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91.
偏头痛患者及接受三叉神经刺激的大鼠血中神经肽水平的改变 总被引:1,自引:0,他引:1
目的:探讨与血管舒缩有关的神经肽以及类阿片肽在偏头痛发病中的主次作用.方法:偏头痛患者156例,正常对照者82名,于肘静脉采取血样.SD大鼠26只,分为预实验组6只,三叉神经刺激组10只与假手术组10只,分别适时采取血样.采用放射免疫方法测定血样中的神经肽含量.结果:与对照组相比,头痛间歇期患者β-内啡肽(β-EP)降低,而神经肽Y(NPY)升高;头痛缓解4天内的患者降钙素基因相关肽(CGRP)、P物质(SP)、血管活性肠肽(VIP)降低,而强啡肽A(DynA)与亮啡肽(LEK)无变化.与假手术组相比,三叉神经刺激大鼠血中NPY、CGRP、SP、VIP升高,而β-EP、LEK与DynA无变化.比较偏头痛者与大鼠三叉神经刺激后血中神经肽改变,唯一的不一致是偏头痛者β-EP降低.结论:β-EP的降低很可能为偏头痛发病的关键环节,而其余肽类含量改变则是继发现象. 相似文献
92.
Wilkinson F Karanovic O Ross EC Lillakas L Steinbach MJ 《Cephalalgia : an international journal of headache》2006,26(6):660-671
The purpose of this study was to examine basic ocular motor function in individuals with migraine. We used an infrared eye-tracking system to measure horizontal smooth pursuit to a sinusoidal target, saccades to horizontal target displacements of 5-20 degrees , and the stability of fixation in 19 migraine without aura (MoA), 19 migraine with aura (MA) and 19 headache-free control (C) subjects. Eye movement measurements were made at two target displacement rates and against both homogeneous grey and patterned backgrounds. We found no statistically significant differences between migraine and control subjects in any of the eye movement parameters measured, but did find highly significant effects of both target speed and background pattern in all groups. Our results do not provide support for subclinical cerebellar impairment in migraineurs, and do provide evidence that previously described visual abnormalities in migraine are not artefacts of abnormal fixation or eye movements. 相似文献
93.
Oelkers-Ax R Parzer P Resch F Weisbrod M 《Cephalalgia : an international journal of headache》2005,25(4):280-289
Evidence for a disturbed maturation of information processing in migraine came recently from evoked and event-related potential studies during childhood. In adult migraineurs, deficient habituation is proposed as principal interictal abnormality and was found inter alia for Visual Evoked Potentials (VEPs). This study investigated response and habituation to pattern-reversal VEPs and its maturation in 102 children with primary headache (migraine with and without aura, tension-type headache) and 79 healthy controls from 6 to 18 years. A reduction of N180 latency from pre- to postpubertal age reflects maturation and was clearly present in controls but lessened in migraineurs. N180 latency was prolonged in migraineurs without aura from 12 years onwards. Habituation did not differ between groups. In conclusion, diminished N180 latency reduction with age in migraineurs gives further evidence that maturation of visual information processing is altered in migraine. Deficient habituation to pattern-reversal VEPs could not be confirmed during childhood migraine. 相似文献
94.
Hristina Vlajinac Sandra ?ipeti? Eleonora D?olji? Jadranka Maksimovi? Jelena Marinkovi? Vlada Kosti? 《The journal of headache and pain》2003,4(2):67-71
Abstract
We performed a prevalence study to compare some lifestyle
habits between subjects with migraine and those with nonmigraine
primary headaches. We surveyed female students in randomly
selected classes of the School of Medicine and the School of
Pharmacy, Belgrade University. Among all observed students (1943
subjects), 245 had migraine and 1053 had non-migraine primary
headache. According to multivariate logistic regression
analysis, the following factors were associated with migraine:
irregular eating (odds ratio (OR)=1.99; 95% confidence interval
(95% CI), 1.69 to 2.34; p<0.01), sleep duration shorter than
usual (OR=1.18; 95% CI 1.00 to 1.38; p=0.0449) and smoking >10 cigarettes
per day (OR=1.18; 95% CI=1.00 to 1.39; p=0.0433). The results of the present
study are in line with some other investigations suggesting that
some lifestyle habits probably play a role as migraine
precipitants. 相似文献
95.
SYNOPSIS
Current treatment of migraine either abortive or prophylactic is often unsatisfactory. Prophylactic treatment of severe migraine may reduce attack frequency, and current therapy centers on beta-blockers, serotonin (5-HT) reuptake blockers and 5-HT 2 receptor antagonists. The author compared the efficacy and safety of amitriptyline and fluvoxamine among migraine patients (24F, 8M vs. 23F, 9M) in a double blind study. The efficacy of amitriptyline has already been established by earlier clinical studies. The other investigated drug, fluvoxamine, has a more selective 5-HT reuptake blocking property than amitriptyline. In this study, amitriptyline significantly reduced the number of headache attacks, but it caused severe drowsiness in many migraineurs. The fluvoxamine also favorably influenced on the number of headache attacks and caused only slight side effects. These findings suggest, that fluvoxamine may be an alternative drug in migraine prophylaxis, however, further studies should be performed with more subjects. 相似文献
Current treatment of migraine either abortive or prophylactic is often unsatisfactory. Prophylactic treatment of severe migraine may reduce attack frequency, and current therapy centers on beta-blockers, serotonin (5-HT) reuptake blockers and 5-HT 2 receptor antagonists. The author compared the efficacy and safety of amitriptyline and fluvoxamine among migraine patients (24F, 8M vs. 23F, 9M) in a double blind study. The efficacy of amitriptyline has already been established by earlier clinical studies. The other investigated drug, fluvoxamine, has a more selective 5-HT reuptake blocking property than amitriptyline. In this study, amitriptyline significantly reduced the number of headache attacks, but it caused severe drowsiness in many migraineurs. The fluvoxamine also favorably influenced on the number of headache attacks and caused only slight side effects. These findings suggest, that fluvoxamine may be an alternative drug in migraine prophylaxis, however, further studies should be performed with more subjects. 相似文献
96.
Barbanti P Fabbrini G Vanacore N Rum A Lenzi GL Meco G Cerbo R 《Cephalalgia : an international journal of headache》2000,20(8):720-723
As brainstem mechanisms and dopaminergic neurotransmission are involved in migraine pathophysiology, we decided to investigate the course of migraine in Parkinson's disease (PD), the paradigm of brainstem dopaminergic disease. We screened 237 consecutive PD out-patients by direct interview to assess the prevalence of lifetime and current migraine. Moreover, we compared the course of migraine in PD patients with that of otherwise healthy age- (+/- 3 years) and sex-paired migraine controls in a cross-sectional study. PD patients showed a lifetime migraine prevalence of 27.8% and a current migraine prevalence of 13.1%. A positive family history of migraine was less frequent in PD patients than in controls. The frequency of current migraine was significantly lower in PD patients than in controls (47.0% vs. 68.2%; odds ratio = 0.41, 95% confidence interval = 0.19-0.89). Approximately two-thirds of PD patients reported an improvement in or remission of migraine after PD onset. Effects of menopause on migraine course were similar in patients and controls. These findings suggest that PD might somehow shorten the clinical course of migraine. Possible explanations include a prolonged prophylactic effect by chronic dopaminergic therapy or a positive effect of PD pathophysiology, namely nigral degeneration, on migraine mechanisms. 相似文献
97.
Efficacy and tolerability in migraine prophylaxis of flunarizine in reduced doses: a comparison with propranolol 160 mg daily 总被引:5,自引:0,他引:5
Diener HC Matias-Guiu J Hartung E Pfaffenrath V Ludin HP Nappi G De Beukelaar F 《Cephalalgia : an international journal of headache》2002,22(3):209-221
This was a phase-IV double-blind equivalence trial designed to assess the efficacy and tolerability of two doses of flunarizine (10 mg o.d.=FLU 10 mg and 5 mg o.d.=FLU 5 mg) in the prophylaxis of migraine, in comparison with slow-release propranolol (160 mg o.d.). A total of 808 subjects were treated in a treatment period of 16 weeks. 142 subjects discontinued the trial prematurely, mainly because of adverse events (n=58). The mean attack frequency in the double-blind period was 2.0 for the FLU 5 mg group, 1.9 for the FLU 10 mg group, and 1.9 for the propranolol group. The mean attack frequency in the last 28 days of the double-blind period was 1.8 for FLU 5 mg, 1.6 for FLU 10 mg, and 1.7 for propranolol. Both flunarizine groups were at least as effective as propranolol (P<0.001 in one-sided test). The percentage of responders (defined as subjects for whom attack frequency decreased by at least 50% compared to run-in) in the last 28 days of the double-blind period was 46% (118/259) for FLU 5 mg, 53% (141/264) for FLU 10 mg, and 48% (125/258) for propranolol. Statistical analysis showed that FLU 10 mg is at least as effective as propranolol (P<0.001) and showed a trend for noninferiority of FLU5 and propranolol (P=0.053). No statistically significant differences between the treatment groups were found for any of the secondary parameters. Overall, 190 subjects reported one or more adverse events during the run-in phase: 54 (20.5%) in the FLU 5 mg group, 76 (27.7%) in the FLU 10 mg group and 60 (22.3%) in the propranolol group. The results of this equivalence trial show that 10 mg flunarizine daily with a drug-free weekend is at least as effective as 160 mg propranolol in the prophylaxis of migraine for all evaluated parameters (one-sided equivalence tests) after 16 weeks of treatment. In addition, 5 mg flunarizine proves to be at least as effective as 160 mg propranolol when looking at the mean attack frequency for both the whole double-blind period and the last 28 days of treatment. However, in the analysis of responders, 160 mg propranolol seems to be slightly better than 5 mg flunarizine. In addition, no significant differences between the three treatments were found with regard to safety: all three treatments were generally well-tolerated and safe. 相似文献
98.
Unilateral cranial autonomic symptoms in migraine 总被引:1,自引:0,他引:1
Barbanti P Fabbrini G Pesare M Vanacore N Cerbo R 《Cephalalgia : an international journal of headache》2002,22(4):256-259
Unilateral cranial autonomic symptoms (UAs) such as lacrimation, conjunctival injection, eyelid oedema and nasal congestion, which are the hallmark of trigeminal autonomic cephalgias, may also occur in an as yet undetermined proportion of migraine patients. We studied 177 consecutive migraineurs to assess the frequency of UAs and the clinical characteristics of such patients. UAs were reported by 81 patients (45.8%), ocular symptoms alone or in combination with nasal symptoms being the most frequent. The headache was more severe (P<0.0002) and more strictly unilateral (P<0.0004) in patients who reported UAs than in those without. Thus, the presence of UAs suggests an activation of the trigeminal-autonomic reflex, probably related to an over-activation of the trigeminal afferent arm. These findings could have therapeutic implications, given the potential large-scale recruitment of peripheral neurovascular 5-HT(1B/1D) receptors (the target of acute migraine treatment) in such patients. 相似文献
99.
Bigal ME Gironda M Tepper SJ Feleppa M Rapoport AM Sheftell FD Lipton RB 《Cephalalgia : an international journal of headache》2006,26(4):445-450
A population-based longitudinal study suggests that obesity is a strong risk factor for the development of headaches on 15 or more days per month. Little is know about the influence of weight on the response to headache preventive treatment. Herein we prospectively assessed the influence of the baseline body mass index (BMI) on the response to headache preventive treatment. We included adults with episodic or chronic migraine (ICHD-2), or transformed migraine (Silberstein and Lipton criteria) that sought care in a headache clinic. BMI was assessed in the first visit. Baseline information included headache frequency, number of days with severe headache (prospectively obtained over 1 month), and headache-related disability (HIT-6). The same information was obtained after 3 months of preventive treatment. Subjects were categorized based on BMI in: normal weight (=24.9), overweight (25-29.9), or obese (>/=30). We contrasted the headache end-points using anova with post-test and Kruskal-Wallis with post-test. We used logistic regression to model BMI and headache parameters adjusting for covariates. Our sample consisted of 176 subjects (79.5% women, mean of 44.4 years). At baseline 40.9% had normal weight, 29.5% were overweight and 27.3% were obese. No significant differences were observed in the number of headache days at baseline. After treatment, frequency declined in the entire population, but no significant differences were found by BMI group. Regarding the number of days with severe pain per month, there were also no significant differences at baseline (normal = 6.1, overweight = 6.5, obese = 6.7), and improvement overall (P = 0.01). However, changes were greater in the obese (reduction in 2.7 days with treatment) and overweight (3.9) vs. normal (1.5, P < 0.01). Finally, HIT scores at baseline did not differ by BMI group (normal weight = 63.8, overweight = 64.1, obese = 63.6). However, compared with the normal weighted group, change in HIT scores (follow-up baseline) were greater in the obese (6.4 vs. 3.5, P < 0.05) and overweight groups (6.8 vs. 3.5, P < 0.05). In the logistic regression model, BMI did not account for changes in disability, headache frequency, or in the number of days with severe headache per month, after adjusting for covariates. Contrary to what we hypothesized, obesity at baseline does not seem to be related to follow-up refractoriness to preventive treatment. 相似文献
100.
Gori S Morelli N Maestri M Fabbrini M Bonanni E Murri L 《The journal of headache and pain》2005,6(4):258-260
Clinical observations
show that migraine attacks have a
seasonal, menstrual and circadian
timing, suggesting a role of chronobiological
mechanisms and their
alterations in the disease, but little
experimental data exists about this
issue. The aim of this study was to
estimate sleep quality chronotypes
and the possible circadian timing of
attacks in migraneurs. One hundred
patients suffering from migraine
without aura according to the IHS
criteria (2004), and 30 controls were
enrolled. Morning and evening type
subjects were more represented in
migraine patients than in controls
and showed a tendency towards
worse sleep quality and higher disability.
Forty–two percent of
migraineurs presented more than
75% of their attacks at night.
Morning and evening types rather
than intermediate and differences
between real and preferred times
may represent stressors that can
worsen the disease. A preferential
timing for occurrence of migraine
attacks during the night and early
morning hours was documented. 相似文献