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| 5. |
- Dahlöf, Carl, 1947, et al.
(författare)
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The course of frequent episodic migraine in a large headache clinic population: a 12-year retrospective follow-up study.
- 2009
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 49:8, s. 1144-52
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite its high prevalence, little is known about the clinical course of migraine. Presented here are the findings of a 12-year follow-up study involving patients diagnosed at baseline with frequent episodic migraine. OBJECTIVE: The main objectives were to determine the long-term outcome of patients with frequent episodic migraine and to identify factors predictive of a favorable vs less favorable prognosis. METHODS: A total of 374 subjects (200 women, 174 men) were selected randomly from a total population of 2812 patients initially diagnosed before December 31, 1996, with episodic migraine and at baseline experiencing 1 to 6 attacks per month. Their subsequent migraine course was evaluated via telephone interviews conducted between 2005 and 2006. RESULTS: Migraine attacks had ceased in 110 (29%) of the 374 patients (57 women and 53 men). The remaining 264 subjects continued to experience migraine attacks at follow-up, and a change in attack frequency was reported by 80% (of whom 80% reported fewer attacks). Sixty-six percent reported a change in pain intensity over time, and of these 83% reported milder pain. Only 6 subjects (6/374 = 1.6%) had developed chronic migraine. CONCLUSION: These data from a headache clinic population suggest that migraine has a favorable prognosis in most patients. Whether the findings reflect the natural history of the disorder or interval improvements in headache management remains conjectural.
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| 6. |
- Edvinsson, Lars
(författare)
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Neuronal signal substances as biomarkers of migraine
- 2006
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 46:7, s. 1088-1094
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Tidskriftsartikel (refereegranskat)abstract
- Of the sensory nervous system associated signal substances it is only calcitonin generelated peptide (CGRP) that is reliably associated with the degree of pain in the acute attacks of primary headaches. The treatment with triptans alleviates both the pain and the associated CGRP release, putatively via a presynaptic effect on the sensory nerves. The studies of opoids and other sensory neuropeptides are inconsistent and require further analysis. Initial positive data on endothelin and its receptors have turned out negative. Nitric oxide mechanisms are still debated both in terms of initiation of attacks and for the treatment.
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| 7. |
- Edvinsson, Lars
(författare)
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The CGRP Pathway in Migraine as a Viable Target for Therapies
- 2018
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Ingår i: Headache. - : Wiley. - 0017-8748. ; 58, s. 33-47
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Tidskriftsartikel (refereegranskat)abstract
- The neuropeptide calcitonin gene-related peptide is well established as a key player in the pathogenesis of migraine. Clinical studies show calcitonin gene-related peptide levels correlate with migraine attacks, and decreases in this neuropeptide can indicate antimigraine therapy effectiveness. Research has revealed a wide distribution of expression sites for calcitonin gene-related peptide in the central and peripheral nervous system. Of these, the calcitonin gene-related peptide receptor, which binds calcitonin gene-related peptide with high affinity, has attracted growing interest as a viable target for antimigraine therapies. An incentive to pursue such research is the continuing unmet medical need of patients. Triptans have offered some clinical benefit, but many patients do not respond and these drugs have important safety considerations. Initial calcitonin gene-related peptide-focused research led to development of the “gepant” small-molecule calcitonin gene-related peptide receptor blockers. Positive efficacy reports concerning the gepants have been tempered by safety findings which led to the discontinuation of some of these agents. Currently, there is considerable excitement regarding monoclonal antibodies against calcitonin gene-related peptide (eptinezumab, galcanezumab, fremanezumab) and the calcitonin gene-related peptide receptor (erenumab). To date, these monoclonal antibodies have shown promising efficacy in clinical trials, with no major safety concerns. If ongoing long-term studies show that their efficacy can be maintained, this may herald a new era for effective antimigraine therapies.
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| 8. |
- Edvinsson, Lars
(författare)
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The Journey to Establish CGRP as a Migraine Target: A Retrospective View.
- 2015
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 55:9, s. 1249-1255
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Tidskriftsartikel (refereegranskat)abstract
- In this retrospective, Dr. Lars Edvinsson recounts early steps and milestones in our understanding of the neuropeptide calcitonin gene-related peptide (CGRP) in the trigeminovascular system and its role in migraine. The discovery of the presence and function of CGRP and other neuropeptides in the cerebral vasculature and its sensory innervation is described. He relates the seminal finding that CGRP is uniquely released during migraine and the journey to develop blockers of CGRP effects. Now, over 30 years since its discovery, CGRP has become the target for a number of promising novel treatments for migraine patients.
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| 9. |
- Edvinsson, Lars
(författare)
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The Trigeminovascular Pathway : Role of CGRP and CGRP Receptors in Migraine
- 2017
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Ingår i: Headache. - : Wiley. - 0017-8748. ; 57, s. 47-55
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Forskningsöversikt (refereegranskat)abstract
- The trigeminal ganglion plays a key role in primary headache pathophysiology. Calcitonin gene-related peptide (CGRP) and CGRP receptors are expressed in trigeminal neurons that form C-fibers and A-fibers, respectively. In acute migraine and cluster headache attacks, there is release of CGRP into the cranial venous outflow. In addition, intravenous CGRP can induce migraine-like symptoms in migraine patients. These findings led to the development of anti-migraine therapies that inhibit CGRP action. Currently, CGRP receptor antagonists, the gepants, and monoclonal antibodies towards CGRP and the CGRP receptor are all showing positive relief of acute and chronic migraine in clinical trials. However, there is still much to learn about the role of CGRP and CGRP receptors in headache pathophysiology, the critical anatomical sites, peripheral or central, of anti-CGRP agents, and the potential involvement of CGRP-related peptides and receptors. This review provides a brief history of the discovery of the role of CGRP in migraine and highlights current progress in understanding the complexity of the trigeminovascular pathway and its peptide transmitters.
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| 10. |
- Ekbom, K, et al.
(författare)
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Cluster headache and aura
- 2009
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 49:5, s. 786-787
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 14. |
- Frederiksen, Simona D., et al.
(författare)
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Serotonin and Neuropeptides in Blood From Episodic and Chronic Migraine and Cluster Headache Patients in Case-Control and Case-Crossover Settings : A Systematic Review and Meta-Analysis
- 2020
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Ingår i: Headache. - : Wiley. - 0017-8748. ; 60:6, s. 1132-1164
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Forskningsöversikt (refereegranskat)abstract
- Objective: The aim of this systematic review and meta-analysis (SR-MA) was to identify signaling molecule profiles and blood-derived biomarkers in migraine and cluster headache (CH) patients. Background: Currently no migraine and CH valid biomarkers are available. Blood tests based on biomarker profiles have been used to gather information about the nervous system. Such tests have not yet been established within the primary headache field. Methods: Case-control and case-crossover studies investigating whole blood, plasma, and serum were identified worldwide. The qualitative synthesis focused on 9 signaling molecules (serotonin [5-HT], calcitonin gene-related peptide [CGRP], endothelin-1 [ET-1], neurokinin A, neurokinin B, neuropeptide Y, pituitary adenylate cyclase-activating peptide 38 [PACAP-38], substance P (SP), and vasoactive intestinal peptide) and the quantitative synthesis on 5-HT and CGRP (≥5 comparisons available). The meta-analysis was conducted using standard and 3-level random effect models. Results: Fifty-four eligible studies were identified (87.0% migraine, 9.3% CH, 3.7% migraine, and CH), and 2768 headache patients and 1165 controls included. Comparable fluctuations of 5-HT, CGRP, ET-1, PACAP-38, and SP in blood were generally observed between migraine and CH. Significant findings were observed for some subgroups and strata, for example, higher interictal and ictal 5-HT venous blood levels (ratio of means = 1.32, 95% CI: 1.08; 1.61; ratio of means = 1.23, 95% CI: 1.01; 1.49) in episodic migraine with aura with a female-dominated case group, higher interictal CGRP blood levels in episodic migraine (ratio of means = 1.63, 95% CI: 1.18; 2.26), and chronic migraine (ratio of means = 1.89, 95% CI: 1.33; 2.68), and higher ictal CGRP blood levels (ratio of means = 1.35, 95% CI: 1.09; 1.68) in episodic migraine were observed. In most subgroups, the quantitative synthesis revealed a high degree of heterogeneity between studies in part explained by the blood sampling site, specimen source, blood specimen, and sex distribution. Other potential confounders were age, aura, study quality, menstrual cycle, and methodology (eg, storage temperature). Conclusions: Potential migraine and CH signaling molecule profiles and biomarkers were revealed. Nevertheless, the high degree of heterogeneity between studies impedes identification of valid biomarkers but allowed us to assess the presence of confounders. Consideration of the potential confounders identified in this SR-MA might be of importance in the experimental planning of future studies. This consideration could be incorporated through establishment of specific guidelines.
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| 23. |
- Hedenrud, Tove, 1967, et al.
(författare)
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Medication Overuse Headache: Self-Perceived and Actual Knowledge Among Pharmacy Staff
- 2014
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Ingår i: Headache. - : Wiley. - 0017-8748 .- 1526-4610. ; 54:6, s. 1019-1025
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this study was to investigate knowledge about medication overuse headache (MOH) among pharmacy staff. Background MOH is a public health problem both in Sweden and in many other countries. Persons with MOH have limited contact with health care, and medications used are to large extent over-the-counter (OTC) medications. Therefore, pharmacists have an important role in, eg, advising these individuals about their medication use. Little is, however, known about the actual level of knowledge about MOH among pharmacy staff, which determines the quality of their advice to MOH sufferers. Methods A total of 326 questionnaires were distributed to 44 pharmacies in Gothenburg, Sweden. The questionnaire included background questions, questions about advice on headache treatment, source of knowledge about MOH, and questions on self-perceived and actual knowledge on MOH. Results The response rate was 70%. A majority of the pharmacy staff (90.6%) considered themselves to have knowledge about MOH to some or a greater extent. Almost half had learned about MOH through their university/vocational education. Only 8.6% knew that all 5 headache medications listed in the questionnaire can cause development of MOH, but 40% responded correctly on which treatment advice one can give a person with MOH. Actual knowledge on treatment advice differed significantly between groups of self-perceived knowledge. Conclusion The knowledge on MOH is insufficient among pharmacy staff, but with the proper knowledge, pharmacy staff is well positioned to effect both primary and secondary prevention of MOH. We suggest not only increasing educational efforts about MOH within pharmacy programs but also continuing education at the pharmacies for all staff. Further, it is also important to increase knowledge among pharmacy customers.
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| 24. |
- Ichesco, Eric, et al.
(författare)
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Altered Functional Connectivity Between the Insula and the Cingulate Cortex in Patients With Temporomandibular Disorder: A Pilot Study.
- 2012
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 52, s. 441-454
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Tidskriftsartikel (refereegranskat)abstract
- Background.- Among the most common chronic pain conditions, yet poorly understood, are temporomandibular disorders (TMDs), with a prevalence estimate of 3-15% for Western populations. Although it is increasingly acknowledged that central nervous system mechanisms contribute to pain amplification and chronicity in TMDs, further research is needed to unravel neural correlates that might abet the development of chronic pain. Objective.- The insular cortex (IC) and cingulate cortex (CC) are both critically involved in the experience of pain. The current study sought specifically to investigate IC-CC functional connectivity in TMD patients and healthy controls (HCs), both during resting state and during the application of a painful stimulus. Methods.- Eight patients with TMD, and 8 age- and sex-matched HCs were enrolled in the present study. Functional magnetic resonance imaging data during resting state and during the performance of a pressure pain stimulus to the temple were acquired. Predefined seed regions were placed in the IC (anterior and posterior insular cortices) and the extracted signal was correlated with brain activity throughout the whole brain. Specifically, we were interested whether TMD patients and HCs would show differences in IC-CC connectivity, both during resting state and during the application of a painful stimulus to the face. Results.- As a main finding, functional connectivity analyses revealed an increased functional connectivity between the left anterior IC and pregenual anterior cingulate cortex (ACC) in TMD patients, during both resting state and applied pressure pain. Within the patient group, there was a negative correlation between the anterior IC-ACC connectivity and clinical pain intensity as measured by a visual analog scale. Conclusions.- Since the pregenual region of the ACC is critically involved in antinociception, we hypothesize that an increase in anterior IC-ACC connectivity is indicative of an adaptation of the pain modulatory system early in the chronification process.
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| 25. |
- Ikoma, Tomoko, et al.
(författare)
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Effects of Low-Intensity Contractions of Different Craniofacial Muscles in Healthy Participants : An Experimental Cross-Over Study
- 2018
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Ingår i: Headache. - : John Wiley & Sons. - 0017-8748 .- 1526-4610. ; 58:4, s. 559-569
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Tidskriftsartikel (refereegranskat)abstract
- Objective.-Repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible, ie, bruxism, is traditionally linked to pain and unpleasantness in the active muscles. The aim of this study was to investigate the effects of standardized craniofacial muscle contractions on self-reported symptoms. Methods.-Sixteen healthy volunteers performed six 5-minute bouts of 20% maximal voluntary contraction task of the jaw-closing (Jaw), the orbicularis-oris (O-oris), and the orbicularis-oculi (O-oculi) muscles. Participants rated their perceived pain, unpleasantness, fatigue, and mental stress levels before, during, and after the contraction tasks on 0-10 Numeric Rating Scales (NRS). Each muscle contraction task (= 1 session) was separated by at least 1 week and the order of the sessions was randomized in each subject. Results.-All muscle contraction tasks evoked significant increases in NRS scores of pain (mean +/- SD: Jaw; 3.8 +/- 2.7, O-oris; 1.9 +/- 2.2, O-oculi; 1.4 +/- 1.3, P < .014), unpleasantness (Jaw; 4.1 +/- 2.5, O-oris; 2.1 +/- 1.9, O-oculi; 2.9 +/- 1.8, P<.001), fatigue (Jaw; 5.8 +/- 2.0, O-oris; 3.2 +/- 2.3, O-oculi; 3.6 +/- 1.9, P<.001), and mental stress (Jaw; 4.1 +/- 2.1, O-oris; 2.2 +/- 2.7, O-oculi; 2.9 +/- 2.2, P<.001). The Jaw contractions were associated with higher NRS scores compared with the O-oris and the O-oculi contractions (P<.005) without differences between the O-oris and the O-oculi (P>.063). All symptoms disappeared within 1 day (P>.469). Conclusions.-The results showed that submaximal static contractions of different craniofacial muscle groups could evoke transient, mild to moderate levels of muscle pain and fatigue and increased stress scores. The fatigue resistance may differ between different muscle groups. Further studies are warranted to better understand the contribution of specific craniofacial muscle groups for the characteristic presentation of musculoskeletal pain conditions in the head.
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| 28. |
- Larsson, Bo, 1943, et al.
(författare)
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Relaxation treatment of adolescent headache sufferers: results from a school-based replication series.
- 2005
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Ingår i: Headache. - : Wiley. - 0017-8748. ; 45:6, s. 692-704
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In recent reviews of psychological and drug treatment, relaxation training approaches have been found to be efficacious for children and adolescents suffering from recurrent tension-type headache (TTH), while biofeedback procedures provide effective help for migraine headache sufferers, primarily treated in tertiary clinics. OBJECTIVE: In a school-based replication series, the effectiveness and efficiency of relaxation training provided within school settings were examined, in addition to the effects on various headache features and the maintenance of treatment gains at a 6 to 10-month follow-up. METHODS: Over a 20-year period, 288 adolescents aged 10 to 18 years participated in seven randomized, controlled trials conducted within regular school health service settings. Subjects were included if they had suffered from frequent migraine or TTHs, or from both headache types for at least 1 year. Various formats of standardized relaxation training procedures were contrasted to different attention-control (ATCO) approaches or self-monitoring (SM) of headaches in prospective diary recordings. RESULTS: The results showed that a therapist-administered relaxation approach was superior to self-help or school-nurse administered relaxation training approaches, ATCO conditions or SM of headaches. Students with TTHs responded positively to any form of relaxation training, whereas those with frequent migraine responded well only to therapist-administered relaxation. However, school-nurse administered procedures were found to be the most efficient form of relaxation treatment, in particular for adolescents suffering from TTHs. Total headache activity, the number of headache days and peak headache intensity were significantly reduced after relaxation treatment, in addition to medication usage. Treatment gains were well maintained at the 6 to 10-month follow-up. CONCLUSION: Therapist-assisted relaxation training is an effective treatment for adolescents suffering from frequent TTHs or migraine. However, such treatment administered by school-nurses administered within school health care settings is an efficient treatment approach for adolescents suffering from the most common form of primary headache, ie, TTHs.
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| 29. |
- Lebwohl, Benjamin, et al.
(författare)
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Risk of Headache-Related Healthcare Visits in Patients With Celiac Disease : A Population-Based Observational Study
- 2016
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Ingår i: Headache. - Hoboken, USA : Wiley-Blackwell. - 0017-8748 .- 1526-4610. ; 56:5, s. 849-858
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: Patients with celiac disease (CD) are reported to be at increased risk for headaches, though large studies are lacking. We aimed to examine the risk of headache-related healthcare encounters in patients with CD in a nationwide population-based setting.Methods: In this population-based retrospective cohort study, we searched all (n = 28) pathology departments in Sweden and identified patients with CD based on the presence of villous atrophy (VA). Each patient was matched to up to 5 controls, by age, gender, calendar period, and region. Using Cox proportional hazards, we tested for an association between CD and subsequent headache-related visit. We also tested this association for those with intestinal inflammation but normal villi, and subjects with positive CD serologies but normal histology.Results: Among 28,638 patients with CD and 143,126 controls, headache-related visit occurred in 1,337 (4.7%) and 4,102 (2.9%), respectively. The incidence of headache-related visit was 423 per 100,000 person-years in CD patients and 254 per 100,000 person-years in controls (HR 1.66; 95% CI 1.56-1.77; P < .0001). Individuals having inflammation without VA on small intestinal biopsy (n = 12,898; HR 2.08; 95% CI 1.90-2.27; P < .0001) and those with normal mucosa but positive CD serology (n = 3,617; HR 1.83; 95% CI 1.57-2.12; P < .0001) were also at increased risk for headache-related visit.Conclusions: In this population-based study we found a significantly increased risk of headache-related visits in patients with CD; this increase was also present in patients with intestinal inflammation and those with positive CD serology but with normal mucosal architecture on small bowel biopsy. Though limited by surveillance bias, this study indicates that headache-related visits are more common in these populations.
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| 31. |
- Molarius, Anu, et al.
(författare)
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Socio-Economic Factors, Lifestyle, and Headache Disorders - A Population-Based Study in Sweden
- 2008
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Ingår i: Headache. - : Wiley. - 0017-8748 .- 1526-4610. ; 48:10, s. 1426-1437
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Tidskriftsartikel (refereegranskat)abstract
- To study the association between socio-economic factors, lifestyle habits, and self-reported recurrent headache/migraine (RH/M) in a general population. The study population comprised a random sample of men and women aged 18-79 years. The data were obtained using a postal survey questionnaire during March-May 2000. The overall response rate was 65%. The area investigated covers 58 municipalities with about one million inhabitants in central part of Sweden. The study is based on 43,770 respondents. Odds ratios for RH/M were calculated for a set of variables using multiple logistic regression models.The overall prevalence of self-reported RH/M during the last 3 months was 10% among men and 23% among women and decreased with increasing age. Physically inactive subjects were more likely to suffer from headache disorders than physically active subjects. Smoking was only moderately associated with RH/M. There was an inverse relationship between heavy alcohol use and RH/M. Underweight and obesity were not associated with headache disorders when adjusted for socio-economic factors.Subjects with frequent economic problems had almost twice the risk of RH/M compared with subjects with no economic problems. Poor social support was associated with headache disorders and subjects who had been belittled during the last 3 months were more than twice as likely to suffer from RH/M as subjects who had not been belittled. The effect of educational level was modest. Marital status and country of origin were not associated with headache disorders after adjustment for other socio-economic factors. Dissatisfaction with work, worry about losing one's job, and absenteeism due to illness were strongly associated with headache disorders. Physical working conditions and working hours were not associated with RH/M. Headache disorders mainly affect young and middle-aged adults. There are, however, socio-economic disparities in self-reported recurrent headache and migraine. The relationship was particularly evident for economic hardship and psychosocial factors. Of lifestyle factors, physical inactivity was strongly associated with headache disorders independent of economic and psychosocial factors.
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| 33. |
- Persson, Bertil
(författare)
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Growth environment and personality in adult migraineurs and their migraine-free siblings
- 1997
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 37:3, s. 159-168
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to compare adult migraine discordant full siblings in terms of personality and psychosocial environment during childhood. The study, involving 30 sibling pairs and use of various personality instruments (Eysenck Personality Inventory [EPI], Color Word Test [CWT], Visual Aftereffects [VAE], Meta Contrast Technique [MCT], Cesarec-Marke Personality Schedule), showed the migraineurs scored significantly higher on neuroticism [EPI], also called emotional stress or trait anxiety; to be more sensitive (MCT); and to display signs of greater anxiety (VAE, CWT). Furthermore, migraineurs tended to report greater scarcity of friends during childhood and less verbal, as well as, nonverbal encouragement from their parents, than their migraine-free siblings. Neuroticism was found to correlate significantly with migraine, but not with headache frequency or severity in the migraine group. It is argued that, due to the high neuroticism of some migraineurs, psychotherapy should be considered as an alternative to other prophylactic treatments such as use of beta-adrenoceptor blockers, although the acute migraine onset should be pharmacologically treated.
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| 34. |
- Raak, Ragnhild, et al.
(författare)
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Work attendance despite headache and its economic impact : a comparison between two workplaces
- 2003
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Ingår i: Headache. - : Wiley. - 0017-8748 .- 1526-4610. ; 43:10, s. 1097-1101
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Tidskriftsartikel (refereegranskat)abstract
- Objective.—To study work attendance despite headache in 2 different workplaces and its economic impact.Background.—Literature on the economic impact of headache traditionally has focused on direct costs. Little is known concerning headache experienced at work and its costs due to loss of effectiveness and productivity.Method.—We sent a questionnaire to 800 employees in Sweden—400 at a technology company (private employee population) and 400 at a university hospital (public employee population). We attempted to assess the prevalence of headache, work attendance despite the presence of acute headache, and the impact of acute headache upon work effectiveness. Subjects self-scored decreased work effectiveness resulting from headache during the previous 3 months and recorded the number of days at work despite headache. From these data, we estimated the economic loss resulting from headache.Results.—The survey response rate was 71.5%. The prevalence of headache was 64% in the private employee population and 78% in the public employee population. Thirty-nine percent of the private employees and 57% of the public employees reported experiencing headache as a result of stress. Fifty percent reported that they went to work despite headache, and the mean number of days at work despite headache, during the previous 3 months, was 6.6 days in the private employee group and 6.1 days in the public employee group. A 25% decrease in work effectiveness was estimated, and, extrapolating from our data, we calculated the cost of lost effectiveness due to headache among employers in Sweden to be approximately 1.4 billion euros a year.Conclusion.—The economic burden of headache experienced at work is substantial, suggesting that workplace-based treatment and prevention programs emphasizing stress management may be financially, as well as clinically, advantageous.
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| 38. |
- Richard, Levi, 1958-, et al.
(författare)
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Episodic cluster headache. I : Personality and some neuropsychological characteristics in male patients.
- 1992
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Ingår i: Headache. - : Wiley-Blackwell. - 0017-8748 .- 1526-4610. ; 32:3, s. 119-25
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Tidskriftsartikel (refereegranskat)abstract
- The etiology and pathogenesis of cluster headache remain largely unknown. Some previous studies have focused on personality characteristics in cluster headache. However, no consistent personality profile has been found. The present study applied two personality inventories, the Karolinska Scales of Personality (KSP) and the Heart and Lifestyle Type A Measure (HALTAM), that have not previously been used in the context of cluster headache. A correlation has been suggested between left-handedness and early learning difficulties, and cluster headache. Thus, these variables were included and measured by inventory techniques. Forty-nine out of 51 consecutive male patients with episodic cluster headache participated in the present study. As compared to controls, the cluster headache patients were significantly more anxiety-prone (higher scores in the KSP Somatic anxiety and Muscular tension subscales), less successfully socialized (low scores in the KSP Socialization scale), and had a more hostile attitude towards others (higher scores in the HALTAM Hostility scale). No relationships between left-handedness or early learning difficulties, and cluster headache disease were found. The implications of the personality differences for the etiology of cluster headache disease are discussed.
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| 39. |
- Richard, Levi, 1958-, et al.
(författare)
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Episodic cluster headache. II : High tobacco and alcohol consumption in males.
- 1992
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Ingår i: Headache. - : Wiley-Blackwell. - 0017-8748 .- 1526-4610. ; 32:4, s. 184-7
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Tidskriftsartikel (refereegranskat)abstract
- Forty-nine out of 51 consecutive male patients with episodic cluster headache were studied with regard to their smoking and drinking habits in general and in relation to cluster headache periods. Questionnaires were constructed for data regarding tobacco intake. Situation-related smoking behavior was registered according to Frith (1971). Screening for alcohol over-consumption was made using the Malmö modification of the brief Michigan Alcoholism Screening Test (Mm-MAST). Eighty-three percent of the patients used tobacco on a regular basis at the time of the study, with an average consumption of 20 cigarettes per day. Only 3% had never used tobacco regularly. The smoking-related desire to smoke in different situations was consistent with what is found in a general population of smokers. Sixty-seven percent of the patients had scores on the Mm-MAST indicative of alcohol over-consumption (i.e. heavy social drinking or alcoholism). During active headache periods 79% decreased their alcohol intake, whereas no consistent change in tobacco consumption was reported for the group as a whole. These findings were further corroborated by the fact that alcohol, but not tobacco intake, was reported by the majority of patients to elicit headache attacks during periods. Thus, our study showed high alcohol and tobacco consumption to be prominent features in male patients with episodic cluster headache. Since neither alcohol nor tobacco appear to have properties of ameliorating headache periods or attacks, the addictive behavior in our patients more likely reflects certain personality characteristics.
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| 42. |
- Sundström-Poromaa, Inger
(författare)
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Action of progesterone and progesterone metabolites in menstrual-cycle-related disorders
- 2008
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Ingår i: Headache. - : Wiley. - 0017-8748 .- 1526-4610. ; 48:Supp 2, s. S90-S98
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Tidskriftsartikel (refereegranskat)abstract
- Progesterone and progesterone metabolites are important modulators of central nervous system function through their interactions with the γ-aminobutyric acid (GABA)A receptor. GABA, neurosteroids, and other modulators of GABAA, such as benzodiazepines, barbiturates, and alcohol, typically inhibit neuronal excitability. The resulting anxiolytic, anticonvulsant, sedative, and anesthetic effects are involved in mood, response to stress, and cognition. The impact of neurosteroids has been demonstrated in women with premenstrual dysphoric disorder: onset of negative mood symptoms has been correlated with peak progesterone levels, and symptoms intensified with progesterone withdrawal in the late luteal phase of the menstrual cycle. These symptoms were not present during anovulatory cycles without the corpus luteum, the primary source of progesterone and metabolites. The focus of this article is the paradox of why high levels of progesterone and neurosteroids, which typically are associated with anxiolytic activity, instead induce irritability, anxiety, and mood fluctuations in women with premenstrual dysphoric disorder.
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| 47. |
- Varkey, Emma, et al.
(författare)
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A Study to Evaluate the Feasibility of an Aerobic Exercise Program in Patients With Migraine.
- 2009
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Ingår i: Headache. - : Wiley. - 1526-4610. ; 49:4, s. 563-70
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Tidskriftsartikel (refereegranskat)abstract
- Objectives.- The aim of this study was to develop and evaluate an exercise program to improve maximum oxygen uptake (VO(2 max)) in untrained patients with migraine without making their migraines worse. Patients and methods.- Twenty-six patients were studied at a headache clinic in Sweden. The exercise program, based on indoor cycling, was performed 3 times per week during 12 weeks. VO(2 max), migraine status, side effects, and quality of life were evaluated. Results.- VO(2 max) increased from 32.9 mL/kg/minute to 36.2 mL/kg/minute (P = .044). Quality of life increased and significant improvements in migraine status (attack frequency, symptom intensity, and intake of medicine) were seen. During the 12 weeks of exercise, on one occasion one patient had a migraine attack, which started immediately after training. No other side effects were reported. Conclusions.- The evaluated exercise program was well tolerated by the patients and improved their VO(2 max) with no deterioration of migraine status.
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- Welander, Nike Zoe, et al.
(författare)
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Migraine, inflammatory bowel disease and celiac disease : A Mendelian randomization study
- 2023
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Ingår i: Headache. - : John Wiley & Sons. - 0017-8748 .- 1526-4610. ; 63:5, s. 642-651
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess whether migraine may be genetically and/or causally associated with inflammatory bowel disease (IBD) or celiac disease.BACKGROUND: Migraine has been linked to IBD and celiac disease in observational studies, but whether this link may be explained by a shared genetic basis or could be causal has not been established. The presence of a causal association could be clinically relevant, as treating one of these medical conditions might mitigate the symptoms of a causally linked condition.METHODS: Linkage disequilibrium score regression and two-sample bidirectional Mendelian randomization analyses were performed using summary statistics from cohort-based genome-wide association studies of migraine (59,674 cases; 316,078 controls), IBD (25,042 cases; 34,915 controls) and celiac disease (11,812 or 4533 cases; 11,837 or 10,750 controls). Migraine with and without aura were analyzed separately, as were the two IBD subtypes Crohn's disease and ulcerative colitis. Positive control analyses and conventional Mendelian randomization sensitivity analyses were performed.RESULTS: Migraine was not genetically correlated with IBD or celiac disease. No evidence was observed for IBD (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.99-1.02, p = 0.703) or celiac disease (OR 1.00, 95% CI 0.99-1.02, p = 0.912) causing migraine or migraine causing either IBD (OR 1.08, 95% CI 0.96-1.22, p = 0.181) or celiac disease (OR 1.08, 95% CI 0.79-1.48, p = 0.614) when all participants with migraine were analyzed jointly. There was some indication of a causal association between celiac disease and migraine with aura (OR 1.04, 95% CI 1.00-1.08, p = 0.045), between celiac disease and migraine without aura (OR 0.95, 95% CI 0.92-0.99, p = 0.006), as well as between migraine without aura and ulcerative colitis (OR 1.15, 95% CI 1.02-1.29, p = 0.025). However, the results were not significant after multiple testing correction.CONCLUSIONS: We found no evidence of a shared genetic basis or of a causal association between migraine and either IBD or celiac disease, although we obtained some indications of causal associations with migraine subtypes.
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