Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache

Cephalalgia ◽  
2013 ◽  
Vol 34 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Song Guo ◽  
Sarvnaz Shalchian ◽  
Pascale Gérard ◽  
Michael Küper ◽  
Zaza Katsarava ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Transcranial Doppler ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Episodic Migraine ◽  
Severe Form ◽  
Cross Sectional ◽  
Headache Clinic ◽  
Chronic Headaches ◽  
Chronic Migraineurs

Background It was suggested that right-to-left shunt (RLS) may be highly prevalent in chronic migraine (CM) patients, indicating that patent foramen ovale (PFO) might be an aggravating and chronifying factor of migraine. Since a high proportion of chronic migraineurs also have medication-overuse headache (MOH), one may wonder if they have a more severe form of the disorder and more frequently a PFO. Objective The objective of this study is to determine the prevalence and grade of RLS in patients suffering from CM and MOH. Methods A cross-sectional multicenter study of air-contrast transcranial Doppler was conducted in 159 patients with CM ( n = 57) or MOH ( n = 102) attending a tertiary headache clinic. Results The prevalence of RLS in CM was 37% (11% large shunts) and in MOH patients 31% (13% large shunts). There was no difference between the two groups ( p = 0.49). Conclusion RLS prevalence in CM is within the upper range of those reported in episodic migraine without aura or in the general population, and not higher in MOH. PFO is thus unlikely to have a significant causal role in these chronic headaches.

scholarly journals Differences in Frontal Lobe Dysfunction in Patients with Episodic and Chronic Migraine

2021 ◽  
Vol 10 (13) ◽  
pp. 2779
Author(s):  
Sang-Hwa Lee ◽  
Yeonkyeong Lee ◽  
Minji Song ◽  
Jae Jun Lee ◽  
Jong-Hee Sohn
Keyword(s):  
Chronic Migraine ◽  
Frontal Lobe ◽  
Iowa Gambling Task ◽  
Medication Overuse Headache ◽  
Wisconsin Card Sorting Test ◽  
Episodic Migraine ◽  
Frontal Lobe Dysfunction ◽  
Card Sorting ◽  
Cross Sectional ◽  
Frontal Lobe Function

Neuroimaging and neuropsychological investigations have indicated that migraineurs exhibit frontal lobe-related cognitive impairment. We investigated whether orbitofrontal and dorsolateral functioning differed between individuals with episodic migraine (EM) and chronic migraine (CM), focusing on orbitofrontal dysfunction because it is implicated in migraine chronification and medication overuse headache (MOH) in migraineurs. This cross-sectional study recruited women with CM with/without MOH (CM + MOH, CM − MOH), EM, and control participants who were matched in terms of age and education. We conducted neuropsychological assessments of frontal lobe function via the Trail Making Test (TMT) A and B, the Wisconsin Card Sorting Test (WCST), and the Iowa Gambling Task (IGT). We enrolled 36 CM (19 CM + MOH, 17 CM–MOH), 30 EM, and 30 control participants. The CM patients performed significantly (p < 0.01) worse on the TMT A and B than the EM patients and the control participants. The WCST also revealed significant differences, with poorer performance in the CM patients versus the EM patients and the control participants. However, the net scores on the IGT did not significantly differ among the three groups. Our findings suggest that the CM patients exhibited frontal lobe dysfunction, and, particularly, dorsolateral dysfunction. However, we found no differences in frontal lobe function according to the presence or absence of MOH.

Analysis of Leukocytes in Medication-Overuse Headache, Chronic Migraine, and Episodic Migraine

2011 ◽  
Vol 51 (8) ◽  
pp. 1228-1238 ◽  
Author(s):  
Cassiano M. Forcelini ◽  
Denise C. M. Dantas ◽  
Clarice Luz ◽  
Ricardo Santin ◽  
Airton T. Stein ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Episodic Migraine

Factors associated to chronic migraine with medication overuse: A cross-sectional study

Cephalalgia ◽  
2018 ◽  
Vol 38 (14) ◽  
pp. 2045-2057 ◽  
Author(s):  
Michele Viana ◽  
Sara Bottiroli ◽  
Grazia Sances ◽  
Natascia Ghiotto ◽  
Marta Allena ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Episodic Migraine ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Preventive Medication ◽  
History Of

Background and aim Factors implicated in the evolution of episodic migraine into chronic migraine are largely elusive. Medication overuse is considered to be one of the main determinants, but other possible clinical and psychological factors can play a role. The aim of this study is to identify factors that are associated with chronic migraine with medication overuse. Method We enrolled consecutive migraine patients, subdividing them in two groups: Subjects with a long history of episodic migraine and subjects with chronic migraine and medication overuse. We then compared their clinical and psychological variables in a cross-sectional study. Results Three hundred and eighteen patients were enrolled, of which 156 were episodic migraine and 162 were chronic migraine and medication overuse patients. The mean age was 42.1 ± 10.3, 80.8% were female. The duration of migraine was 24.6 years in episodic migraine and 24.0 years in chronic migraine and medication overuse ( p = 0.57). After the multivariate analysis, the factors associated to chronic migraine and medication overuse were: Marital status (married vs. unmarried, OR 3.65, 95% CI 1.63–8.19, p = 0.002; separated/divorced/widowed vs. unmarried, OR 4.19, 95% CI 1.13–15.47, p = 0.031), physical activity (OR 0.42, 95% CI 0.19–0.91, p = 0.029), age at onset of migraine (OR 0.94, 95% CI 0.89–0.98, p = 0.016), use of at least one migraine preventive medication (OR 2.36, 95% CI 1.18–4.71, p = 0.014), history of depression (OR 2.91, 95% CI 1.25–6.73, p = 0.012), insomnia associated with the use of hypnotics (OR 5.59, 95% CI 1.65–18.93, p = 0.006), traumatic head injuries (OR 3.54, 95% CI 1.57–7.99, p = 0.002), snoring (OR 2.24, 95% CI 1.05–4.79, p = 0.036), previous and/or actual use of combined oral contraceptives (OR 3.38, 95% CI 1.10–10.3, p = 0.031) and higher scores in the Childhood Trauma questionnaire (OR 1.48, 95% CI 1.09–2.02, p = 0.012). Conclusion We considered several aspects that may be involved in the development of chronic migraine and medication overuse. A multivariate analysis identified 10 factors belonging to five different areas, to suggest that chronic migraine and medication overuse onset is likely influenced by a complex mixture of factors. This information is useful when planning strategies to prevent and manage chronic migraine and medication overuse.

scholarly journals Cognitive Decline in Chronic Migraine with Nonsteroid Anti-inflammation Drug Overuse: A Cross-Sectional Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaoying Cai ◽  
Xiaotian Xu ◽  
Aiwu Zhang ◽  
Jianwen Lin ◽  
Xiaojuan Wang ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Life Quality ◽  
Executive Dysfunction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Background. Chronic migraine with medication overuse headache (CM-MOH) is the most common type of chronic migraine, and it increases risk of stroke and white matter lesions. These pathologic changes could induce cognitive decline. However, the alteration of cognitive function in CM-MOH patients is not established. Therefore, we took this study to reveal the cognitive performances in CM-MOH. Methods. This cross-sectional study was conducted between December 2015 and January 2017. Patients were divided into CM-MOH, CMwoMOH (chronic migraine without medication overuse), and MO (migraine without aura) groups. Cognitive function was assessed in all cases during interictal periods using Addenbrooke’s Cognitive Examination Test (ACE-R), Trail Making Test A/B (TMT A/B), and Digit Symbol Test (DST). Detailed headache characteristics and evaluation of anxiety, depression, and living and sleep quality were collected. Results. 116 patients were included in this study. There were 21 CM-MOHs, 20 CMwoMOHs, 35 MOs, and 40 controls. Age and education were the independent risk factors of cognitive decline (P<0.05). After adjusting, the risk of cognitive decline was higher in CM compared with control in ACE-R score and language fluency (P<0.05). In addition, CM-MOH sufferers were in higher risk of memory and executive dysfunction (P<0.05). The cognitive function had no difference between CM-MOH and CMwoMOH (P>0.05). Meanwhile, CM-MOH got significantly higher scores than MO in anxiety and depression, with poorer performances in sleep and life quality (P<0.05). Conclusion. The risk of cognitive decline increased in chronic migraine patients. Nonsteroid anti-inflammatory drugs overuse had no influence on cognitive performances among chronic migraine sufferers.

Interim analysis of the Registry for Load and Management of Medication Overuse Headache (RELEASE): A multicenter, comprehensive medication overuse headache registry

Cephalalgia ◽  
2021 ◽  
pp. 033310242110571
Author(s):  
Hong-Kyun Park ◽  
Min Kyung Chu ◽  
Sun-Young Oh ◽  
Heui-Soo Moon ◽  
Tae-Jin Song ◽  
...  
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Treatment Strategies ◽  
Severe Depression ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
The Past ◽  
History Of ◽  
Chronic Headaches

Background Characteristics, disabilities, and optimal management of medication overuse headache remain uncertain. This study aimed to elucidate the clinical characteristics of patients with medication overuse headache enrolled in a medication overuse headache registry in Korea. Methods The Registry for Load and Management of MEdicAtion OveruSE Headache (RELEASE), a cross-sectional prospective observational study including seven referral headache centers in Korea, started enrolling adult patients with medication overuse headache in April 2020. Data included information on headache characteristics, burden on daily function, depression, anxiety, history of acute and preventive medications, and treatment strategies. Results A total of 229 patients (85.6% females; mean age, 45.5 ± 13.5 years) were enrolled by June 2021. The average durations of chronic headaches and medication overuse were 6.5 and 4.3 years, respectively. In the past month before enrollment, patients had headaches for 25 days and severe headaches for 12 days, and used acute medications for 20 days. Patients were disabled in 66.8 days in the past 3 months and had moderate/severe depression and anxiety in 56% and 35%, respectively. The proportion of patients on preventive treatments increased from 38% to 93% during the study period. Conclusions RELEASE study reflects the current management status and opportunities to improve the quality of care in patients with medication overuse headache.

White matter lesions in chronic migraine with medication overuse headache: a cross-sectional MRI study

2014 ◽  
Vol 261 (4) ◽  
pp. 784-790 ◽  
Author(s):  
Zhenyang Zheng ◽  
Zijian Xiao ◽  
Xiaolei Shi ◽  
Minghui Ding ◽  
Wei Di ◽  
...  
Keyword(s):  
White Matter ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
White Matter Lesions ◽  
Cross Sectional ◽  
Mri Study

scholarly journals Sociodemographic characteristics of patients with chronic headache

2020 ◽  
pp. 22-24
Author(s):  
Patrick Giordanni Gomes Sampaio ◽  
Hiago Diniz Maracajá ◽  
Sara Raquel Nóbrega Figueiredo ◽  
Virgínia Gabriela Nóbrega Figueiredo ◽  
Túlio Carneiro Monteiro Temoteo ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Interpersonal Relationships ◽  
Medical Records ◽  
Chronic Headache ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Cross Sectional Study ◽  
Secondary Headache ◽  
Cross Sectional ◽  
Number Of Patients

Introduction: Headache is an entity characterized by a painful process in the cephalic segment and may originate from cranial or facial structures, being considered a common medical complaint. The chronification process of the pain can present a decrease in quality, the functional capacity and the patient’s and labor environment, and also as well as affect their interpersonal relationships, since the chronic cephalalgic process can lead the patient to moments of social isolation, mood swings, depression. Methods: The research was conducted through a retrospective cross-sectional study, performing the analysis of medical records of patients seen at the Unifacisa’s outpatient neurology School Clinic complaining of chronic headache, from February 1st to August 31, 2019. Results: With the analysis of the medical records, 684 attendances were obtained, where 30 of the patients treated had the diagnosis of chronic headache, 29 women and 01 man. These patients received the following diagnoses: 18 (60%) patients with chronic migraine without aura, 4 (13.3%) patients with chronic migraine with aura, 12 (40%) patients with chronic daily medication overuse headache, 9 (30%) patients with chronic tensiontype headache (CTTH), 1 (3.3%) patient with basilar migraine, 2 (6.6%) patients with secondary headache. Conclusion: Although a small number of chronic headache patients were obtained, yet we realize that it is the migraine that leads to a greater demand for specialized medical care. In addition, as expected due to the latest research, a significant number of patients with headache due to excessive use of common painkillers.

scholarly journals P060. Vitamin D deficiency in episodic migraine, chronic migraine and medication-overuse headache patients

2015 ◽  
Vol 16 (S1) ◽  
Author(s):  
Rosario Iannacchero ◽  
Amerigo Costa ◽  
Aida Squillace ◽  
Luca Gallelli ◽  
Umberto Cannistrà ◽  
...  
Keyword(s):  
Vitamin D ◽  
Chronic Migraine ◽  
Vitamin D Deficiency ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Episodic Migraine ◽  
Headache Patients

New Daily Persistent Headache in a Pediatric Population

2021 ◽  
pp. 088307382110045
Author(s):  
Eric Strong ◽  
Emily Linda Pierce ◽  
Raquel Langdon ◽  
Jeffery Strelzik ◽  
William McClintock ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Medication Overuse ◽  
Pediatric Population ◽  
Medication Overuse Headache ◽  
Activity Level ◽  
New Daily Persistent Headache ◽  
Tertiary Referral Center ◽  
Preventive Medication ◽  
Headache Clinic ◽  
Persistent Headache

Introduction: New daily persistent headache (NDPH) is a primary headache disorder characterized by an intractable, daily, and unremitting headache lasting for at least 3 months. Currently, there are limited studies in the pediatric population describing the characteristics of NDPH. Objective: The objective of the current study is to describe the characteristics of NDPH in pediatric patients presenting to a headache program at a tertiary referral center. Methods: The participants in the current study were pediatric patients who attended the Headache Clinic at Children’s National Hospital between 2016 and 2018. All patients seen in the Headache Clinic were enrolled in an institutional review board–approved patient registry. Results: Between 2016 and 2018, NDPH was diagnosed in 245 patients, representing 14% of the total headache population. NDPH patients were predominantly female (78%) and white (72%). The median age was 14.8 years. The median pain intensity was 6 of 10 (standard deviation = 1.52). Most patients reported experiencing migrainous features, namely, photophobia (85%), phonophobia (85%), and a reduced activity level (88%). Overall, 33% of patients had failed at least 1 preventive medication, and 56% had failed at least 1 abortive medication. Furthermore, 36% of patients were additionally diagnosed with medication overuse headache. Conclusion: NDPH is a relatively frequent disorder among pediatric chronic headache patients. The vast majority of these patients experience migrainous headache characteristics and associated symptoms and are highly refractory to treatment—as evidenced by a strong predisposition to medication overuse headache and high rates of failed preventive management.

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