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 clinical characteristics of migraine without aura (MO) and migraine with aura (MA) were compared in 484 migraineurs from the general population. We used the criteria of the International Headache Society. The lifetime prevalence of MO was 14.7% with a M:F ratio of 1:2.2; that of MA was 7.9% with a M:F ratio of 1:1.5. The female preponderance was significant in both MO and MA. The female preponderance was present in all age groups in MA, but was first apparent after menarche in MO, suggesting that female hormones are an initiating factor in MO, but not likely so in MA. The age at onset of MO followed a normal distribution, whereas the age at onset of MA was bimodally distributed, which could be explained by a composition of two normal distributions. The estimated separation between the two groups of MA was at age 26 years among the females and age 31 years among the males. The observed number of persons with co-occurrence of MO and MA was not significantly different from the expected number. The specificity and importance of premonitory symptoms are questioned, but prospective studies are needed. Bright light was a precipitating factor in MA, but not in MO. Menstruation was a precipitating factor in MO, but not likely in MA. Both MO and MA improved during pregnancy. The clinical differences indicate that MO and MA are distinct entities.
Cephalalgia 1996 Jun
PMID:Migraine without aura and migraine with aura are distinct clinical entities: a study of four hundred and eighty-four male and female migraineurs from the general population. 879 27

Two patients are described who were originally published in Reports of medical cases (1827; 1831) by Richard Bright. The first patient suffered from haematuria and oedema (dropsy) and died after acute epiglottitis. At autopsy the kidneys were swollen and haemorrhagic (acute glomerulonephritis in present terms). The second patient died after two episodes of acute headache and decreased consciousness. At autopsy an aneurysmatic dilatation of a brain artery was found. Today the diagnosis of acute glomerulonephritis or subarachnoid haemorrhage would have been made from the history and physical examination, and newly developed laboratory and histological techniques would have been helpful in securing it. But even nowadays, clinical skills are still continually expanding by feedback from new diagnostic techniques.
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PMID:[Importance of supplementary testing for diagnostic proficiency at the bedside]. 1063 94

Circadian system is master clock of daily sleep-wake cycle. It is able to create periodic activity with a period of almost 24 hours autonomously, and is able to entrain itself to day-night cycle of environment using with daily change of sunlight as time clue. Circadian rhythm sleep disorders (CRSDs) are defined as sleep disorders caused by misalignment between internal circadian clock and social schedule. Insomnia, hypersomnia, headache or intestinal symptoms are common complaints of CRSD patients, and these symptoms may deteriorate patients' social function. Jet lag disorder and shift work disorder are originated by acute shift of social schedule that exceed ability of circadian entrainment. However, pathophysiology of other CRSDs are not fully cleared. Treatments of CRSDs aim to facilitate circadian entrainment to desirable schedule with time clues at proper timing of circadian system. Bright light therapy (BLT) and melatonin administration are effective. Hypnotic administration is not effective in most cases.
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PMID:[Circadian rhythm sleep disorders]. 1976 31

Migraine is a neurological disorder characterized by episodic head pain and visual cortical phenomena. The pathogenesis of migraine is unknown and remains to be determined. Bright light, flickering light and certain visual patterns can trigger a migraine attack, and visual cortical hyperexcitability has been hypothesized to be responsible. Interictally, the brain of migraineurs functions normally under general conditions but abnormally only under some specific conditions, such as the observation of stressful visual patterns, suggesting studying the brain function could provide insights in migraine pathophysiology. The functional MRI technique is unique in probing specific cortical area activation under various stimulation conditions and studying the abnormal cortical activation associated with functional disorders in migraine. In this perspective, we discuss how a novel functional MRI technique can be used to identify those migraineurs suffering visual cortical hyperexcitability, and its potential as a biomarker to evaluate and possibly predict effectiveness of migraine-preventive treatments.
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PMID:Functional MRI as a biomarker for evaluation and prediction of effectiveness of migraine prophylaxis. 2291 53

Abstract Objective. Bright light therapy (BLT) is regarded to be an effective treatment against seasonal depression (SAD). Conventional BLT devices are reported to evoke few, but inconvenient symptoms. This study evaluated side effects associated with a new technology for BLT in a healthy population. Methods. In an uncontrolled study design 20 healthy Caucasians received 30 min light exposures on three consecutive mornings. Immediate side effects were evaluated using questionnaires. The new light cabin was equipped with fluorescent lamps (light colour 965 = 6,500 K, CRI >90) with a maximum illumination of 5,000 lux and a maximum luminance of 1,500 cd/m(2). Occurrence of headache was determined to be the main objective. Results. Nineteen volunteers completed the study. No headache was reported at any time. With a prevalence of 21.1% blurring was observed to occur more often after light exposure. Conclusion. With the evaluated light cabin the most prominent short-term side effects of BLT can be minimized, enhancing patients' adherence.
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PMID:Bright light therapy: Minimizing light induced side effects with an innovative light setup. 2491 44

Bright light can cause excessive visual discomfort, referred to as photophobia. The precise mechanisms linking luminance to the trigeminal nociceptive system supposed to mediate this discomfort are not known. To address this issue in healthy human subjects we modulated differentially visual cortex activity by repetitive transcranial magnetic stimulation (rTMS) or flash light stimulation, and studied the effect on supraorbital pain thresholds and the nociceptive-specific blink reflex (nBR). Low frequency rTMS that inhibits the underlying cortex, significantly decreased pain thresholds, increased the 1st nBR block ipsi- and contralaterally and potentiated habituation contralaterally. After high frequency or sham rTMS over the visual cortex, and rMS over the right greater occipital nerve we found no significant change. By contrast, excitatory flash light stimulation increased pain thresholds, decreased the 1st nBR block of ipsi- and contralaterally and increased habituation contralaterally. Our data demonstrate in healthy subjects a functional relation between the visual cortex and the trigeminal nociceptive system, as assessed by the nociceptive blink reflex. The results argue in favour of a top-down inhibitory pathway from the visual areas to trigemino-cervical nociceptors. We postulate that in normal conditions this visuo-trigeminal inhibitory pathway may avoid disturbance of vision by too frequent blinking and that hypoactivity of the visual cortex for pathological reasons may promote headache and photophobia.
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PMID:Effects of visual cortex activation on the nociceptive blink reflex in healthy subjects. 2493 54

A number of drugs, including triptans, promote migraine chronification in susceptible individuals. In rats, a period of triptan administration over 7 days can produce "latent sensitization" (14 days after discontinuation of drug) demonstrated as enhanced sensitivity to presumed migraine triggers such as environmental stress and lowered threshold for electrically induced cortical spreading depression (CSD). Here we have used fMRI to evaluate the early changes in brain networks at day 7 of sumatriptan administration that may induce latent sensitization as well as the potential response to stress. After continuous infusion of sumatriptan, rats were scanned to measure changes in resting state networks and the response to bright light environmental stress. Rats receiving sumatriptan, but not saline infusion, showed significant differences in default mode, autonomic, basal ganglia, salience, and sensorimotor networks. Bright light stress produced CSD-like responses in sumatriptan-treated but not control rats. Our data show the first brain-related changes in a rat model of medication overuse headache and suggest that this approach could be used to evaluate the multiple brain networks involved that may promote this condition.
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PMID:Triptans disrupt brain networks and promote stress-induced CSD-like responses in cortical and subcortical areas. 2649 Feb 91