Symptoms of depression and anxiety,and screening for mental disorders in migrainous patients

The purpose of this clinic-based study was the assessment of symptoms of depression, anxiety, and non-specific psychiatric disorders amongst patients with migraine, compared with healthy subjects and with individuals with a non-neurological chronic disease. A cross-sectional study was carried out in which 178 individuals (migraine 51; psoriasis 35; healthy 92) were submitted to three scales: MADRS (depression), STAI-T (anxiety) and SRQ (screening for mental disorders). The subjects with migraine and psoriasis were from the Out-patient Clinics of Headache and of Dermatology, and the healthy volunteers were persons who were accompanying out-patients in the same hospital. Scores were analysed by manova and by association analysis and logistic regression. Scores of all instruments were higher in the migrainous group, but the univariate analysis of association (using cut-offs) showed significance only for suspicion of mental disorders (SRQ). By logistic regression, variables with strongest association to migraine were gender, education, and SRQ in decreasing order.     

Clinical and biological aspects of juvenile thrombophilia

Summary The clinical status of 418 consecutive thrombotic patients was assessed and they were investigated for deficiencies of the proteins involved in the modulation of blood coagulation and fibrinolysis. The whole cohort was divided into two groups according to the age at which the first thrombotic event occurred: group 1 younger than 45 years and group 2 older than 45 years. Deficiencies were significantly more frequent in the juvenile thrombotic population; in this subset of patients the prevalences of single deficiencies were: protein S (6.9%), protein C (4.9%), antithrombin III (3%), plasminogen (0.5%) and dysfibrinogenemia (0.3%). It was possible to diagnose 41 additional deficiencies in the relatives of the probands. The clinical picture and the presence, absence and type of predisposing factors were not statistically different in deficient and non-deficient patients. However, deficient patients experienced their first episode significantly earlier than non-deficient patients and had a significantly higher number of recurrences and pulmonary embolism episodes. From the analysis of the thrombosis-free survival curves, there is no doubt that age represents a strong cofactor in thrombotic risk-related deficiency.     

复发性流产患者易栓症指标筛检的意义

目的 探讨易栓症相关指标与不明原因复发性流产(URSA)的相关性,为URSA患者的病因排查和治疗提供参考.方法 选取2016年11月—2018年3月上海交通大学医学院附属国际和平妇幼保健院104例流产次数≥2次的URSA患者作为URSA组,以45例健康经产妇作为对照组,检测所有研究对象血浆狼疮抗凝物(LA)阳性率、抗心...     

Headaches related to triptans therapy in patients of migrainous vertigo

Dizziness and vertigo are frequently reported by patients with migraine. In migrainous vertigo (MV), vertigo is causally related to migraine. Patients of MV usually have an attenuated or absent headache with their vertigo as compared with their usual headache of migraine. Here we report three female patients of MV in which administration of triptan was associated with induction (two patients) or exacerbation (one patient) of headache with disappearance of vertigo. We suggest that headache and vertigo of migraine may be inversely related to each other and suppression of one may induce or aggravate the other.     

Aerobic exercise and plasma beta endorphin levels in patients with migrainous headache without aura

This study aims to evaluate the effects of plasma beta endorphin level and exercise on migrainous headache. Forty patients with migrainous headache without aura (MWOA), firstly exercised on a treadmill and afterwards were asked to continue an aerobic home exercise program for six weeks. On evaluation, basal plasma beta endorphin level was negatively correlated with total duration of attacks in the last month period (P = 0.01). Exercise was found to have beneficial effects on all migraine parameters (P < 0.0001) and to increase beta endorphin levels after the treadmill practice (P < 0.0001) and after the home exercise program except four patients not regularly attended to the program (P < 0.0001). Any of the changes in headache parameters was not correlated with the change in beta endorphin level. However, pre-exercise beta endorphin level was found to be negatively correlated with the changes in the number of attacks (P < 0.05) and total duration of attacks (P = 0.01) and also with the change in beta endorphin level due to exercise (P < 0.0001). As a result, this study emphasizes the beneficial effect of exercise on migrainous headache, especially in patients with lower basal beta endorphin level.     

Trigger factors in childhood migraine: a clinic-based study from Eastern India

Literature on triggers of childhood migraine is sparse. This study was carried out in 200 children (7–15 years) with migraine from a metropolitan city in Eastern India, both retrospectively and prospectively, with headache diaries to note the incidence of various triggers. In the retrospective study, triggers could be identified in 94% of subjects while in 100% of children in the prospective part of the study more than one trigger could be identified. Most migraine triggers identified were environmental (sun exposure, hot humid weather, smoke and noise) and stress related (school stress mostly). Quite often these operated concurrently to precipitate individual migraine attacks.     

Vestibular disorders in migrainous children and adolescents

Recurrent vertigo is a special form of migraine in childhood. It is a periodic syndrome of childhood which was previously called migraine equivalent. Thirty young patients (less than 18 years of age) with migraine and vertigo were examined by the authors. The vestibular system of the patients was examined by computer-based electronystagmography. All patients had migraine-related vestibular dysfunction. Most had spontaneous nystagmus and 86.7% had an abnormal bithermal caloric test. Other forms of migraine-associated periodic syndromes – especially abdominal pain – were found in about 25% of the patients. Approximately one-third of the patients had a family history of migraine, and about half of them had motion sickness. The cause of migraine and migraine-related vestibular disorders is still unidentified, but the origin of the attacks is believed to be located in the brainstem, especially in the pons. This fact is congruent with our results indicating that a central vestibular dysfunction can be found in patients with migraine. Received: 25 November 1999 / Accepted in revised form: 19 May 2000     

Sex-hormone-related events in migrainous females. A clinical comparative study between migraine with aura and migraine without aura

In this study, the relationship between hormonal-related events and migraine with aura (MA) and without aura (MO) was investigated. Subjects included 268 women suffering from MA (88) and MO (180). Data were collected on the relationship between sex-hormone-related events and migraine. Migraine during menses was observed in a significantly higher percentage of MO than MA patients ( p < 0.03). Menstrual migraine was significantly more common in MO than in MA patients ( p < 0.01). Migraine began during pregnancy in a significantly higher percentage of MA than of MO patients ( p < 0.01). No significant difference was observed between the two groups of patients regarding the onset of migraine at menarche, after menopause, in the postpartum period or during the early cycles of oral contraceptives. Also, both groups of patients showed a similar migraine course during pregnancy, oral contraceptive use and menopause. Eight patients with coexisting migraine with aura and migraine without aura attacks reported the appearance of the aura symptom for the first time in the early cycles of oral contraceptive intake. These findings suggest that gonadal hormone fluctuation may influence both types of migraine.     

新疆哈萨克族人群易栓症危险性因素分析

目的分析新疆哈萨克族人群易栓症的危险性因素。方法调查398例新疆阿勒泰地区正常人群,检测蛋白c、蛋白s以及活化蛋白c抵抗,将检测结果超出正常42例分为病例组,其余356例分为对照组。对可能影响易栓症形成的因素进行单因素分析和logistic回归模型分析。结果在logistic回归模型分析结果显示性别、年龄、高血压、体质量、吸烟、喝酒并不是哈萨克族人群易栓症的危险因素。结论本次研究中性别、年龄、高血压、体质量、吸烟、喝酒等常见危险因素与哈萨克族人群易栓症发生并无明显关系。受制于此次调查的样本例数,更加确切的流行病学证据还有待于进一步扩大样本量后进行调查分析论证。     

Increased C-reactive protein in young adult patients with migraine

Interictal serum C-reactive protein (CRP) was measured in 50 young adult patients with migraine and compared with 50 controls. The median CRP level was 1.42 mg/l in patients with migraine and 0.90 mg/l in controls (P = 0.03). This finding supports the role of inflammation in migraine, but needs confirmation in larger controlled studies. Prospective studies may establish whether measurements of CRP can identify patients with migraine at risk for cardiovascular events.     

Diffusion- and perfusion-weighted MR imaging in persistent migrainous visual disturbances

Pathological changes on diffusion-weighted MR scans had been described in hemiplegic migraine and perfusion changes had been demonstrated in typical migraine aura with radio-isotope studies and, more recently, MR perfusion imaging. However, there is relatively little knowledge of the pathophysiology of long-lasting migraine aura and its possibly variant phenotype, visual snow. Our aim was to investigate with advanced MR techniques whether patients with long-lasting visual disturbance showed regional alterations in cerebral water diffusion and perfusion. We have studied four patients using MR perfusion and MR diffusion imaging. Two patients had typical visual aura and two had a primary persistent visual disturbance (visual snow phenomenon). All patients had normal conventional structural MR imaging. MR diffusion-weighted images were acquired with a b-value of up to 1000 s/mm2. From the diffusion weighted images we generated maps of apparent diffusion coefficient (ADC), which were inspected visually and used for ADC measurements of predefined regions of interest, which included the visual, frontal, insular and temporal cortices. MR perfusion imaging was performed using a bolus tracking technique with dynamic susceptibility-weighted images. Colour coded maps of relative cerebral blood volume, mean transit time and bolus arrival time were generated, as well as time-signal intensity curves over the anterior, middle and posterior cerebral artery territories. The maps of the ADC and above perfusion parameters appeared symmetrical in all patients with no evidence of decreased water diffusion or cerebral perfusion in the occipital regions, or elsewhere. There was no statistically significant difference between the ADC measurements of the primary visual cortices and other cortical regions. Our findings suggest that regional changes in cerebral water diffusion and perfusion do not play an important part in the pathophysiology of persistent migraine aura or primary persistent visual disturbance.     

Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study

The aim was to assess whether women suffering from migraine are at higher risk of developing hypertensive disorders in pregnancy. In a prospective cohort study, performed at antenatal clinics in three maternity units in Northern Italy, 702 normotensive women with singleton pregnancy at 11–16 weeks' gestation were enrolled. Women with a history of hypertensive disorders in pregnancy or presenting chronic hypertension were excluded. The presence of migraine was investigated according to International Headache Society criteria. The main outcome measure was the onset of hypertension in pregnancy, defined as the occurrence of either gestational hypertension or preeclampsia. Two hundred and seventy women (38.5%) were diagnosed with migraine. The majority (68.1%) suffered from migraine without aura. The risk of developing hypertensive disorders in pregnancy was higher in migraineurs (9.1%) compared with non-migraineurs (3.1%) [odds ratio (OR) adjusted for age, family history of hypertension and smoking 2.85, 95% confidence interval (CI) 1.40, 5.81]. Women with migraine also showed a trend to increased risk for low birth weight infants with respect to women without migraine (OR 1.97, 95% CI 0.98, 3.98). Women with migraine are to be considered at increased risk of developing hypertensive disorders in pregnancy. The diagnosis of primary headaches should be taken into account at antenatal examination.     

Identifying genetic variants for age of migraine onset in a Han Chinese population in Taiwan

BackgroundConsidering the involvement of genetics in migraine pathogenesis in diverse ethnic populations, genome-wide association studies (GWAS) are being conducted to identify migraine-susceptibility genes. However, limited surveys have focused on the onset age of migraine (AoM) in Asians. Therefore, in this study, we aimed to identify the susceptibility loci of migraine considering the AoM in an Asian population.MethodsWe conducted a GWAS in 715 patients with migraine of Han Chinese ethnicity, residing in Taiwan, to identify the susceptibility genes associated with AoM. Based on our standard demographic questionnaire, the population was grouped into different subsets. Single-nucleotide polymorphism (SNP) associations were examined using PLINK in different AoM onset groups.ResultsWe discovered eight novel susceptibility loci correlated with AoM that reached the GWAS significance level in the Han Chinese population. First, rs146094041 in ESRRG was associated with AoM ≤ 12 years. The other SNPs including rs77630941 in CUX1, rs146778855 in CDH18, rs117608715 in NOL3, rs150592309 in PRAP1, and rs181024055 in NRAP were associated with the later AoM.ConclusionsTo our knowledge, this is the first GWAS to investigate the AoM in an Asian Han Chinese population. Our newly discovered susceptibility genes may have prospective associations with migraine pathogenesis.Supplementary InformationThe online version contains supplementary material available at 10.1186/s10194-021-01301-y.     

Multiplex assay for genetic testing of thrombophilia: a method for routine clinical care

There is an increasing demand for genetic testing of patients with hypercoagulability. We have developed a multiplex-polymerase chain reaction (PCR) technique that incorporates the state-of-the art of genetic testing for thrombosis mutations (Factor V Leiden [FVL] and G20210A F2 and C46T F12). The sequences are detected by enzyme-linked immunosorbent assay (ELISA)-resolved colorimeter after hybridization with an amplification product labeled with digoxygenin. To evaluate the reliability of this method, we analyzed 122 deoxyribonucleic acid (DNA) samples of known genotypes for these three mutations. Six subjects initially assigned as heterozygous for FVL and two subjects assigned as normal for the G20210A F2 mutation showed discrepancies between the current techniques and our newly-developed ELISA-based technique. When these samples were sequenced the concordance using our method was 100%. Thus, initially they were assigned incorrectly based on the available methodologies. It is noteworthy that our method is adaptable to an Automated ELISA Analyzer that allows for routine processing of both small and large numbers of DNA samples. We present a robust, rapid, reproducible, cost-effective, and simple multiplex PCR ELISA method to simultaneously detect carriers of thrombotic genetic risk factors. Testing for thrombophilia should contribute to better diagnosis, prevention, and treatment strategies, providing valuable information to assess the risk of recurrence in the proband, and in family members who are asymptomatic.