Headaches during pregnancy

Headache during pregnancy is frequent and challenging. A secondary headache is diagnosed in one third of women, and most causes are vascular and infectious disorders. Anamnestic and clinical features must be investigated, and brain imaging is often required. Primary headaches are commonly modified during pregnancy. Migraine is mainly improved in this context, especially migraine without aura. Particular cautions about treatment must be applied, and non-pharmacological measures must be preferred. Tension-type headache and cluster headache seem to be less hormone-dependent.     

Headaches and multiple sclerosis: a clinical study and review of the literature

Summary Whether multiple sclerosis (MS) can cause headaches is controversial. To clarify the association between headaches and MS we prospectively analyzed 104 consecutive MS patients using detailed headache evaluations. Fifty-four patients (52%) reported headaches, compared with 5 of 35 (14%) patients initially suspected to have MS but subsequently proven to have other disorders, and 18 of 100 (18%) matched general neurology patients. The MS patients had tension headaches or vascular headaches of the migraine type; there was no distinctive MS headache. Seven of these patients had headaches with their first MS symptoms, but in only one did headaches recur with disease activity. Headaches did not correlate with any clinical features of MS. We conclude that an association between headaches and MS may exist.     

阿尔茨海默病与血管性痴呆患者临床特征和影像学比较

目的 探讨阿尔茨海默病(AD)和血管性痴呆(VaD)患者的临床特征和影像学改变,以期寻找鉴别诊断的方法. 方法 收集武警广东医院老年病科自2006年8月至2011年6月收治的162例和同期本地区痴呆症状调查发现的42例痴呆患者的临床资料,采用简易精神状况检查(MMSE)量表进行筛选,其中AD患者114例、VaD患者90例,分析并比较AD、VaD患者的认知能力、行为症状和影像学资料. 结果 与VaD患者比较,AD患者女性较多,文化程度普遍较高,病程更长,差异有统计学意义(P＜0.05);VaD患者注意和计算分项评分低于AD患者,AD患者短程记忆、语言复述和阅读理解分项评分低于VaD患者,差异有统计学意义(P＜0.05); AD患者重复收敛行为的发生高于VaD患者,差异有统计学意义(P＜0.05);AD患者海马萎缩的比例高于VaD患者,VaD患者脑区域发生血管病变的发生率明显高于AD患者,差异均有统计学意义(P＜0.05). 结论 AD和VaD患者具有不同的临床特征和影像学改变,是由各自的病变本质、病变部位和病理机制所共同导致的.     

Exercise, Learned Helplessness, and the Stress-Resistant Brain

Exercise can prevent the development of stress-related mood disorders, such as depression and anxiety. The underlying neurobiological mechanisms of this effect, however, remain unknown. Recently, researchers have used animal models to begin to elucidate the potential mechanisms underlying the protective effects of physical activity. Using the behavioral consequences of uncontrollable stress or "learned helplessness" as an animal analog of depression- and anxiety-like behaviors in rats, we are investigating factors that could be important for the antidepressant and anxiolytic properties of exercise (i.e., wheel running). The current review focuses on the following: (1) the effect of exercise on the behavioral consequences of uncontrollable stress and the implications of these effects on the specificity of the "learned helplessness" animal model; (2) the neurocircuitry of learned helplessness and the role of serotonin; and (3) exercise-associated neural adaptations and neural plasticity that may contribute to the stress-resistant brain. Identifying the mechanisms by which exercise prevents learned helplessness could shed light on the complex neurobiology of depression and anxiety and potentially lead to novel strategies for the prevention of stress-related mood disorders.     

Structural covariance in schizophrenia and first-episode psychosis: An approach based on graph analysis

Schizophrenia is a neurodevelopmental disorder that produces abnormalities across different brain regions. Measuring structural covariance with MRI is a well-established approach to investigate common changes in distinct systems. We investigated structural covariance in schizophrenia in a large Brazilian sample of individuals with chronic schizophrenia (n = 143), First Episode Psychosis (n = 32), and matched healthy controls (n = 82) using a combination of graph analysis and computational neuroanatomy.Firstly, we proposed the connectivity-closeness and integrity-closeness centrality measures and them compared healthy controls with chronic schizophrenia regarding these metrics. We then conducted a second analysis on the mapped regions comparing the pairwise difference between the three groups.Our results show that compared with controls, both patient groups (in pairwise comparisons) had a reduced integrity-closeness in pars orbitalis and insula, suggesting that the relationship between these areas and other brain regions is increased in schizophrenia. No differences were found between the First Episode Psychosis and Schizophrenia groups. Since in schizophrenia the brain is affected as a whole, this may mirror that these regions may be related to the generalized structural alteration seen in schizophrenia.     

Exercise,Depression, and Anxiety in Young People: A Cross-Sectional Survey

Background: Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health. While exercise can reduce the symptoms of depression and anxiety, the relationship between mental disorders among American university students has been rarely reported. Accordingly, this study aimed to explore the association between exercise, depression and anxiety among American university students in the 2018–2019 academic year. Methods: In this cross-sectional study, the association between exercise, depression and anxiety was investigated in a large representative sample of American university students. In the 2018–2019 academic year, university students aged 18+ years old from 79 institutions participated in this school-based study. The questionnaire included measurements of demographic characteristics, exercise, and validated screen instructions for depression (PHQ-9) and anxiety (GAD-7). The multivariable logistic regression model was applied to explore the association between exercise, depression and anxiety. Results: A total of 62026 individuals (31.9% males) participated in this survey, and the prevalence of exercising at least 5 h each day was 24.6%. The prevalence of depression and anxiety was 25.7% and 22.3%, respectively. In the multivariable logistic regression model, compared to exercise at least 5 h daily, participants whose exercise less than 1 h daily (OR = 1.31 [1.29, 1.33], p < 0.05), 2 to 3 h daily (OR = 1.13 [1.11, 1.15], p < 0.05), 3 to 4 h daily (OR = 1.04 [1.02, 1.06], p < 0.05), were correlated with greater odds of depression, while exercise less than 1 h daily (OR = 1.23 [1.21, 1.25], p < 0.05), 2 to 3 h daily (OR = 1.10 [1.08, 1.12], p < 0.05) were significantly correlated with greater odds of anxiety. Conclusion: Higher levels of exercise are associated with lower risk of depression and anxiety among American university students. Community and school interventions should focus on increasing exercise participation in university populations to promote both physical and mental health.     

Changes in Magnetic Resonance Imaging and Sex Behavior After 6-OHDA Injection in the Medial Preoptic Area

Magnetic resonance imaging (MRI) of the brains of male rats was done before and after destroying the catecholamine (CA) fibers by local application of 6-hydroxydopamine (6-OHDA) in the medial preoptic area (mPOA). The male sexual behavior was also assessed before and after injection of this toxic drug. The administration of 6-OHDA (8 μg) resulted in highly variable lesions, as shown by MRI and confirmed by histological examination. A hyperintense area was visible either on one or on both sides, about 1–3 h after the administration of the drug. Postmortem histofluorescence showed destruction of CA fibers in the mPOA on those sides that showed hyperintense areas in the MRI. No CA fiber destruction was seen in those rats that had shown no change in MRI after 6-OHDA injection. There was a transient reduction in sex drive score in all the 6-OHDA-treated rats. The present findings point out a correlation between the MRI changes and CA fiber destruction, whereas the transient reduction in the sexual behavior was not related to these changes. It is suggested that some biochemical events related to 6-OHDA destruction of CA fibers may have been responsible for the hyperintensity seen in the MRI.     

Nighttime snacking,stress, and migraine activity

Missing meals and fasting have long been reported as headache triggers. Stress also has received attention for its role in precipitating headaches. This study explored the effects of eating behaviors on new-onset headache. Analyzing only the 1070 of 1648 (64.9%) diary days that followed a non-headache day, the study included 34 migraineurs who contributed a median (25th, 75th percentile) of 28 (22, 40) days of diary entries. Multivariable survival modeling with random effects was conducted, and hazards ratios and 95% confidence intervals were calculated. Nighttime snacking was associated with a 40% reduction in the odds of experiencing a headache compared to having no food (p = 0.013). Eating a late dinner was associated with a 21% reduction in the odds of headache when compared to no additional food, but this association was not statistically significant (p = 0. 22). These results demonstrate the potential for eating behaviors to be targeted in headache management, as regulated eating habits may have the potential to reduce the occurrence of headache. Although no causal relationship can be established, these results indicate that further research into the mechanisms of the association between eating behaviors and headache activity is warranted.     

Exercise, mood and cognitive performance in intellectual disability - a neurophysiological approach

While numerous researches addressed the connection between physical exercise, changes in brain cortical activity and its relationship to psycho-physiological processes, most of these neuro-scientific studies were set up for healthy individuals. However, the benefits of exercise, such as well being, physical and cognitive health enhancements are also becoming increasingly important for intellectually disabled individuals.This study aimed to localize electroencephalographic activity changes in intellectually disabled individuals following a moderate running exercise for 30 min. An increase in cognitive performance and in mood was hypothesized to correlate with a decrease in fronto-temporal brain areas following exercise.Significant changes in cortical current density in frontal brain areas as well as decreases in perceived physical energy could be shown. Overall motivational states (including self-confidence and social acceptance) as well as positive mood increased significantly. However, no changes could be observed for the cognitive tasks following exercise.With respect to the data provided here there is reason to believe, that a self-selected pace running exercise, enhances self-esteem, coincided with cortical activity changes in fronto-temporal brain areas.     

Cognitive Training in Parkinson’s Disease Induces Local,Not Global,Changes in White Matter Microstructure

Previous studies showed that cognitive training can improve cognitive performance in various neurodegenerative diseases but little is known about the effects of cognitive training on the brain. Here, we investigated the effects of our cognitive training paradigm, COGTIPS, on regional white matter microstructure and structural network topology. We previously showed that COGTIPS has small, positive effects on processing speed. A subsample of 79 PD patients (N = 40 cognitive training group, N = 39 active control group) underwent multi-shell diffusion-weighted imaging pre- and post-intervention. Our pre-registered analysis plan (osf.io/cht6g) entailed investigating white matter microstructural integrity (e.g., fractional anisotropy) in five tracts of interest, including the anterior thalamic radiation (ATR), whole-brain tract-based spatial statistics (TBSS), and the topology of the structural network. Relative to the active control condition, cognitive training had no effect on topology of the structural network or whole-brain TBSS. Cognitive training did lead to a reduction in fractional anisotropy in the ATR (B [SE]: − 0.32 [0.12], P = 0.01). This reduction was associated with faster responses on the Tower of London task (r = 0.42, P = 0.007), but this just fell short of our statistical threshold (P < 0.006). Post hoc “fixel-based” analyses showed that this was not due to changes in fiber density and cross section. This suggests that the observed effect in the ATR is due to training-induced alterations in neighboring fibers running through the same voxels, such as intra-striatal and thalamo-striatal fibers. These results indicate that 8 weeks of cognitive training does not alter network topology, but has subtle local effects on structural connectivity.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13311-021-01103-9.