bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Role of Sink Patches in Source‐Sink Metapopulations: Reed Warbler in an Agricultural Landscape
Authors: Foppen Ruud P. B. , Chardon J. Paul , Liefveld Wendy
Published: August 2010

Abstract: Populations in agricultural landscapes often occur in source‐sink situations: small patches of marginal habitat (sinks) are supported by an immigration flux from larger patches of high‐quality habitat (sources). We sought to demonstrate that this situation occurs for Reed Warblers (Acrocephalus scirpaceus) in a riverine, mainly agricultural landscape in the Netherlands. We collected data on occurrence and habitat features in a large number of mostly small marshlands. We used a stochastic model to simulate the population dynamics in a metapopulation with sinks and sources. A statistical analysis of the field data, using regression techniques with occupation probability and abundance index as dependent variables, showed that habitat quality was less favourable in small habitat patches (e.g., ditches with reeds) than in larger patches ( large, heterogeneous marshlands). The spatial cohesion of the landscape also played an important role: abundance of breeding Reed Warblers in regions with low spatial cohesion was low. Local extinctions and recolonizations occurred, and their rates depended on the spatial parameters of the patch. This supports the hypothesis that metapopulation theory is applicable here. The results of the modeling study demonstrated that, besides the trivial dependence of sinks on sources, a larger amount of sink area and increased exchange of individuals increased the stability of source patches. This was shown not only by the larger size of the source population but also by increased resilience after a catastrophe. The area of the sink seemed less important than its distance to the source. The simulation indicated an optimal area of a few hectares (compared to a 10‐ha area of the source) and a maximum distance of 2–5 km from the source. In creating sustainable landscapes, for example, by setting up an ecological network consisting of a limited number of high‐quality patches, these small and seemingly insignificant habitat patches could play an important role and should be taken into consideration.
Habitat Mosaic, Wildlife Availability, and Hunting in the Tropical Forest of Calakmul, Mexico
Authors: Escamilla Alfredo , Sanvicente Mauro , Sosa Miguel , Galindo‐Leal Carlos
Published: August 2010

Abstract:Habitat loss and subsistence hunting are two of the main activities that affect wildlife in frontier areas. We compared subsistence hunting patterns in four villages with different ethnic composition and degree of habitat disturbance in the vicinity of Calakmul Biosphere Reserve, Campeche, Mexico. We also compared differences between some of these villages in harvest composition and prey availability to determine hunting preferences. We used a Landsat TM satellite image to analyze the degree of disturbance around the villages. We conducted periodic surveys of subsistence hunting and prey availability. Wildlife availability was assessed monthly on nine transects (3000 m) established in the vicinity of three villages. The relative amount of disturbed habitat was smaller in an indigenous Maya village ( IV ) and larger in a mestizo village ( MV ). The two mixed‐composition villages ( MCVs) had intermediate levels of disturbance. Ten species, four large and six small, of birds and mammals accounted for 97% of the hunting records. Hunting was more intense in IV and less intense in MCV1. The three village types had different hunting preferences. The habitat‐mosaic composition in the vicinity of the villages influenced prey availability and subsistence‐hunting preferences. Changes in the habitat mosaic were caused by the size of the holding and by ethnic composition. In spite of longer settlement time, the habitat mosaic in the vicinity of IV was less transformed than that of the other sites. Their larger holding size and greater diversity of economic activities may explain why the Mayas at IV have transformed the landscape less than the other groups and can hunt more and larger prey.
Roads, Development, and Conservation in the Congo Basin
Authors: Wilkie David , Shaw Ellen , Rotberg Fiona , Morelli Gilda , Auzel Philippe
Published: August 2010

Abstract: Road density is closely linked to market accessibility, economic growth, natural resource exploitation, habitat fragmentation, deforestation, and the disappearance of wildlands and wildlife. Research in the Republic of Congo shows that roads established and maintained by logging concessions intensify bushmeat hunting by providing hunters greater access to relatively unexploited populations of forest wildlife and by lowering hunters' costs to transport bushmeat to market. Reconciling the contrary effects of roads on economic development and biodiversity conservation is one of the key challenges to wildlife managers in all nations. As the Democratic Republic of Congo prepares to reconstruct its almost completely collapsed road system, the government, donors, and conservation organizations have a unique opportunity to strategically prioritize investment in segments of the network that would maximize local and national economic benefits while minimizing adverse effects on forest wildlife.
The Effect of Space‐Use Patterns of Reintroduced Asiatic Wild Ass on Effective Population Size
Authors: Saltz David , Rowen Mary , Rubenstein Daniel I.
Published: August 2010

Abstract: Empirical data on behavior, such as space‐use patterns, are important to the success of animal reintroductions. We studied space‐use patterns in a growing population of Asiatic wild ass (   Equus hemionus) reintroduced into the Ramon erosion cirque in the Negev desert, Israel. Between 1988 and 1995 we used direct observation to determine the location and association of males and females. All adult females and dominant males were individually recognized. Home ranges of dominant males overlapped little, suggesting that in this population males are territorial. After the first release of males and females into the wild, only one territory was established, and it covered most of the 20,000 ha of the cirque. After 6 years the number of male territories increased as the number of males in the population increased, and average territory size decreased. Male territories were near permanent and ephemeral water sources, but the water sources were at the peripheries of the territories and were not centers of activity. When there was only one territorial male, female home ranges were almost entirely within the territory. As male territory size decreased, so did the spatial association of females with a single male. During the breeding season, males spent more time in close association with female groups, adopting what may temporarily appear to be a harem breeding strategy. Although demographic and environmental factors pose a greater threat to small populations, our data support the hypothesis that in small, reintroduced populations of territorial, polygynous species, effective population size (  Ne  ) may be dangerously small. Our data suggest that this situation may last for several years until new males are recruited into the population. Thereafter, rapid male turnover and female use of several male territories may ameliorate this problem. We found no relationship between male turnover rate and female reproductive success. The establishment of more male territories is key to increasing Ne and should be the basis for planning reserves for territorial, polygynous species.
Consequences of Embryonic UV‐B Exposure for Embryos and Tadpoles of the Plains Leopard Frog
Authors: Smith Geoffrey R. , Waters Mary Ann , Rettig Jessica E.
Published: August 2010

Abstract: In organisms with complex life cycles, understanding the effects of environmental change requires investigating the possibility that the effect of such change on one stage will have consequences for other stages. We investigated the effects of embryonic exposure to UV‐B radiation on embryo and tadpole development of the plains leopard frog (  Rana blairi). Embryos were exposed to sunlight filtered to provide two levels of UV‐B exposure (e.g., at 310 nm: high exposure is approximately 84% transmittance and low exposure is approximately 58% transmittance). Hatching success of embryos exposed to different UV‐B levels did not differ. Tadpoles resulting from exposed embryos were raised at three densities. Growth and development were slower in tadpoles exposed to higher UV‐B levels as embryos. Density negatively affected growth and development. Survivorship did not differ among UV‐B or density treatments. Our results suggest that even if lethal effects are not exhibited at one stage, sublethal effects may manifest themselves at other stages, possibly affecting the long‐term success of exposed individuals and populations.
The Application of IUCN Red List Criteria at Regional Levels
Authors: Gärdenfors Ulf , Hilton‐Taylor Craig , Mace Georgina M. , Rodríguez Jon Paul
Published: August 2010

This paper represents a work in progress by the World Conservation Union (IUCN). Earlier drafts of the work have appeared in IUCN publications, but the “International Issues” section of Conservation Biology seems an appropriate and important place to publish the penultimate version of the document. Comments on this issue in general or on the approach taken by the IUCN should be sent to the authors directly.

Joshua Ginsburg
Prescribed Burning to Restore Mixed‐Oak Communities in Southern Ohio: Effects on Breeding‐ Bird Populations
Authors: Artman Vanessa L. , Sutherland Elaine K. , Downhower Jerry F.
Published: August 2010

Abstract: Fire is being experimentally reintroduced to the forests of southern Ohio to determine its effectiveness in restoring and maintaining mixed‐oak ( Quercus spp.) forest communities. We studied the effects of repeated burning (1–4 years of annual burning) and recovery (1 year after burning ) on the breeding bird community. Burning resulted in incremental but temporary reductions in the availability of leaf litter, shrubs, and saplings, but it did not affect trees, snags, or understory vegetation cover. Of 30 bird species monitored, 4 were affected negatively and 2 were affected positively by burning. Population densities of Ovenbirds (  Seiurus aurocapillus), Worm‐eating Warblers (   Helmitheros vermivorus), and Hooded Warblers (   Wilsonia citrina) declined incrementally in response to repeated burning and did not recover within 1 year after burning, suggesting a lag time in response to the changes in habitat conditions. Densities of Northern Cardinals ( Cardinalis cardinalis) fluctuated among years in the control units, but remained low in the burned units. Densities of American Robins (   Turdus migratorius) and Eastern Wood‐Pewees ( Contopus virens) increased in response to burning, but these increases were apparent only after several years of repeated burning. In general, burning resulted in short‐term reductions in the suitability of habitat for ground‐ and low‐shrub‐nesting birds, but it improved habitat for ground‐ and aerial‐foraging birds. Overall, there were no changes in the composition of the breeding‐bird community. Total breeding bird population levels were also unaffected by burning. Our results suggest that prescribed burning applied on a long‐term basis or across large spatial scales is likely to have adverse effects on ground‐ and low‐shrub‐nesting bird species, but other changes in the composition of the breeding‐bird community are likely to be minimal as long as the closed‐canopy forest structure is maintained within the context of prescribed burning.
Conservation of Mammals in Eastern North American Wildlife Reserves: How Small Is Too Small?
Authors: Gurd D. Brent , Nudds Thomas D. , Rivard Donald H.
Published: August 2010

Abstract: A common objective of methods of systematic reserve selection has been to maximize conservation benefits—frequently current species richness—while reducing the costs of acquiring and maintaining reserves. But the probability that a reserve will lose species in the future is frequently not known because the minimum area requirements for most species have not been estimated empirically. For reserves within the Alleghenian‐Illinoian mammal province of eastern North America, we empirically estimated the minimum area requirement of terrestrial mammals such that reserves should not lose species because of insularization. We compared this estimate to the actual size of 2355 reserves and reserve assemblages within the mammal province. The estimated minimum area requirement was 5037 km2 (95% CI: 2700–13,296 km2). Fourteen reserves and reserve assemblages were> 2700 km2, 9 were> 5037 km2, and 3 were> 13,296 km2. These 14 reserves accounted for 73% of the total area of reserves and 10% of the total area of the mammal province. Few reserves appear large enough to avoid loss of some mammal species without the additional cost of active management of habitat or populations. Immigration corridors and buffer zones that combine small reserves into assemblages totaling at least 2700 km2 may be the most efficient means of conserving mammals in these reserves.
Correlates of Population Recovery Goals in Endangered Birds
Authors: Elphick Chris S. , Reed J. Michael , Bonta J. Marcelo
Published: August 2010

Abstract:Endangered species recovery plans commonly set goals for population size that are used to define the success of recovery efforts. We examined variation in these population recovery goals for bird species listed under the U. S. Endangered Species Act to determine whether there were simple predictors of recovery population size. The median population sizes that must be met for a species to be removed from the list or downlisted to the threatened category are 4000 and 1500 respectively, but the thresholds varied considerably. Most variation in population recovery goals ( ≥75%) was explained by the population size when the recovery plan was written. Species listed when their population's size was relatively large have higher population recovery goals, whereas those listed when populations were small have lower population goals. Population sizes set for recovery also increased over time and were higher for species listed throughout the United States rather than for part of the country. In combination, these three variables explained 86% of the variance in population goals for delisting and 94% of the variance in goals for downlisting. Body mass, annual fecundity, maximum lifespan, whether the population was listed as threatened or endangered, and whether a formal population viability analysis was conducted were variables not significantly associated with population recovery goals. Thus, we found that variables relating to the circumstances under which the populations were listed could explain almost all of the variance in recovery population goals, and that biological traits of the endangered birds explained little of the variance.
Contribution of Natural History Collection Data to Biodiversity Assessment in National Parks
Authors: O'CONNELL ALLAN F. , GILBERT ANDREW T. , HATFIELD JEFF S.
Published: August 2010

Abstract:  There has been mounting interest in the use of museum and herbaria collections to assess biodiversity; information is often difficult to locate and access, however, and few recommendations are available for effectively using natural history collections. As part of an effort to inventory vertebrates and vascular plants in U.S. national parks, we searched manually and by computer for specimens originating within or adjacent to 14 parks throughout the northeastern United States. We compared the number of specimens located to collection size to determine whether there was any effect on detection rate of specimens. We evaluated the importance of park characteristics (e.g., age since establishment, size, theme [natural vs. cultural]) for influencing the number of specimens found in a collection. We located >31,000 specimens and compiled associated records (hereafter referred to as specimens) from 78 collections; >9000 specimens were park‐significant, originating either within park boundaries or in the local township where the park was located. We found >2000 specimens by means of manual searches, which cost $0.001–0.15 per specimen searched and $0.81–151.95 per specimen found. Collection effort appeared relatively uniform between 1890 and 1980, with low periods corresponding to significant sociopolitical events. Detection rates for specimens were inversely related to collection size. Although specimens were most often located in collections within the region of interest, specimens can be found anywhere, particularly in large collections international in scope, suggesting that global searches will be necessary to evaluate historical biodiversity. Park characteristics indicated that more collecting effort occurred within or adjacent to larger parks established for natural resources than in smaller historical sites. Because many institutions have not yet established electronic databases for collections, manual searches can be useful for retrieving specimens. Our results show that thorough, systematic searching of natural history collections for park‐significant specimens can provide a historical perspective on biodiversity for park managers.
Systematic Conservation Planning and the Cost of Tackling Conservation Conflicts with Large Carnivores in Italy
Authors: RONDININI CARLO , BOITANI LUIGI
Published: August 2010

Abstract:  Conservation in Europe (including the establishment of protected areas) is undertaken mainly through legislation and on densely populated private land. Consequently, conflicts of interest arise between human economic activities and biodiversity conservation. We used a systematic approach to conservation planning to explore different conservation scenarios for the Apennine populations of wolves (Canis lupus) and bears (Ursus arctos marsicanus) in Italy. The conservation measures we considered were electrified fences and guard dogs to prevent wolves and bears from preying on sheep. We used habitat suitability models of the two species as an estimate of their distributions. Across the study area, we estimated the potential intensity of conflict caused by predation on sheep and the cost of the antipredator measures. We examined scenarios for the conservation of wolves and bears that identified systems of sites where antipredator measures should be applied to either minimize the economic cost of the plan or tackle a predetermined amount of conflict. The overall cost of the conservation plans ranged between €1,486,000 and €16,876,000, depending on the scenario and on the size of the conservation target. Because potential conflict intensity (i.e., potential predation) and cost of conflict resolution were correlated, the scenarios that minimized cost also minimized the amount of conflict that was addressed. Conserving these two species by addressing their predation on sheep was up to 4.36 times more expensive than conserving them by providing suitable habitat in areas of low conflict. Yet avoiding conflicts is not always desirable because it can drastically reduce the options for conservation. Choosing a conservation plan requires consideration of the level of threat to the target species and their sensitivity to conflicts.
Facial Pain Associated With Lung Cancer: A Case Report
Authors: Prez Roger D. Des , Freemon Frank R.
Published: August 2010

SYNOPSIS

We report a patient with severe and refractory facial pain which was dramatically relieved following resection of a bronchogenic carcinoma. We hypothesize that the pain was referred via the vagus nerve.
Lisuride in Cluster Headache
Authors: Raffaelli Edgard , Martins Orlando J. , Dágua Filho Américo dos Santos P.
Published: August 2010

SYNOPSIS

Ten patients with cluster headache of different types, treated previously with several kinds of drugs, received lisuride hydrogen maleate in doses varying from 2X0.025 mg to 16X0.025 mg.

The results obtained with lisuride were quite satisfactory as compared to results with other drugs, and there were no side‐effects in this small group of patients.

Comparatively to migraine, which requires low dosages of lisuride, cluster headache seems to require a higher dosage of the drug for better results.
Changes in EMG Power Spectra During Fatigue in Muscle Contraction and Migraine Headache Patients
Authors: Boxtel A. van , Goudswaard P.
Published: August 2010

SYNOPSIS

Muscle contraction headaches are assumed to be associated with relative ischemia in head muscles due to sustained contractions of these muscles. The present study examined whether an abnormally high degree of relative ischemia occurs during such contractions which were experimentally induced in various types of headache patients. Sustained fatiguing contractions at 50% of the maximum EMG amplitude were carried out in the frontalis, corrugator supercilii, and temporalis muscles. The rate of change of the power spectrum of the surface EMG was measured during the contractions. This measure may be considered as an indirect indication of the degree of relative ischemia. Patients with muscle contraction headaches, migraine, or mixed muscle contraction‐migraine headaches did not show a faster spectral shift in any of the three muscles than a group of non‐headache control subjects. Muscle contraction and mixed headache patients even showed significantly slower spectral shifts in the frontalis muscle. These results suggest that muscle contraction headaches are not associated with an abnormally high degree of relative ischemia during the sustained contractions which are believed to underlie this type of headaches.
Tension Headache Patients: A Comparison of a Recruited Subject Sample and a Clinic‐based Subject Sample
Authors: Belar Cynthia D. , Sutton Elyse P. , Wilson Eugenie
Published: August 2010

SYNOPSIS

To assess comparability of research populations, tension headache sufferers recruited through advertisement or obtained from a medical psychology clinic were compared on relevant psychological and physiological variables. Differences in headache activity, personality profiles, and muscle tension were noted which may have implications for generalization of treatment results from recruited subjects to clinic patients.
Psychophysiological Characteristics of Migraine and Tension Headache Patients
Authors: Passchier J. , van der Helm‐Hylkema H. , Orlebeke J.F.
Published: August 2010

SYNOPSIS

There are few findings of increased stress responses of the vascular system and the (head) muscles in migraine and tension headache patients. However, several studies ignored the headache state of the patients during the experiment and differences in sex, or used small experimental groups. In this controlled study, physiological parameters in migraine patients, tension headache patients and non‐headache controls were investigated during conditions of stress and rest. Each group was composed of at least 25 subjects. Sex was included as an independent variable, and separate analyses were carried out on patients with pain during the measurements. There were no differences in vascular responding nor in muscular responding to stress between migraine patients, tension headache patients and controls. Male migraine patients showed enhanced activity in some indicators of sympathetic activity. No evidence was found for a discrete border separating the two headache types.
Ketotifen in the Treatment of Chronic Cluster Headache
Authors: Split Wojciech , Szmidt Miroslaw , Prusinski Antoni , Rozniecki Jerzy
Published: August 2010

SYNOPSIS

Based on observations indicating histamine release in cluster headache, Ketotifen was given to 15 patients suffering from a chronic form of this disease. The drug shows a mast cell membrane stabilizing action which proved effective in the treatment of bronchial asthma. It was administered in dosage of 1 mg 3 times daily for 8 weeks. Full remission was achieved in 8 patients. A considerable improvement was noted in 2 cases, a moderate improvement in 3, and only a slight improvement in 2 cases.
Case Report: Chronic Cluster Headache with Unusual High Frequency of Attacks
Authors: Bogucki Andrzej , Niewodniczy Aleksander
Published: August 2010

SYNOPSIS

A case of chronic cluster headache with unusually frequent attacks (up to 30 per day) is discussed. Such numerous attacks are usually observed in chronic paroxysmal hemicrania only. The patient did not respond to indomethacin therapy, but rapid improvement during lithium treatment was observed.
Caffeine Consumption, Withdrawal and Cerebral Blood Flow
Authors: Mathew Roy J. , Wilson William H.
Published: August 2010

SYNOPSIS

Regional cerebral blood flow (CBF) measurements were conducted under resting conditions and after twenty‐four hours of caffeine abstinence in groups of high and low caffeine users. CBF was also measured thirty minutes after the oral administration of 250 rag. of caffeine in the high caffeine users and after a placebo in the low caffeine users. Caffeine administration was associated with significant CBF reduction and caffeine abstinence with significant frontal flow increases in the high caffeine group. The low caffeine group showed no differences between the resting, post‐placebo and post‐caffeine abstinence CBF values.
Migraine and Cerebral Infarction; Three Case Studies
Authors: Carneiro A. Leite , Monteiro J.M Pereira , Lima A.F. Bastos , Lopes J.R. Castro
Published: August 2010

SYNOPSIS

The authors describe three female patients, ages 30, 23 and 18, with migraine and cerebral infarction, selected from a series of 51 young patients with stroke. All of them were submitted to an extensive clinical and laboratory protocol that included angiography and computer tomography (C.T.), in order to exclude other etiologies for cerebral infarction (C.I.). All patients had episodes of hemispheric cerebral ischemia or infarction and the C.T. scan showed cerebral infarction in each case. The angiograms were normal (except in the first case which showed a transient spasm of the extracranial internal carotid arteries). The first patient has a residual motor deficit but the others recovered completely in a few days. The data analysis suggest a close relationship between migraine and cerebral infarction in our three cases.
Slow Wave Photic Stimulation in the Treatment of Headache ‐ a Preliminary Report
Authors: Solomon Glen D.
Published: August 2010

SYNOPSIS

The Dzidra Glass is a battery powered, self‐contained eyeglass using two liquid crystals to cast shadows on the closed or open eyelids at a rate of 1 to 3 hz. They are designed to induce relaxation through slow wave photic stimulation with one to five minutes of use, without concomitant medications or prior relaxation training. This study reports the preliminary experience with this modality in the treatment of headache.

Fifteen patients with acute muscle‐contraction type headache, six patients with chronic muscle‐contraction type headache, three patients with headache associated with acute sinusitis, and four patients with migraine were treated with the Dzidra glasses for five minutes. Fourteen of fifteen patients with acute muscle‐contraction type headache and five of six patients with chronic muscle‐contraction type headache and five of six patients with chronic muscle‐contraction type headache noted complete relief after treatment. One patient with chronic muscle contraction type headache and all patients' with headache associated with acute sinusitis and migraine headache noted no relief after treatment. Four patients with acute muscle‐contraction type headache were treated in a placebo‐controlled trial. None of the four responded to placebo, but all responded to treatment with slow wave photic stimulation.

We conclude that in this preliminary report, slow wave photic stimulation appears to be effective in the treatment of acute and chronic muscle‐contraction type headache.
Intracranial Hypotension: The Nonspecific Nature of MRI Findings
Authors: Bruera Osvaldo Carlos , Bonamico Lucas , Giglio Jorge Alberto , Sinay Vladimiro , Leston Jorge Alberto , Figuerola Maria de Lourdes
Published: August 2010

We present three patients who complained of postural headache related to different types of intracranial hypotension: spontaneous or primary, and secondary, but presenting the same findings on brain magnetic resonance imaging. Diffuse pachymeningeal gadolinium enhancement supports the belief that the enhancement is a nonspecific meningeal reaction to low pressure.
Mixing Sumatriptan: A Prospective Study of Stratified Care Using Multiple Formulations
Authors: Kaniecki Robert G.
Published: August 2010

Objective.—To assess the acceptability, utility, and tolerability of a system of stratified care of acute migraine using multiple formulations of sumatriptan.

Background.—Stratified care matches the treatment of a disease to its level of severity. Sumatriptan, with its multiple formulations, seems a logical option in a stratified care approach. Little data exists on the use of multiple formulations in a single patient population.

Design and Methods.—A prospective, open‐label, outpatient study recruited patients from a single center during the period from January 1998 through June 1998. Entry criteria included International Headache Society migraine diagnostic codes 1.1 or 1.2 and an established response to sumatriptan tablets or nasal spray. Patients who enrolled were allowed to use subcutaneous sumatriptan as either primary or rescue therapy for individual migraine attacks.

Results.—Two hundred eighteen (80%) of 273 patients on tablets and 40 (85%) of 47 patients on nasal spray enrolled. During a period of 6 months, 61% of the patients on tablets and 85% of the patients using the nasal spray used at least one subcutaneous dose of sumatriptan. This system was efficacious and well tolerated. The majority of injections were used as rescue treatments following a failed oral or nasal dose. Two percent withdrew due to lack of efficacy, and 6% withdrew due to adverse events; however, 92% professed satisfaction with subcutaneous sumatriptan as an available tool for migraine management.

Conclusion.—A system of stratified care using multiple formulations of sumatriptan is efficacious, well tolerated, and preferable to a program involving a single form of the drug.
Topiramate for Migraine Prevention in Children: A Randomized, Double‐Blind, Placebo‐Controlled Trial
Authors: Winner Paul , Pearlman Eric M. , Linder Stephen L. , Jordan Donna M. , Fisher Alan C. , Hulihan Joseph ,   for the Topiramate Pediatric Migraine Study Investigators
Published: August 2010

Objective.—To assess the efficacy and safety of topiramate for the prevention of pediatric migraine with or without aura in a double‐blind, randomized, placebo‐controlled trial.

Background.—Treatment options for pediatric migraine are currently limited, and no migraine preventive agents are approved for use in children in the United States. Topiramate is an effective migraine preventive therapy in adults, as demonstrated in several large, randomized, placebo‐controlled trials.

Methods.—One hundred and sixty‐two children with migraine (age, 6 to 15 years) were randomized in a 2:1 ratio to receive topiramate (n = 112) or placebo (n = 50). This study was designed to ensure that 150 participants were randomized to study medication. An additional 12 qualified patients were randomized because they had successfully completed the screening phase. The double‐blind phase of the trial consisted of a titration period and a maintenance period. Topiramate was initiated at 15 mg/day and titrated over 8 weeks to 2 to 3 mg/kg per day, or maximum tolerated dose, whichever was less (maximum allowed dose was 200 mg/day). The target dose was maintained for 12 weeks. The primary efficacy variable was the change in mean number of migraine days per month (28 days) during the double‐blind phase relative to the 4‐week prospective baseline phase for each treatment group.

Results.—Topiramate treatment was associated with a mean reduction over the entire double‐blind phase of 2.6 migraine days per month, compared with a mean reduction of 2.0 migraine days per month for placebo (P= .061 topiramate vs. placebo). A significantly greater percentage of topiramate patients (32%) experienced a ≥75% reduction in mean monthly migraine days compared with placebo (14%, P= .02). Discontinuation rates due to adverse events were low: 6.5% for the topiramate group and 4.0% for the placebo group. The adverse events that occurred most commonly in the topiramate group at an incidence rate greater than in the placebo group were: upper respiratory tract infection, anorexia, weight decrease, gastroenteritis, paresthesia, and somnolence. The mean average daily dose of topiramate during the maintenance period was 2.0 mg/kg per day.

Conclusions.—This pilot study suggests that topiramate may be an effective migraine preventive therapy in children. Topiramate was well tolerated in this population. Further randomized studies would be required to definitively establish the efficacy of topiramate for pediatric migraine prevention.
Visual Cortex Excitability in Migraine Evaluated by Single and Paired Magnetic Stimuli
Authors: Gerwig Marcus , Niehaus Ludwig , Kastrup Oliver , Stude Philipp , Diener Hans C.
Published: August 2010

Objective.—To determine the excitability of the visual cortex by phosphene thresholds (PT) in patients with migraine using transcranial magnetic stimulation (TMS) with single‐ and paired‐pulses.

Methods.—Nineteen patients with migraine with aura (MWA), 19 patients with migraine without aura (MWoA), and 22 control subjects were included. Patients were free from preventive anti‐migraine treatment and were investigated within 3 days before or after an acute migraine attack. In each subject, PT were assessed by single‐pulse and paired‐pulse TMS with an interstimulus interval of 50 ms.

Results.—The main effect of diagnosis indicated that mean PT were significantly lower in migraine patients than in control subjects (P= .001). Using single‐pulse TMS, mean PT tended to be lower in MWoA‐patients (57.7 ± 11.8%) compared with control subjects (64.4 ± 10.5%) (P= .064). In MWA‐patients, mean PT (53.1 ± 5.7%) were significantly lower compared with controls (P < .001). Using TMS with paired pulses, mean PT were significantly reduced in MWoA‐patients (40.3 ± 4.9%, P= .017) as well as in MWA‐patients (39.6 ± 4.2%, P= .005) compared with controls (44.6 ± 6.0%). The main effect of stimulation type indicated that mean PT were lower determined with paired‐pulse stimulation than with single pulses (P < .001).

Conclusions.—PT are reduced in patients with migraine in the interictal state suggesting an increased excitability of visual cortical areas. Compared with single‐pulse TMS, paired‐pulse magnetic stimulation is more efficient to elicit phosphenes. This technique provides the opportunity to evaluate visual cortex excitability with lower stimulus intensities and less discomfort.
Behavioral Facilitation of Medical Treatment for Headache—Part II: Theoretical Models and Behavioral Strategies for Improving Adherence
Authors: Rains Jeanetta C. , Penzien Donald B. , Lipchik Gay L.
Published: August 2010

This is the second of 2 articles addressing the problem of noncompliance in medical practice and, more specifically, compliance with headache treatment. The companion paper describes the problem of noncompliance in medical practice and reviews literature addressing compliance in headache care (Behavioral Facilitation of Medical Treatment for Headache—Part I: Review of Headache Treatment Compliance). The present paper first summarizes relevant health behavior theory to help account for the myriad biopsychosocial determinants of adherence, as well as patient's shifting responsiveness or “readiness for change” over time. Appreciation of health behavior models may assist in optimally tailoring interventions to patient needs through instructional, motivational, and behavioral treatment strategies. A wide range of specific cognitive and behavioral compliance‐enhancing interventions are described, which may facilitate treatment adherence among headache patients. Strategies address patient education, patient/provider interaction, dosing regimens, psychiatric comorbidities, self‐efficacy enhancement, and other behavioral interventions.
Visual Stimuli Are Common Triggers of Migraine and Are Associated With Pattern Glare
Authors: Harle Deacon E. , Shepherd Alex J. , Evans Bruce J.W.
Published: August 2010

Objective.—To investigate the associations between interictal pattern glare, visual stress, and visual triggers of migraine.

Background.—There has been relatively little research on the visual stimuli that can trigger migraine episodes. This is surprising, since if practitioners can obviate such triggers, then some attacks may be prevented. The existing literature suggests that patients who are prone to visually triggered migraines report more illusions on viewing striped patterns (“pattern glare”) and that colored filters may be an effective intervention for these people.

Methods.—Headache symptoms and headache triggers were investigated in migraine and control groups in 2 separate experiments. In one experiment, we also determined, for each participant, pattern glare, whether it was reduced by colored filters and, if so, what the optimum color of filter was. Color vision was also assessed with the D15 test.

Results.—People with migraine saw significantly more illusions on viewing each striped pattern and experienced greater pattern glare. They were also more likely to select a colored filter to aid visual comfort, particularly colors in the blue‐to‐green sector of the spectrum. Color vision was impaired subtly but significantly in migraine. Principal component analyses grouped common headache triggers into 5 broadly equal components: food, visual triggers, alcohol, stress and tiredness, and the environment. In a second analysis, the overall number of illusions seen in striped patterns was associated with visual triggers while pattern glare, use of colored filters, and interictal light sensitivity together formed a sixth component interpreted as visual stress.

Conclusions.—It is suggested that clinicians should ask migraine patients whether visual stimuli trigger their migraine, about interictal visual symptoms, and use the pattern glare test to ensure that those who may benefit from optometric interventions are appropriately managed.
Trigeminal Neuralgia in Wind Musicians
Authors: Cheshire William P.
Published: August 2010

The author reports 3 patients with trigeminal neuralgia whose pain was triggered by musical performance. Use of the muscles of embouchure activated the trigger zone when playing the clarinet, saxophone, flute, piccolo, trombone, or whistling. In each case, the location of the trigger zone was perioral, regardless of which division of the trigeminal nerve emanated pain. Trigeminal neuralgia is a particularly disabling affliction when it occurs in wind musicians.
Insulin Metabolism is Altered in Migraineurs: A New Pathogenic Mechanism for Migraine?
Authors: Cavestro Cinzia , Rosatello Annalisa , Micca GianMatteo , Ravotto Marisa , Pia Marino Maria , Asteggiano Giovanni , Beghi Ettore
Published: August 2010

Background.— Migraine is a complex biochemical dysfunction attributed to a disorder of the trigeminal and hypothalamic pathways. Impairment of glucose metabolism has been reported in migraine, but data are scanty and inconsistent.

Objective.— The main aim was to verify whether migraineurs have abnormalities of the glucose and insulin metabolism.We also studied correlations between blood glucose and insulin and between insulin levels and migraine severity.

Patients and methods.— Patients with migraine or headache other than migraine, and healthy volunteers were included. All had general blood tests and a standard oral glucose tolerance test after a 12‐hour fast, and glucose and insulin were measured.

Results.— Over a 6‐month period, we recruited 84 migraineurs (73 women, 11 men), 25 patients with nonmigraine headache (20 women, 5 men), and 26 healthy controls (24 women, 2 men). Multivariate analysis confirmed a significant difference between groups for glucose levels (P < .0001), but no significant time interaction. The differences were mostly between migraine and healthy controls (P < .0001) and to a lesser extent between other headaches and healthy controls (P < .05). A significant difference between groups was also found for insulin (P < .0001), with a significant time interaction. The difference was confirmed for migraine compared to other headaches (P < .0001) and healthy controls (P < .0001).

Conclusions.— Blood glucose levels may be high in headache patients, but do not seem to be specific to migraineurs. Insulin levels were higher in migraineurs, and seemed specific to this group. These findings are in keeping with recent reports on the effects of insulin on brain functions and lend support to the possibility that insulin is involved in the pathogenesis of migraine.
Levetiracetam Prophylaxis in Pediatric Migraine—An Open‐Label Study
Authors: Pakalnis Ann , Kring Donna , Meier Lisa
Published: August 2010

Background.—Migraine is common in the pediatric population. Levetiracetam, an anti‐epileptic drug, has shown some efficacy in small prospective adult headache studies.

Methods.—We prospectively evaluated levetiracetam in an open‐label study in 20 pediatric migraine patients to assess tolerability and efficacy.

Results.—Eighteen of 20 patients had significant reduction in headache frequency. PedMIDAS showed significant decrease in disability scores, side effects were minimal (mild behavioral changes).

Conclusion.—Levetiracetam had some efficacy in reducing migraine frequency and disability. Further larger studies are warranted, possibly utilizing a placebo‐controlled design.
Cervical Sympathetic Neuralgia Arising From a Schwannoma
Authors: Cheshire William P. , Odell John A. , Woodward Timothy A. , Wharen Robert E.
Published: August 2010

We describe an unusual case of neuropathic pain of the left face and shoulder accompanied by ipsilateral hyperhidrosis caused by a schwannoma of the cervical sympathetic chain. Additional signs of associated sympathetic hyperactivity included left‐sided lacrimation, conjunctival injection, and nasal congestion. Autonomic testing demonstrated signs of increased vasomotor and sudomotor activity in the left palm. The pain was refractory to analgesic and antimigraine medications but resolved following surgical resection of the T2 schwannoma.
Eletriptan for the Acute Treatment of Migraine in Adolescents: Results of a Double‐Blind, Placebo‐Controlled Trial
Authors: Winner Paul , Linder Steven L. , Lipton Richard B. , Almas Mary , Parsons Bruce , Pitman Verne
Published: August 2010

Background.—Eletriptan is a potent 5‐HT1B/1D agonist with proven efficacy in the acute treatment of migraine in adults.

Objective.—To evaluate the efficacy and tolerability of eletriptan 40 mg versus placebo in adolescent patients (aged 12‐17).

Methods.—A multicenter, double‐blind, parallel‐group, placebo‐controlled trial was conducted comparing 40 mg of oral eletriptan with placebo for the treatment of migraine in adolescent patients. The primary efficacy endpoint was 2‐hour headache response, and a number of secondary endpoints were also evaluated. An exploratory analysis evaluated which clinical and demographic characteristics might be correlated with high placebo response.

Results.—Of 274 patients who treated a migraine attack, 267 were evaluated for efficacy (n = 138 eletriptan; n = 129 placebo) at 2 hours post‐dose. There was no significant difference in 2‐hour headache response for eletriptan 40 mg versus placebo (57% vs 57%), and no significant improvements were observed for any of the outcomes at 1 or 2 hours post‐dose. By contrast, there was a significant advantage for eletriptan 40 mg in reducing headache recurrence within 24 hours post‐dose (11% vs 25%, P= .028), and post hoc analyses showed statistically significant differences for sustained headache response rates (52% vs 39%; P= .04) and sustained pain‐free response rates (22% vs 10%; P= .013). The strongest clinical predictor of placebo response was triptan‐naïve status (ie, no previous use of any triptan). Eletriptan 40 mg was well tolerated in this population, and the profile of adverse events was similar to that observed in Phase III trials in adult patients.

Conclusions.—The high placebo response rates reported here for 1‐ and 2‐hour outcomes are in accordance with other studies of triptans in adolescent patients. The evaluation of treatment effect in adolescent migraine might benefit from use of more stringent outcome measures, such as headache recurrence, sustained headache response, and sustained pain‐free response at 24 hours post‐dose.
Spontaneous Low‐Pressure Headache Complicating Bagpiping
Authors: Patrick Alasdair , McAuley David , Roxburgh Richard
Published: August 2010

We describe an interesting case of a 40‐year‐old lady who developed a spontaneous low‐pressure headache whilst playing the bagpipes. Playing wind instruments requires the generation of significant intra‐thoracic pressure, which may have contributed to this musician's condition.
Topiramate for Migraine Prophylaxis Among Chinese Population
Authors: Li Ho Lun , Kwan Patrick , Leung Howan , Yu Evelyn , Tsoi Tak Hong , Hui Andrew Che Fai , Sheng Bun , Lau Kwok Kwong
Published: August 2010

We evaluated the efficacy and safety of topiramate for migraine prophylaxis among Chinese patients in a multicenter prospective observational study. We found that topiramate at low doses was effective in preventing migraine headache in Chinese patients and was generally well tolerated. There was no difference in baseline headache frequency or intensity between responders and nonresponders.
Headache in a Case of Rhupus Syndrome
Authors: Chowdhury Subhasis Roy , Majumder Shounak , Chakraborty Partha Pratim , Mandal Sanjay Kumar , Bandyopadhyay Ramtanu , Bandyopadhyay Dipanjan , Chatterjee Ananya , Basu Krishna
Published: August 2010

We report a case of Rhupus with secondary anti‐phospholipid syndrome who presented with headache and papilloedema due to cerebral venous thrombosis. We propose that an increased awareness about the condition and meticulous investigation of headaches in lupus can avert catastrophic outcomes.
Occipital Nerve Stimulation for Headache: Mechanisms and Efficacy
Authors: Goadsby Peter J. , Bartsch Thorsten , Dodick David W.
Published: August 2010

Headache disorders are common problems in medicine and it is this commonness that often provides an air of the simple or obvious. Patients expect doctors understand headache; indeed doctors expect they may understand headache, and in turn since simple treatments exist and can be purchased from a supermarket, the very concept of the difficult headache problem has a pejorative connotation. A decade ago none of the authors were using device‐based therapies to any substantial extent, and now hardly a week goes by when we will not see a patient who has considerable potential to benefit from such approaches. Here we cover the most promising of the device‐based approaches, neurostimulation therapy using occipital nerve stimulation. Far from proven and with much work to be done, this is an exciting potential development for patients and doctors. Other device‐based therapies, such as deep brain stimulation for cluster headache and patent foramen ovale closure, are covered elsewhere.