Cerebrospinal Fluid Cytokine Levels in Migraine, Tension-Type Headache and Cervicogenic Headache

Cephalalgia ◽  
2009 ◽  
Vol 29 (3) ◽  
pp. 365-372 ◽  
Author(s):  
SH Bø ◽  
EM Davidsen ◽  
P Gulbrandsen ◽  
E Dietrichs ◽  
G Bovim ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Migraine With Aura ◽  
Transforming Growth Factor ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Significant Group ◽  
Significant Difference ◽  
Cytokine Levels ◽  
Type Headache ◽  
Tgf Β1

Cytokines have been measured in cerebrospinal fluid (CSF) from headache patients [infrequent episodic tension-type headache (TTH) and migraine with or without aura, all during attack, and cervicogenic headache] and compared with levels in pain-free individuals. Both proinflammatory [interleukin (IL)-1β, tumour necrosis factor-α and monocyte chemoattractant protein-1 (MCP-1)] and anti-inflammatory cytokines IL-1 receptor antagonist (IL-1ra), IL-4, IL-10 and transforming growth factor-β1 (TGF-β1)] were included. There were significant group differences in IL-1ra, TGF-β1 and MCP-1 in episodic TTH and migraine compared with controls, and a significant difference in MCP-1 between cervicogenic headache and migraine with aura. Intrathecal MCP-1 correlated with IL-1ra, IL-10 and TGF-β1 in episodic TTH, and MCP-1 with IL-10 in migraine with aura. Cytokine increases were modest compared with those often accompanying serious neurological conditions, and may represent a mild response to pain. We believe this to be the first comparative study of CSF cytokine levels in connection with headache.

scholarly journals Effectiveness of Mulligan manual therapy over exercise on headache frequency, intensity and disability for patients with migraine, tension-type headache and cervicogenic headache – a protocol of a pragmatic randomized controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kiran Satpute ◽  
Nilima Bedekar ◽  
Toby Hall
Keyword(s):  
Outcome Measures ◽  
Manual Therapy ◽  
Controlled Trial ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Secondary Outcome ◽  
Headache Frequency ◽  
Significant Difference ◽  
Type Headache ◽  
Frequency Intensity

Abstract Background Non - pharmacological management of migraine, tension-type headache (TTH), and cervicogenic headache (CGH) may include spinal manual therapy and exercise. Mulligan Manual Therapy (MMT) utilizes a protocol of headache elimination procedures to manage headache parameters and associated disability, but has only been evaluated in CGH. There is little evidence for its effectiveness in migraine and TTH. This study aims to determine the effectiveness of MMT and exercise over exercise and placebo in the management of migraine, TTH, and CGH. Methods This pragmatic trial is designed as a prospective, three-armed randomised controlled trial in a clinical setting provided at a general hospital physiotherapy department. Two hundred ninety-seven participants with a diagnosis of migraine, TTH or CGH based on published headache classification guidelines will be included. An assessor blind to group allocation will measure outcomes pre-and post-intervention as well as 3 and 6 months after commencement of treatment. Participants will be allocated to one of the three groups: MMT and exercise; placebo and exercise; and exercise alone. The primary outcome measure is headache frequency. Secondary outcome measures are headache duration and intensity, medication intake, pressure pain threshold (PPT), range of motion recorded with the flexion rotation test, and headache disability recorded with Headache Activities of Daily Living Index (HADLI). The intention-to-treat principle will be followed for statistical analysis. Between groups differences for all outcome measures at baseline and at reassessment points and 95% confidence intervals will be calculated using a mixed model ANOVA. Post hoc tests will be conducted to identify any significant difference between groups and over time. Discussion This pragmatic study will provide evidence for the effectiveness of MMT when compared with a placebo intervention and exercise on headache frequency, intensity, and disability. Limitations are that baseline evaluation of headache parameters may be affected by recall bias. External validity will be limited to the population with a minimum 1-year history of headache. The HADLI is not yet extensively evaluated for its psychometric properties and association between PPT and headache parameters is lacking. Performance bias is inevitable as a single therapist will be delivering all interventions. Trial registration The trial was registered prospectively under the Clinical Trial Registry India (Registration number: CTRI/2019/06/019506, dated on 03/06/2019). .

Headache in Children and Adolescents: The Association between Screen Time and Headache within a Clinical Headache Population

2021 ◽  
Author(s):  
Josefine Lund ◽  
Amalie Berring-Uldum ◽  
Merve Colak ◽  
Nanette Marinette Monique Debes
Keyword(s):  
Children And Adolescents ◽  
Migraine With Aura ◽  
Screen Time ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
University Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Headache Diagnosis ◽  
Type Headache

Abstract Background More than half of children and adolescents have experienced headache within the last 3 months. Several risk factors for headache have been identified, including obesity and lack of sleep. The association between screen time and headache in children and adolescents is sparsely investigated. The aim of this study was to assess this association and evaluate if it varied according to headache diagnosis. Method This cross-sectional study was performed at the tertiary pediatric outpatient clinic for headache at Herlev University Hospital. A total of 139 participants who answered a questionnaire on lifestyle factors and their daily living were included. Diagnoses of migraine and tension-type headache (TTH) were made according to the International Classification of Headache Disorders-3. Children with both migraine and TTH were allocated to a mixed headache group. We differentiated between total, leisure, and school-related screen time. Results The mean age was 13.20 ± 3.38 years and 53.2% were girls. Note that 25.2% were diagnosed with migraine without aura, 23.0% migraine with aura, 28.1% TTH, 15.8% mixed headache, and 7.9% had an unclassified headache diagnosis at the time of inclusion. There was no statistically significant difference in screen time across the five headache groups. An association between screen time and headache frequency was found in children with migraine with aura. Conclusion In this study, we investigated the association between screen time and headache in children and adolescents. More screen time was associated with more frequent headaches in children with migraine with aura. Future prospective studies are needed to determine the causality of this association.

Manual therapies for pain relief in patients with headache

2015 ◽  
Vol 23 (1) ◽  
pp. 89-96
Author(s):  
Débora Wanderley ◽  
Andrea Lemos ◽  
Larissa de Andrade Carvalho ◽  
Daniella Araújo de Oliveira
Keyword(s):  
Treatment Effect ◽  
Cervicogenic Headache ◽  
Allocation Concealment ◽  
Tension Type Headache ◽  
Manual Therapies ◽  
Osteopathic Manipulation ◽  
Intention To Treat ◽  
Headache Relief ◽  
Type Headache ◽  
Treat Analysis

Objective. This systematic review aimed to assess the efficacy of manual therapies for headache relief. Method. A systematic search in MEDLINE, LILACS, Cochrane, CINAHL, Scopus and Web of Sci­ence databases was conducted for randomized and quasi-randomized trials, with no restrictions for language or year of publication. The de­scriptors were ‘Headache’, ‘Headache disorders’ and ‘Musculoskeletal manipulations’, in addition to the keyword ‘Manual therapy’ and its equivalents in Portuguese. We included studies that compared mas­sage, chiropractic manipulation, osteopathic manipulation and other spinal manipulation to groups with no intervention, other physiother­apeutic modalities or to a sham group. Results. Seven of the 567 ar­ticles initially screened were selected, including patients with tension type headache, cervicogenic headache or migraine. It was not possible to assess the magnitude of the treatment effect on the findings of this review. The main limitations were the absence of randomization and adequate allocation concealment, the lack of blinded evaluators and intention-to-treat analysis and inadequate statistical analysis. Conclu­sions. We were unable to determine the size of the treatment effect due to the selective description of findings. Owing to the high risk of bias in the articles included, the available evidence regarding the ef­ficacy of manual therapies for headache relief is insufficient.

Perinatal outcomes in women affected by different types of headache disorders: A prospective cohort study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110292
Author(s):  
Isabella Neri ◽  
Daniela Menichini ◽  
Francesca Monari ◽  
Ludovica Spanò Bascio ◽  
Federico Banchelli ◽  
...  
Keyword(s):  
Migraine With Aura ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Migraine Without Aura ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Aneuploidy Screening ◽  
Type Headache

Objective This study aims to investigate pregnancy and perinatal outcomes in women with tension-type headache, migraine without aura and migraine with aura by comparing them to women without any headache disorders. Study design Prospective cohort study including singleton pregnancies attending the first trimester aneuploidy screening at the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019. Results A total of 515 consecutive women were included and headache disorders were reported in 43.5% of them (224/515). Tension-type headache was diagnosed in 24.3% of the cases, while 14% suffered from migraine without aura and 5.2% from migraine with aura. Birthweight was significantly lower in women affected by migraine with aura respective to other groups, and a significantly higher rate of small for gestational age infants was found in tension-type headache (10.4%) and in migraine with aura (24.9%) groups respective to the others (p < 0.001). Moreover, the admission to the neonatal intensive care unit was significantly higher in all the headache groups (p = 0.012). Multivariate analysis showed that women presenting tension-type headache (OR 4.19, p = 0.004), migraine with aura (OR 5.37, p = 0.02), a uterine artery pulsatility index >90th centile (OR 3.66, p = 0.01), low multiple of the median (MoM) of Pregnancy-associated plasma protein-A (PAPP-A) (OR 0.48, p = 0.05) and high MoM of Inhibin-A (OR 3.24, p = 0.03) at first trimester, are independently associated with the delivery of small for gestational age infants when compared to women without headache disorders. Conclusion Migraine with aura and tension type headache expose women to an increased risk of delivering small for gestational age infants, in association with some utero-placenta markers evaluated at first trimester. These women with headache disorders have an additional indication to undergo first trimester aneuploidy screening and would possibly benefit from specific interventions.

scholarly journals Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

2021 ◽  
Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder
Keyword(s):  
Systemic Inflammation ◽  
Tension Type Headache ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

History of Headache Research in Denmark

Cephalalgia ◽  
2001 ◽  
Vol 21 (7) ◽  
pp. 748-752 ◽  
Author(s):  
P Tfelt-Hansen
Keyword(s):  
Migraine With Aura ◽  
Tension Type Headache ◽  
Regional Cerebral Blood ◽  
Danish Population ◽  
Genetic Studies ◽  
History Of ◽  
Headache Clinic ◽  
Type Headache ◽  
Acute Headache ◽  
First Time

Headache research in Denmark started with the description in 1949 by Dalsgaard-Nielsen of the percutaneous nitroglycerin test. In 1976 Jes Olesen started The Copenhagen Acute Headache Clinic and from that time modern headache research began in Denmark. Specific changes in regional cerebral blood flow during attacks of migraine with aura, spreading oligaemia, were described for the first time in 1980. The first headache classification with operational diagnostic criteria was published in 1988 and used in a Danish population study from 1989. The lifetime prevalence of migraine was 8% in men and 25% in women. An intravenous nitroglycerin test was introduced in 1989 and has been developed as an experimental headache model. In 1993 it was suggested by Jes Olesen et al. that NO supersensitivity could be a possible molecular mechanism of migraine pain. Recent genetic studies have supported the distinction between migraine with aura and migraine without aura. From the middle of the 1980s the pathophysiology of tension-type headache has been investigated and recent results indicate central sensitization in patients with chronic tension-type headache.

scholarly journals Effects of Acute Confinement Stress-induced Hypothalamic-pituitary Adrenal Axis Activation and Concomitant Peripheral and Central Transforming Growth Factor-β1 Measures in Nonhuman Primates

2017 ◽  
Vol 1 ◽  
pp. 247054701668869 ◽  
Author(s):  
Jeremy D. Coplan ◽  
Srinath Gopinath ◽  
Chadi G. Abdallah ◽  
Jeffrey Margolis ◽  
Wei Chen ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Stress Condition ◽  
Transforming Growth Factor ◽  
Transforming Growth Factor Β1 ◽  
Hypothalamic Pituitary Adrenal Axis ◽  
Hypothalamic Pituitary Adrenal ◽  
Adrenal Axis ◽  
Confinement Stress ◽  
Pituitary Adrenal Axis ◽  
Tgf Β1

Transforming growth factor-β1 (TGF-β1) is a multifunctional cytokine with anti-inflammatory, immunosuppressive, and neuroprotective properties. The hypothalamic-pituitary-adrenal axis and immune system exert bidirectional influences on each other, via cortisol and TGF-β1, but the exact nature of the interaction is not well characterized. The current study examined the effects, in bonnet macaques ( Macaca radiata), of two consecutive acute confinement stress periods in an unfamiliar room while mildly restrained, first without and then with dexamethasone pretreatment (0.01 mg/kg intramuscular). Preceding the confinement studies, a non-stress control condition obtained contemporaneous levels of cortisol and TGF-β1 in both plasma and cerebrospinal fluid to match the confinement stress studies. Subjects were reared under either normative or variable foraging demand conditions. Since there were no rearing effects at baseline or for any of the conditions tested—either for cortisol or TGF-β—the study analyses were conducted on the combined rearing groups. The stress condition increased both plasma and cerebrospinal fluid cortisol levels whereas dexamethasone pretreatment decreased cortisol concentrations to below baseline levels despite stress. The stress condition decreased TGF-β1 concentrations only in cerebrospinal fluid but not in serum. Together, the data suggested that stress-induced reductions of a centrally active neuroprotective cytokine occur in the face of hypothalamic-pituitary-adrenal axis activation, potentially facilitating glucocortoid-induced neurotoxicity. Stress-induced reductions of neuroprotective cytokines prompt exploration of protective measures against glucocorticoid-induced neurotoxicity.

scholarly journals Prevalence and impact of headache in undergraduate students in Southern Brazil

2010 ◽  
Vol 68 (6) ◽  
pp. 873-877 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Alisson Roberto Teles ◽  
Maíra Cristina Velho ◽  
Viviane Maria Vedana ◽  
Roberta Castilhos da Silva ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Significant Difference ◽  
Headache Episode ◽  
Headache Type ◽  
Probable Migraine ◽  
Type Headache ◽  
The University

OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS), to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache; [6] no headache. RESULTS: Of all undergraduate students interviewed, 74.5% had at least one headache episode in the last three months. Regarding disability, there was a significant difference between the headache types (p<0.0001). In the post-hoc analysis, migraine was the headache type with most reported disability. CONCLUSION: Headache is a highly prevalent condition among the students at the University of Caxias do Sul. This disease may have a major impact on the students' lives and in some cases, ultimately lead to educational failure.

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