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- Dahlöf, Carl, 1947, et al.
(author)
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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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In: Headache. - : Wiley. - 1526-4610. ; 49:8, s. 1144-52
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Journal article (peer-reviewed)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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- Edvinsson, Lars
(author)
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Neuronal signal substances as biomarkers of migraine
- 2006
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In: Headache. - : Wiley. - 1526-4610. ; 46:7, s. 1088-1094
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Journal article (peer-reviewed)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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- Ekbom, K, et al.
(author)
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Cluster headache and aura
- 2009
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In: Headache. - : Wiley. - 1526-4610. ; 49:5, s. 786-787
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Journal article (other academic/artistic)
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- Larsson, Bo, 1943, et al.
(author)
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Relaxation treatment of adolescent headache sufferers: results from a school-based replication series.
- 2005
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In: Headache. - : Wiley. - 0017-8748. ; 45:6, s. 692-704
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Journal article (peer-reviewed)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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- Molarius, Anu, et al.
(author)
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Socio-Economic Factors, Lifestyle, and Headache Disorders - A Population-Based Study in Sweden
- 2008
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In: Headache. - : Wiley. - 0017-8748 .- 1526-4610. ; 48:10, s. 1426-1437
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Journal article (peer-reviewed)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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- Sundström-Poromaa, Inger
(author)
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Action of progesterone and progesterone metabolites in menstrual-cycle-related disorders
- 2008
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In: Headache. - : Wiley. - 0017-8748 .- 1526-4610. ; 48:Supp 2, s. S90-S98
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Journal article (peer-reviewed)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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- Varkey, Emma, et al.
(author)
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A Study to Evaluate the Feasibility of an Aerobic Exercise Program in Patients With Migraine.
- 2009
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In: Headache. - : Wiley. - 1526-4610. ; 49:4, s. 563-70
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Journal article (peer-reviewed)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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