disabling primary headache associated with a high socioeconomic burden and a generally high prevalence. The clinical management of migraine remains a challenge. This study was undertaken to identify potential serum biomarkers of migraine. Using Liquid Chromatography coupled to Mass Spectrometry (LC-MS), the metabolomic profile of migraine was compared with healthy individuals. Principal component analysis (PCA) and Orthogonal partial least squares-discriminant analysis (orthoPLS-DA) showed the metabolomic profile of migraine is distinguishable from controls. Volcano plot analysis identified 10 serum metabolites significantly decreased during migraine. One of these was serotonin, and the other 9 were amino acids. Pathway analysis and enrichment analysis showed tryptophan metabolism (serotonin metabolism), arginine and proline metabolism, and aminoacyl-tRNA biosynthesis are the three most prominently altered pathways in migraine. ROC curve analysis indicated Glycyl-l-proline, N-Methyl-dl-Alanine and l-Methionine are potential sensitive and specific biomarkers for migraine. Our results show Glycyl-l-proline, N-Methyl-dl-Alanine and l-Methionine may be as specific or more specific for migraine than serotonin which is the traditional biomarker of migraine. We propose that therapeutic manipulation of these metabolites or metabolic pathways may be helpful in the prevention and treatment of migraine. Copyright © 2018 Elsevier Inc. All rights reserved.

Migraine genetics : from monogenic to complex forms

NARCIS (Netherlands)

Vanmolkot, Kaate Raymond Josepha

2008-01-01

Migraine has a strong genetic component, but the identification of these factors has proven difficult mainly because of the complex interaction of multiple loci and environmental factors. Unraveling its molecular basis and deciphering pathways leading to migraine attacks will help identifying novel

Cognitive, Personality, and Family Factors in Patients with Migraine Headache

OpenAIRE

Reza Johari-Fard; Farzad Goli; Amirreza Boroumand

2014-01-01

Migraine is a disorder that has debilitating pain, and affects all aspects of life, including the academic, social, and family life of patients. In addition, studies show the effects of migraine on patient's relationships with family members such as spouse, children, and other family members. In addition to physical pain, migraines are tied to significant psychological and economic costs. Migraineurs tend to have high levels of depression and anxiety, and migraine headaches have a profoundly ...

The impact of serum 25-hydroxyvitamin D level on migraine headache

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Gökhan Özer

2018-03-01

Full Text Available Objective: To investigate the impact of serum 25-hydroxyvitamin D levels on migraine headache in migraineurs Patients and Methods: A total of 72 patients were included in the study. Serum vitamin D concentration and its impact on the migraine headache were assessed in migraineurs and migraine subgroups. To assess serum levels of vitamin D, 25(OH D3 was measured by enzymelinked immunosorbent assay (ELISA. Patients were categorized as follows based on the results of serum vitamin D measurements. Severity of migraine, average duration and frequency of attacks per month were recorded. The headache diary result (HDR was determined as: Duration of headache × frequency of headache. Results: Average vitamin D level was 7.4 ng/ml among patients with migraine with aura group and 8.5 ng/ml in patients with migraine without aura. Severe vitamin D deficiency was detected in 14 (66.7% patients with migraine with aura and 9 (64.3% patients with migraine without aura, with no statistically significant difference between the two groups. No significant correlation was found between vitamin D levels and HDR among migraineurs (r=-0.042, p=0.812 as well as in patients with migraine with aura (r=0.044, p=0.842 and in patients with migraine without aura (r=0.059, p=0.842 versus control group with respect to HDR and vitamin D levels. The severity of migraine pain was not associated with vitamin D levels. Serum vitamin D concentration was lower in male patients versus control group. Conclusion: The impact of vitamin D on the severity and number of migraine attacks is not clear. Further studies are needed to demonstrate the association between vitamin D status and neurological diseases.

Cerebral and cerebellar ADC values during a migraine attack

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Degirmenci, Bumin; Haktanir, Alpay; Albayrak, Ramazan; Acar, Murat [University of Kocatepe, Department of Radiology, Faculty of Medicine, Afyon (Turkey); Yaman, Mehmet [University of Kocatepe, Department of Neurology, Faculty of Medicine, Afyon (Turkey)

2007-05-15

We investigated the diffusion-weighted MRI changes, apparent diffusion coefficient (ADC) values, and conventional MRI findings in specific brain areas during migraine attacks in patients with and without aura. Included in the study were 22 patients (2 male, 20 female) aged between 17 and 49 years who were diagnosed as having migraine according to the diagnostic criteria of the International Headache Society. Also included in the study were 18 age- and sex-matched healthy volunteers. Hyperintense lesions were evaluated in conventional MR images. Heavily diffusion-weighted images, ADC maps, and segmented ADC maps generated for regional ADC (rADC) measurements, were also studied. ADC values from specific brain areas were used with appropriate region of interests (ROI). Migraine with aura was diagnosed in 13 patients and migraine without aura was diagnosed in 9 patients. A total of 23 hyperintense lesions within the periventricular white matter and deep white matter were detected in five patients (21.8%). All of these hyperintense lesions were seen in migraine patients with aura. In only one patient did a hyperintense lesion show an increased diffusion pattern on diffusion-weighted images and ADC maps. One hyperintense lesion was detected in the control group (5.5%). There was no significant difference in ADC values between the migraine and control groups. T2-weighted hyperintense lesions were significantly more frequent in migraine patients especially in those with aura than in the control group. No diffusion alterations in diffusion-weighted images were detected in the infra- and supratentorial brain areas during migraine attacks in patients with and without aura. (orig.)

Cerebral and cerebellar ADC values during a migraine attack

International Nuclear Information System (INIS)

Degirmenci, Bumin; Haktanir, Alpay; Albayrak, Ramazan; Acar, Murat; Yaman, Mehmet

2007-01-01

We investigated the diffusion-weighted MRI changes, apparent diffusion coefficient (ADC) values, and conventional MRI findings in specific brain areas during migraine attacks in patients with and without aura. Included in the study were 22 patients (2 male, 20 female) aged between 17 and 49 years who were diagnosed as having migraine according to the diagnostic criteria of the International Headache Society. Also included in the study were 18 age- and sex-matched healthy volunteers. Hyperintense lesions were evaluated in conventional MR images. Heavily diffusion-weighted images, ADC maps, and segmented ADC maps generated for regional ADC (rADC) measurements, were also studied. ADC values from specific brain areas were used with appropriate region of interests (ROI). Migraine with aura was diagnosed in 13 patients and migraine without aura was diagnosed in 9 patients. A total of 23 hyperintense lesions within the periventricular white matter and deep white matter were detected in five patients (21.8%). All of these hyperintense lesions were seen in migraine patients with aura. In only one patient did a hyperintense lesion show an increased diffusion pattern on diffusion-weighted images and ADC maps. One hyperintense lesion was detected in the control group (5.5%). There was no significant difference in ADC values between the migraine and control groups. T2-weighted hyperintense lesions were significantly more frequent in migraine patients especially in those with aura than in the control group. No diffusion alterations in diffusion-weighted images were detected in the infra- and supratentorial brain areas during migraine attacks in patients with and without aura. (orig.)

Job stress is associated with migraine in current workers: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Science.gov (United States)

Santos, I S; Griep, R H; Alves, M G M; Goulart, A C; Lotufo, P A; Barreto, S M; Chor, D; Benseñor, I M

2014-10-01

Migraine is an important source of social burden and work-related costs. Studies addressing the association of migraine with job stress are rare. The aim of this paper was to study the association of job stress components and migraine using structured, validated questionnaires that were part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The ELSA-Brasil is a multicentre cohort of 15,105 civil servants (12,096 current workers) in Brazil. Job strain was assessed using the 17-item Brazilian version of the Swedish Demand-Control-Support Questionnaire. Headache episodes in the preceding 12 months were assessed using a questionnaire based on the International Headache Society criteria. We analysed the association between job stress domains and migraine in men and women using adjusted logistic regression and interaction models. We included 3113 individuals without headache and 3259 migraineurs. Low job control [odds ratio (OR) 1.30; 95% confidence interval (95% CI) 1.10-1.53], high job demands (OR 1.37; 95% CI 1.18-1.59) and low social support (OR 1.49; 95% CI 1.29-1.71) were associated with migraine. Job control was more strongly associated with migraine in women (p for interaction = 0.02). High-strain (high demand and low control) jobs were associated with migraine in both men (OR 1.48; 95% CI 1.11-1.97) and women (OR 1.51; 95% CI 1.17-1.95). We observed a strong association between high-strain jobs and migraine. Job control was a stronger migraine-related factor for women. Low social support was associated with migraine in both sexes. © 2014 European Pain Federation - EFIC®

Aggressiveness and characteristics of object-relations in students at risk of migrainous headaches

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Darja Škrila

2001-06-01

Full Text Available The purpose of the research, carried out in a sample of Slovene students, was to determine how subjects with migraine differ from subjects with migrainous disorder, subjects with non-migrainous headaches and subjects without recurrent headaches. The existence of migraine was assessed by UCSD migraine questionnaire, aggressiveness by Buss-Durkee hostility inventory and characteristics of object-relations by Bell object relations and reality testing inventory - form O. Subjects with migraine express significantly more negativism, indirect aggressiveness, irritability, hostility, suspicion and feelings of guilt than subject without recurrent headaches, while there are no differences in physical and verbal aggressiveness. There are less significant differences among subjects with different types of headache (migraine, migrainous disorder, non-migrainous headaches. Subjects with migraine and subjects without recurrent headaches differ significantly in characteristics of object-relations, subjects with migraine having more disturbed object-relations. Subject with different types of headaches do not differ in characteristics of object-relations. It is concluded that subjects with migraine have a raised level of aggressiveness, especially of indirect forms, which can indicate non-neutralized aggressiveness, and their object-relations are more disturbed.

Cytokine polymorphism in patients with migraine: some suggestive clues of migraine and inflammation.

Science.gov (United States)

Yilmaz, Ibrahim Arda; Ozge, Aynur; Erdal, Mehmet Emin; Edgünlü, Tuba Gökdoğan; Cakmak, Sema Erol; Yalin, Osman Ozgür

2010-04-01

There are contrasting results obtained in migraineurs concerning the levels and the role of both pro-inflammatory and anti-inflammatory cytokines. In this study, the association of the occurrence and clinical characteristics of migraine with the polymorphisms of tumor necrosis factor alpha (TNF-alpha) -308 G/A (rs1800629), interleukin-1alpha (IL-1alpha) +4845 G/T (rs17561), IL-1beta+3953 C/T (rs1143634) and interleukin-1 receptor antagonist variable number tandem repeat (IL-1RA VNTR) genes were studied. We also investigated the genetic linkage between these genes. Sixty-seven patients with migraine without aura (MwoA) and 96 unrelated, age- and sex-matched migraine-free, healthy control subjects from the same geographic area were investigated. We observed significant differences in the genotypic distribution of the TNF-alpha-308 G/A and IL-1beta+3953 C/T polymorphism for migraineurs compared with controls (P = 0.004). Frequency of the TNF-alpha-308 GG genotype was higher in the control group than MwoA group (82.1% vs 55.2%). Differences in the distribution of the allele frequencies were also observed, being the TNF-alpha-308 G allele overrepresented in control group and TNF-alpha-308 A allele in MwoA group. In addition, there was a significant increase of the IL-1beta+3953 T allele in MwoA cases compared with controls (P = 0.004). In conclusion, the present results indicate the possible contribution of TNF-alpha and IL-1beta gene polymorphisms to migraine headache generation in MwoA patients.

Nurses improve migraine management in primary care

NARCIS (Netherlands)

Veenstra, Petra; Kollen, Boudewijn J.; de Jong, Gosse; Baarveld, Frans; van den Berg, J. S. Peter

Introduction Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve

Didactic Migraine Education in US Doctor of Pharmacy Programs

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Padiyara, Rosalyn S.; Schommer, Jon C.

2010-01-01

Objective To compare didactic migraine education in doctor of pharmacy (PharmD) programs in the United States with the Headache Consortium's evidence-based migraine treatment recommendations. Methods A self-administered survey instrument was mailed to all 90 Accreditation Council for Pharmacy Education (ACPE) approved PharmD programs in the United States. Results Seventy-seven programs responded (86%) and 69 useable survey instruments were analyzed. Fifty-five percent of programs discussed the Consortium's guidelines, 49% discussed the selection of nonprescription versus prescription agents, 45% recommended a butalbital-containing product as migraine treatment, and 20% educated students about tools for assessing migraine-related debilitation. At least 50% of programs taught information consistent with the remaining Consortium recommendations. Conclusion Approximately half of the PharmD programs teach concepts about migraine headache treatment consistent with the US Headache Consortium's recommendations. PMID:20221355

Analysis of the MTHFR C677T variant with migraine phenotypes

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Haupt Larisa M

2010-07-01

Full Text Available Abstract Background The methylenetetrahydrofolate reductase (MTHFR gene variant C677T has been implicated as a genetic risk factor in migraine susceptibility, particularly in Migraine with Aura. Migraine, with and without aura (MA and MO have many diagnostic characteristics in common. It is postulated that migraine symptomatic characteristics might themselves be influenced by MTHFR. Here we analysed the clinical profile, migraine symptoms, triggers and treatments of 267 migraineurs previously genotyped for the MTHFR C677T variant. The chi-square test was used to analyse all potential relationships between genotype and migraine clinical variables. Regression analyses were performed to assess the association of C677T with all migraine clinical variables after adjusting for gender. Findings The homozygous TT genotype was significantly associated with MA (P P = 0.002. While the CT genotype was significantly associated with physical activity discomfort (P P = 0.002. Females with the TT genotype were significantly associated with unilateral head pain (P P P = 0.002, and the use of natural remedy for migraine treatment (P = 0.003. Conversely, male migraineurs with the TT genotype experienced higher incidences of bilateral head pain (63% vs 34% and were less likely to use a natural remedy as a migraine treatment compared to female migraineurs (5% vs 20%. Conclusions MTHFR genotype is associated with specific clinical variables of migraine including unilateral head pain, physical activity discomfort and stress.

[An encounter between medicine and astronomy: migraine visions].

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Lardreau, Esther

2011-06-01

Until the second half of the eighteenth century, the very definition of migraine as hemicrania (pain felt in one side of the head) eclipsed symptoms that were then considered as "marginal", although tingling sensations, speech impairment and visual impairment had already been described by Piso and Wepfer. The possibility of a migraine without a headache nevertheless started to be envisaged, inviting one to re-evaluate the status of these phenomena. But, as paradoxical as it may seem, it is in the field of astronomy that some of these phenomena such as visual aberrations were analyzed systematically and acknowledged to be migrainous. Scintillating scotoma is no exception: it was indeed mentioned as early as in the Hippocratic corpus, but until the end of the nineteenth century it was addressed as a separate condition to migraine. We limit our study to the visual aura. Our purpose is to show that the ophthalmic symptoms affecting migraine sufferers were not, by themselves, a medical object--which somehow calls into question the very functioning of science.

Meta-analysis of the relationship between multiple sclerosis and migraine.

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Pakpoor, Julia; Handel, Adam E; Giovannoni, Gavin; Dobson, Ruth; Ramagopalan, Sreeram V

2012-01-01

Studies investigating a proposed association between multiple sclerosis (MS) and migraine have produced conflicting results and a great range in the prevalence rate of migraine in MS patients. By meta-analysing all available data we aimed to establish an overall estimate of any association in order to more accurately inform clinicians and care-givers about a potential association between MS and migraine. Pubmed and EMBASE were searched to identify suitable studies. Studies were included if they were a case-control study or cohort study in which controls were not reported to have another neurological condition, were available in English, and specified migraine as a headache sub-type. The odds ratio (OR) of migraine in MS patients vs. controls was calculated using the inverse variance with random effects model in Review Manager 5.1. Eight studies were selected for inclusion, yielding a total of 1864 MS patients and 261563 control subjects. We found a significant association between migraine and MS (OR = 2.60, 95% CI 1.12-6.04), although there was significant heterogeneity. Sensitivity analysis showed that migraine without aura was associated with MS OR = 2.29 (95% CI 1.14-4.58), with no significant heterogeneity. MS patients are more than twice as likely to report migraine as controls. Care providers should be alerted to ask MS patients about migraine in order to treat it and potentially improve quality of life. Future work should further investigate the temporal relationship of this association and relationship to the clinical characteristics of MS.

Meta-analysis of the relationship between multiple sclerosis and migraine.

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Julia Pakpoor

Full Text Available BACKGROUND: Studies investigating a proposed association between multiple sclerosis (MS and migraine have produced conflicting results and a great range in the prevalence rate of migraine in MS patients. By meta-analysing all available data we aimed to establish an overall estimate of any association in order to more accurately inform clinicians and care-givers about a potential association between MS and migraine. METHODS: Pubmed and EMBASE were searched to identify suitable studies. Studies were included if they were a case-control study or cohort study in which controls were not reported to have another neurological condition, were available in English, and specified migraine as a headache sub-type. The odds ratio (OR of migraine in MS patients vs. controls was calculated using the inverse variance with random effects model in Review Manager 5.1. RESULTS: Eight studies were selected for inclusion, yielding a total of 1864 MS patients and 261563 control subjects. We found a significant association between migraine and MS (OR = 2.60, 95% CI 1.12-6.04, although there was significant heterogeneity. Sensitivity analysis showed that migraine without aura was associated with MS OR = 2.29 (95% CI 1.14-4.58, with no significant heterogeneity. CONCLUSIONS: MS patients are more than twice as likely to report migraine as controls. Care providers should be alerted to ask MS patients about migraine in order to treat it and potentially improve quality of life. Future work should further investigate the temporal relationship of this association and relationship to the clinical characteristics of MS.

The visual system in migraine: from the bench side to the office.

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Kowacs, Pedro A; Utiumi, Marco A; Piovesan, Elcio J

2015-02-01

Throughout history, migraine-associated visual symptoms have puzzled patients, doctors, and neuroscientists. The visual aspects of migraine extend far beyond the aura phenomena, and have several clinical implications. A narrative review was conducted, beginning with migraine mechanisms, then followed by pertinent aspects of the anatomy of visual pathways, clinical features, implications of the visual system on therapy, migraine on visually impaired populations, treatment of visual auras and ocular (retinal) migraine, effect of prophylactic migraine treatments on visual aura, visual symptoms induced by anti-migraine or anti-headache drugs, and differential diagnosis. A comprehensive narrative review from both basic and clinical standpoints on the visual aspects of migraine was attained; however, the results were biased to provide any useful information for the clinician. This paper achieved its goals of addressing and condensing information on the pathophysiology of the visual aspects of migraine and its clinical aspects, especially with regards to therapy, making it useful not only for those unfamiliar to the theme but to experienced physicians as well. © 2015 American Headache Society.

Effectiveness of behavioural management on migraine in adult patients visiting family practice clinics: a randomized controlled trial

International Nuclear Information System (INIS)

Bhombal, S. T.; Usman, A.; Ghufran, M.

2014-01-01

Objectives: To assess the effectiveness of behavioural management in the treatment of migraine among adult patients. Methods: The randomised control trial was conducted from August 2011 to August 2012 at the Aga Khan University Hospital, Karachi, in which adult patients aged 18-65 years were recruited with diagnosis of migraine from five outpatient sites. The patients were randomised into 2 equal groups. The controls were given pharmacological treatment, while the cases were given a structured behavioural management and pharmacological treatment. Primary outcome was the change in frequency of migraine attacks. Secondary outcome included change in severity of migraine and effect on the quality of life. SPSS 19 was used for statistical analysis. Results: Of the 90 subjects in the study, 72(80%) were female. A significant reduction in the average frequency of migraine attacks was observed from baseline up to 4 weeks (p<0.001) but no difference in the mean migraine attacks was observed in the two groups (p<0.945). In the average score of severity of pain, significant reduction was observed for time (p <0.001) as well as for the intervention status (p<0.034). There was no significant difference (p<0.450) between treatment type and duration of migraine, but a significantly better quality of life (p<0.001) was observed in the trial group compared to the controls. Conclusion: There was significant decrease in frequency, severity and duration of migraine attacks in the trial group compared to the control group. The quality of life also showed improvement in the trial group. (author)

Tips for Starting Yoga in Adults with Migraines

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... impact during MHAM What is Migraine and Headache Awareness Month? June is Migraine and Headache Awareness Month, ... approved last week, which is called erenumab, the brand name of which is Aimovig, is a monoclonal ...

Resolution of chronic migraine headaches with intrathecal ziconotide: a case report

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Narain S

2015-09-01

Full Text Available Sachin Narain,1 Lama Al-Khoury,2 Eric Chang3–6 1Department of Anesthesiology and Perioperative Care, 2Department of Neurology, 3Department of Physical Medicine and Rehabilitation, 4Department of Neurosurgery, 5Department of Orthopedics, 6Reeve-Irvine Research Center for Spinal Cord Injury, University of California Irvine, Irvine, CA, USA Background: Migraine headaches are a common and functionally debilitating disorder affecting approximately 17% of women and 5.6% of men. Compared to episodic migraine patients, chronic migraineurs are more likely to be occupationally disabled, miss family activities, have comorbid anxiety and/or chronic pain disorders, and utilize significantly more health care dollars. Ziconotide is a calcium channel blocker used for the treatment of chronic severe pain without issues of tolerance or dependency found with opioid therapy. Case: A 59-year-old female had an intrathecal baclofen pump placed for spasticity secondary to multiple sclerosis. Her symptoms also included lower extremity neuropathic pain and severe migraine headaches with 22 migraine headache days per month. Prior treatments included nonsteroidal anti-inflammatory drugs, triptans, anticonvulsants, antihypertensives, and Botox injections which reduced her symptoms to four migraine days per month at best. While her spasticity had markedly improved with intrathecal baclofen, ziconotide was added to help her neuropathic pain complaints. Following initiation of low-dose ziconotide (1 µg/day, the patient noted both lower extremity pain improvement and complete resolution of migraine headaches resulting in zero migraine days per month. She has now been migraine free for 8 months. Conclusion: Upon review of the available literature, there are no published cases of migraine improvement with intrathecal ziconotide. This represents the first case describing resolution of migraine symptoms with low-dose ziconotide. Keywords: ziconotide, migraine, symptoms, chronic

Anxiety and depression symptoms and migraine: a symptom-based approach research.

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Peres, Mario Fernando Prieto; Mercante, Juliane P P; Tobo, Patricia R; Kamei, Helder; Bigal, Marcelo Eduardo

2017-12-01

Anxiety and mood disorders have been shown to be the most relevant psychiatric comorbidities associated with migraine, influencing its clinical course, treatment response, and clinical outcomes. Limited information is available on how specific anxiety and depression symptoms are related to migraine. Symptoms-based approach, a current trend in mental health research, may improve our understanding in migraine comorbidity. The purpose of this study was to analyze how anxiety and depression aspects are related to migraine through a symptom-based approach. We studied 782 patients from the general population who completed a self-administered questionnaire assessing demographics, headache features, anxiety and depression symptoms. A binary logistic regression analyses were conducted to test the association between all four ratings in GAD-7 (anxiety) and PHQ-9 (depression) scales subitems as covariates, and migraine vs no headache as the outcome. The leading Odd Ratios (OR) observed in individuals with migraine relative to those without migraine were anxiety related, "Not being able to stop or control worrying" on a daily basis [OR (CI 95%)] 49.2 (13.6-178.2), "trouble relaxing" 25.7 (7.1-92.6), "Feeling nervous, anxious or on edge" on a daily basis 25.4 (6.9-93.8), and "worrying too much about different things" 24.4 (7.7-77.6). Although the hallmark symptoms of depression are emotional (hopelessness and sadness), the highest scores found were physical: apetite, fatigue, and poor sleep. Irritability had a significant increase in migraine risk [OR 3.8 (1.9-7.8) if experienced some days, 7.5 (2.7-20.7) more than half the days, and 22.0 (5.7-84.9) when experienced nearly every day]. Anxiety was more robustly associated with increase in migraine risk than depression. Lack of ability to properly control worrying and to relax are the most prominent issues in migraine psychiatric comorbidity. Physical symptoms in depression are more linked to migraine than emotional symptoms. A

Cognitive, Personality, and Family Factors in Patients with Migraine Headache

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Reza Johari-Fard

2014-01-01

Full Text Available Migraine is a disorder that has debilitating pain, and affects all aspects of life, including the academic, social, and family life of patients. In addition, studies show the effects of migraine on patient's relationships with family members such as spouse, children, and other family members. In addition to physical pain, migraines are tied to significant psychological and economic costs. Migraineurs tend to have high levels of depression and anxiety, and migraine headaches have a profoundly negative impact on sufferers’ quality of life. In the present research, we investigated the correlations and regressions of cognitive, personality, and family factors with migraine headache, to find predictor factors of migraine. In this study, the following questionnaires were used: For migraine: six-item Headache Impact Test (HIT-6, and Specific Quality of Life Questionnaire Version 2.1.; for cognitive factors: Irrational Beliefs Test and Dysfunctional Attitudes Scale; for personality factors: NEO Personality Inventory; and for family factors: Family Assessment Device. This project was on 58 women with migraine headaches, diagnosed by neurologist. The findings show that, there is a significant regression between cognitive, personality, and family factors and HIT-6. In cognitive factors, frustration reactivity and anxious overconcern, in personality factors, extraversion trait, and in family factors, affective involvement are significant. Moreover, there is a significant regression between cognitive, personality, and family factors and MSQ. In cognitive factors, frustration reactivity, anxious overconcern, and helplessness, in personality factors, agreeableness and consciousness, and in family factors, affective involvement and general functioning are significant. This project showed that cognitive, personality, and family factors have a correlation with migraine headache.

Migraine's House of Headaches…and Visiting the Neighbors

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... Headache) Migraine in Women Secondary Headaches Headaches in Children FAQ Learn More Migraine Information Find Help Doctors & Resources Get Connected Join the Conversation Follow Us on Social Media Company About News Resources Privacy Policy Contact Phone: ...

Migraine and magnetic resonance spectroscopy

DEFF Research Database (Denmark)

Younis, Samaira; Hougaard, Anders; Vestergaard, Mark B.

2017-01-01

Purpose of review: To present an updated and streamlined overview of the metabolic and biochemical aspect of the migraine pathophysiology based on findings from phosphorous (31P) and hydrogen (1H) magnetic resonance spectroscopy (MRS) studies. Recent findings: Despite of the variation in the meth......Purpose of review: To present an updated and streamlined overview of the metabolic and biochemical aspect of the migraine pathophysiology based on findings from phosphorous (31P) and hydrogen (1H) magnetic resonance spectroscopy (MRS) studies. Recent findings: Despite of the variation...

Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population.

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Rhyne, Danielle N; Anderson, Sarah L; Gedde, Margaret; Borgelt, Laura M

2016-05-01

No clinical trials are currently available that demonstrate the effects of marijuana on patients with migraine headache; however, the potential effects of cannabinoids on serotonin in the central nervous system indicate that marijuana may be a therapeutic alternative. Thus, the objective of this study was to describe the effects of medical marijuana on the monthly frequency of migraine headache. Retrospective chart review. Two medical marijuana specialty clinics in Colorado. One hundred twenty-one adults with the primary diagnosis of migraine headache who were recommended migraine treatment or prophylaxis with medical marijuana by a physician, between January 2010 and September 2014, and had at least one follow-up visit. The primary outcome was number of migraine headaches per month with medical marijuana use. Secondary outcomes were the type and dose of medical marijuana used, previous and adjunctive migraine therapies, and patient-reported effects. Migraine headache frequency decreased from 10.4 to 4.6 headaches per month (pmedical marijuana. Most patients used more than one form of marijuana and used it daily for prevention of migraine headache. Positive effects were reported in 48 patients (39.7%), with the most common effects reported being prevention of migraine headache with decreased frequency of migraine headache (24 patients [19.8%]) and aborted migraine headache (14 patients [11.6%]). Inhaled forms of marijuana were commonly used for acute migraine treatment and were reported to abort migraine headache. Negative effects were reported in 14 patients (11.6%); the most common effects were somnolence (2 patients [1.7%]) and difficulty controlling the effects of marijuana related to timing and intensity of the dose (2 patients [1.7%]), which were experienced only in patients using edible marijuana. Edible marijuana was also reported to cause more negative effects compared with other forms. The frequency of migraine headache was decreased with medical

Systematic methodological review: developing a framework for a qualitative semi-structured interview guide.

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Kallio, Hanna; Pietilä, Anna-Maija; Johnson, Martin; Kangasniemi, Mari

2016-12-01

To produce a framework for the development of a qualitative semi-structured interview guide. Rigorous data collection procedures fundamentally influence the results of studies. The semi-structured interview is a common data collection method, but methodological research on the development of a semi-structured interview guide is sparse. Systematic methodological review. We searched PubMed, CINAHL, Scopus and Web of Science for methodological papers on semi-structured interview guides from October 2004-September 2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected 10 papers. We analysed the data using the qualitative content analysis method. Our analysis resulted in new synthesized knowledge on the development of a semi-structured interview guide, including five phases: (1) identifying the prerequisites for using semi-structured interviews; (2) retrieving and using previous knowledge; (3) formulating the preliminary semi-structured interview guide; (4) pilot testing the guide; and (5) presenting the complete semi-structured interview guide. Rigorous development of a qualitative semi-structured interview guide contributes to the objectivity and trustworthiness of studies and makes the results more plausible. Researchers should consider using this five-step process to develop a semi-structured interview guide and justify the decisions made during it. © 2016 John Wiley & Sons Ltd.

Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine.

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Lipton, Richard B; Fanning, Kristina M; Serrano, Daniel; Reed, Michael L; Cady, Roger; Buse, Dawn C

2015-02-17

To test the hypothesis that ineffective acute treatment of episodic migraine (EM) is associated with an increased risk for the subsequent onset of chronic migraine (CM). In the American Migraine Prevalence and Prevention Study, respondents with EM in 2006 who completed the Migraine Treatment Optimization Questionnaire (mTOQ-4) and provided outcome data in 2007 were eligible for analyses. The mTOQ-4 is a validated questionnaire that assesses treatment efficacy based on 4 aspects of response to acute treatment. Total mTOQ-4 scores were used to define categories of acute treatment response: very poor, poor, moderate, and maximum treatment efficacy. Logistic regression models were used to examine the dichotomous outcome of transition from EM in 2006 to CM in 2007 as a function of mTOQ-4 category, adjusting for covariates. Among 5,681 eligible study respondents with EM in 2006, 3.1% progressed to CM in 2007. Only 1.9% of the group with maximum treatment efficacy developed CM. Rates of new-onset CM increased in the moderate treatment efficacy (2.7%), poor treatment efficacy (4.4%), and very poor treatment efficacy (6.8%) groups. In the fully adjusted model, the very poor treatment efficacy group had a more than 2-fold increased risk of new-onset CM (odds ratio = 2.55, 95% confidence interval 1.42-4.61) compared to the maximum treatment efficacy group. Inadequate acute treatment efficacy was associated with an increased risk of new-onset CM over the course of 1 year. Improving acute treatment outcomes might prevent new-onset CM, although reverse causality cannot be excluded. © 2015 American Academy of Neurology.

Can nitric oxide induce migraine in normal individuals?

DEFF Research Database (Denmark)

Olesen, Jes; Ashina, Messoud

2015-01-01

INTRODUCTION: For many years, scientists have debated the possibility that an individual "migraine threshold" determines the likelihood with which individuals may express migraine attacks. DISCUSSION: Recent discoveries provided evidence for both genetic and environmental influences on individual...

Factors associated to chronic migraine with medication overuse: A cross-sectional study.

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Viana, Michele; Bottiroli, Sara; Sances, Grazia; Ghiotto, Natascia; Allena, Marta; Guaschino, Elena; Nappi, Giuseppe; Tassorelli, Cristina

2018-01-01

Background and aim Factors implicated in the evolution of episodic migraine into chronic migraine are largely elusive. Medication overuse is considered to be one of the main determinants, but other possible clinical and psychological factors can play a role. The aim of this study is to identify factors that are associated with chronic migraine with medication overuse. Method We enrolled consecutive migraine patients, subdividing them in two groups: Subjects with a long history of episodic migraine and subjects with chronic migraine and medication overuse. We then compared their clinical and psychological variables in a cross-sectional study. Results Three hundred and eighteen patients were enrolled, of which 156 were episodic migraine and 162 were chronic migraine and medication overuse patients. The mean age was 42.1 ± 10.3, 80.8% were female. The duration of migraine was 24.6 years in episodic migraine and 24.0 years in chronic migraine and medication overuse ( p = 0.57). After the multivariate analysis, the factors associated to chronic migraine and medication overuse were: Marital status (married vs. unmarried, OR 3.65, 95% CI 1.63-8.19, p = 0.002; separated/divorced/widowed vs. unmarried, OR 4.19, 95% CI 1.13-15.47, p = 0.031), physical activity (OR 0.42, 95% CI 0.19-0.91, p = 0.029), age at onset of migraine (OR 0.94, 95% CI 0.89-0.98, p = 0.016), use of at least one migraine preventive medication (OR 2.36, 95% CI 1.18-4.71, p = 0.014), history of depression (OR 2.91, 95% CI 1.25-6.73, p = 0.012), insomnia associated with the use of hypnotics (OR 5.59, 95% CI 1.65-18.93, p = 0.006), traumatic head injuries (OR 3.54, 95% CI 1.57-7.99, p = 0.002), snoring (OR 2.24, 95% CI 1.05-4.79, p = 0.036), previous and/or actual use of combined oral contraceptives (OR 3.38, 95% CI 1.10-10.3, p = 0.031) and higher scores in the Childhood Trauma questionnaire (OR 1.48, 95% CI 1.09-2.02, p = 0.012). Conclusion We considered

A genome-wide linkage study of bipolar disorder and co-morbid migraine

DEFF Research Database (Denmark)

Oedegaard, K. J.; Greenwood, T. A.; Lunde, Asger

2010-01-01

Migraine and Bipolar Disorder (BPAD) are clinically heterogeneous disorders of the brain with a significant, but complex, genetic component. Epidemiological and clinical studies have demonstrated a high degree of co-morbidity between migraine and BPAD. Several genomewide linkage studies in BPAD...... that using migraine comorbidity to look at subsets of BPAD families in a genetic linkage analysis would prove useful in identifying genetic susceptibility regions in both of these disorders. We used BPAD with comorbid migraine as an alternative phenotype definition in a re-analysis of the NIMH Bipolar...... osome 4 (not co-segregating with BPAD) in a sample of BPAD families with comorbid migraine, and suggest a susceptibility locus on chromosome 20, harboring a gene for the migraine/BPAD phenotype. Together these data suggest that some genes may predispose to both bipolar disorder and migraine....

Menstrual migraine: a review of current and developing pharmacotherapies for women.

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Allais, G; Chiarle, Giulia; Sinigaglia, Silvia; Benedetto, Chiara

2018-02-01

Migraine is one of the most common neurological disorders in the general population. It affects 18% of women and 6% of men. In more than 50% of women migraineurs the occurrence of migraine attacks correlates strongly with the perimenstrual period. Menstrual migraine is highly debilitating, less responsive to therapy, and attacks are longer than those not correlated with menses. Menstrual migraine requires accurate evaluation and targeted therapy, that we aim to recommend in this review. Areas covered: This review of the literature provides an overview of currently available pharmacological therapies (especially with triptans, anti-inflammatory drugs, hormonal strategies) and drugs in development (in particular those acting on calcitonin gene-related peptide) for the treatment of acute migraine attacks and the prophylaxis of menstrual migraine. The studies reviewed here were retrieved from the Medline database as of June 2017. Expert opinion: The treatment of menstrual migraine is highly complex. Accurate evaluation of its characteristics is prerequisite to selecting appropriate therapy. An integrated approach involving neurologists and gynecologists is essential for patient management and for continuous updating on new therapies under development.

Sex and the Migraine Brain

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Borsook, D; Erpelding, N; Lebel, A; Linnman, C; Veggeberg, R; Grant, PE; Buettner, C; Becerra, L; Burstein, R

2014-01-01

The brain responds differently to environmental and internal signals that relates to the stage of development of neural systems. While genetic and epigenetic factors contribute to a premorbid state, hormonal fluctuations in women may alter the set point of migraine. The cyclic surges of gonadal hormones may directly alter neuronal, glial and astrocyte function throughout the brain. Estrogen is mainly excitatory and progesterone inhibitory on brain neuronal systems. These changes contribute to the allostatic load of the migraine condition that most notably starts at puberty in girls. PMID:24662368

Cognitive development in children with migraine and their healthy unaffected siblings.

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Haverkamp, F; Hönscheid, A; Müller-Sinik, K

2002-09-01

The discussion about neuropsychological sequalae from migraine occurring in adults is controversial. The purpose of our study was to examine whether children with migraine may be at risk for impaired intellectual development compared with their siblings free of migraine.

Validating Migraine-Specific Quality of Life Questionnaire v2.1 in episodic and chronic migraine.

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Bagley, Christine L; Rendas-Baum, Regina; Maglinte, Gregory A; Yang, Min; Varon, Sepideh F; Lee, Jeff; Kosinski, Mark

2012-03-01

To provide evidence for the reliability and validity of the Migraine-Specific Quality of Life Questionnaire Version 2.1 (MSQ) for use in chronic migraine (CM) in adults. MSQ is one of the most frequently utilized disease-specific tools assessing impact of migraine on health-related quality of life (HRQL). However, evidence for its reliability and validity are based on studies in episodic migraine (EM) populations. Additional studies assessing the reliability and validity of the MSQ in patients with CM are needed. Cross-sectional data were collected via web-based survey in 9 countries/regions. Participants were classified as having CM (≥15 headache days/month) or EM (s α), construct validity (correlations between MSQ scales and measures of depression/anxiety [Patient Health Questionnaire; PHQ-4], disability [Migraine Disability Assessment Questionnaire; MIDAS], and functional impact [Headache Impact Test; HIT-6], where lower scores indicate better HRQL for each measure), as well as discriminant validity across migraine groups. A total of 8726 eligible respondents were classified: 5.7% CM (n = 499) and 94.3% EM (n = 8227). Subjects were mostly female (83.5%) with a mean (±SD) age of 40.3 ± 11.4, and were similar between the 2 groups. MSQ domain scores for CM and EM groups, respectively, were: RP = 61.4 ± 26.1 and 71.7 ± 24.0; RR = 44.4 ± 22.1 and 56.5 ± 24.1; EF = 48.3 ± 28.1 and 67.2 ± 26.7. Internal consistency of the overall sample for RP, RR, and EF was 0.90, 0.96, and 0.87, respectively. Similar values were observed for CM and EM. MSQ scores for the overall sample correlated moderately to highly with scores from the PHQ-4 (r = -0.21 to -0.42), MIDAS (r = -0.38 to -0.39), and HIT-6 (r = -0.60 to -0.71). Similar values were observed for CM and EM. Known-groups validity indicated significant differences (P < .0001) in the hypothesized direction between CM and EM for RP (F = 86.19), RR (F = 119.24), and EF (F = 235.90). The MSQ is a reliable and valid

Beta-endorphin and ACTH in plasma during attacks of common and classic migraine

DEFF Research Database (Denmark)

Bach, F W; Jensen, K; Blegvad, N

1985-01-01

Plasma levels of beta-endorphin and ACTH were measured during and outside migraine attacks in 17 patients with common migraine and 11 patients with classic migraine. Specific radioimmunoassays for beta-endorphin and ACTH were used. The beta-endorphin assay did not cross-react with beta-lipotropin...... migraine. Accordingly, we could not add evidence to the theory of a dysfunction of the endogenous opioid system in migraine....

Animal Migraine Models for Drug Development

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Jansen-Olesen, Inger; Tfelt-Hansen, Peer; Olesen, Jes

2013-01-01

Migraine is number seven in WHO's list of all diseases causing disability and the third most costly neurological disorder in Europe. Acute attacks are treatable by highly selective drugs such as the triptans but there is still a huge unmet therapeutic need. Unfortunately, drug development...... for headache has almost come to a standstill partly because of a lack of valid animal models. Here we review previous models with emphasis on optimal characteristics of a future model. In addition to selection of animal species, the method of induction of migraine-like changes and the method of recording...... responses elicited by such measures are crucial. The most naturalistic way of inducing attacks is by infusion of endogenous signaling molecules that are known to cause migraine in patients. The most valid response is recording of neural activity in the trigeminal system. The most useful headache related...

Migraine: treatments, comorbidities, and quality of life, in the USA

Directory of Open Access Journals (Sweden)

Malone CD

2015-08-01

Full Text Available Christopher D Malone,1 Amrita Bhowmick,2 Amy B Wachholtz,11Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 2Health Union, Philadelphia, PA, USAAbstract: This study sought to characterize the experience of stress, treatment patterns, and medical and disability profile in the migraineur population to better understand how the experience of migraines impacts the social and psychological functioning of this group. A 30-minute self-report survey was presented via a migraine-specific website with data collection occurring between May 15 and June 15, 2012. Recruitment for the study was done through online advertisements. In total, 2,907 individuals began the survey and 2,735 met the inclusion criteria for the study. The sample was predominantly female (92.8%. Migraine-associated stress was correlated with length of time since first onset of symptoms (P<0.01 and number of symptoms per month (P<0.01. Disorders related to stress, such as depression (P<0.01 and anxiety (P<0.01, were also positively correlated with the measured stress resulting from migraines. Migraine-associated stress must be understood as a multidimensional experience with broader impacts of stress on an individual correlating much more highly with negative mental and physical health profiles. Stress resulting from frequent migraine headaches may contribute to the development of medical and psychological comorbidities and may be a part of a cyclical relationship wherein stress is both a cause and effect of the social and medical impairments brought about by migraine.Keywords: characteristics, migraine, headache, stress, treatment satisfaction

Menstrual-Cycle and Menstruation Disorders in Episodic vs Chronic Migraine: An Exploratory Study.

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Spierings, Egilius L H; Padamsee, Aliya

2015-07-01

Migraine is a chronic condition of recurring moderate-to-severe headaches that affects an estimated 6% of men and 18% of women. The highest prevalence is in those 18-49 years of age, generally when women menstruate. It is divided into episodic and chronic migraine depending on the total number of headache days per month being 14 or less or 15 or more, respectively. Migraine has been associated with menorrhagia, dysmenorrhea, and endometriosis, the latter particularly in chronic migraine. We conducted a questionnaire survey of 96 women with migraine, 18-45 years old, to determine the occurrence of the menstrual-cycle disorders, oligomenorrhea, polymenorrhea, and irregular cycle, and the menstruation disorders, dysmenorrhea and menorrhagia, in episodic vs chronic migraine. The prevalence of menstrual-cycle disorders in general (41.2 vs 22.2%) and dysmenorrhea (51.0 vs 28.9%) was statistically significantly higher in the women with chronic migraine than in those with episodic migraine (P ≤ 0.05) (not corrected for multiple comparisons). Whether the migraine was menstruation sensitive, that is, the headaches consistently occurred or worsened with menstruation, did not impact the prevalence of menstrual disorders. We conclude that chronic migraine is possibly more often than episodic migraine associated with menstrual-cycle disorders in general and dysmenorrhea, without impact on menstruation sensitivity of the headaches. Wiley Periodicals, Inc.

Migraine and the risk of post-traumatic stress disorder among a cohort of pregnant women.

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Friedman, Lauren E; Aponte, Christina; Perez Hernandez, Rigoberto; Velez, Juan Carlos; Gelaye, Bizu; Sánchez, Sixto E; Williams, Michelle A; Peterlin, B Lee

2017-12-01

Individually both migraine and post-traumatic stress disorder (PTSD) prevalence estimates are higher among women. However, there is limited data on the association of migraine and PTSD in women during pregnancy. We examined the association between migraine and PTSD among women attending prenatal clinics in Peru. Migraine was characterized using the International Classification of Headache Disorders (ICHD)-III beta criteria. PTSD was assessed using the PTSD Checklist-Civilian Version (PCL-C). Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. Of the 2922 pregnant women included, 33.5% fulfilled criteria for any migraine (migraine 12.5%; probable migraine 21.0%) and 37.4% fulfilled PTSD criteria. Even when controlling for depression, women with any migraine had almost a 2-fold increased odds of PTSD (OR: 1.97; 95% CI: 1.64-2.37) as compared to women without migraine. Specifically, women with migraine alone (i.e. excluding probable migraine) had a 2.85-fold increased odds of PTSD (95% CI: 2.18-3.74), and women with probable migraine alone had a 1.61-fold increased odds of PTSD (95% CI: 1.30-1.99) as compared to those without migraine, even after controlling for depression. In those women with both migraine and comorbid depression, the odds of PTSD in all migraine categories were even further increased as compared to those women without migraine. In a cohort of pregnant women, irrespective of the presence or absence of depression, the odds of PTSD is increased in those with migraine. Our findings suggest the importance of screening for PTSD, specifically in pregnant women with migraine.

Evaluation of the function of the vestibular system in patients with migraine.

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Rzeski, Maciej; Stepień, Adam; Kaczorowski, Zbigniew

2008-01-01

Migraine is a common disorder with 1-year prevalence of 17.2% in women and 6% in men. Otoneurological symptoms such as phonophobia, tinnitus, vertigo, and dizziness are quite common in migraine. It is estimated that vertigo and dizziness are associated with migraine in 10% of all dizzy patients. The aim of the study was to evaluate the function of the vestibular system using electronystagmography (ENG) and videonystagmography (VNG) in patients with migraine compared to healthy controls. Sixty-two patients (46 women and 16 men) aged 20-35 years (mean age: 28.4 years) with migraine were qualified to the study. All other illnesses that can cause dysfunction of the vestibular system were excluded. The control group consisted of 31 healthy volunteers fulfilling the same demographic criteria as the migraine group (mean age: 29.2 years). Vertigo or dizziness was reported by 41 patients with migraine (66.1%). In ENG/VNG examination changes suggesting impairment of the peripheral or central part of the vestibular system were found in 34 patients (54.8%). In the control group, any abnormalities in ENG/VNG examination were present in 22.6% of individuals (p=0.0031). No statistical significance was found in the frequency of any ENG/VNG abnormalities in subgroups of patients with migraine with aura and migraine without aura. Factors predisposing to dysfunction of the vestibular system in our group of migraineurs were the frequency and duration of the migraine. Vertigo and dizziness are frequent co-existing symptoms in patients with migraine. ENG/VNG abnormali-ties are significantly more frequent in migraineurs than in healthy controls.

Precipitating and Relieving Factors of Migraine Headache in 200 Iraqi Kurdish Patients

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Ehsan K. Al-Shimmery

2010-07-01

Full Text Available Objectives: To study the precipitating and relieving factors of migraine headache in a group of Iraqi Kurdish patients including the effect of fasting in Ramadan, and to estimate the percentage of family history of migraine. Methods: A series of 200 migraine cases from different parts of the Kurdistan region in the North of Iraq attending the out-patient Neurology clinic at Rizgary Teaching Hospital and a private Neurology clinic at Erbil City was carried out between October 2007 and May 2008 were reviewed. The precipitating factors and relieving factors for migraine headache were registered and tabulated to be compared with others. Case definition of migraine was based on the International Headache Society (IHS criteria.Results: 33% of the patients were aged between 30-39 years, while 40.5% of patients experienced their first attack aged between 20-29 years. Stress or psychological upset was the commonest triggering factor (80%, followed by increasing physical activity (68%, change in weather (65.5%, and in relation to fasting (65%. Fasting in Ramadan was a triggering factor for headaches in 65% of patients. However, there was no significant association between the triggering factors with regards to sex difference. Relief of migraine in the studied sample was achieved using NSAIDs in 50% of patients, and sleep (45.5%. Hence, 61% of the study population had positive family history of migraine, 32.5% of them reported maternal history of migraine. Conclusion: Psychological upset, stress and excessive physical activity were the commonest triggering factors of migraine headache, while NSAID was the commonest relieving factor of migraine in this population. Family history was present in 61% of migraine patients based mainly from maternal root.

Central auditory processing and migraine: a controlled study.

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Agessi, Larissa Mendonça; Villa, Thaís Rodrigues; Dias, Karin Ziliotto; Carvalho, Deusvenir de Souza; Pereira, Liliane Desgualdo

2014-11-08

This study aimed to verify and compare central auditory processing (CAP) performance in migraine with and without aura patients and healthy controls. Forty-one volunteers of both genders, aged between 18 and 40 years, diagnosed with migraine with and without aura by the criteria of "The International Classification of Headache Disorders" (ICDH-3 beta) and a control group of the same age range and with no headache history, were included. Gaps-in-noise (GIN), Duration Pattern test (DPT) and Dichotic Digits Test (DDT) tests were used to assess central auditory processing performance. The volunteers were divided into 3 groups: Migraine with aura (11), migraine without aura (15), and control group (15), matched by age and schooling. Subjects with aura and without aura performed significantly worse in GIN test for right ear (p = .006), for left ear (p = .005) and for DPT test (p UNIFESP.

Altered Cortical Activation in Adolescents With Acute Migraine: A Magnetoencephalography Study

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Xiang, Jing; deGrauw, Xinyao; Korostenskaja, Milena; Korman, Abraham M.; O’Brien, Hope L.; Kabbouche, Marielle A.; Powers, Scott W.; Hershey, Andrew D.

2013-01-01

To quantitatively assess cortical dysfunction in pediatric migraine, 31 adolescents with acute migraine and age- and gender-matched controls were studied using a magnetoencephalography (MEG) system at a sampling rate of 6,000 Hz. Neuromagnetic brain activation was elicited by a finger-tapping task. The spectral and spatial signatures of magnetoencephalography data in 5 to 2,884 Hz were analyzed using Morlet wavelet and beamformers. Compared with controls, 31 migraine subjects during their headache attack phases (ictal) showed significantly prolonged latencies of neuromagnetic activation in 5 to 30 Hz, increased spectral power in 100 to 200 Hz, and a higher likelihood of neuromagnetic activation in the supplementary motor area, the occipital and ipsilateral sensorimotor cortices, in 2,200 to 2,800 Hz. Of the 31 migraine subjects, 16 migraine subjects during their headache-free phases (interictal) showed that there were no significant differences between interictal and control MEG data except that interictal spectral power in 100 to 200 Hz was significantly decreased. The results demonstrated that migraine subjects had significantly aberrant ictal brain activation, which can normalize interictally. The spread of abnormal ictal brain activation in both low- and high-frequency ranges triggered by movements may play a key role in the cascade of migraine attacks. Perspective This is the first study focusing on the spectral and spatial signatures of cortical dysfunction in adolescents with migraine using MEG signals in a frequency range of 5 to 2,884 Hz. This analyzing aberrant brain activation may be important for developing new therapeutic interventions for migraine in the future. PMID:23792072

Survey on prevalence and related factors of migraine in underwater operation personnel in China

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Mei-yan PAN

2014-04-01

Full Text Available Objective To investigate the prevalence, clinical features and related factors of migraine in underwater operation personnel in China.  Methods A total of 308 underwater operation personnel sampled by a cluster sampling method were visited by door-to-door calling and surveyed using the structured questionnaire including sociodemographic data, diagnostic questions on headache, life quality and sleep quality.  Results Seventy-three (23.70% cases suffered from headache in the past one year, among whom 64 cases presented primary headaches (20.78%, including 19 cases of migraine (6.17% manifesting unilateral pain (14/19, pulsatile pain (15/19 and moderate or severe pain (18/19. Phonophobia (14/19 and photophobia (12/19 were the most common accompanying symptoms. Univariate and multivariate Logistic regression analysis revealed that risk factors including age, education, residence, marital status, length of sevice and identity, had no significant differences from migraine prevalence (P > 0.05, for all.  Conclusions Migraine has a high prevalence in underwater operation personnel and exerts serious impact on their work and life quality. doi: 10.3969/j.issn.1672-6731.2014.04.013

Evolution of migraine after a 10-year follow-up.

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Nachit-Ouinekh, Fatima; Dartigues, Jean-François; Chrysostome, Virginie; Henry, Patrick; Sourgen, Christophe; El Hasnaoui, Abdelkader

2005-01-01

To assess the evolution of headaches in a workplace cohort over a 10-year period. Migraine headaches are associated with significant handicap in everyday activities and poor quality of life. The prevalence of migraine shows a bell-shaped age distribution with a peak during the third and fourth decades. However, there is little longitudinal data available on the natural history of this condition. A prospective health survey undertaken in a large workplace cohort since 1989 provides an opportunity to assess the evolution of migraine and other headache syndromes over a 10-year period. A sample of 2500 subjects who reported regular headaches was chosen at random from those with headache identified in a cohort of 46,244 employees of the French national power company aged between 35 and 50 years in 1989 participating in a yearly health survey. In 1993, all subjects were sent a headache questionnaire to complete and return. In 2003, an identical questionnaire was sent to all subjects who had returned exploitable data in 1993. Headache diagnosis was assigned retrospectively using the International Headache Society (IHS) criteria to migraine (IHS categories 1.1 and 1.2), migrainous disorder (IHS category 1.7), or other episodic headaches. Of 2500 subjects sampled, 2051 (82%) returned exploitable data for the first questionnaire in 1993. In 2003, 1250 (61%) of these provided a second data set. In 1993, 623 (30.4%) of subjects fulfilled diagnostic criteria for migraine. However, only 37% of these retained the diagnosis 10 years later. In contrast, the proportion of subjects with other forms of episodic headache rose from 23.7% to 31.6%. In 2003, 9.5% of the sample were headache-free. Retention or acquisition of a diagnosis of migraine was more common in women than in men, and age was associated with evolution to a less severe headache syndrome. In those subjects who continued to have headaches, frequency and severity were lower at the second assessment. Only a minority of

Statistical testing of association between menstruation and migraine.

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Barra, Mathias; Dahl, Fredrik A; Vetvik, Kjersti G

2015-02-01

To repair and refine a previously proposed method for statistical analysis of association between migraine and menstruation. Menstrually related migraine (MRM) affects about 20% of female migraineurs in the general population. The exact pathophysiological link from menstruation to migraine is hypothesized to be through fluctuations in female reproductive hormones, but the exact mechanisms remain unknown. Therefore, the main diagnostic criterion today is concurrency of migraine attacks with menstruation. Methods aiming to exclude spurious associations are wanted, so that further research into these mechanisms can be performed on a population with a true association. The statistical method is based on a simple two-parameter null model of MRM (which allows for simulation modeling), and Fisher's exact test (with mid-p correction) applied to standard 2 × 2 contingency tables derived from the patients' headache diaries. Our method is a corrected version of a previously published flawed framework. To our best knowledge, no other published methods for establishing a menstruation-migraine association by statistical means exist today. The probabilistic methodology shows good performance when subjected to receiver operator characteristic curve analysis. Quick reference cutoff values for the clinical setting were tabulated for assessing association given a patient's headache history. In this paper, we correct a proposed method for establishing association between menstruation and migraine by statistical methods. We conclude that the proposed standard of 3-cycle observations prior to setting an MRM diagnosis should be extended with at least one perimenstrual window to obtain sufficient information for statistical processing. © 2014 American Headache Society.

Grinding patterns in migraine patients with sleep bruxism: a case-controlled study.

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Kato, Momoko; Saruta, Juri; Takeuchi, Mifumi; Sugimoto, Masahiro; Kamata, Yohei; Shimizu, Tomoko; To, Masahiro; Fuchida, Shinya; Igarashi, Hisaka; Kawata, Toshitsugu; Tsukinoki, Keiichi

2016-11-01

Details on grinding patterns and types of contact during sleep bruxism in association with migraine headache have not yet been elucidated. This study compared the characteristics of sleep bruxism between patients with migraine and controls. The study included 80 female patients who had been diagnosed with migraine and 52 women with no history of migraine. Grinding patterns were measured using the BruxChecker® (Scheu Dental, Iserlohn, Germany). There was a significant difference between the two groups in the distribution of grinding patterns at the laterotrusive side (p grinding area at all sites was significantly larger in the migraine group than in the control group (p grinding over a large area among migraine patients, particularly in the molar region.

Ability to Cope with Pain Puts Migraine Surgery Patients in Perspective.

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Gfrerer, Lisa; Lans, Jonathan; Faulkner, Heather R; Nota, Sjoerd; Bot, Arjan G J; Austen, William Gerald

2018-01-01

Candidates for migraine surgery are chronic pain patients with significant disability. Currently, migraine-specific questionnaires are used to evaluate these patients. Analysis tools widely used in evaluation of better understood pain conditions are not typically applied. This is the first study to include a commonly used pain questionnaire, the Pain Self-Efficacy Questionnaire (PSEQ) that is used to determine patients' pain coping abilities and function. It is an important predictor of pain intensity/disability in patients with musculoskeletal pain, as low scores have been associated with poor outcome. Ninety patients were enrolled prospectively and completed the Migraine Headache Index and PSEQ preoperatively and at 12 months postoperatively. Scores were evaluated using paired t tests and Pearson correlation. Representative PSEQ scores for other pain conditions were chosen for score comparison. All scores improved significantly from baseline (p migraine surgery was higher than seen in other pain conditions after treatment (112 percent). Preoperative PSEQ scores did not influence postoperative outcome. The PSEQ successfully demonstrates the extent of debility in migraine surgery patients by putting migraine pain in perspective with other known pain conditions. It further evaluates functional status, rather than improvement in migraine characteristics, which significantly adds to our understanding of outcome. Poor preoperative PSEQ scores do not influence outcome and should not be used to determine eligibility for migraine surgery. Therapeutic, IV.

Diagnosis and Development of Screening Items for Migraine in Neurological Practice in Taiwan

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Shuu-Jiun Wang

2008-06-01

Conclusion: Migraine was the most common headache diagnosis in the neurologists’ clinics. Probable migraine was not completely adopted as a migraine spectrum among neurologists. In contrast to ID™, moderate or severe headache intensity replaced headache-related disability as one screening item for migraine in Taiwan.

[Intravenous lysine clonixinate for the treatment of migraine: an open pilot study].

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Krymchantowski, A V; Barbosa, J

1999-09-01

Several oral nonsteroidal anti-inflammatory drugs (NSAID) are effective to treat migraine attacks. Despite its efficacy to treat migraine and other pain, there are a few commercial NSAIDs available for intravenous (i.v.) administration. Lysine clonixinate (LC) is a NSAID derived from nicotinic acid that has been proven effective in various algic syndromes such as renal colic, nerve compression, muscular pain and odontalgias. The aim of this study was to evaluate the efficacy of the i.v. LC in the treatment of severe attacks of migraine. We studied prospectively 19 patients, 17 women and 2 men, ages from 18 to 57 years, with the diagnosis of migraine according to the International Headache Society criteria. The patients were oriented to proceed to the clinic once the headache has started, and were placed under an i.v. infusion of LC and saline in a superficial vein of the forearm, once the intensity reached severe. Evaluating the headache intensity after 30, 60 and 90 minutes, as well as the presence of side effects, we observed that all of the 19 patients were headache free after 90 minutes. Some patients presented mild adverse effects and the vital signs were not significantly affected. We then concluded that the i.v. infusion of the NSAID LC (2-3-chloro-o-toluidin)piridin-3-lysine carboxilate), a derived from the nicotinic acid with a chemical structure that resembles the flufenamic acid, was efficient abolishing a severe migraine attack after 90 minutes in 19 patients. Controlled studies with a double-blind and randomized design, and treating a greater number of patients and attacks are necessary to confirm these initial observations.

Migraine Nurses in Primary Care : Costs and Benefits

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van den Berg, Jan S. P.; Steiner, Timothy J.; Veenstra, Petra J. L.; Kollen, Boudewijn J.

Objective. We examined the costs and benefits of introducing migraine nurses into primary care. Background. Migraine is one of the most costly neurological diseases. Methods. We analyzed data from our earlier nonrandomized cohort study comparing an intervention group of 141 patients, whose care was

Headaches and Migraines: Headache Symptoms, Diagnosis, and Treatment

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... are thought to involve abnormal functioning of the brain's blood vessels. Migraines cause severe pain on one or both ... migraines. Toxic: The second most common type of vascular headache, toxic ... They are brought on by stressful events and involve the tightening or tensing of facial ...

Headache impact of chronic and episodic migraine: results from the American Migraine Prevalence and Prevention study.

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Buse, Dawn; Manack, Aubrey; Serrano, Daniel; Reed, Michael; Varon, Sepideh; Turkel, Catherine; Lipton, Richard

2012-01-01

The Headache Impact Test-6 (HIT-6) has been demonstrated to be a reliable and valid measure that assesses the impact of headaches on the lives of persons with migraine. Originally used in studies of episodic migraine (EM), HIT-6 is finding increasing applications in chronic migraine (CM) research. (1) To examine the headache-impact on persons with migraine (EM and CM) using HIT-6 in a large population sample; (2) to identify predictors of headache-impact in this sample; (3) to assess the magnitude of effect for significant predictors of headache-impact in this sample. The American Migraine Prevalence and Prevention study is a longitudinal, population-based study that collected data from persons with severe headache from 2004 to 2009 through annual, mailed surveys. Respondents to the 2009 survey who met International Classification of Headache Disorders 2 criteria for migraine reported at least 1 headache in the preceding year, and completed the HIT-6 questionnaire were included in the present analysis. Persons with migraine were categorized as EM (average headache days per month) or CM (average ≥15 headache days per month). Predictors of headache-impact examined include: sociodemographics; headache days per month; a composite migraine symptom severity score (MSS); an average pain severity rating during the most recent long-duration headache; depression; and anxiety. HIT-6 scores were analyzed both as continuous sum scores and using the standard, validated categories: no impact; some impact; substantial impact; and severe impact. Group contrasts were based on descriptive statistics along with linear regression models. Multiple imputation techniques were used to manage missing data. There were 7169 eligible respondents (CM = 373, EM = 6554). HIT-6 scores were normally distributed. After converting sum HIT-6 scores to the standard categories, those with CM were significantly more likely to experience "severe" headache impact (72.9% vs 42.3%) and had higher odds of

The diet factor in pediatric and adolescent migraine.

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Millichap, J Gordon; Yee, Michelle M

2003-01-01

Diet can play an important role in the precipitation of headaches in children and adolescents with migraine. The diet factor in pediatric migraine is frequently neglected in favor of preventive drug therapy. The list of foods, beverages, and additives that trigger migraine includes cheese, chocolate, citrus fruits, hot dogs, monosodium glutamate, aspartame, fatty foods, ice cream, caffeine withdrawal, and alcoholic drinks, especially red wine and beer. Underage drinking is a significant potential cause of recurrent headache in today's adolescent patients. Tyramine, phenylethylamine, histamine, nitrites, and sulfites are involved in the mechanism of food intolerance headache. Immunoglobulin E-mediated food allergy is an infrequent cause. Dietary triggers affect phases of the migraine process by influencing release of serotonin and norepinephrine, causing vasoconstriction or vasodilatation, or by direct stimulation of trigeminal ganglia, brainstem, and cortical neuronal pathways. Treatment begins with a headache and diet diary and the selective avoidance of foods presumed to trigger attacks. A universal migraine diet with simultaneous elimination of all potential food triggers is generally not advised in practice. A well-balanced diet is encouraged, with avoidance of fasting or skipped meals. Long-term prophylactic drug therapy is appropriate only after exclusion of headache-precipitating trigger factors, including dietary factors.

Temporomandibular disorder in chronic migraine

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N. V. Latysheva

2017-01-01

Full Text Available Rationale: For many years, temporomandibular disorder (TMD has been studied primarily by dentists and maxillofacial surgeons. However, new data is emerging that TMD is comorbid with various types of headache; however this association has not been studied in detail. Aim: To analyze TMD prevalence and clinical structure in patients with migraine. Materials and methods: We assessed 84 patients with chronic migraine (CM and 42 patients with episodic migraine (EM. TMD was diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders: Clinical Protocol and Assessment Instruments 2014. We also performed subgroup analysis for low-frequency EM (less than 4 headache days per month, LFEM vs. high-frequency EM and CM (over 10 headache days per month, HFEM + CM. Results: In both groups, myofascial pain was the most prevalent form of TMD. The prevalence of TMD was higher in CM as compared to EM (52.4% vs. 28.6%, correspondingly, р = 0.02. Even more evident differences were observed between LFEM and HFEM + CM (18.2% vs. 51.6%, correspondingly, р < 0.009. The difference was significant for painrelated TMD only. The prevalence of bruxism was comparable across LFEM and HFEM + CM (18% vs. 30.5%, correspondingly, р = 0.3 and significantly lower than TMD prevalence in HFEM + CM (30.5% vs. 51.6%, correspondingly, p = 0.005. The anxiety level in patients with and without TMD was also comparable (8.1 ± 4.1 vs. 8.3 ± 4.7, correspondingly, р = 0.8. Conclusion: CM patients have a high prevalence of pain-related TMD (52.4%. The prevalence of TMD in LFEM is comparable to that in the general population. The presence of bruxism or anxiety cannot be associated with a high TMD prevalence in our patients. In CM, pain in the masticatory muscles may be caused by anti-nociceptive dysfunction, mirroring central sensitization and disrupted descending modulation of pain.

Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.

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Levis, Brooke; Benedetti, Andrea; Riehm, Kira E; Saadat, Nazanin; Levis, Alexander W; Azar, Marleine; Rice, Danielle B; Chiovitti, Matthew J; Sanchez, Tatiana A; Cuijpers, Pim; Gilbody, Simon; Ioannidis, John P A; Kloda, Lorie A; McMillan, Dean; Patten, Scott B; Shrier, Ian; Steele, Russell J; Ziegelstein, Roy C; Akena, Dickens H; Arroll, Bruce; Ayalon, Liat; Baradaran, Hamid R; Baron, Murray; Beraldi, Anna; Bombardier, Charles H; Butterworth, Peter; Carter, Gregory; Chagas, Marcos H; Chan, Juliana C N; Cholera, Rushina; Chowdhary, Neerja; Clover, Kerrie; Conwell, Yeates; de Man-van Ginkel, Janneke M; Delgadillo, Jaime; Fann, Jesse R; Fischer, Felix H; Fischler, Benjamin; Fung, Daniel; Gelaye, Bizu; Goodyear-Smith, Felicity; Greeno, Catherine G; Hall, Brian J; Hambridge, John; Harrison, Patricia A; Hegerl, Ulrich; Hides, Leanne; Hobfoll, Stevan E; Hudson, Marie; Hyphantis, Thomas; Inagaki, Masatoshi; Ismail, Khalida; Jetté, Nathalie; Khamseh, Mohammad E; Kiely, Kim M; Lamers, Femke; Liu, Shen-Ing; Lotrakul, Manote; Loureiro, Sonia R; Löwe, Bernd; Marsh, Laura; McGuire, Anthony; Mohd Sidik, Sherina; Munhoz, Tiago N; Muramatsu, Kumiko; Osório, Flávia L; Patel, Vikram; Pence, Brian W; Persoons, Philippe; Picardi, Angelo; Rooney, Alasdair G; Santos, Iná S; Shaaban, Juwita; Sidebottom, Abbey; Simning, Adam; Stafford, Lesley; Sung, Sharon; Tan, Pei Lin Lynnette; Turner, Alyna; van der Feltz-Cornelis, Christina M; van Weert, Henk C; Vöhringer, Paul A; White, Jennifer; Whooley, Mary A; Winkley, Kirsty; Yamada, Mitsuhiko; Zhang, Yuying; Thombs, Brett D

2018-06-01

Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit. A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15-3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98-10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) (OR = 0.96; 95% CI = 0.56-1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26-0.97). The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the

Systemic right-to-left shunts, ischemic brain lesions, and persistent migraine activity.

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Koppen, Hille; Palm-Meinders, Inge H; Mess, Werner H; Keunen, Ruud W; Terwindt, Gisela M; Launer, Lenore J; van Buchem, Mark A; Kruit, Mark C; Ferrari, Michel D

2016-05-03

To assess whether migraine in the general population is associated with increased risk of systemic right-to-left shunts (RLS) and whether RLS are associated with increased prevalence of brain infarcts and persistent recurrence of migraine attacks at older age. Brain MRI and transcranial Doppler with air contrast in 166 unselected migraineurs (mean age ± SD 56 ± 7.7 years; 70% women; n = 96 migraine with aura) and 69 controls (mean age ± SD 55 ± 7.6 years; 65% women) from the general population. Participants with migraine with aura more frequently had Valsalva-induced RLS (60%), in particular large-sized, compared to controls (42%; odds ratio [OR] 2.1; 95% confidence interval [CI] 1.1-3.9; p = 0.02) and participants with migraine without aura (40%; OR 2.3; 95% CI 1.2-4.3; p = 0.01). They also more frequently had spontaneous RLS (35%) than participants with migraine without aura (17%; OR 2.6; 95% CI 1.3-5.6; p = 0.01) but not compared to controls (26%; OR 1.6; 95% CI 0.8-3.1; p = 0.2). Participants with migraine with aura and spontaneous RLS more frequently had persistent migraine activity (85%) than participants with migraine without spontaneous RLS (63%; OR 3.4; 95% CI 1.2-10.1; p = 0.03). Nine percent of participants with RLS had silent posterior circulation infarcts compared to 3% of participants without RLS (OR 2.8; 95% CI 0.9-9.3; p = 0.08), independent of migraine status. RLS were not associated with white matter lesions. RLS are more prevalent in migraineurs with aura but do not explain the increased prevalence of silent posterior circulation infarcts or white matter lesions in migraineurs. Spontaneous RLS are associated with persistent migraine. © 2016 American Academy of Neurology.

Magnetic resonance imaging of the brain in patients with migraine

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Igarashi, H.; Sakai, F.; Kan, S.; Okada, J.; Tazaki, Y. (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

1991-05-01

Magnetic resonance imaging (MRI) was studied in 91 patients with migraine and in 98 controls. Risk factors known to cause MRI lesions were carefully examined. In 36 patients with migraine (39.6%), small foci of high intensity on T{sub 2}-weighted and proton-density-weighted images were seen in the white matter. Of patients with migraine who were less than 40 years old and without any risk factor, 29.4% showed lesions on MRI; this was singificantly higher than the 11.2% for the group of age-matched controls (n=98). The lesions were distributed predominantly in the centrum semiovale and frontal white matter in young patients, but extended to the deeper white matter at the level of basal ganglia in the older age group. The side of the MRI lesions did not always correspond to the side of usual aura or headache. Migraine-related variables such as type of migraine, frequency, duration or intensity of headache or consumption of ergotamine showed no significant correlation with the incidence om MRI abnormalities. The data indicated that migraine may be associated with early pathologic changes in the brain. 26 refs., 4 figs., 3 tabs.

Magnetic resonance imaging of the brain in patients with migraine

International Nuclear Information System (INIS)

Igarashi, H.; Sakai, F.; Kan, S.; Okada, J.; Tazaki, Y.

1991-01-01

Magnetic resonance imaging (MRI) was studied in 91 patients with migraine and in 98 controls. Risk factors known to cause MRI lesions were carefully examined. In 36 patients with migraine (39.6%), small foci of high intensity on T 2 -weighted and proton-density-weighted images were seen in the white matter. Of patients with migraine who were less than 40 years old and without any risk factor, 29.4% showed lesions on MRI; this was singificantly higher than the 11.2% for the group of age-matched controls (n=98). The lesions were distributed predominantly in the centrum semiovale and frontal white matter in young patients, but extended to the deeper white matter at the level of basal ganglia in the older age group. The side of the MRI lesions did not always correspond to the side of usual aura or headache. Migraine-related variables such as type of migraine, frequency, duration or intensity of headache or consumption of ergotamine showed no significant correlation with the incidence om MRI abnormalities. The data indicated that migraine may be associated with early pathologic changes in the brain. 26 refs., 4 figs., 3 tabs

Family studies to find rare high risk variants in migraine

DEFF Research Database (Denmark)

Hansen, Rikke Dyhr; Christensen, Anne Francke; Olesen, Jes

2017-01-01

genetic variants with bigger effect size may be involved in the disease. Since migraine has a tendency to cluster in families, a family approach might be the way to find these variants. This is also indicated by identification of migraine-associated loci in classical linkage-analyses in migraine families....... A single migraine study using a candidate-gene approach was performed in 2010 identifying a rare mutation in the TRESK potassium channel segregating in a large family with migraine with aura, but this finding has later become questioned. The technologies of next-generation sequencing (NGS) now provides...... an affordable tool to investigate the genetic variation in the entire exome or genome. The family-based study design using NGS is described in this paper. We also review family studies using NGS that have been successful in finding rare variants in other common complex diseases in order to argue the promising...

Matrix metalloproteinases during and outside of migraine attacks without aura

DEFF Research Database (Denmark)

Ashina, M.; Tvedskov, J.F.; Thiesen, Kerstin Lipka

2010-01-01

Ashina M, Tvedskov JF, Lipka K, Bilello J, Penkowa M & Olesen J. Matrix metalloproteinases during and outside of migraine attacks without aura. Cephalalgia 2009. London. ISSN 0333-1024To test the hypothesis that permeability of the blood-brain barrier (BBB) is altered during migraine attack due...... to enhanced activation of matrix metalloproteinases (MMPs), we investigated MMP-3, MMP-9 and tissue inhibitor of metalloproteases (TIMP)-1 in the external jugular vein during and outside of migraine attacks in 21 patients with migraine without aura. In addition, we measured plasma levels of several other...... of MMP-3 in the external jugular (P = 0.002) and cubital (P = 0.008) vein during attacks compared with outside of attacks. We found no correlation of ictal or interictal MMP-3, MMP-9 and TIMP-1 to migraine duration and frequency analysed in 21 patients (P > 0.05). There was no difference between ictal...

Is Celiac Disease an Etiological Factor in Children With Migraine?

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Balcı, Oya; Yılmaz, Deniz; Sezer, Taner; Hızlı, Şamil

2016-06-01

To determine the prevalence of celiac disease in children and adolescents with migraine, the authors investigated serum levels of tissue transglutaminase antibody immunoglobulin A and total immunoglobulin A from 81 children with migraine and in a healthy control group of 176 children. Study participants who were positive for tissue transglutaminase immunoglobulin A antibodies underwent a duodenal biopsy. Two patients in the migraine group (2.5%) and 1 in the control group (0.57%) tested positive for serum tissue transglutaminase immunoglobulin A antibodies (P > .05). Duodenal biopsy did not confirm celiac disease in both groups, and these patients were considered "potential celiac" cases. In the present study, children with migraine did not exhibit a higher prevalence rate of celiac disease compared with healthy controls. Therefore, the screening test for celiac disease is not a necessary part of the management of migraine in children. © The Author(s) 2016.

Correlation or causation: untangling the relationship between patent foramen ovale and migraine.

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Adler, Eric; Love, Barry; Giovannone, Steve; Volpicelli, Frank; Goldman, Martin E

2007-03-01

Observational evidence from the literature has shown an association between migraine headaches and patent foramen ovale (PFO). This observation has led to hypotheses that could explain the etiology of migraines in those with a PFO, including right-to-left shunting of venous agents such as serotonin that are normally broken down in the pulmonary circulation. Further evidence suggests that closure of a PFO may improve migraine symptoms and serve as an effective treatment modality for migraines. Several randomized controlled double-blinded studies are underway that will more definitively establish the role of specific devices in PFO closure in those suffering from migraines.

Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States.

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Bonafede, Machaon; Sapra, Sandhya; Shah, Neel; Tepper, Stewart; Cappell, Katherine; Desai, Pooja

2018-05-01

The goal of this analysis was to provide a contemporary estimate of the burden of migraine, incorporating both direct and indirect costs, by comparing the costs of migraine patients to a matched group of patients without migraine in a large, nationally representative sample of commercially insured patients in the United States. Previous studies have shown that the economic burden of migraine in the United States is substantial for payers, patients, and employers. Despite the availability of multiple acute and preventive pharmacological treatment options and a relatively stable migraine prevalence in the United States, there has been a documented increase in migraine-related healthcare resource and pharmacy use. Given the frequently disabling nature of migraine and its high prevalence, especially during peak productive years, and the lack of recent estimates of the burden of migraine, there is a need to update the existing literature with more current data. This retrospective, observational cohort study identified migraine patients in the Truven Health Market Scan Research Databases between January 2008 and June 2013. Adult patients had 12 months of continuous enrollment before (baseline period) and after (follow-up period) the day they received migraine diagnoses and/or medications (index) and no diagnosis of HIV or malignancy during the study period. The patients with migraine were matched 1:1 to a group of patients without migraine on demographic variables and index date. Direct healthcare utilization and costs and indirect (absenteeism, short-term disability, and long-term disability) costs were assessed during the 12-month follow-up period and differences between patients with vs without migraine were assessed. Two additional multivariable logistic regression analyses were conducted. First, an analysis was conducted comparing the odds of having a short-term disability claim between patients with and without migraine after controlling for patient demographic and

In-Depth Review of Symptoms, Triggers, and Treatment of Occipital Migraine Headaches (Site IV).

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Ascha, Mona; Kurlander, David E; Sattar, Abdus; Gatherwright, James; Guyuron, Bahman

2017-06-01

This study reports the surgical technique and efficacy of deactivation of occipital-triggered migraine headaches. In addition, it reports the effect of surgical deactivation of occipital-triggered migraine headaches on migraine triggers and associated symptoms other than pain. One hundred ninety-five patients undergoing surgery for occipital-triggered migraine headaches performed by a single surgeon, and followed for at least 1 year, were analyzed. Median regression adjusted for age, sex, and follow-up time was used to determine postoperative reduction in occipital-specific Migraine Headache Index, which is the product of migraine duration, frequency, and severity. Reduction in migraine-days was also measured. The association between symptom or trigger resolution and occipital-specific Migraine Headache Index reduction was studied by logistic regression. Details of surgical treatment are discussed and complication rates reported. Eighty-two percent of patients (n = 160) reported successful surgery at least 12 months postoperatively (mean follow-up, 3.67 years). Eighty-six percent (n = 168) had successful surgery as measured by migraine-days. Fifty-two percent reported complete occipital-triggered migraine headaches elimination. Symptoms resolving with successful surgery beyond headache include being bothered by light and noise, feeling lightheaded, difficulty concentrating, vomiting, blurred/double vision, diarrhea, visual aura, numbness and tingling, speech difficulty, and limb weakness (p occipital-triggered migraine headaches provides long-lasting migraine relief. Successful site IV surgery is associated with changes in specific symptoms and triggers. This can assist in trigger avoidance and aid occipital-triggered migraine headache trigger-site identification. Therapeutic, IV.

Treatment of Chronic Migraine with OnabotulinumtoxinA: Mode of Action, Efficacy and Safety

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Délia Szok

2015-07-01

Full Text Available Background: Chronic migraine is a common, highly disabling, underdiagnosed and undertreated entity of migraine. It affects 0.9%–2.2% of the general adult population. The present paper overviews the preclinical and clinical data regarding the therapeutic effect of onabotulinumtoxinA in chronic migraineurs. Methods: A literature search was conducted in the database of PubMed up to 20 May 2015 for articles related to the pathomechanism of chronic migraine, the mode of action, and the efficacy, safety and tolerability of onabotulinumtoxinA for the preventive treatment of chronic migraine. Results: The pathomechanism of chronic migraine has not been fully elucidated. The mode of action of onabotulinumtoxinA in the treatment of chronic migraine is suggested to be related to the inhibition of the release of calcitonin gene-related peptide and substance P in the trigeminovascular system. Randomized clinical trials demonstrated that long-term onabotulinumtoxinA fixed-site and fixed-dose (155–195 U intramuscular injection therapy was effective and well tolerated for the prophylactic treatment of chronic migraine. Conclusions: Chronic migraine is a highly devastating entity of migraine. Its exact pathomechanism is unrevealed. Two-third of chronic migraineurs do not receive proper preventive medication. Recent clinical studies revealed that onabotulinumtoxinA was an efficacious and safe treatment for chronic migraine.

The Effect of Migraine Headache on Educational Attainment

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Rees, Daniel I.; Sabia, Joseph J.

2011-01-01

Despite the fact that migraine headaches are common and debilitating, little is known about their effect on educational attainment. Using data drawn from the National Longitudinal Study of Adolescent Health, we estimate the relationship between migraine headache and three outcomes: high school grade point average, the probability of graduating…

Migraine and risk of hemorrhagic stroke

DEFF Research Database (Denmark)

Gaist, David; González-Pérez, Antonio; Ashina, Messoud

2014-01-01

to select 10,000 controls free from hemorrhagic stroke. Using unconditional logistic regression models, we calculated the risk of hemorrhagic stroke associated with migraine, adjusting for age, sex, calendar year, alcohol, body mass index, hypertension, previous cerebrovascular disease, oral contraceptive......BACKGROUND: We investigated the association between hemorrhagic stroke and migraine using data from The Health Improvement Network database. FINDINGS: We ascertained 1,797 incident cases of intracerebral hemorrhage (ICH) and 1,340 of subarachnoid hemorrhage (SAH). Density-based sampling was used...

Clinical characteristics of migraine and episodic tension-type headache in relation to old and new diagnostic criteria

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Iversen, Helle Klingenberg; Langemark, M; Andersson, P G

1990-01-01

Eighty-one patients were diagnosed as having migraine, tension headache or both according to previously used criteria. Then we performed a standardized interview to determine the frequency and severity of headache characteristics used in the new operational diagnostic criteria of the International...... Headache Society (IHS). In every patient the original diagnosis fulfilled also the IHS criteria, but in 9 patients the criteria were only fulfilled in half or less of the attacks, and applying the IHS criteria they also achieved an additional diagnosis. In one patient these attacks did not fulfill the pain...... criteria and in 8 (4 migraine, 4 tension headache) they did not fulfill the criteria for accompanying symptoms. Overall the IHS criteria are sensitive and specific, but they may possibly be improved with regard to accompanying symptoms. The present study suggests that recording of frequency and graded...

Intact blood-brain barrier during spontaneous attacks of migraine without aura

DEFF Research Database (Denmark)

Amin, F M; Hougaard, A; Cramer, S P

2017-01-01

BACKGROUND AND PURPOSE: The integrity of the blood-brain barrier (BBB) has been questioned in migraine, but BBB permeability has never been investigated during spontaneous migraine attacks. In the present study, BBB permeability during spontaneous attacks of migraine without aura was investigated......, brain stem, posterior pons and whole brain. The paired samples t test was used to compare Ki (permeability) values between the attack and headache-free days. RESULTS: Nineteen patients completed the study. Median time from onset of migraine attack to scan was 6.5 h (range 4.0-15.5 h). No change...

Study of psychiatric comorbidity in patients with headache using a short structured clinical interview in a rural neurology clinic in Western India

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Soaham Dilip Desai

2014-01-01

Full Text Available Background: Psychiatric disorders are common in patients attending neurology clinics with headache. Evaluation of psychiatric comorbidity in patients with headache is often missed in the busy neurology clinics. Aims: To assess the prevalence of Axis-I DSM-IV psychiatric disorders in patients with primary headache disorders in a rural-based tertiary neurology clinic in Western India. Settings and Design : A cross-sectional observation survey was conducting assessing all patients with migraine, tension-type headache and chronic daily headache attending the Neurology Clinic of Shree Krishna Hospital, a rural medical teaching hospital in Karamsad, in Gujarat in Western India. Materials and Methods: A total of 101 consecutive consenting adults with headache were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I., a structured diagnostic clinical interview to assess prevalence of Axis-I DSM-IV psychiatric disorders. Statistical Analysis: Descriptive statistics were calculated using SPSS software version 16 and a binomial regression model was used to study the relationship of psychiatric co-morbidity with patient-related factors. Results: 49 out of 101 (48.5% patients with headache suffered from depressive disorders (dysthymia or depression or suicidality, 18 out of 101 patients with headache (17.90% suffered from anxiety related disorders (generalized anxiety disorder or agoraphobia or social phobia or panic disorder. Conclusions: Axis-I psychiatric disorders are a significant comorbidity among patients with headache disorders. M.I.N.I. can be used as a short, less time consuming instrument to assess all patients with headache disorders.

A Comparison of Dysautonomias Comorbid with Cyclic Vomiting Syndrome and with Migraine

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Gisela Chelimsky

2009-01-01

Full Text Available Cyclic vomiting syndrome (CVS shares many features with migraine headache, including auras, photophobia, and antimigrainous treatment response being traditionally viewed as a migraine variant. Aims. To determine whether CVS is associated with the same disorders as migraine headache, and compare these associations to those in healthy control subjects. Methods. Cross-sectional study of patients utilizing the ODYSA instrument, evaluating the probability of 12 functional/autonomic diagnoses, CVS, migraine, orthostatic intolerance (OI, reflex syncope, interstitial cystitis, Raynaud's syndrome, complex regional pain syndrome (CRPS, irritable bowel syndrome, functional dyspepsia, functional abdominal pain, fibromyalgia, and chronic fatigue syndrome. Control subjects were age-matched gender-matched friends. Patients had to fulfill criteria for CVS or migraine, while control subjects could not. Results. 103 subjects were studied, 21 with CVS, 46 with migraine and 36 healthy controls. CVS and migraine did not differ in the relative frequencies of fibromyalgia, OI, syncope, and functional dyspepsia. However, CVS patients did demonstrate a significantly elevated frequency of CRPS. Conclusions. Although CVS and migraine clearly share many of the same comorbidities, they do differ in one important association, suggesting that they may not be identical in pathophysiology. Since OI is common in CVS, treatment strategies could also target this abnormality.

Art and Migraine: Researching the Relationship between Artmaking and Pain Experience

Science.gov (United States)

Vick, Randy M.; Sexton-Radek, Kathy

2009-01-01

This research project extends a previous study (Vick & Sexton-Radek, 1999) in examining the relationship between artmaking and pain among 127 migraine sufferers. A basic overview of migraine symptoms and treatment is presented along with a discussion of concepts relating to "migraine art" in order to provide a context for this project. Surveys…

Investigation of carbachol and PACAP38 in a human model of migraine

DEFF Research Database (Denmark)

Schytz, Henrik Winther

2011-01-01

and VIP in migraine and head pain. In study I-III we investigated acetylcholine, via the analogue carbachol, and PACAP38 in a human model of migraine. In study IV we studied if PACAP38 and VIP might induce central sensitization, neurogenic inflammation and mast cell degranulation in a cutaneous model...... in migraine patients as well as sustained dilatation of cephalic vessels. In study IV VIP and PACAP38 evoked skin pain, central sensitization, neurogenic inflammation and mast cell degranulation, but VIP showed to be more potent than PACAP38 in inducing neurogenic inflammation and mast cell degranulation...... that neurogenic inflammation and mast cell degranulation are unlikely to cause PACAP38 induced migraine. The present thesis contributes to our knowledge on migraine pathophysiology and suggests PAC1 receptor antagonism as a new target for migraine treatment....

Canadian Headache Society guideline for migraine prophylaxis.

Science.gov (United States)

Pringsheim, Tamara; Davenport, W Jeptha; Mackie, Gordon; Worthington, Irene; Aubé, Michel; Christie, Suzanne N; Gladstone, Jonathan; Becker, Werner J

2012-03-01

The primary objective of this guideline is to assist the practitioner in choosing an appropriate prophylactic medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. This guideline is focused on patients with episodic migraine (headache on ≤ 14 days a month). Through a comprehensive search strategy, randomized, double blind, controlled trials of drug treatments for migraine prophylaxis and relevant Cochrane reviews were identified. Studies were graded according to criteria developed by the US Preventive Services Task Force. Recommendations were graded according to the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. In addition, a general literature review and expert consensus were used for aspects of prophylactic therapy for which randomized controlled trials are not available. Prophylactic drug choice should be based on evidence for efficacy, side-effect profile, migraine clinical features, and co-existing disorders. Based on our review, 11 prophylactic drugs received a strong recommendation for use (topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, butterbur, riboflavin, coenzyme Q10, and magnesium citrate) and 6 received a weak recommendation (divalproex sodium, flunarizine, pizotifen, venlafaxine, verapamil, and lisinopril). Quality of evidence for different medications varied from high to low. Prophylactic treatment strategies were developed to assist the practitioner in selecting a prophylactic drug for specific clinical situations. These strategies included: first time strategies for patients who have not had prophylaxis before (a beta-blocker and a tricyclic strategy), low side effect strategies (including both drug and herbal/vitamin/mineral strategies), a strategy for patients with high body mass index, strategies for patients with co-existent hypertension or with co-existent depression and /or

PRRT2 links infantile convulsions and paroxysmal dyskinesia with migraine

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Cloarec, Robin; Bruneau, Nadine; Rudolf, Gabrielle; Massacrier, Annick; Salmi, Manal; Bataillard, Marc; Boulay, Clotilde; Caraballo, Roberto; Fejerman, Natalio; Genton, Pierre; Hirsch, Edouard; Hunter, Alasdair; Lesca, Gaetan; Motte, Jacques; Roubertie, Agathe; Sanlaville, Damien; Wong, Sau-Wei; Fu, Ying-Hui; Rochette, Jacques; Ptáček, Louis J.

2012-01-01

ABSTRACT Objective: Whole genome sequencing and the screening of 103 families recently led us to identify PRRT2 (proline-rich-transmembrane protein) as the gene causing infantile convulsions (IC) with paroxysmal kinesigenic dyskinesia (PKD) (PKD/IC syndrome, formerly ICCA). There is interfamilial and intrafamilial variability and the patients may have IC or PKD. Association of IC with hemiplegic migraine (HM) has also been reported. In order to explore the mutational and clinical spectra, we analyzed 34 additional families with either typical PKD/IC or PKD/IC with migraine. Methods: We performed Sanger sequencing of all PRRT2 coding exons and of exon-intron boundaries in the probands and in their relatives whenever appropriate. Results: Two known and 2 novel PRRT2 mutations were detected in 18 families. The p.R217Pfs*8 recurrent mutation was found in ≈50% of typical PKD/IC, and the unreported p.R145Gfs*31 in one more typical family. PRRT2 mutations were also found in PKD/IC with migraine: p.R217Pfs*8 cosegregated with PKD associated with HM in one family, and was also detected in one IC patient having migraine with aura, in related PKD/IC familial patients having migraine without aura, and in one sporadic migraineur with abnormal MRI. Previously reported p.R240X was found in one patient with PKD with migraine without aura. The novel frameshift p.S248Afs*65 was identified in a PKD/IC family member with IC and migraine with aura. Conclusions: We extend the spectrum of PRRT2 mutations and phenotypes to HM and to other types of migraine in the context of PKD/IC, and emphasize the phenotypic pleiotropy seen in patients with PRRT2 mutations. PMID:23077017

Trigger factors in migraine with aura

DEFF Research Database (Denmark)

Hauge, A W; Kirchmann, M; Olesen, J

2010-01-01

The aim of the present study was to identify trigger factors in migraine with aura (MA). A total of 629 MA patients representative of the Danish population were sent a questionnaire listing 16 trigger factors thought to be relevant as well as space for free text. Distinction was made between...... attacks with or without aura within each patient. The questionnaire was returned by 522 patients of whom 347 had current MA attacks. In total 80% with current attacks (278/347) indicated that at least one factor triggered their migraine, and 67% (187/278) in this group indicated that they were aware...... of at least one factor often or always giving rise to an attack of MA. Forty-one per cent (113/278) had co-occurring attacks of migraine without aura (MO). Stress (following stress), bright light, intense emotional influences, stress (during stress) and sleeping too much or too little were the trigger factors...

Sublingual piroxicam in migraine without aura.

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Ravishankar, K; Tayade, Himanshu; Mandlik, Rahul

2011-08-01

The aim of the present study was to compare the analgesic efficacy of a single dose of sublingual piroxicam to that of a placebo during acute attacks of migraine without aura. The drug (N = 30) or a placebo (N = 30) was administered, on randomisation and double-blind basis, to 60 patients between 18 and 50 years of age suffering from migraine without aura. The patients were instructed to take a single tablet sublingually [corresponding to piroxicam 40 mg or placebo] and the severity of the painful symptomatology and associated symptoms were evaluated by this study. The patients treated with sublingual piroxicam showed a significant (P piroxicam administration. In 83.3%, the drug resulted in excellent to good response as compared to only 10% in the placebo group. No local and systemic side effects were reported with sublingual piroxicam. The present study has demonstrated that for the acute management of migraine without aura sublingual piroxicam showed significant analgesic effect with excellent tolerability.

Aerobic Exercise for Reducing Migraine Burden: Mechanisms, Markers, and Models of Change Processes.

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Irby, Megan B; Bond, Dale S; Lipton, Richard B; Nicklas, Barbara; Houle, Timothy T; Penzien, Donald B

2016-02-01

Engagement in regular exercise routinely is recommended as an intervention for managing and preventing migraine, and yet empirical support is far from definitive. We possess at best a weak understanding of how aerobic exercise and resulting change in aerobic capacity influence migraine, let alone the optimal parameters for exercise regimens as migraine therapy (eg, who will benefit, when to prescribe, optimal types, and doses/intensities of exercise, level of anticipated benefit). These fundamental knowledge gaps critically limit our capacity to deploy exercise as an intervention for migraine. Clear articulation of the markers and mechanisms through which aerobic exercise confers benefits for migraine would prove invaluable and could yield insights on migraine pathophysiology. Neurovascular and neuroinflammatory pathways, including an effect on obesity or adiposity, are obvious candidates for study given their role both in migraine as well as the changes known to accrue with regular exercise. In addition to these biological pathways, improvements in aerobic fitness and migraine alike also are mediated by changes in psychological and sociocognitive factors. Indeed a number of specific mechanisms and pathways likely are operational in the relationship between exercise and migraine improvement, and it remains to be established whether these pathways operate in parallel or synergistically. As heuristics that might conceptually benefit our research programs here forward, we: (1) provide an extensive listing of potential mechanisms and markers that could account for the effects of aerobic exercise on migraine and are worthy of empirical exploration and (2) present two exemplar conceptual models depicting pathways through which exercise may serve to reduce the burden of migraine. Should the promise of aerobic exercise as a feasible and effective migraine therapy be realized, this line of endeavor stands to benefit migraineurs (including the many who presently remain

Transcranial magnetic simulation in the treatment of migraine.

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Lipton, Richard B; Pearlman, Starr H

2010-04-01

Transcranial magnetic stimulation (TMS) is a diagnostic and therapeutic modality that is being developed as both an acute and preventive treatment for migraine. TMS delivers a fluctuating magnetic field from the scalp surface to induce current in the subjacent cortex. Magnetic pulses are delivered one at a time in single-pulse TMS (sTMS) or as a train of pulses in repetitive TMS (rTMS). For most of its 30-year history, TMS has been delivered in clinical and research settings using large tabletop devices. Based on the theory that sTMS may disrupt cortical spreading depression, sTMS has been studied and shown to be effective as an acute treatment for migraine with aura. Subsequent work in animal models confirms that sTMS disrupts cortical spreading depression. To make outpatient self-treatment possible, a portable device has been developed for acute treatment of migraine with aura. Based on the theory that rTMS alters brain excitability and neurotransmitter activity, rTMS has been studied as a preventive migraine treatment. A small body of evidence suggests that rTMS may have a role, but further studies are needed. In this review, we summarize the data on TMS as a treatment of migraine, and we suggest directions for future research. Copyright 2010 The American Society for Experimental NeuroTherapeutics, Inc. Published by Elsevier Inc. All rights reserved.

Human migraine models

DEFF Research Database (Denmark)

Iversen, Helle Klingenberg

2001-01-01

, which is a human experience. A set-up for investigations of experimental headache and migraine in humans, has been evaluated and headache mechanisms explored by using nitroglycerin and other headache-inducing agents. Nitric oxide (NO) or other parts of the NO activated cascade seems to be responsible...

Sustained long-term benefit of patent foramen ovale closure on migraine.

Science.gov (United States)

Trabattoni, Daniela; Fabbiocchi, Franco; Montorsi, Piero; Galli, Stefano; Teruzzi, Giovanni; Grancini, Luca; Gatto, Pamela; Bartorelli, Antonio L

2011-03-01

This single-center, observational, prospective study evaluated the impact of patent foramen ovale (PFO) closure on migraine attacks over time. PFO closure may reduce the frequency and severity of migraine headaches in patients with significant right-to-left shunts. Between May 2000 and September 2009, 305 consecutive patients (mean age, 43 ± 12 years; 54.5% women) with a prior embolic cerebrovascular event underwent PFO closure with the Amplatzer PFO occluder for recurrence prevention. All patients had right-to-left shunts; the shunts were associated with migraine symptoms in 77 (25%), either alone (n = 64, 83%) or with aura (n = 13, 17%). Septal aneurysm was present in 15 (19.5%) migraine patients, and 43 (56%) had a previous transient brain ischemic attack. All migraine patients had a computed tomography scan or magnetic resonance imaging, indicating a previous brain ischemic lesion. All 305 patients underwent transthoracic echocardiography with clinical follow-up at 24 hr, at 3, 6, and 12 months, and then yearly. An acute migraine attack occurred 24-48 hr after PFO closure in 28 (36.4%) of 77 patients. There was a significant reduction (>50%) in the number and intensity of attacks in 46 (60.5%) of 77 patients at the 3-month follow-up. At the 12-month follow-up, migraine had ceased in 23 (46%) patients, and 20 (40%) had a reduction in the migraine recurrence rate and disabling symptoms. These results were maintained at follow-up (mean, 28 ± 27 months). There was overall improvement in migraine in 89% of the treated patients. Percutaneous PFO closure in migraineurs may provide beneficial mid-term and long-term results, with significant reduction in the intensity and frequency of headache symptoms. Copyright © 2010 Wiley-Liss, Inc.

A large pharmacy claims-based descriptive analysis of patients with migraine and associated pharmacologic treatment patterns

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Muzina DJ

2011-11-01

Full Text Available David J Muzina, William Chen, Steven J BowlinMedco Health Solutions Inc and Medco Research Institute, LLC, Franklin Lakes, NJ, USAPurpose: To investigate drug use, prescribing patterns, and comorbidities among patients with migraine in a large pharmacy claims database.Methods: 104,625 migraine subjects (identified according to the criteria in the International Classification of Diseases, Ninth Revision [ICD-9] for migraine or migraine-specific acute medication use and an equal number of control patients were selected from a de-identified claims database; the prevalence of patients with migraine-specific claims was determined. Patient demographics, migraine-related medication use, other psychotropic medication use, and comorbidities over a 12-month period were compared between the migraine population and the control group and between migraine subgroups.Results: Of the study population, 3.5% had a migraine diagnosis according to the ICD-9 or received a migraine-specific acute medication. Compared with controls, migraine patients had significantly greater disease comorbidity and higher use of prescription nonsteroidal anti-inflammatory drugs and controlled painkillers; they were also more likely to receive medications used to prevent migraines and other nonmigraine psychotropic medications, such as anxiolytics and hypnotics. Among migraine patients, 66% received acute migraine-specific medication while only 20% received US Food and Drug Administration–approved migraine preventive therapy. Notably, one-third of high triptan users did not receive any kind of preventive medication. Multiple medical and psychiatric comorbidities were observed at higher rates among migraine sufferers. In addition to significantly higher utilization of antidepressants compared with controls, migraine patients also received significantly more other psychotropic drugs by a factor of 2:1.Conclusion: Acute migraine medications are commonly used and frequently dispensed at

Serum vitamin B12, folic acid and ferritin levels in patients with migraine

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Abdullah Acar

2011-06-01

Full Text Available OBJECTIVE: It has been reported that disability due to migraine may be reduced with homocysteine-lowering treatment including folic acid and vitamin B12. In addition, recently the periaqueductal gray matter iron deposits have been found to be increased in migraine patients. There are few studies regarding vitamin B12, folic acid, ferritin and transferrin levels in patients with migraine. The aims of this study was to measure vitamin B12, folic acid, ferritin and transferrin levels in patients with migraine and compare them with the control group. METHODS: Fifty-one consecutive newly diagnosed migraine patients who did not receive any vitamin supplement medication were enrolled. The study group consisted of 51 patients, suffering from migraine with aura (n= 23 and migraine without aura (n= 28. The control group consisted of 28 healthy participants without history of headache, anemia and vitamin supplement. Serum vitamin B12, folic acid, ferritin and transferin levels were measured using a chemiluminescence method. RESULTS: Migraine patients had significantly lower concentrations of vitamin B12 and folic acid compared with the healthy controls (for vitamin B12; 215.6±133.7 pg/ml vs. 289.9±12 pg/ml, respectively, p=0.005; for folic acid; 6.74 ± 4.31 pg/ml vs. 8.47 ± 1.85 pg/ml, respectively, p=0.048. The vitamin B12 levels were found to be significantly lower during attacks in migraine patients than in interictal periods (177.3 ± 139.2 pg/ml vs 252.5 ± 119.5 pg/ml, p=0.043. There were no differences in folic acid, ferritin, and transferritin levels between during attacks and in interictal period of patients with migraine (p>0.05. The ferritin levels were found to be significantly lower during attacks in migraine patients than in interictal periods (43.4 ± 41.1 mg/ml, vs 75.4 ± 51.7, mg/ml, p=0.018. CONCLUSION: Migraine patients had lower serum vitamin B12 and folic acid levels than healthy subjects. These findings supported that vitamin B12

CGRP may play a causative role in migraine

DEFF Research Database (Denmark)

Lassen, L H; Haderslev, P A; Jacobsen, V B

2002-01-01

Calcitonin gene-related peptide (CGRP) has been detected in increased amounts in external jugular venous blood during migraine attacks. However, it is unknown whether this is secondary to migraine or whether CGRP may cause headache. In a double-blind crossover study, the effect of human alphaCGRP...... attacks may play a causative role....

Improved description of the migraine aura by a diagnostic aura diary

DEFF Research Database (Denmark)

Russell, M B; Iversen, Helle Klingenberg; Olesen, J

1994-01-01

We present a diagnostic aura diary for prospective recordings of migraine with aura. Three questionnaires are supplemented with sheets for drawings and plottings of visual and sensory auras. Twenty patients recorded 54 attacks of migraine with aura and 2 attacks of migraine aura without headache...... head pain, headache and aura symptoms were contralateral in 90% and ipsilateral in 10%....

Low serum diamine oxidase (DAO) activity levels in patients with migraine.

Science.gov (United States)

Izquierdo-Casas, Joan; Comas-Basté, Oriol; Latorre-Moratalla, M Luz; Lorente-Gascón, Marian; Duelo, Adriana; Vidal-Carou, M Carmen; Soler-Singla, Luis

2018-02-01

Histamine intolerance is a disorder in the homeostasis of histamine due to a reduced intestinal degradation of this amine, mainly caused by a deficiency in the enzyme diamine oxidase (DAO). Among the several multi-faced symptoms associated with histamine intolerance, headache is one of the most recognized and disabling consequences. The aim of this study was to determine the prevalence of DAO deficiency in patients with a confirmed migraine diagnosis according to the current International Headache Society (IHS) and in non-migraine subjects. DAO activity was assessed in a total of 198 volunteers recruited at the Headache Unit of the Hospital General de Catalunya, 137 in the migraine group and 61 as a control group. DAO enzyme activity in blood samples was determined by ELISA test. Values below 80 HDU/ml (Histamine Degrading Unit/ml) were considered as DAO deficient. Mean value of DAO activity from migraine population (64.5 ± 33.5 HDU/ml) was significantly lower (p < 0.0001) than that obtained from healthy volunteers (91.9 ± 44.3 HDU/ml). DAO deficiency was more prevalent in migraine patients than in the control group. A high incidence rate of DAO deficiency (87%) was observed in the group of patients with migraine. On the other hand, 44% of non-migranous subjects had levels of DAO activity lower than 80 HDU/ml. Despite the multifactorial aetiology of migraine, these results seem to indicate that this enzymatic deficit could be related to the onset of migraine.

Interictal dysfunction of a brainstem descending modulatory center in migraine patients.

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Eric A Moulton

Full Text Available The brainstem contains descending circuitry that can modulate nociceptive processing (neural signals associated with pain in the dorsal horn of the spinal cord and the medullary dorsal horn. In migraineurs, abnormal brainstem function during attacks suggest that dysfunction of descending modulation may facilitate migraine attacks, either by reducing descending inhibition or increasing facilitation. To determine whether a brainstem dysfunction could play a role in facilitating migraine attacks, we measured brainstem function in migraineurs when they were not having an attack (i.e. the interictal phase.Using fMRI (functional magnetic resonance imaging, we mapped brainstem activity to heat stimuli in 12 episodic migraine patients during the interictal phase. Separate scans were collected to measure responses to 41 degrees C and noxious heat (pain threshold+1 degrees C. Stimuli were either applied to the forehead on the affected side (as reported during an attack or the dorsum of the hand. This was repeated in 12 age-gender-matched control subjects, and the side tested corresponded to that in the matched migraine patients. Nucleus cuneiformis (NCF, a component of brainstem pain modulatory circuits, appears to be hypofunctional in migraineurs. 3 out of the 4 thermal stimulus conditions showed significantly greater NCF activation in control subjects than the migraine patients.Altered descending modulation has been postulated to contribute to migraine, leading to loss of inhibition or enhanced facilitation resulting in hyperexcitability of trigeminovascular neurons. NCF function could potentially serve as a diagnostic measure in migraine patients, even when not experiencing an attack. This has important implications for the evaluation of therapies for migraine.

Body posture changes in women with migraine with or without temporomandibular disorders

OpenAIRE

Ferreira, Mariana C.; Bevilaqua-Grossi, Débora; Dach, Fabíola É.; Speciali, José G.; Gonçalves, Maria C.; Chaves, Thais C.

2014-01-01

Background: Migraine and temporomandibular disorders (TMDs) are reported to be associated. However, there are no reports on the association among migraines, TMDs and changes in body posture. Objectives : To assess changes in body posture in women suffering migraines with or without TMD compared with a control group. Method: Sixty-six women with a mean age of 18 to 45 years participated in this study. The groups were composed of 22 volunteers with migraine and TMD (MTMD), 22 volunteers ...

Meta-Analysis of the Relationship between Multiple Sclerosis and Migraine

OpenAIRE

Pakpoor, Julia; Handel, Adam E.; Giovannoni, Gavin; Dobson, Ruth; Ramagopalan, Sreeram V.

2012-01-01

BACKGROUND: Studies investigating a proposed association between multiple sclerosis (MS) and migraine have produced conflicting results and a great range in the prevalence rate of migraine in MS patients. By meta-analysing all available data we aimed to establish an overall estimate of any association in order to more accurately inform clinicians and care-givers about a potential association between MS and migraine. METHODS: Pubmed and EMBASE were searched to identify suitable studies. Studie...

The relationships between migraine, depression, anxiety, stress, and sleep disturbances.

Science.gov (United States)

Yalinay Dikmen, Pinar; Yavuz, Burcu Goksan; Aydinlar, Elif Ilgaz

2015-06-01

To assess the relationships between migraine, depression, anxiety, stress, and sleep problems. Psychiatric conditions and sleep disturbances are common in migraineurs. Depression, anxiety, stress, migraine, and sleep problems frequently coexist as comorbidities. Eighty-seven episodic migraineurs (62 females, 25 males; 32.8 ± 6.9) and 41 control subjects (25 females, 16 males; 31.5 ± 5.6) were prospectively enrolled for the study. The participants completed a sociodemographic data form and a migraine disability assessment scale (MIDAS), depression, anxiety, stress scale (DASS), and Pittsburg Sleep Quality Index (PSQI). In migraineurs, a significant positive correlation was found between PSQI total scores and MIDAS scores (migraine related disability for at least three consecutive months) (r = 0. 234, p = 0.04). Only 24.1 % of migraineus (n = 21) had minimal or no disability, 75.9 % of the patients (n = 66) had more than a little disability according to MIDAS scores. PSQI total scores were also correlated with pain intensity over a three month period (MIDAS B) (r = 0.221, p = 0.04). While PSQI scores were found significantly different between migraineurs and control subjects (5.5 ± 2.9 vs 4.5 ± 2.5; p = 0.04), the correlation of all the DASS subscale scores between the groups was not statistically significant. Our findings showed that episodic migraine was a risk factor on its own for sleep disturbances without comorbid depression, anxiety, and stress. Moreover, migraine-related disability and pain intensity in migraine attacks were related to poor sleep quality.

[Prophylactic treatments of migraine].

Science.gov (United States)

Massiou, H

2000-01-01

Prophylactic treatment is mainly intended to reduce the frequency of migraine attacks. It is usually proposed to patients who suffer from two or more attacks per month. It should also be considered in patients who suffer from less frequent, but prolonged, disabling attacks with a poor response to abortive treatment, and who consider that their quality of life is reduced between attacks. Excessive intake of acute medication, more than twice a week, is a strong indication for prophylactic treatment. In order to obtain a good compliance to treatment, the patient must be informed of the expected efficacy of the drugs, and of their most frequent side effects. Thus, the choice of a prophylactic drug is made together with the patient. Based on the results of published controlled trials, the main prophylactic drugs are some betablockers, methysergide, pizotifene, oxetorone, flunarizine, amitriptyline, NSAIDs, and sodium valproate. Some less evaluated drugs such as aspirin, DHE, indoramine, verapamil, may be useful. Other substances such as riboflavin and new antiepileptic dugs are being evaluated. The choice of the drug to start with depends on several considerations. The first step is to make sure that there are no contra indications, and no possible interaction with the abortive medications. Then, possible side effects will be taken into account, for example, weight gain is a problem for most young women and patients who practice sports may not tolerate betablockers. Associated pathologies have to be checked. For example, a hypertensive migraine sufferers may benefit from betablockers; in a patient who suffers both from migraine and tension type headaches or from depression, amitriptyline is the first choice drug. The type of migraine should also be considered; for instance, in frequent attacks with aura, aspirin is recommended and betablockers avoided. In most cases, prophylaxis should be given as monotherapy, and it is often necessary to try successively several drugs

Migraine and epilepsy: a focus on overlapping clinical, pathophysiological, molecular, and therapeutic aspects.

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Bianchin, Marino Muxfeldt; Londero, Renata Gomes; Lima, José Eduardo; Bigal, Marcelo Eduardo

2010-08-01

The association of epilepsy and migraine has been long recognized. Migraine and epilepsy are both chronic disorders with episodic attacks. Furthermore, headache may be a premonitory or postdromic symptom of seizures, and migraine headaches may cause seizures per se (migralepsy). Migraine and epilepsy are comorbid, sharing pathophysiological mechanisms and common clinical features. Several recent studies identified common genetic and molecular substrates for migraine and epilepsy, including phenotypic-genotypic correlations with mutations in the CACNA1A, ATP1A2, and SCN1A genes, as well as in syndromes due to mutations in the SLC1A3, POLG, and C10orF2 genes. Herein, we review the relationship between migraine and epilepsy, focusing on clinical aspects and some recent pathophysiological and molecular studies.

Trigger factors mainly from the environmental type are reported by adolescents with migraine

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Marcela Dalla Bernardina Fraga

2013-05-01

Full Text Available Migraine can be triggered by many factors such as stress, sleep, fasting and environmental causes. There are few studies that evaluated migraine trigger factors in the adolescent population. Methods: A total of 100 participants from 10 to 19 years were subjected to a detailed headache questionnaire, with demographic and clinical data, and a headache diary including trigger factors during a two-month period was asked. Results: Fifty of the participants exhibited chronic migraine and the other 50 participants demonstrated episodic migraine. The most common group of trigger factors reported was the environmental one, mainly sun/clarity, followed by hot weather and the smell of perfume. Conclusions: Ninety-one percent of children and adolescents with migraine reported a trigger factor precipitating the migraine attack.

Low 5-HT1B receptor binding in the migraine brain

DEFF Research Database (Denmark)

Deen, Marie; Hansen, Hanne D; Hougaard, Anders

2018-01-01

Background The pathophysiology of migraine may involve dysfunction of serotonergic signaling. In particular, the 5-HT1B receptor is considered a key player due to the efficacy of 5-HT1B receptor agonists for treatment of migraine attacks. Aim To examine the cerebral 5-HT1B receptor binding....... Patients who reported migraine brain regions involved in pain modulation as regions of interest and applied a latent variable model (LVM) to assess the group effect on binding across these regions. Results Our data...... support a model wherein group status predicts the latent variable ( p = 0.038), with migraine patients having lower 5-HT1B receptor binding across regions compared to controls. Further, in a whole-brain voxel-based analysis, time since last migraine attack correlated positively with 5-HT1B receptor...

Higher P-Wave Dispersion in Migraine Patients with Higher Number of Attacks

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A. Koçer

2012-01-01

Full Text Available Objective and Aim. An imbalance of the sympathetic system may explain many of the clinical manifestations of the migraine. We aimed to evaluate P-waves as a reveal of sympathetic system function in migraine patients and healthy controls. Materials and Methods. Thirty-five episodic type of migraine patients (complained of migraine during 5 years or more, BMI < 30 kg/m2 and 30 controls were included in our study. We measured P-wave durations (minimum, maximum, and dispersion from 12-lead ECG recording during pain-free periods. ECGs were transferred to a personal computer via a scanner and then used for magnification of x400 by Adobe Photoshop software. Results. P-wave durations were found to be similar between migraine patients and controls. Although P WD (P-wave dispersion was similar, the mean value was higher in migraine subjects. P WD was positively correlated with P max (P<0.01. Attacks number per month and male gender were the factors related to the P WD (P<0.01. Conclusions. Many previous studies suggested that increased sympathetic activity may cause an increase in P WD. We found that P WD of migraine patients was higher than controls, and P WD was related to attacks number per month and male gender. Further studies are needed to explain the chronic effects of migraine.

Effect of Helicobacter Pylori Treatment on the Number and Intensity of Migraine Attacks

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Alireza Bakhshipour

2012-06-01

Full Text Available Background: Migraine is a common headache with an unknown cause. Migraine is about three times more common in women (18.2% than in men (6.2%. The recent studies have posed the possible relationship between the Helicobacter pylori infection and migraine headache. This study tries to analyze the effect of treating H. pylori infection on number and severity of migraine attacks.Materials and Methods: In this clinical pilot study, a number of 60 patients with migraine were examined in terms of infecting with H. pylori. Patients with the infections were treated by H. pylori eradication treatment standard triple regimen and the frequency and severity of their migraine attacks were measured for three months and finally the average of frequency and severity of attacks before and after treatment were compared. Results: The average frequency of the migraine attacks in patients with the H.pylori infection who have been treated was 7.1 before treatment and 2.7 after treatment (p=0.001. Likewise, the severity rate of such attacks in such patients was 9 which decreased to 4.5 after treatment (p=0.002. Conclusion: According to our study, patients with migraine attacks are preferred to be examined tested in terms of infecting with H. pylori. Thus, and eradication of this infection can be effective in decreasing of the migraine attacks.

Adherence to Biobehavioral Recommendations in Pediatric Migraine as Measured by Electronic Monitoring: The Adherence in Migraine (AIM) Study.

Science.gov (United States)

Kroon Van Diest, Ashley M; Ramsey, Rachelle; Aylward, Brandon; Kroner, John W; Sullivan, Stephanie M; Nause, Katie; Allen, Janelle R; Chamberlin, Leigh A; Slater, Shalonda; Hommel, Kevin; LeCates, Susan L; Kabbouche, Marielle A; O'Brien, Hope L; Kacperski, Joanne; Hershey, Andrew D; Powers, Scott W

2016-07-01

The purpose of this investigation was to examine treatment adherence to medication and lifestyle recommendations among pediatric migraine patients using electronic monitoring systems. Nonadherence to medical treatment is a significant public health concern, and can result in poorer treatment outcomes, decreased cost-effectiveness of medical care, and increased morbidity. No studies have systematically examined adherence to medication and lifestyle recommendations in adolescents with migraine outside of a clinical trial. Participants included 56 adolescents ages 11-17 who were presenting for clinical care. All were diagnosed with migraine with or without aura or chronic migraine and had at least 4 headache days per month. Medication adherence was objectively measured using electronic monitoring systems (Medication Event Monitoring Systems technology) and daily, prospective self-report via personal electronic devices. Adherence to lifestyle recommendations of regular exercise, eating, and fluid intake were also assessed using daily self-report on personal electronic devices. Electronic monitoring indicates that adolescents adhere to their medication 75% of the time, which was significantly higher than self-reported rates of medication adherence (64%). Use of electronic monitoring of medication detected rates of adherence that were significantly higher for participants taking once daily medication (85%) versus participants taking twice daily medication (59%). Average reported adherence to lifestyle recommendations of consistent noncaffeinated fluid intake (M = 5 cups per day) was below recommended levels of a minimum of 8 cups per day. Participants on average also reported skipping 1 meal per week despite recommendations of consistently eating three meals per day. Results suggest that intervention focused on adherence to preventive treatments (such as medication) and lifestyle recommendations may provide more optimal outcomes for children and adolescents with

Unique Migraine Subtypes, Rare Headache Disorders, and Other Disturbances.

Science.gov (United States)

Goadsby, Peter J

2015-08-01

The medical aphorism that common things happen commonly makes unique (and less common) migraine subtypes especially appropriate to review for the general neurologist. This article also identifies some rare headache disorders and other disturbances, and offers strategies to manage them. This article discusses migraine with brainstem aura, which is troublesome clinically and has had a change in terminology in the International Classification of Headache Disorders, Third Edition, beta version (ICHD-3 beta), and hemiplegic migraine, which is also troublesome in practice. The rare headache disorder hypnic headache and the exploding head syndrome are also discussed. When hypnic headache is recognized, it is eminently treatable, while exploding head syndrome is a benign condition with no reported consequences. Unique migraine subtypes, rare headache disorders, and other disturbances present to neurologists. When recognized, they can often be managed very well, which offers significant benefits to patients and practice satisfaction to neurologists.

Migraine strikes as neuronal excitability reaches a tipping point.

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Marten Scheffer

Full Text Available Self-propagating waves of cerebral neuronal firing, known as spreading depolarisations, are believed to be at the roots of migraine attacks. We propose that the start of spreading depolarisations corresponds to a critical transition that occurs when dynamic brain networks approach a tipping point. We show that this hypothesis is consistent with current pathogenetic insights and observed dynamics. Our view implies that migraine strikes when modulating factors further raise the neuronal excitability in genetically predisposed subjects to a level where even minor perturbations can trigger spreading depolarisations. A corollary is that recently discovered generic early warning indicators for critical transitions may be used to predict the onset of migraine attacks even before patients are clinically aware. This opens up new avenues for dissecting the mechanisms for the onset of migraine attacks and for identifying novel prophylactic treatment targets for the prevention of attacks.

Flunarizine versus metoprolol in migraine prophylaxis

DEFF Research Database (Denmark)

Sørensen, P S; Larsen, B H; Rasmussen, M J

1991-01-01

The prophylactic effect of flunarizine and metoprolol was studied in a multi-center randomized, double-blind trial of 149 patients with migraine with or without aura. After a 4-week placebo run-in period, patients were randomly allocated to treatment with flunarizine 10 mg daily or metoprolol 200......). Depression was the most serious side-effect occurring in 8% on flunarizine and 3% on metoprolol. We conclude that both drugs are effective in the prevention of migraine attacks but a higher number of dropouts occurred on flunarizine because of depression or weight gain....

Migraine attacks among medical students in Soochow University, Southeast China: a cross-sectional study

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Gu X

2018-04-01

Full Text Available Xiao Gu,1,2 Yaojie Xie1 1School of Nursing, The Hong Kong Polytechnic University, Hong Kong; 2Intensive Care Unit, Suzhou Municipal Hospital, Suzhou, China Purpose: Migraine is one of the most common primary headache disorders and is burdensome to both the individual and society, influencing the academic performance and quality of daily lives of medical students worldwide. This study aimed to investigate the migraine prevalence in a sample of university medical students in China and to examine the features and typical trigger factors of migraine among these students. Patients and methods: From May 2016 to August 2016, a total of 1,060 medical students who were enrolled in Soochow University in Jiangsu Province in China were chosen through stratified random sampling. A self-administered questionnaire that included the ID MigraineTM for screening of migraine cases was used to collect data. The frequency, severity, duration of migraine attacks, and relevant trigger factors were measured for migraine cases. In total, 986 students completed the questionnaire. Results: The overall migraine prevalence among students was 7.91%, with 4.64% in male and 9.84% in female students. Junior-grade students had a higher migraine prevalence than senior students (prevalence of migraine of year 1 to year 5 undergraduates: 10.83%, 8.9% vs. 6.25%, 4.42%, 5.33%, P<0.05; prevalence of migraine of year 1 to year 3 graduates: 9.68%, 9.71% vs. 6.38%, P<0.05. Students with a positive family history were more likely to suffer migraine than those without (OR=8.48, 95% CI: 4.33–16.59. Stress (n=73, 93.59%, lack of sleep (n=72, 92.31%, and change of sleeping time (n=68, 87.18% were the top three trigger factors among the students. Conclusion: Migraine was common among medical students from a university in China, and especially higher in female and junior-grade students, and those with a family history of migraine. Reducing stress and improving sleep quality might be effective

Comparative reliability of structured versus unstructured interviews in the admission process of a residency program.

Science.gov (United States)

Blouin, Danielle; Day, Andrew G; Pavlov, Andrey

2011-12-01

Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains

Allodynia is associated with a higher prevalence of depression in migraine patients

NARCIS (Netherlands)

Louter, M. A.; Wardenaar, K. J.; Veen, G.; van Oosterhout, W. P. J.; Zitman, F. G.; Ferrari, M. D.; Terwindt, G. M.

2014-01-01

Introduction There is a strong association between migraine and depression. The aim of this study is to identify migraine-specific factors involved in this association. Methods We conducted a cross-sectional study in a large, well-defined cohort of migraine patients (n=2533). We assessed lifetime

Spotlight on frovatriptan: a review of its efficacy in the treatment of migraine

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Allais G

2016-10-01

Full Text Available Gianni Allais, Chiara Benedetto Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy Abstract: Migraine is a common neurovascular disorder, affecting millions of people worldwide. Current guidelines recommend triptans as first-line treatment for moderate-to-severe migraine attacks. Frovatriptan is a second-generation triptan with a longer terminal elimination half-life in blood than other triptans (~26 hours. Three double-blind, randomized crossover preference studies have been recently conducted, assessing efficacy and safety of frovatriptan versus rizatriptan, zolmitriptan, and almotriptan, respectively. Frovatriptan showed favorable tolerability and sustained effect, with a significantly lower rate of relapse over 48 hours versus the other triptans. These findings were confirmed in a series of analyses of patient subsets from the three studies, including patients with menstrually related and oral contraceptive-induced migraine, hypertension, obesity, weekend migraine, as well as patients with migraine with aura. In all patient subsets analyzed, lower headache recurrence rates were observed versus the comparator triptans, indicating a more sustained pain-relieving effect on migraine symptoms. A further randomized, double-blind study demonstrated that frovatriptan given in combination with the fast-acting cyclooxygenase inhibitor dexketoprofen provided improved migraine pain-free activity at 2 hours, and gave more sustained pain-free activity at 24 hours, versus frovatriptan alone. These benefits were observed both when the combination was administered early (<1 hour after symptom onset or late (>1 hour after onset. Different pharmacokinetic, but synergistic, properties between frovatriptan and dexketoprofen may make the combination of these agents particularly effective in migraine treatment, with rapid onset of action and sustained effect over 48 hours. These benefits, together with potential cost

Meta-analysis of 375,000 individuals identifies 38 susceptibility loci for migraine.

Science.gov (United States)

Gormley, Padhraig; Anttila, Verneri; Winsvold, Bendik S; Palta, Priit; Esko, Tonu; Pers, Tune H; Farh, Kai-How; Cuenca-Leon, Ester; Muona, Mikko; Furlotte, Nicholas A; Kurth, Tobias; Ingason, Andres; McMahon, George; Ligthart, Lannie; Terwindt, Gisela M; Kallela, Mikko; Freilinger, Tobias M; Ran, Caroline; Gordon, Scott G; Stam, Anine H; Steinberg, Stacy; Borck, Guntram; Koiranen, Markku; Quaye, Lydia; Adams, Hieab H H; Lehtimäki, Terho; Sarin, Antti-Pekka; Wedenoja, Juho; Hinds, David A; Buring, Julie E; Schürks, Markus; Ridker, Paul M; Hrafnsdottir, Maria Gudlaug; Stefansson, Hreinn; Ring, Susan M; Hottenga, Jouke-Jan; Penninx, Brenda W J H; Färkkilä, Markus; Artto, Ville; Kaunisto, Mari; Vepsäläinen, Salli; Malik, Rainer; Heath, Andrew C; Madden, Pamela A F; Martin, Nicholas G; Montgomery, Grant W; Kurki, Mitja I; Kals, Mart; Mägi, Reedik; Pärn, Kalle; Hämäläinen, Eija; Huang, Hailiang; Byrnes, Andrea E; Franke, Lude; Huang, Jie; Stergiakouli, Evie; Lee, Phil H; Sandor, Cynthia; Webber, Caleb; Cader, Zameel; Muller-Myhsok, Bertram; Schreiber, Stefan; Meitinger, Thomas; Eriksson, Johan G; Salomaa, Veikko; Heikkilä, Kauko; Loehrer, Elizabeth; Uitterlinden, Andre G; Hofman, Albert; van Duijn, Cornelia M; Cherkas, Lynn; Pedersen, Linda M; Stubhaug, Audun; Nielsen, Christopher S; Männikkö, Minna; Mihailov, Evelin; Milani, Lili; Göbel, Hartmut; Esserlind, Ann-Louise; Christensen, Anne Francke; Hansen, Thomas Folkmann; Werge, Thomas; Kaprio, Jaakko; Aromaa, Arpo J; Raitakari, Olli; Ikram, M Arfan; Spector, Tim; Järvelin, Marjo-Riitta; Metspalu, Andres; Kubisch, Christian; Strachan, David P; Ferrari, Michel D; Belin, Andrea C; Dichgans, Martin; Wessman, Maija; van den Maagdenberg, Arn M J M; Zwart, John-Anker; Boomsma, Dorret I; Smith, George Davey; Stefansson, Kari; Eriksson, Nicholas; Daly, Mark J; Neale, Benjamin M; Olesen, Jes; Chasman, Daniel I; Nyholt, Dale R; Palotie, Aarno

2016-08-01

Migraine is a debilitating neurological disorder affecting around one in seven people worldwide, but its molecular mechanisms remain poorly understood. There is some debate about whether migraine is a disease of vascular dysfunction or a result of neuronal dysfunction with secondary vascular changes. Genome-wide association (GWA) studies have thus far identified 13 independent loci associated with migraine. To identify new susceptibility loci, we carried out a genetic study of migraine on 59,674 affected subjects and 316,078 controls from 22 GWA studies. We identified 44 independent single-nucleotide polymorphisms (SNPs) significantly associated with migraine risk (P < 5 × 10(-8)) that mapped to 38 distinct genomic loci, including 28 loci not previously reported and a locus that to our knowledge is the first to be identified on chromosome X. In subsequent computational analyses, the identified loci showed enrichment for genes expressed in vascular and smooth muscle tissues, consistent with a predominant theory of migraine that highlights vascular etiologies.

Percutaneous Closure of Patent Foramen Ovale in Patients With Migraine: The PREMIUM Trial.

Science.gov (United States)

Tobis, Jonathan M; Charles, Andrew; Silberstein, Stephen D; Sorensen, Sherman; Maini, Brijeshwar; Horwitz, Phillip A; Gurley, John C

2017-12-05

Migraine is a prevalent and disabling disorder. Patent foramen ovale (PFO) has been associated with migraine, but its role in the disorder remains poorly understood. This study examined the efficacy of percutaneous PFO closure as a therapy for migraine with or without aura. The PREMIUM (Prospective, Randomized Investigation to Evaluate Incidence of Headache Reduction in Subjects With Migraine and PFO Using the AMPLATZER PFO Occluder to Medical Management) was a double-blind study investigating migraine characteristics over 1 year in subjects randomized to medical therapy with a sham procedure (right heart catheterization) versus medical therapy and PFO closure with the Amplatzer PFO Occluder device (St. Jude Medical, St. Paul, Minnesota). Subjects had 6 to 14 days of migraine per month, had failed at least 3 migraine preventive medications, and had significant right-to-left shunt defined by transcranial Doppler. Primary endpoints were responder rate defined as 50% reduction in migraine attacks and adverse events. Secondary endpoints included reduction in migraine days and efficacy in patients with versus without aura. Of 1,653 subjects consented, 230 were enrolled. There was no difference in responder rate in the PFO closure (45 of 117) versus control (33 of 103) groups. One serious adverse event (transient atrial fibrillation) occurred in 205 subjects who underwent PFO closure. Subjects in the PFO closure group had a significantly greater reduction in headache days (-3.4 vs. -2.0 days/month, p = 0.025). Complete migraine remission for 1 year occurred in 10 patients (8.5%) in the treatment group versus 1 (1%) in the control group (p = 0.01). PFO closure did not meet the primary endpoint of reduction in responder rate in patients with frequent migraine. (Prospective, Randomized Investigation to Evaluate Incidence of Headache Reduction in Subjects With Migraine and PFO Using the AMPLATZER PFO Occluder to Medical Management [PREMIUM]; NCT00355056). Copyright

The effects of Maras powder use on patients with migraine

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İnanç Y

2018-05-01

Full Text Available Yılmaz İnanç,1 Fatma Özlem Orhan,2 Yusuf İnanç3 1Department of Neurology, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey; 2Department of Psychiatry, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey; 3Department of Neurology, Gaziantep University School of Medicine, Kahramanmaraş, Turkey Background: It is accepted that smoking often triggers migraine. However, studies evaluating the relationship between the use of smokeless tobacco and migraine are limited, and there is no clear consensus on the subject. In this study, it was aimed to evaluate the relationship between migraine and Maras powder, which is the most common smokeless tobacco in Turkey. Subjects and methods: The study included a total of 600 subjects, consisting of 300 patients (aged >18 years diagnosed with a migraine according to the International Headache Society (IHS-ICHD-3 Beta criteria after presenting at Sütçü Imam University Medical Faculty Neurology Policlinic with the complaint of headache between July 2016 and December 2016 and a control group of 300 individuals with similar features of age, gender, and educational level. A questionnaire was administered to each patient to record the status of smoking or using Maras powder. Results: In the migraine patient group, 16.4% smoked and 9.7% used Maras powder. In the control group, the rate of smoking was 8.5% and the rate of Maras powder use was 11.86%. In males diagnosed with a migraine, the use of Maras powder was found to be at a higher rate than smoking (p<0.001. The Visual Pain Score and the headache frequency values were higher in those who smoked or used Maras powder than in non-users (p<0.001. The Fagerström Test for Nicotine Dependence Smokeless Tobacco results of the patients diagnosed with migraine and who used Maras powder were found to be higher than of those who smoked (Fagerström Test for Nicotine Dependence; p<0.001. When patients were

Subcutaneous blood flow in the temporal region of migraine patients

International Nuclear Information System (INIS)

Jensen, K.

1987-01-01

Subcutaneous blood flow in the temporal region (TSBF) was measured by the local 133 Xenon washout technique in 43 migraine patients; 19 were reexamined in the course of spontaneous attacks. During attacks, TSBF was normal compared to headache-free state. In 13 unilateral attacks, the median ipsilateral to contralateral ratio TSBF was 1: 1.276, (NS). During 30 deg C passive head-up tilt, TSBF descreased by a median of 27% during headache-free intervals and by a median, 21% during migraine attacks. The difference between the 2 occasions was not significant. Head-up tilt resulted in a median 4.5% increase in mean arterial blood pressure (MAP) and a median 5.3% increase in heart rate (HR) during headache-free intervals and 3.4% and 3.2% respectively during migraine attacks. These results are evidence against a vasomotor disturbance of the extracranial tissues during attacks of migraine. The cardio-vascular response to the orthostatic stimulus indicates a normal function of this part of the autonomic nervous system during migraine attacks. (author)

Subcutaneous blood flow in the temporal region of migraine patients

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Jensen, K.

1987-01-01

Subcutaneous blood flow in the temporal region (TSBF) was measured by the local 133 Xenon washout technique in 43 migraine patients; 19 were reexamined in the course of spontaneous attacks. During attacks, TSBF was normal compared to headache-free state. In 13 unilateral attacks, the median ipsilateral to contralateral ratio TSBF was 1: 1.276, (NS). During 30 deg C passive head-up tilt, TSBF descreased by a median of 27% during headache-free intervals and by a median, 21% during migraine attacks. The difference between the 2 occasions was not significant. Head-up tilt resulted in a median 4.5% increase in mean arterial blood pressure (MAP) and a median 5.3% increase in heart rate (HR) during headache-free intervals and 3.4% and 3.2% respectively during migraine attacks. These results are evidence against a vasomotor disturbance of the extracranial tissues during attacks of migraine. The cardio-vascular response to the orthostatic stimulus indicates a normal function of this part of the autonomic nervous system during migraine attacks.

Perfusion-weighted MR imaging in persistent hemiplegic migraine

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Mourand, Isabelle; Menjot de Champfleur, Nicolas; Carra-Dalliere, Clarisse; Le Bars, Emmanuelle; Bonafe, Alain; Thouvenot, Eric [Hopital Gui de Chauliac, Service de Neuroradiologie, Montpellier (France); Roubertie, Agathe [Hopital Gui de Chauliac, Service de Neuropediatrie, Montpellier (France)

2012-03-15

Hemiplegic migraine is a rare type of migraine that has an aura characterized by the presence of motor weakness, which may occasionally last up to several days, and then resolve without sequela. Pathogenesis of migraine remains unclear and, recently, perfusion-weighted imaging (PWI) has provided a non-invasive method to study hemodynamic changes during acute attacks. Two female patients were admitted in our hospital suffering from prolonged hemiparesis. In both cases, they underwent MRI examination using a 1.5 T magnet including axial diffusion-weighted and perfusion sequences. From each perfusion MRI acquisition two regions of interest were delineated on each hemisphere and, the index of flow, cerebral blood volume, mean transit time, and time to peak were recorded and asymmetry indices from each perfusion parameter were calculated. Perfusion alterations were detected during the attacks. In one case, we observed, after 3 h of left hemiparesia, hypoperfusion of the right hemisphere. In the other case, who presented a familial hemiplegic migraine attack, on the third day of a persistent aura consisting of right hemiplegia and aphasia, PWI revealed hyperperfusion of the left hemisphere. Asymmetry indices for temporal parameters (mean transit time and time to peak) were the most sensitive. These findings resolved spontaneously after the attacks without any permanent sequel or signs of cerebral ischemia on follow-up MRI. PWI should be indicated for patients with migraine attacks accompanied by auras to assess the sequential changes in cerebral perfusion and to better understand its pathogenesis. (orig.)

Perfusion-weighted MR imaging in persistent hemiplegic migraine

International Nuclear Information System (INIS)

Mourand, Isabelle; Menjot de Champfleur, Nicolas; Carra-Dalliere, Clarisse; Le Bars, Emmanuelle; Bonafe, Alain; Thouvenot, Eric; Roubertie, Agathe

2012-01-01

Hemiplegic migraine is a rare type of migraine that has an aura characterized by the presence of motor weakness, which may occasionally last up to several days, and then resolve without sequela. Pathogenesis of migraine remains unclear and, recently, perfusion-weighted imaging (PWI) has provided a non-invasive method to study hemodynamic changes during acute attacks. Two female patients were admitted in our hospital suffering from prolonged hemiparesis. In both cases, they underwent MRI examination using a 1.5 T magnet including axial diffusion-weighted and perfusion sequences. From each perfusion MRI acquisition two regions of interest were delineated on each hemisphere and, the index of flow, cerebral blood volume, mean transit time, and time to peak were recorded and asymmetry indices from each perfusion parameter were calculated. Perfusion alterations were detected during the attacks. In one case, we observed, after 3 h of left hemiparesia, hypoperfusion of the right hemisphere. In the other case, who presented a familial hemiplegic migraine attack, on the third day of a persistent aura consisting of right hemiplegia and aphasia, PWI revealed hyperperfusion of the left hemisphere. Asymmetry indices for temporal parameters (mean transit time and time to peak) were the most sensitive. These findings resolved spontaneously after the attacks without any permanent sequel or signs of cerebral ischemia on follow-up MRI. PWI should be indicated for patients with migraine attacks accompanied by auras to assess the sequential changes in cerebral perfusion and to better understand its pathogenesis. (orig.)

Towards a pragmatic human migraine model for drug testing

DEFF Research Database (Denmark)

Hansen, Emma Katrine; Olesen, Jes

2017-01-01

Background A model for the testing of novel anti-migraine drugs should preferably use healthy volunteers for ease of recruiting. Isosorbide-5-mononitrate (5-ISMN) provokes headache in healthy volunteers with some migraine features such as pulsating pain quality and aggravation by physical activity.......003). Difference in area under the headache score curve (AUC) 0-4 hours between sumatriptan and placebo was not significant ( p = 0.30). Conclusion 5-ISMN is a very powerful inducer of migraine-like headache in healthy individuals but the headache does not respond to sumatriptan. The model is not useful for future...

Abnormal functional integration across core brain networks in migraine without aura.

Science.gov (United States)

Yu, Dahua; Yuan, Kai; Luo, Lin; Zhai, Jinquan; Bi, Yanzhi; Xue, Ting; Ren, Xiaoying; Zhang, Ming; Ren, Guoyin; Lu, Xiaoqi

2017-01-01

As a complex subjective experience, pain processing may be related to functional integration among intrinsic connectivity networks of migraine patients without aura. However, few study focused on the pattern alterations in the intrinsic connectivity networks of migraine patients without aura. Thirty-one migraine patients without aura and 31 age- and education-matched healthy controls participated in this study. After identifying the default mode network, central executive network and salience network as core intrinsic connectivity networks by using independent component analysis, functional connectivity, and effective connectivity during the resting state were used to investigate the abnormalities in intrinsic connectivity network interactions. Migraine patients without aura showed decreased functional connectivity among intrinsic connectivity networks compared with healthy controls. The strength of causal influences from the right frontoinsular cortex to the right anterior cingulate cortex became weaker, and the right frontoinsular cortex to the right medial prefrontal cortex became stronger in migraine patients without aura. These changes suggested that the salience network may play a major role in the pathophysiological features of migraine patients without aura and helped us to synthesize previous findings into an aberrant network dynamical framework.

The Association between Shift Work and Treatment-seeking Migraine in Denmark

DEFF Research Database (Denmark)

Jakobsen, Gitte Sofie; Timm, Anne Matilde; Hansen, Åse Marie

2017-01-01

In Europe, the one-year prevalence of migraine is 14.9% and migraine is on the top-ten list of leading causes of years lost to disability. Sleep disturbances and irregular daily routines are considered triggers of migraine and these factors are well-known consequences of shift work. We studied...... the association between treatment-seeking migraine and shift work, categorised as fixed evening work, fixed night work and variable working hours with and without night work in a Danish working population of 5,872 participants. When compared with fixed day workers, only participants with fixed evening work were...... found to have significantly increased odds of reporting treatment-seeking migraine after adjustment for socio-demographic and behavioural covariates (OR=1.56; 95% CI 1.05-2.32). Participants with seniority of ten years or more notably accounted for this association. Due to the cross-sectional design...

Cerebral angiographic changes on serial examination of a patient with migraine

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Masuzawa, T.; Shinoda, S.; Nakahara, N.; Abe, F.; Sato, F.; Furuse, M.

1983-03-01

Curious cerebral angiographic changes are described in a 27-year-old female migraine patient. During the period of observation of this patient, both the intracranial carotid artery and the vertebrobasilar artery systems presented unusual and fascinating cerebral arteriographic pictures. In an attack of migraine, angiography showed that all the intracranial secondary and tertiary branches of the carotid arterial system were dilated without showing any changes in the extracranial arteries and when the migraine attack had subsided, all branches of the carotid arteries as well as the vertebrobasilar arteries demonstreated abnormal segmental narrowings or vasospasm. These sequential angiographic changes have not been hitherto reported in migraine.

Family studies to find rare high risk variants in migraine.

Science.gov (United States)

Hansen, Rikke Dyhr; Christensen, Anne Francke; Olesen, Jes

2017-12-01

Migraine has long been known as a common complex disease caused by genetic and environmental factors. The pathophysiology and the specific genetic susceptibility are poorly understood. Common variants only explain a small part of the heritability of migraine. It is thought that rare genetic variants with bigger effect size may be involved in the disease. Since migraine has a tendency to cluster in families, a family approach might be the way to find these variants. This is also indicated by identification of migraine-associated loci in classical linkage-analyses in migraine families. A single migraine study using a candidate-gene approach was performed in 2010 identifying a rare mutation in the TRESK potassium channel segregating in a large family with migraine with aura, but this finding has later become questioned. The technologies of next-generation sequencing (NGS) now provides an affordable tool to investigate the genetic variation in the entire exome or genome. The family-based study design using NGS is described in this paper. We also review family studies using NGS that have been successful in finding rare variants in other common complex diseases in order to argue the promising application of a family approach to migraine. PubMed was searched to find studies that looked for rare genetic variants in common complex diseases through a family-based design using NGS, excluding studies looking for de-novo mutations, or using a candidate-gene approach and studies on cancer. All issues from Nature Genetics and PLOS genetics 2014, 2015 and 2016 (UTAI June) were screened for relevant papers. Reference lists from included and other relevant papers were also searched. For the description of the family-based study design using NGS an in-house protocol was used. Thirty-two successful studies, which covered 16 different common complex diseases, were included in this paper. We also found a single migraine study. Twenty-three studies found one or a few family specific

Patent foramen ovale and migraine: a cross-sectional study from the Northern Manhattan Study (NOMAS).

Science.gov (United States)

Rundek, Tatjana; Elkind, Mitchell S V; Di Tullio, Marco R; Carrera, Emmanuel; Jin, Zhezhen; Sacco, Ralph L; Homma, Shunichi

2008-09-30

A causal relationship between patent foramen ovale (PFO) and migraine has been hypothesized, and improvement of migraine frequency and severity after percutaneous PFO closure has been reported. Population-based data on the relationship between PFO and migraine are sparse, however. The objective of this study was to examine the association between PFO and migraine among stroke-free individuals in an urban, population-based, multiethnic cohort. As a part of the ongoing Northern Manhattan Study (NOMAS), 1101 stroke-free subjects were assessed for self-reported history of migraine. The presence of PFO was assessed by transthoracic echocardiography. The mean age of the group was 69+/-10 years; 58% were women. Forty-eight percent were Caribbean Hispanic, 24% were white, 26% were black, and 2% were another race/ethnicity. The prevalence of self-reported migraine was 16% (13% migraine with aura). The prevalence of PFO was 15%. Migraine was significantly more frequent among younger subjects, women, and Hispanics. The prevalence of PFO was not significantly different between subjects who had migraine (26/178, or 14.6%) and those who did not (138/923, or 15.0%; P=0.9). In an adjusted multivariate logistic regression model, the presence of PFO was not associated with increased prevalence of migraine (odds ratio 1.01, 95% confidence interval 0.63 to 1.61). Increasing age was associated with lower prevalence of migraine in both subjects with a PFO (odds ratio 0.94, 95% confidence interval 0.90 to 0.99 per year) and those without PFO (odds ratio 0.97, 95% confidence interval 0.95 to 0.99 per year). The observed lack of association between PFO and migraine (with or without aura) was not modified by diabetes mellitus, hypertension, cigarette smoking, or dyslipidemia. In this multiethnic, elderly, population-based cohort, PFO detected with transthoracic echocardiography and agitated saline was not associated with self-reported migraine. The causal relationship between PFO and

Aura-like features and photophobia in sightless migraine patients

Directory of Open Access Journals (Sweden)

Greice Cardoso de Carvalho Silva

2014-12-01

Full Text Available Migraine is a central nervous system disorder frequently expressed with paroxysmal visual dysfunctions. Objective To test the hypothesis that normal visual input is vital for the migrainous aura and photophobia. Method We studied the migraine-related visual disturbances in 8 sightless migraineurs identified among 200 visually impaired subjects. Results The main findings were the visual aura and photophobia disappearance along with blindness development, the oddness of aura – too short, colourful (e.g. blue or fire-like, auditory in nature or different in shape (round forms – and the lack of photophobia. Conclusion We propose that the aura duration should be accepted as shorter in visually impaired subjects. The changes in aura phenotype observed in our patients may be the result of both cerebral plasticity induced by the visual impairment and/or the lack of visual input per se. Integrity of visual pathways plays a key role in migraine visual aura and photophobia.

Serum Bilirubin and Their Association With C-Reactive Protein in Patients With Migraine.