scholarly journals Vitamin D, Chronic Migraine, and Extracranial Pain: Is There a Link? Data From an Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Valentina Rebecchi ◽  
Daniela Gallo ◽  
Lucia Princiotta Cariddi ◽  
Eliana Piantanida ◽  
Payam Tabaee Damavandi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Primary Headache ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Exact Test ◽  
Pain Chronification ◽  
Type Headache

Several studies focused on the role of vitamin D (vitD) in pain chronification. This study focused on vitD level and pain chronification and extension in headache disorders. Eighty patients with primary headache underwent neurological examination, laboratory exams, including serum calcifediol 25(OH)D, and headache features assessment along with three questionnaires investigating depression, anxiety, and allodynia. The 86.8% of the population had migraine (48% episodic and 52% chronic). The 44.1% of patients had extracranial pain, and 47.6% suffered from allodynia. A vitD deficit, namely a serum 25(OH)D level <20 ng/ml, was detectable in 46.1% of the patients, and it occurred more frequently (p = 0.009) in patients suffering from chronic migraine (CM)–medication overuse migraine (MOH) (62.9%) than in episodic migraine (EM, 25.7%) or tension-type headache (TTH, 11.4%). The occurrence of extracranial pain and allodynia was higher in the CM-MOH than in the EM and in the TTH groups but was not related to the co-occurrence of vitD deficiency (Fisher's exact test p = 0.11 and p = 0.32, respectively). Our findings show that 25(OH)D deficit is also related to chronic headache, probably because of vitD anti-inflammatory and tolerogenic properties, reinforcing the idea of a neuroinflammatory mechanism underpinning migraine chronification.

scholarly journals Vitamin D, Chronic Migraine and Extracranial Pain: Is there a Link? Data from an Observational Study.

2020 ◽  
Author(s):  
Valentina Rebecchi ◽  
Daniela Gallo ◽  
Lucia Princiotta Cariddi ◽  
Eliana Piantanida ◽  
Payam Tabaee Damavandi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Antinociceptive Effect ◽  
Primary Headache ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Exact Test ◽  
Type Headache

Abstract Background: Several studies focused on the possible role of vitamin D (vitD) in pain chronicization.. The aim of this study was to assess the potential implications of VitD deficit on headache characteristics and extracranial pain extension.Methods: Eighty consecutive patients with primary headache underwent neurological examination, laboratory exams including serum calcifediol 25(OH)D and headache features assessment along with three questionnaires investigating depression, anxiety and allodynia. Results: The 82.6% of the population had migraine (48% episodic and 52% chronic form). The 45% of patients had extracranial pain and 47% suffered from allodynia. In the 45% of patients had a VitD deficit since the serum 25(OH)D levels fell below the cut-off level of 20 ng/ml. The occurrence of VitD deficit was significantly higher (p=0.009) in patients suffering from chronic migraine (CM)- medication overuse migraine (MOH) (64.7%) than in episodic migraine (EM) or tension type headache (TTH). The occurrence of subjects with extracranial pain and allodynia was higher, as expected, in the CM-MOH than in the EM and in the TTH groups but was not related to the co-occurrence of vit-D deficiency (Fischer’s exact test p=0.11 and p=0.32 respectively).Conclusions: Our findings show that 25(OH)D deficit is related to chronic pain suggesting that vitD probably has anti-inflammatory and tolerogenic properties, rather than a direct antinociceptive effect, and reinforce the idea of a neuroinflammatory mechanisms underpinning migraine chronicization.

Clinical Features of Probable Medication-Overuse Headache: A Retrospective Study in Japan

Cephalalgia ◽  
2007 ◽  
Vol 27 (9) ◽  
pp. 1020-1023 ◽  
Author(s):  
N Imai ◽  
E Kitamura ◽  
T Konishi ◽  
Y Suzuki ◽  
M Serizawa ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Migraine ◽  
Clinical Picture ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Headache Type ◽  
Combination Analgesics ◽  
Type Headache

This study examined the clinical picture of probable medication-overuse headache (MOH) and the presence of any features peculiar to Japan. In a retrospective study of 47 patients, type of primary headache, type of medicine overused, method and result of withdrawal were investigated. Among the 47 patients, 80.9% had migraine only, and 85.1% overused combination medications. While 36 patients (76.6%) succeeded in withdrawal, five patients (10.6%) failed. One patient (2.1%) had not improved by 2 months after withdrawal and was diagnosed with chronic migraine and chronic tension-type headache without MOH. The remaining five patients (10.6%) dropped out. All dropout patients were recommended abrupt inpatient withdrawal, but chose abrupt outpatient withdrawal. As features peculiar to Japan, many patients with probable MOH overused combination analgesics, particularly females.

Prevalence of Primary Headaches in People with Multiple Sclerosis

Cephalalgia ◽  
2004 ◽  
Vol 24 (11) ◽  
pp. 980-984 ◽  
Author(s):  
D D'Amico ◽  
L La Mantia ◽  
A Rigamonti ◽  
S Usai ◽  
N Mascoli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Exact Test ◽  
Relapsing Remitting ◽  
Type Headache ◽  
Ms Therapy

The aim was to investigate the lifetime prevalence of headache and primary headache (diagnoses according to International Headache Society criteria) in multiple sclerosis (MS). The relationships between headache and clinical features of MS and MS therapy were also investigated. We studied 137 patients with clinically definite MS; 88 reported headache, 21 of whom developed headache after the initiation of interferon. The prevalence of all headaches in the remaining 116 patients was 57.7%. Migraine was found in 25.0%, tension-type headache in 31.9%, and cluster headache in one patient. A significant correlation ( P = 0.007, Fisher's exact test) between migraine and relapsing-remitting MS was found. Primary headaches are common in MS patients. Further studies are needed to clarify the mechanisms underlying this association, particularly the association between migraine and relapsing-remitting MS, and the role of interferon in the development of new headache.

Neurovascular Headache and A Midbrain Vascular Malformation: Evidence for A Role of the Brainstem in Chronic Migraine

Cephalalgia ◽  
2002 ◽  
Vol 22 (2) ◽  
pp. 107-111 ◽  
Author(s):  
PJ Goadsby
Keyword(s):  
Chronic Migraine ◽  
Functional Imaging ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Positron Emission ◽  
Neurovascular Headache ◽  
Daily Headache ◽  
Type Headache

Migraine is a common, disabling form of primary headache that has been linked by functional imaging studies to activation in the rostral brainstem. In specialty clinics migraine is most commonly seen in association with frequent less feature full headache that has been called transformed migraine or more recently termed chronic migraine. A patient is described with frequent migraine, 3 days per week, and less feature full headaches on other days. The patient has a cavernoma in the midbrain that has bled. She was previously headache free and now has contralateral daily headache. The patient supports the functional imaging observations from positron emission tomography (PET) that the rostral brainstem is pivotal in migraine pathophysiology, particularly the contralateral midbrain periaqueductal grey matter. Moreover, the patient's lesion provides biologically plausible support that a single entity causes her clinical presentation: chronic migraine, not two-disorders, migraine and tension-type headache.

The impact of parental attitudes toward children with primary headaches

2019 ◽  
Vol 24 (4) ◽  
pp. 767-775
Author(s):  
Devrimsel Harika Ertem ◽  
Ayhan Bingol ◽  
Busra Ugurcan ◽  
Özlem Mercan ◽  
Ismail Simsek ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Parental Attitudes ◽  
Episodic Migraine ◽  
Attitude Scale ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Scale Scores ◽  
Vas Scores ◽  
Attitudes Toward Children ◽  
Type Headache

There is a lack of data on parental attitudes toward children with primary headaches. The aim of this study is to determine whether there is a relationship between primary headaches and parental attitudes in the pre-adolescent pediatric population. In this cross-sectional study, 195 children with primary headache and 43 healthy children aged 9–16 years were included. A questionnaire for sociodemographic variables, visual analog scale (VAS), Social Anxiety Scale and Depression Inventory for Adolescents and Children, and Parental Attitudes Determining Scale (PATS), which is an attitude measure specifically designed to evaluate psychological adjustment, were administered. Of 195 children (female/male ratio: 89/106, mean age: 12.59 ± 1.09 years), episodic migraine ( n = 90), chronic migraine ( n = 25), and tension-type headache ( n = 80) were evaluated. There was no significant difference among headache groups and healthy subjects in terms of depression, anxiety, and fathers’ attitude scale scores. However, there were significant differences in mean mothers’ attitude scale scores and VAS scores ( p = .002, p = .000). Mean oppressive-authoritarian attitude subscale scores of mothers’ was significantly higher in children with chronic migraine ( p = .000). A relationship between depression and VAS scores among all patient groups was detected ( p = .000). Parental age was negatively related to PATS scores of children with episodic migraine and tension-type headache ( p = .037 and p = .036). Parental attitudes may elevate psychiatric symptoms and influence children’s perception of pain intensity and result in chronification of headache. Our findings support that mothers’ attitude toward children with chronic migraine has strong impacts on the child’s pain experience.

MMPI Personality Profiles in Patients With Primary Headache Syndromes

Cephalalgia ◽  
1991 ◽  
Vol 11 (6) ◽  
pp. 263-268 ◽  
Author(s):  
Volker Pfaffenrath ◽  
Josef Hummelsberger ◽  
Walter Pöllmann ◽  
Holger Kaube ◽  
Michael Rath
Keyword(s):  
Cluster Headache ◽  
Minnesota Multiphasic Personality Inventory ◽  
Normal Population ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Personality Profiles ◽  
Mean Values ◽  
Ihs Criteria ◽  
Type Headache

The role of psychological factors in the course of primary headache syndromes is still controversial. Using the Minnesota Multiphasic Personality Inventory (MMPI) we investigated the personality profiles of 434 headache patients (160 migraineurs, 95 with tension type headache, 30 with cluster headache and 149 with combination headache) in accordance with the IHS criteria. In the first three MMPI scales (hypochondria, depression, hysteria) there was a slight increase in T mean values to over 60, but still in the range of two standard deviations of the normal population. There were no statistically significant differences between the four headache groups and between patients with and without analgesic abuse. It was impossible to distinguish headache groups on the basis of their personality profiles by means of reclassification with discriminant analysis. In a cluster analysis, patients with cluster headache showed the highest number (20%) of abnormalities, but also the highest percentage (13%) of completely normal results. Our findings- a cross section analysis of personality profiles-contradict many other MMPI-based studies.

scholarly journals Integrative East–West Medicine Intervention for Chronic Daily Headache: A Case Report and Care Perspective

2020 ◽  
Vol 9 ◽  
pp. 216495612090581
Author(s):  
Justin G Laube ◽  
Thais Salles Araujo ◽  
Lawrence B Taw
Keyword(s):  
Chronic Migraine ◽  
Chronic Daily Headache ◽  
Medication Overuse ◽  
Trigger Point ◽  
Tension Type Headache ◽  
Contributing Factors ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Type Headache ◽  
East West

Chronic daily headache is a group of headache syndromes including most commonly chronic migraine and chronic tension-type headache, which often overlap, are complicated by medication overuse and are disabling, costly, and variable responsive to western pharmacotherapeutic interventions. There is growing research and awareness of integrative health approaches and therapies to address patients with chronic headache, yet limited examples of how to deliver this approach. This article reviews a commonly seen challenging case of a patient with overlapping chronic migraine and chronic tension-type headache complicated by medication overuse managed with an integrative east–west medicine intervention. This included person-centered biopsychosocial history taking, traditional Chinese medicine informed acupuncture, trigger point injections, and contributing factors modifications. A narrative review of the literature is presented to demonstrate an evidence-informed rationale for incorporating nonpharmacologic approaches to effectively help reduce the symptom burden of this patient population.

CGRP in human models of primary headaches

Cephalalgia ◽  
2016 ◽  
Vol 38 (2) ◽  
pp. 353-360 ◽  
Author(s):  
Håkan Ashina ◽  
Henrik Winther Schytz ◽  
Messoud Ashina
Keyword(s):  
Treatment Strategies ◽  
Primary Headache ◽  
Experimental Models ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Human Models ◽  
New Treatment ◽  
Type Headache ◽  
Methodological Aspects

Objective To review the role of CGRP in human models of primary headaches and to discuss methodological aspects and future directions. Discussion Provocation experiments demonstrated a heterogeneous CGRP migraine response in migraine patients. Conflicting CGRP plasma results in the provocation experiments are likely due to assay variation; therefore, proper validation and standardization of an assay is needed. To what extent CGRP is involved in tension-type headache and cluster headache is unknown. Conclusion Human models of primary headaches have elucidated the role of CGRP in headache pathophysiology and sparked great interest in developing new treatment strategies using CGRP antagonists and antibodies. Future studies applying more refined human experimental models should identify biomarkers of CGRP-induced primary headache and reveal whether CGRP provocation experiments could be used to predict efficacy of CGRP antagonists in migraine patients.

Medication Overuse Headache and Chronic Migraine in a Specialized Headache Centre: Field-Testing Proposed New Appendix Criteria

Cephalalgia ◽  
2009 ◽  
Vol 29 (2) ◽  
pp. 214-220 ◽  
Author(s):  
P Zeeberg ◽  
J Olesen ◽  
R Jensen
Keyword(s):  
Chronic Migraine ◽  
Pain Perception ◽  
Medication Overuse ◽  
International Headache Society ◽  
Medication Overuse Headache ◽  
Field Testing ◽  
Tension Type Headache ◽  
Main Body ◽  
Headache Centre ◽  
Type Headache

The classification subcommittee of the International Headache Society (IHS) has recently suggested revised criteria for medication overuse headache (MOH) and chronic migraine (CM). We field tested these revised criteria by applying them to the headache population at the Danish Headache Centre and compared the results with those using the current criteria. For CM we also tested two alternative criteria, one requiring ≥ 4 migraine days/month and ≥ 15 headache days/month, the second requiring ≥ 15 headache days/month and ≥ 50% migraine days. We included 969 patients with migraine or tension-type headache (TTH) among 1326 patients treated and dismissed in a 2-year period. Two hundred and eighty-five patients (30%) had TTH, 265 (27%) had migraine and 419 (43%) had mixed migraine and TTH. The current criteria for MOH classified 86 patients (9%) as MOH, 98 (10%) as probable MOH and 785 (81%) as not having MOH after a 2-month drug-free period. Using the appendix criteria, 284 patients (29%) were now classified as MOH, no patients as probable MOH and 685 (71%) as not having MOH. For CM only 16 patients (3%) fulfilled the current diagnostic criteria. This increased to 42 patients (7%) when we applied the appendix criteria. Using the less restrictive criteria of ≥ 4 migraine days and ≥ 15 headache days, 88 patients (14%) had CM, whereas the more restrictive criteria of ≥ 15 headache days and ≥ 50% migraine days resulted in 24 patients (4%) with CM. Our data suggest that the IHS has succeeded in choosing new criteria for CM which are neither too strict, nor too loose. For MOH, a shift to the appendix criteria will increase the number of MOH patients, but take into account the possibility of permanent changes in pain perception due to medication overuse and the possibility of a renewed effect of prophylactic drugs due to medication withdrawal. We therefore recommend the implementation of the appendix criteria for both MOH and CM into the main body of the International Classification of Headache Disorders.

The role of tyrosine metabolism in the pathogenesis of chronic migraine

Cephalalgia ◽  
2013 ◽  
Vol 33 (11) ◽  
pp. 932-937 ◽  
Author(s):  
Giovanni D’Andrea ◽  
Domenico D’Amico ◽  
Gennaro Bussone ◽  
Andrea Bolner ◽  
Marco Aguggia ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Plasma Levels ◽  
High Plasma ◽  
Tension Type Headache ◽  
Predisposing Factor ◽  
Tyrosine Metabolism ◽  
Potent Agonist ◽  
Type Headache

Objective: The pathogenesis of chronic migraine (CM) remains largely unknown. We hypothesized that anomalies of tyrosine metabolism, found in migraine without aura (MwwA) patients, play an important role in the transformation of MwwA into CM, since the increase in the number of MwwA attacks is the most predisposing factor for the occurrence of CM. Methods: To test our hypothesis we measured the plasma levels of dopamine (DA), noradrenaline (NE) and trace amines, including tyramine (TYR) and octopamine (OCT), in a group of 73 patients with CM, 13 patients with chronic tension-type headache (CTTH) and 37 controls followed in the Headache Centers of the Neurology Departments of Asti, Milan and Vicenza hospitals in Italy. Results: The plasma levels of DA and NE were several-fold higher in CM patients compared with control subjects ( p > 0.001). The plasma levels of TYR were also extremely elevated ( p > 0.001); furthermore, these levels progressively increased with the duration of the CM. Conclusions: Our data support the hypothesis that altered tyrosine metabolism plays an important role in the pathogenesis of CM. The high plasma levels of TYR, a potent agonist of the trace amine associated receptors type 1 (TAAR1), may ultimately down-regulate this receptor because of loss of inhibitory presynaptic regulation, therein resulting in uncontrolled neurotransmitter release. This may produce functional metabolic consequences in the synaptic clefts of the pain matrix implicated in CM.

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