Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The view that "spreading oligemia" reflects spreading depression in the human brain during the migraine aura is based on a defective analysis of CBF data where the most important methodological source of error (scattered radiation) has been ignored. When scattered radiation is taken into account it appears that CBF in the low flow area during the migraine aura is reduced to the ischemic level. There is no reason to believe that "spreading" of the low flow area occurs. Most likely the blood flow decreases in an area of fixed size. All available CBF evidence in fact lends support to "the vascular theory" of migraine pathogenesis.
Cephalalgia 1993 Apr
PMID:Spreading oligemia in the migraine aura--most likely an artifact due to scattered radiation. 849 61

The thalamus is believed to play an integrative role in the central nervous system. In the present study, thalamic rCBF was measured in 65 CVD patients and 15 normal volunteers by stable Xe/CT scanning. ROIs were chosen in the thalamic slice at a level 5cm over the OM line, and mean CBF was 7 cm over the OM line. The clinical factors focused on in multiple regression analysis were: age (A), sex (Se), stage from onset (St), lesion side (Sd); unilaterality or bilaterality, size (Sz) thalamic lesion (Tl). GCS (G), HDS-R (H); Hasegawa dementia score (revised), symptoms (Ss) such as anxiety, dizziness, head-headed feeling and headache, and neurological deficits (N). Each factor was graded and scored. Statistically, there was a significant correlation between thalamic rCBF (Y) and mean CBF (X) in the less affected hemisphere: Y = 1.82X + 2.2, r = 0.801, p < 0.001, n = 65. Multiple regression analysis of the thalamic rCBF revealed that the Sz factor was significant (p < 0.0001) on the lesion side: Y = 76.7-10.2Sz, r = 0.644, p < 0.001, n = 51, while the Se, Sd and St factors were significant (p < 0.005) on the less affected side: Y = 71.9 + 9.7Se-6.8Sd-5.0St, R = 0.585, p < 0.001, n = 65. The thalamic index (X), an indicator of thalamic atrophy, and thalamic rCBF were significantly correlated: Y = 28.7X + 10.2, r = 0.386, p < 0.001, n = 80. In conclusion, thalamic rCBF appeared to reflect the degree of organic changes and time course in the cerebral hemisphere, because factors such as size, sex and stage were statistically significant.
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PMID:[Assessment of thalamic regional cerebral blood flow in patients with cerebrovascular disease]. 888 29

Migraine headaches usually decrease in frequency and severity and often cease during advancing age. Occasionally, migraineurs report late-life migrainous accompaniments, i.e., auras without headache, particularly when typical migraine attacks terminate or diminish following major or minor strokes, at which time the auras may become atypical. Clinical observations such as these suggest that degenerative cerebrovascular changes accompanying aging may modify the course of migraine headaches particularly those with aura. To test this hypothesis, we quantitated age-related changes in cerebral vasodilator capacitance by measuring local cerebral blood flow utilizing xenon contrast computed tomography (CT) scanning before and after oral administration of the pharmacological cerebral vasodilator, acetazolamide (Diamox). Measurements were compared among 27 normal volunteers without headache (aged 24-94 years; mean age 61.1 +/- 17.6) and 37 carefully categorized groups of migraine patients (aged 27-83 years; mean age 59.4 +/- 12.4). The normals comprised Group A. Migraineurs were divided into two subgroups: Group B consisted of 27 migraineurs with and without aura who continued to suffer from incapacitating and frequent headaches and Group C consisted of 10 migraineurs who no longer suffered from severe and frequent headaches, two of whom still complained of atypical auras of the "late-life migrainous accompaniments" type. Cerebral vasodilator capacitance significantly declined with advancing age among normals and the two groups of migraineurs, confirming the development of age-related cerebrovascular diseases. Global CBF increases after Diamox in Group B (with persistent and severe migraine), were significantly greater compared with normals without headache, and with Group C consisting of migraineurs whose headaches had decreased, subsided, or become replaced by late-life migrainous accompaniments (Group C). Results establish that cerebrovasodilator capacitance declines with advancing age, probably due to progressive cerebral atherosclerosis, since these declines were accentuated by risk factors for stroke, particularly TIAs or documented lacunar infarcts by CT. Progressive impairments of cerebral vasodilator capacitance among migraineurs were associated with: (i) reductions in frequency and severity of migrainous cephalalgia and (ii) appearance of late-life migrainous accompaniments.
Cephalalgia 1998 May
PMID:Age-related cerebrovascular disease alters the symptomatic course of migraine. 964 95

Isolated angiitis of the central nervous system (IAC) is an inflammatory, rare vasculopathy confined to the central nervous system, and the exact etiology has remained uncertain. We report serial changes in the vasculature and the mean cerebral blood flow (mCBF) in two patients with IAC. The first patient, a 58-year-old female, had sudden onset of severe headache and CT 4 days later showed cerebral hemorrhage in the frontal lobe. MRA revealed that the main trunks were dilated on admission, whereas two weeks later, diffuse narrowing of affected arteries occurred in multiple vascular distributions. She required about two months for almost full recovery in MRA findings. Mean CBF during the period of vascular narrowing did not correlate with the form of vasculature, and was much the same as that in the chronic phase. The second patient, a 24-year-old female, presented with severe headache one day after delivery following an uncomplicated pregnancy. MRA findings showed that, at first, segmental stenoses were located only in the peripheral regions of the middle cerebral artery, but this vascular abnormality spread to the anterior, middle and posterior cerebral arteries. She showed almost full recovery in MRA findings after about 3 months. SPECT analysis showed approximately 35% decrease in mCBF compared with that in the chronic phase. In the first case, hyperemia, which was caused by inflammatory cells infiltrating into the brain parenchyma through the vessel wall, contributed to cerebral hemorrhage. On the other hand, in the second case it was presumed that because inflammation was restricted to the vascular wall, mCBF consequently correlated with the form of vasculature. Our experience suggests that IAC has several etiologies.
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PMID:[Chronological changes in the vasculature and the cerebral blood flow of two patients with isolated angiitis of the central nervous system]. 1367 6

This study is to investigate changes in regional cerebral blood flow (rCBF) of Alzheimer's disease (AD) in short-term treatment with acetylcholinesterase inhibitor (ChEI). rCBF was measured by single photon emission computed tomography (SPECT). CBF measurements were performed in 13 AD patients before treatment and 4 months later, while the control group with syncope or headache consisted of 17 patients. The clinical diagnosis of AD was based on the NINCDS-ADRDA criteria. Significant increases in rCBF were noted in the left angular, the right superior frontal gyrus, the right occipital, the left temporal lobe and the left orbital gyrus at the end of short-term therapy. Reduction in the rCBF before treatment is more profound in the left superior temporal, the right precentral and the both inferior frontal gyri compared with the control group. It achieved increase of rCBF after ChEI treatment. Also it overall increased in global cognitive functions including Korean Version Mini Mental State Examination (K-MMSE) and Clinical Dementia Rating (CDR). Treatment with ChEI for 4 months could increase rCBF and improve cognitive function of patients with AD.
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PMID:The short-term effect of acetylcholinesterase inhibitor on the regional cerebral blood flow of Alzheimer's disease. 1939 34

Study aimed at research of cerebral blood flow and blood NO contents in patients with chronic non-surgical nasal pathology with accompanying headaches. Eighty five patients with non-surgical chronic nasal pathology with accompanying headaches were investigated. Patients were divided in two age categories: 1st group of 58 patients (18 to 55 years), and 2nd group of 27 patients (>55 years). Control consisted of 30 age-matched healthy individuals. CBF was studied by means of Transcranial Doppler Imaging in patients and control. Free blood NO and NO - complexes were measured by Electron Paramagnet Resonance (EPR) method. Statistics performed by SPSS-11.0. In both age categories of patients the mean blood velocity in middle cerebral artery, anterior cerebral artery, basilar artery of patients was significantly increased against control (p<0.05). Pulsation index (PI) found to be decreased compared to control. The blood free NO signals were non-significantly increased against control. The intensive EPR signals of HbNO and FeSNO were revealed in patients and no signals were detected in control. No differences were revealed between clinical groups regarding the blood EPR signals of NO and NO-complexes (p<0.5). Negative correlation was found between the PI and intensity of headaches (r=-0.37; p<0.01). Multivariate linear regression analysis found the significance of longevity of chronic nasal pathology, Pulastion Index and blood hemoglobin contents for Intensity of headaches (p<0.05). It is concluded that CBF disturbances in chronic nasal pathology may result in intensive headaches.
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PMID:Headaches and cerebral blood flow disturbances in patients with chronic nasal pathology. 1980 27

Over the last decades MRI has proved to be very useful in the field of drug development and drug discovery. Pharmacological MRI (phMRI) explores the interaction between brain physiology, neuronal activity and drugs. The BOLD signal is an indirect method to investigate brain activity by way of measuring task related hemodynamic changes. Pharmacological substances that induce hemodynamic changes can therefore potentially alter the BOLD signal and in turn falsely can be interpreted as changes in neuronal activity. It is therefore important to characterize possible effects of a pharmacological substance on the BOLD response per se before that substance can be used in an fMRI experimental setup in order to avoid false positive or false negative results. Furthermore MRI and MRA is useful in determining the vascular site-of-action of vasoactive substances. Four substances; acetazolamide, GTN, CGRP and sumatriptan has been examined in double-blind placebo controlled crossover studies. The present thesis includes three papers with the aim to determine the site-of-action and to explore the effects of the pharmacological agents on the BOLD signal. Study I showed that acetazolamide depressed the BOLD signal by increasing CBF. GTN is known to increase CBV but had surprisingly no effect on the BOLD signal. This is probably because the GTN induces CBV increase is limited to the large arteries whereas the hemodynamic changes associated with the BOLD signal are anatomically located in the capillaries and venoules. Study II and III showed that systemic administration of CGRP induces immediate headache and dilates the MMA but contrarily to previous belief does not dilate the MCA. Nor does CGRP increase brain activity per se. Sumatriptan ameliorates headache, contracts MMA and marginally contrasts MCA without altering brain activity. In conclusion we found that acetazolamide depresses the BOLD signal while GTN does not alter the BOLD signal. While systemic administration of CGRP or sumatriptan has no direct effects on brain activity in healthy volunteers. Instead it seems that both migraine provoking peptide CGRP and anti-migraine drug sumatriptan exert their actions outside of the BBB. This thesis shows that phMRI is a powerful tool in understanding mechanisms and site-of-action of pharmacological compounds. phMRI could be a useful addition to the existing methods for development of future drugs.
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PMID:Effects of glyceryl trinitrate and calcitonin gene-related peptide on BOLD signal and arterial diameter: methodological studies by fMRI and MRA. 2275 54

Previous studies reported that long-term nociceptive stimulation could result in neurovascular coupling (NVC) dysfunction in brain, but these studies were based mainly on unimodal imaging biomarkers, thus could not comprehensively reflect NVC dysfunction. We investigated the potential NVC dysfunction in chronic migraine by exploring the relationship between neuronal activity and cerebral perfusion maps. The Pearson correlation coefficients between these 2 maps were defined as the NVC biomarkers. NVC biomarkers in migraineurs were significantly lower in left inferior parietal gyrus (IPG), left superior marginal gyrus (SMG) and left angular gyrus (AG), but significantly higher in right superior occipital gyrus (SOG), right superior parietal gyrus (SPG), and precuneus. These brain regions were located mainly in parietal or occipital lobes and were related to visual or sensory information processing. ALFF-CBF in right SPG was positively correlated with disease history and that in right precuneus was negatively correlated with migraine persisting time. fALFF-CBF in left SMG and AG were negatively related to headache frequency and positively related to health condition and disease history. In conclusion, multi-modal MRI could be used to detect NVC dysfunction in chronic migraine patients, which is a new method to assess the impact of chronic pain on the brain.
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PMID:Multi-modal MRI Reveals the Neurovascular Coupling Dysfunction in Chronic Migraine. 3168 27


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