bluuebunny/crossref_metadata_2025 huggingface dataset:
PREHISTORIC COPPER PRODUCTION IN THE INN VALLEY (AUSTRIA), AND THE EARLIEST COPPER IN CENTRAL EUROPE*
Authors: HÖPPNER B. , BARTELHEIM M. , HUIJSMANS M. , KRAUSS R. , MARTINEK K.‐P. , PERNICKA E. , SCHWAB R.
Published: June 2005

In recent years archaeological finds and scientific analyses have provided increasing evidence for a very early beginning of copper production in the rich mining area of the Tyrolean Alps. The earliest findings derive from an excavation of a multi‐phase settlement on the Mariahilfbergl in Brixlegg, which revealed evidence that a small amount of fahlores, probably of local provenance, was at least heated if not even smelted there in the Late Neolithic Münchshöfen culture (the second half of the fifth millennium bc). However, most copper finds of this horizon consist of low‐impurity copper that most probably derives from Majdanpek in Serbia. This long‐distance relationship is corroborated by typological features that link some aspects of the Münchshöfen culture with the Carpathian basin. Thus it is not yet clear if, at Brixlegg, actual copper production took place or, rather, an experimental treatment of the local ores. The typical fahlore composition, with arsenic and antimony in the per cent and silver and bismuth in the per mille ranges, appears in quantity only in the Early Bronze Age. Many thousands of Ösenringe are known from many central European Early Bronze Age sites, with a chemical composition typical of fahlores. At Buchberg near Brixlegg, a fortified settlement with slags from fahlore smelting proves that the local ores were indeed exploited. The lead isotope ratios of Ösenringe from the Gammersham hoard in Bavaria, which consist of fahlore copper, confirm this and suggest that copper mining and production in the Inn Valley reached a first climax during that period. In the Late Bronze Age, copper was produced at an almost industrial level.
A NEW SETTING FOR THE NORTHERN BORDER OF THE VENETI: METALLIC FINDS FROM THE VENETIC SITE OF MONTE CALVARIO, AURONZO DI CADORE*
Authors: ZAGHIS F. , MOLIN G. , SALVIULO G. , CALLIARI I. , RAMOUS E. , GANGEMI G.
Published: June 2005

In 2000 several bronze and lead objects were discovered at the Venetic‐Roman site (200 bc–ad 200) of Monte Calvario di Auronzo, in the Italian eastern Alps. They were mostly finished artefacts plus semi‐worked products. Analysis included SEM–EDS, EMPA, XRPD, TMS and AMS spectrometry. The compositional results of the finished artefacts suggest that the choice of the alloy had been made according to the decorative techniques to be used. A semi‐worked high‐leaded bronze object indicates the existence of a metallurgical production of cast artefacts at the site. TMS analyses of a lead ingot exclude local provenance, proving the existence of important trade routes.
GLASS CORROSION ACROSS THE ALPS: A SURFACE STUDY OF CHEMICAL CORROSION OF GLASSES FOUND IN MARINE AND GROUND ENVIRONMENTS*
Authors: DAL BIANCO B. , BERTONCELLO R. , MILANESE L. , BARISON S.
Published: June 2005

Ancient glasses deriving from differing environments (marine and ground) and areas (Mediterranean and Continental) have been investigated to understand their weathering processes. Although the glass technologies, developed in various ways, and the differing compositions of the glasses from the two areas, have generated differing durabilities, the weathering features of both typologies of glass are identical. Therefore, the corrosion phenomena are due to the action of water, and they are not related to the sample microclimate. Data have been collected using optical microscopy, RGA and surface analysis techniques: XPS, ESEM and SIMS.
Being Feminist
Authors: Lister Ruth
Published: June 2005

The article starts by locating both the author and men in relation to feminism as an identity, which cuts across the public–private divide. It then attempts to illuminate the meaning of ‘being feminist’ by addressing three, tightly interwoven, issues. First is the question: what is the ‘woman’ who is the subject of feminism? The second section discusses the nature of feminism in its various guises, focusing mainly on feminism in Britain since the late 1960s. It engages with the notions of ‘post-feminism’, ‘global sisterhood’ and a ‘third wave’. Finally, the article analyses critically feminism's uneasy relationship with identity politics.
Biofeedback, Migraine Headache and New Symptom Formation
Authors: Szajnberg Nathan , Diamond Seymour
Published: June 2005

SYNOPSIS

In this retrospective study of 12 migraine patients successfully treated with biofeedback, we find that 67% experienced some form of symptom substitution. This manifested as classical psychosomatic symptoms, clinical depression, or a quasi‐delusional belief in controlling one's own or others' thoughts or feelings.
Considerations on the Use of Propranolol in Complicated Migraine
Authors: Prendes J. L.
Published: June 2005

SYNOPSIS

An analogy is drawn between ergotamines and propranolol treatment of complicated migraine. A case report and supportive clinical and experimental data are presented to caution against the indiscriminate use of beta blocking agents in these patients.
Effect of Isometheptene on the Distribution and Shunting of 15μ M Microspheres Throughout the Cephalic Circulation of the Cat
Authors: Spierings Egilius L.H. , Saxena Pramod R.
Published: June 2005

SYNOPSIS

We have studied the effect of isometheptene, an indirectly acting sympathomimetic with a reported anti‐migraine action, on carotid blood flow and the distribution of carotid blood flow throughout the cephalic circulation of the cat, using 15μm‐microspheres. Microspheres measuring 15μm in diameter were used to separate capillary flow from flow through the arteriovenous anastomoses. Apart from decreasing carotid blood flow, isometheptene vigorously reduced the fraction of carotid blood flow shunted through the arteriovenous anastomoses. This mode of action of isometheptene may be relevant to its beneficial effect in migraine.
Cluster Headache: Response to Chlorpromazine
Authors: Caviness Verne S. , O'Brien Patrick
Published: June 2005

SYNOPSIS

Chlorpromazine (CPZ), in doses ranging from 75–700 mg per day, gave full headache relief in twelve of thirteen (93%) of patients with the cluster headache syndrome. For nine, withdrawal of CPZ within two to three weeks was tolerated without recurrence of symptoms. After a period of extended remission, four of these found CPZ equally effective treatment for subsequent attacks. Three others received sustained relief from headache over six to eight months on maintenance CPZ at 75 mg per day although the cluster was not terminated. The apparent effectiveness of CPZ in this limited series is greater than that of other medications currently employed in the treatment of cluster headaches.
A Replication and Generalization of the “Psychobiological” Model of Headache
Authors: Thompson J. Kevin , Haber Joel D. , Figueroa Jorge Luis , Adams Henry E.
Published: June 2005

SYNOPSIS

Bakal and Kaganov 1 recently reported data supporting a “psychobiological” approach to the study of headache pain. Their results suggested that individuals delineated by degree of self‐reported headache pain would differ on quantitative rather than qualitative headache characteristics. The present study was an attempt to systematically replicate and generalize the above findings. Seventy‐eight undergraduates and 25 chronic headache patients rated the extent to which common symptoms accompanied their “usual” headache on a five point scale. Subjects were divided into groups on the basis of: subjective ratings of headache problem, headache frequency, and headache type. Results were consistent with the psychobiological model. Individuals rating degree of headache problem as moderate or severe reported a significantly greater incidence of symptoms than non‐problem subjects. Headache frequency was not related to quantitative differences in headache symptomatology. Migraine and chronic muscle contraction (CMC) patients reported similar symptoms that differed significantly on quantitative (frequency) characteristics. The results replicate and generalize Bakal and Kaganov's findings and suggest that the model may help explain etiological factors in headache development. Results are discussed with regard to the need for future research in the area.
The Biochemistry of Migraine
Authors: Bruyn G.W.
Published: June 2005

SYNOPSIS

In the stereotyped, transient and paroxysmal triad of autonomic, vascular and nociceptive dysfunction, precipitated by non‐specific factors, known as the migraine attack certain biochemical mediators appear to occupy key‐positions in the chain of pathomechanic events occurring at the neural and humoral interface.Of these are reviewed: histamine and serotonin (inhibitory at the microvascular level), substance P and the kinins (excitatory at the nociceptive neural level), tyramine as an a‐adrenergic activator, and prostaglandins as humoral agents acting on certain cell‐membranes. Anatomical, clinical and biochemical arguments are marshalled to bring the neurogenic origin of the migraine attack into focus, in particular at hypothalamic level.
Enhanced Dilatory Response to Histamine in Large Extracranial Vessels in Chronic Cluster Headache
Authors: Hardebo Jan Erik , Krabbe Annette Aebelholt , Gjerris Flemming
Published: June 2005

SYNOPSIS

Against the background of a postulated involvement of histamine in the vasodilatation of cranial vessels in an attack of cluster headache, the reactivity to histamine of large human extracranial arteries was tested in vitro in non‐chronic and chronic sufferers from cluster headache, and compared to that of arteries from non‐sufferers. The vessels from chronic sufferers dilated much more readily upon administration of histamine ‐ via an action on histamine H2 receptors ‐ than did vessels from non‐sufferers. Vessels from non‐chronic sufferers (taken within a period of attacks but when a considerable relief due to medical treatment had occurred) reacted to histamine as vessels from non‐sufferers. The responses to various other vasoactive agents, such as noradrenaline, isoprenaline, serotonin, acetylcholine, VIP and prostaglandin F2a were similar in vessels from sufferers and non‐sufferers. The implication of this finding in the medical treatment of chronic cluster headache is discussed.
A Comparison of Two Psychophysiological Approaches to the Treatment of Migraine
Authors: Elmore Andrew M. , Tursky Bernard
Published: June 2005

SYNOPSIS

An investigation was conducted to assess the relative effectiveness of two psychophysiological approaches to migraine treatment. 23 migraineurs were assigned to two treatment groups: Temporal Pulse Amplitude Reduction (TPA, n = 12) or Hand Temperature Biofeedback (HTB, n = 11). During all sessions temporal pulse amplitude, finger pulse amplitude and hand temperature were continuously recorded. Analysis of the clinical outcome data was based on the comparison of one month pre‐ and one month post‐treatment diaries of headache symptomatology and medication intake. Results showed both groups learned significant physiological control during training and testing. The TPA group showed significant reductions in 2 of the 6 measures of headache activity and a trend toward a decrease in a third. The HTB group showed only a trend toward a decrease in I measure, a significant increase in another and a trend toward an increase in a third. While there were no significant differences on any of the measures during the pre‐treatment period, the groups were significantly different on 3 of the 6 measures during the post‐treatment period, with each difference indicating the superiority of temporal pulse amplitude reduction biofeedback. The results are discussed in terms of the challenge they pose to the commonly held view that migraine is related to a syndrome of sympathetic overactivity.
Headaches in the First Post Partum Week and Their Relationship to Migraine
Authors: Stein George S.
Published: June 2005

SYNOPSIS

15 out of 40 women on a post natal ward had headaches in the first post partum week, particularly between day 3–6 post partum. The incidence of these headaches was increased among women with a previous personal or family history of migraine or pre‐menstrual migraine, but they were usually milder and more frequently bilateral than the patients usual migraine. These headaches were not associated with previous neurotic depression or mood changes during the puerperium and are therefore unlikely to be tension headaches. Weight gain preceded the onset of the headache and weight loss followed it, but as these changes occur among women without the headache they are unlikely to be causal, though of interest since similar weight changes sometimes occur with migraine attacks. The rapidly falling levels of estrogen and progesterone, or possibly alterations in serotonin metabolism may be responsible for these headaches, most of which appeared to be mild episodes of common migraine.
Assessing the Reactive as Well as the Sensory Component of Headache Pain
Authors: Andrasik Frank , Blanchard Edward B. , Ahles Tim , Pallmeyer Thomas , Barron Kevin D.
Published: June 2005

SYNOPSIS

The traditional numerical scale used for measuring headache intensity was compared with an adjectival scale developed by Tursky (1976) designed to assess both the intensity and reactive components of the pain experience. As predicted Tursky's intensity adjectives correlated highly with the numerical ratings of intensity whereas all correlations involving the affective adjectives were significantly lower in magnitude. These results support the hypothesis that Tursky's procedure measures two different aspects of pain and suggest that research would profit from the incorporation of similar multi‐component self‐report measures.
Transformation of Episodic Migraine Into Daily Headache: Analysis of Factors
Authors: Mathew Ninan T. , Stubits Eva , Nigam Mool P.
Published: June 2005

SYNOPSIS

Seventy‐six percent of patients with daily headaches were found to have a history of episodic migraine in the past, more than half of them hormone dependent headache such as menstrual migraine. Various factors possibly influencing the transformation of episodic migraine into daily headaches were analyzed in a series of 61 patients who presented with daily headaches. Abnormal personality profile, especially neuroticism including depression, excessive stress, excessive use of medications such as caffeine containing analgesics, narcotic analgesics and ergotamine, and development of hypertension were found to be significant in the transformation of episodic migraine into daily headache.

The problem of daily headache is discussed. It is suggested that the majority of daily headaches are a continuum of episodic migraine, influenced and perpetuated by various factors such as neuroticism, excessive medication, stress, and development of hypertension. It is pointed out that diagnosis of tension headache under those circumstances is not justified.
Frontal Intermittent Rhythmic Delta Activity, Impairment of Consciousness and Migraine
Authors: Walser Hermann , Isler Hansruedi
Published: June 2005

SYNOPSIS

Six migraine patients presented with episodes of impairment of consciousness and neurological deficit indicating dysfunction of upper brainstem and occipital and medial temporal lobes. These episodes were either continuous with migraine attacks or interspersed in courses of frequent migraine attacks. EEG recorded during or shortly after the episodes showed frontal intermittent rhythmic delta activity (FIRDA). The clinical and EEG changes are both explained as results of spasm of the rostral basilar artery. The episodes of impairment of consciousness are interpreted as migraine attacks with insufficient or missing vasodilatation rebound. The FIRDA pattern in these cases appears to be a sign of ischemia of the rostral basilar artery region analogous to focal slowing in “hemiplegic” migraine which indicates ischemia in other cerebrovascular regions. This view is supported by a simultaneous recording of both types of EEG changes in one patient with “hemiplegic” migraine followed by impairment of consciousness.
Plasma Testosterone Levels in Patients with Cluster Headache
Authors: Klimek Andrzej
Published: June 2005

SYNOPSIS

Plasma testosterone levels were determined radio‐immunologically in 57 men, including 23 patients suffering from cluster headache where the tests were carried out during the exacerbation of the disease but between the fits, 10 patients with trigeminal nerve neuralgia, 10 with radicular pain and 14 blood donors. Only in blood donors the normal plasma testosterone level was found and in the remaining tested groups this level was lowered in a statistically significant degree, the lowest values were observed in patients suffering from radicular pain. It is suggested that during cluster headache the level of testosterone is lowered but this is associated with repetitive pain seizures and not with the processes involving hypothalamus.
A Psychophysiological Investigation of Tension Headache
Authors: Philips H. C. , Hunter M. S.
Published: June 2005

SYNOPSIS

In a psychophysiological investigation of tension headache cases (n = 23) with migraine headache controls (n = 10) and non‐headache controls (n = 30), both tonic and phasic activity of the key muscles (frontalis and temporalis) and the temporal artery pulse were examined. Although all headache cases had significantly elevated levels of temporalis tension, tension headache sufferers were not differentiated from migraine in this respect. A substantial subgroup of tension sufferers (30%) had no detectable muscular or arterial abnormality associated with their severe pain. Idiosyncratic stress stimuli evoked significant frontalis reactivity in all headache cases (tension and migraine). These responses were triggered only by potent stimuli. Migraine cases had higher level of temporal artery abnormality at rest, in response to stress, and during pain episodes than tension cases. The implications of these results were discussed with respect to the prevailing view of tension headaches. An alternative model of this disorder was considered.
Ultrasonic Doppler Flow in Migraine and Cluster Headache
Authors: Schroth G. , Gerber W.D. , Langohr H.D.
Published: June 2005

Synopsis

Systematic ultrasonic Doppler flow examinations of 98 migraine patients during a headache free interval revealed a highly significant reduction of blood flow in the A. supratrochlearis, an endbranch of the A. ophthalmica, compared with a control group (n=55). 34 migraineurs with invariable hemicrania showed a significant reduction of ophthalmica‐blood‐flow on the affected side, compared with the painfree side. Doppler flow examinations during spontaneous migraine attacks revealed a characteristical increase of the flow velocity in Aa. carotides communes, internae, externae and Aa. vertebrales, whereas the A. ophthalmica showed a flow reduction during the attack. Of 6 patients suffering from cluster headache, there was a marked flow acceleration in the A. ophthalmica during spontaneous or nitrolingual provoked attacks. The results indicate that the noninvasive transcutaneous Doppler sonography is of value in the differential diagnosis of migraine patients and cluster headache. The implications of the results are discussed with respect to the hemodynamics of migraine and cluster headache.
Stress, Temporal Artery Activity, and Pain in Migraine Headache: a Prospective Analysis
Authors: Feuerstein Michael , Bortolussi Lina , Houle Manon , Labbé Elise
Published: June 2005

SYNOPSIS

Temporal artery, frontal EMG, systemic blood pressure, peripheral temperature, heart rate, and anxiety levels were monitored daily four days preceding a typical migraine attack and during the headache in twelve female migraine cases. The specific relationship between temporal artery activity and anxiety and temporal artery activity and pain was also determined. The results indicated the presence of an increased variability in the right temporal artery three days preceding the migraine with the absence of changes in the general autonomic and skeletal muscle measures. Considerable individual differences in temporal artery amplitude were observed necessitating an analysis of individual patients which revealed a general pattern of dilation three days prior to the attack and constriction the day preceding the attack. Increased anxiety was noted only on the headache day. Elevations in anxiety four days prior to the migraine were associated with the increased temporal artery variability observed three days prior to the attack. Anxiety experienced on the headache day was not related to changes in temporal artery amplitude variability or pain. Temporal artery dilation was not consistently associated with the site of pain. The results provide support for a disregulation theory of migraine relating anxiety to temporal artery change across days preceding the attack but question major assumptions regarding anxiety, temporal artery activity and pain during the headache itself.
Relative Potency and Selectivity of Calcium Antagonists Used in the Treatment of Migraine
Authors: Peroutka Stephen J. , Banghart Suzanne B. , Allen George S.
Published: June 2005

SYNOPSIS

Calcium channel antagonists selectively block intracerebral vasoconstriction and appear clinically effective in the treatment of migraine. The in vitromethod described in the present report measured both the absolute and relative potencies of a group of calcium blockers. The dihydropyridine drugs, nimodipine and nifedipine, were both the most potent and selective of the calcium antagonists studied. Cinnarizine and flunarizine were essentially equipotent in both basliar and femoral arteries while the traditional therapeutic agents, cyproheptadine and amitriptyline, were 10‐fold more potent in femoral than basilar artery. This rapid in vitromethod may provide pharmacologic information which can be used as a guide in the selection of calcium channel antagonists for future clinical trials.
A Bio‐psycho‐social Investigation of Headache Activity in a Chronic Headache Population *
Authors: Blanchard Edward B. , Andrasik Frank , Arena John G. , Neff Debra F. , Jurish Susan E. , Teders Steven J. , Saunders Nancy L. , Pallmeyer Thomas P. , Dudek Bruce C. , Rodichok Lawrence D.
Published: June 2005

SYNOPSIS

Comparisons of responses in a month long Headache Diary were made among three groups of carefully characterized headache sufferers (41 tension, 25 migraine, and 25 combined migraine and tension) and revealed more headache‐free days per week for the migraineurs than the other two groups but more daily average headache activity (headache index) for the tension headache patients than for the migraineurs. Multiple regression analyses of potential predictors from the biological realm (psychophysiological responses), psychological realm (psychological test scores) and social realm (social‐demographic data) on headache index revealed stronger biological influences on tension headache than on migraine or combined headache but less psychological influence. The relation of social‐demographic variables to headache index was roughly equivalent across all three headache types.
Effects of Voluntary Muscle Tension Increases in Tension Headache
Authors: Borgeat Francois , Hade Bernard , Elie Robert , Larouche Léon M.
Published: June 2005

SYNOPSIS

The relationship between hyperactivity of the head and neck muscles and the pain experienced in tension headache was assessed by comparing the subjective effects of voluntary frontal muscle contraction on self‐reports of pain in chronic tension headache patients and in normal volunteers.

Ten tension headache patients and ten volunteers were taught to increase their frontal muscle tension over 10 μvolts through biofeedback and, on three occasions, were asked to maintain that level for periods of one, two or five minutes consecutively.

No difference in EMG levels were observed between patients and control either during baselines, contraction periods or subsequent resting phases. In contrast, headache patients reported more pain immediately and ten minutes after the contraction periods. The longer contraction periods were associated with higher pain intensity score, while the EMGs of the subsequent resting phases were lower. This occurred in both groups.

These results suggest that chronic tension headache patients are more prone to experience pain than normal volunteers with contraction of frontal muscles, in spite of the fact that EMG levels do not differ. A different pain threshold to muscle tension could be responsible for those differences.
The Utility of the Millon Behavioral Health Inventory in the Study of Chronic Headaches
Authors: Gatchel Robert J. , Deckel A. Wallace , Weinberg Norris , Smith John E.
Published: June 2005

SYNOPSIS

The present study evaluated the use of the Millon Behavioral Health Inventory (MBHI) in predicting response to a behavioral treatment program for headache reduction. A secondary goal was to also assess whether the MBHI could significantly differentiate among headache patients, patients with other types of chronic pain, and normal subjects. Twenty‐three chronic headache sufferers were administered a behavioral treatment program which consisted of 16, one‐hour weekly sessions. During the course of the treatment program, subjects were requested to keep daily records of four measures which later served as the treatment‐outcome indices: (1) daily number of headaches, (2) duration of headaches, (3) intensity of headaches, (4) medications taken. Results demonstrated that a number of MBHI scales significantly predicted response to treatment. Also, it was found that the MBHI significantly differentiated the chronic headache patients from the normal controls and patients with other forms of chronic pain.
Cardiovascular Changes in Cluster Headache
Authors: Sacquegna Tommaso , Cortelli Pietro , Amici Roberto , Pich Emilio Merlo , De Carolis Piero , Baldrati Anna , Cirignotta Fabio , D'Alesandro Roberto , Lugaresi Elio
Published: June 2005

SYNOPSIS

Five patients suffering from cluster headache underwent simultaneous recordings of the pneumogram, ECG, and systemic arterial pressure before and during attacks.

The polygraphic investigations showed the following: systolic and diastolic blood pressure increased during attacks; mean heart rate decreased or increased; mean respiratory rate decreased or remained unchanged. Standard deviations and coefficients of variation of all three measures calculated during attacks were higher than those recorded before attacks. The polygraphic recordings showed that during attacks there were phasic cardiovascular changes characterized by an increase and subsequent decrease in arterial pressure and heart rate, synchronous with the respiratory movements.

Cardiovascular reflex function was assessed in two patients prior to and during attacks: Valsalva maneuver was normal be fore and during attacks; beat‐to‐beat variation of heart rate and heart rate variability during deep breathing showed higher values during attacks compared with values beforehand.

The findings of this study suggest a central disturbance of vagus‐sympathetic equilibrium.
Do Certain Headache Syndromes Occur in “Pain‐Prone” Patients?
Authors: Ziegler Dewey K. , Kodanaz Altan , Hassanein Ruth S.
Published: June 2005

SYNOPSIS

To clarify the actual components of headache syndromes and their possible association with other types of pain and psychological traits, 177 patients subject to severe intermittent headaches were studied. Data used were derived from (a) a de tailed headache questionnaire, (b) a second questionnaire concerning the occurrence of other pain and of feelings of good or ill health, (c) the Cornell Medical Index. A stepwise regression analysis was run for each headache characteristic using data from the pain questionnaire and the Cornell Medical Index as independent variables. Interesting associations of variables were (1) increased frequency of headache with male sex and increased duration of headache with female, (2) inability to carry on work load during headache, headache preceded by spots before the eyes, weakness of arm or leg preceding headache were all positively associated with history of fainting. Neither vomiting with headache, nor unilaterality of pain was associated with any other pain variables. Also of note was the fact that there was no evidence by testing of increased psychological disturbance in patients with back pain. The results suggest that the “tension headache‐neurosis” concept is dubious, that autonomic instability as evidenced by fainting is indeed important in some headache syndromes, and that new headache syndromes need to be defined.
Occurrence of Headaches in Anxiety Disordered Patients
Authors: Garvey Michael J.
Published: June 2005

SYNOPSIS

Several previous investigations have suggested a positive relationship between anxiety symptoms and headaches. Twenty patients with anxiety symptoms severe enough to warrant a psychiatric diagnosis of anxiety disorder were questioned about headaches. The number of anxiety disorder patients afflicted with headaches was not different from that reported by 49 non‐ill controls.
Plasma and CSF Endorphin Levels in Primary and Symptomatic Headaches
Authors: Nappi G. , Facchinetti F. , Martignoni E. , Petraglia F , Bono G. , Micieli G. , Rosaschino C. , Manzoni G.C. , Genazzani A.R.
Published: June 2005

SYNOPSIS

The role of opiates in pain perception and neuroendocrine responses to environmental stimuli is well known, so that plasma and CSF endorphin levels may represent useful markers of endogenous analgesia and adaptive body mechanisms.

The present study concerns various forms of headache: primary (Common Migraine: CM; Migraine with Interparoxysmal Headache: MIH; Cluster Headache: CH) and symptomatic (Chronic Post Traumatic Headache: CPTH; Ischemic Cerebrovascular Headache: ICVH). A group of age‐matched healthy subjects was used as controls (C).

The results show a significant decrease of plasma B‐EP levels only in MIH patients (p<0.001), while in the CSF a significant reduction of B‐EP is present in MIH (p<0.001) and CM (p<0.005) subgroups, coupled with an inverse relationship between peptide levels and headache severity scores. In the symptomatic headaches, in which a normal functioning of the pain control systems may be presumed, no difference is present when compared to normal subjects.

These data support the hypothesis that migraine syndrome is a “pain disease” sustained by precarious, either genetic or acquired, biochemical mechanisms.
Thromboxane Synthetase Inhibition: Potential Therapy in Migraine
Authors: Joseph Rajiv , Steiner J.T. , Poole C.J.M. , Littlewood J. , Rose E Clifford
Published: June 2005

SYNOPSIS

Sixteen patients with migraine were treated prophylactically for 3 months with dazoxiben, a specific thromboxane synthetase inhibitor, in an open study, Frequency of all attacks was reduced by more than 50% in 7 patients, and of severe attacks in 8 of 10 patients who initially suffered severe attacks. Reductions in thromboxane B2 levels measured at intervals during treatment by radioimmunoassay may have reflected standards of compliance with the 6‐hourly treatment regimen. However, a relationship emerged between thromboxane reduction and clinical response, with significantly greater reductions observed in patients who reported good symptomatic relief. This appears to support the hypothesis that platelet activation features in migraine causation.
Flunarizine, a Calcium Entry Blocker in Migraine Prophylaxis
Authors: Amery W.K. , Caers L.I. , Aerts T.J.L.
Published: June 2005

SYNOPSIS

To obtain a sample size sufficiently large to enable valid statistical analysis, patients with common or classical migraine treated in different centres with the calcium‐entry blocker flunarizine, 10 mg daily, were pooled into 2 sets. In a first group of 202 patients, flunarizine was shown to reduce the frequency of attacks in 83%. Improvement was more marked when the duration of the disease was shorter and was more rapid when the pretreatment frequency of attacks was high. Somnolence and weight gain, sometimes labeled increased appetite, were the main adverse reactions but rarely caused withdrawal of the drug. Weight gain was significantly correlated with the global result and occurred more in patients with a low pre‐treatment weight. In a second group of 125 patients, most of them being treated for a year, the effect of flunarizine was fully sustained at the 4‐month level, i.e., at a median reduction in attacks by 51% to 60%.
Common Migraine Attack: Platelet Modifications Are Mainly Due to Plasma Factor(s)
Authors: Launay J.M. , Pradalier A.
Published: June 2005

SYNOPSIS

Various biochemical determinations were performed on plasma and platelets of unmedicated common migrainous patients, either during crisis or in attack‐free intervals. The main change occurring during crisis appears to be a release of dense bodies and a‐granules, with a concomitant decrease of platelet serotonin uptake but without important modifications of the platelet metabolism of bioamines. From the data concerning platelet serotonin uptake, a slight platelet defect cannot be excluded. Nevertheless, the role of unidentified plasma factor(s) appears to be much more important in the genesis of the biochemical changes observed during common migraine attack.
Relationship Between HLA System in Cluster Headache and Clinical Response to Lithium Therapy
Authors: Giacovazzo M. , Martelletti R , Romiti  , Gallo M.F. , Iuvara E.
Published: June 2005

SYNOPSIS

The relationship between the major system of histocompatibility antigens and cluster headache has already been studied by our group, and decreased frequency of HLA‐B14 antigen shown in cluster headache patients in comparison to a control population.

The therapy of cluster headache with lithium salts is already widely acclaimed; nevertheless there are patients who derive no benefit or must suspend treatment due to side‐effects. Thus we wanted to study the relationship between genetic markers of patients with the illness and the therapeutic efficacy of lithium salts.

35 episodic cluster headaches have been studied; they had been already typed for the HLA antigens. The patients were treated with lithium carbonate for a period of 3 months. As parameters for evaluation of the efficacy of treatment, the headache index ratio, the wake‐sleep rhythm and the pupil diameter measurement were studied.

Statistical evaluation was made and it was possible to separate two subgroups of patients: “responders” and “non responders” to lithium therapy. The phenotypical frequencies in the two subgroups was analyzed using the X2 test.

A higher frequency of HLA‐B18 antigen (23.8% vs 0%; p< 0.0005; pc<0.06) and of HLA‐A9 antigen (42.9% vs 14.3%) showed in the “responders” group. In the “non responders” group was found a higher frequency in HLA‐A1 antigen (35.7% vs 14.3%).
Non‐Migrainous Headache and Transient Neurological Deficits
Authors: Neufeld Miriam Y. , Nisipanu Puiu F. , Korczyn Amos D.
Published: June 2005

SYNOPSIS

Two young patients experienced transient and recurrent neurological deficits, associated with headache, without fever, signs of meningeal irritation or systemic disease.

This situation in a young patient is usually a manifestation of migraine, but none of our patients had a history f vascular headache. Lumbar puncture was performed, and CSF pleocytosis found in both cases. These cases may represent a poorly recognized benign syndrome of transient neurological signs of headache and a sterile inflammatory reaction in the CSF.
Pain Response to Voluntary Muscle Tension Increases and Biofeedback Efficacy in Tension Headache
Authors: Borgeat François , Elie Robert , Larouche Léon M.
Published: June 2005

SYNOPSIS

The hypothesis that patients reporting an association between head pain and voluntary muscle tension increases could react more positively to EMG biofeedback was evaluated in 33 tension headache sufferers involved in a program of six training sessions and of a follow‐up two months later. These patients were taught to increase their frontal muscle tension over 10 μvolts through biofeedback for a period of one minute at the first session and of two minutes at the second one. According to their subjective pain response, 14 patients were considered to show a positive association between head pain and muscle tension increases while the 19 others did not show such an association. The group of patients with a positive association between head pain and muscle tension showed a rapid symptomatic improvement which was partially lost as the training progressed, while the other reported a more linear gradual improvement. At follow‐up, there was no difference in headache, drug usage and frontal EMG between the two groups. The differences in the shapes of the symptomatic responses are discussed in terms of patients’ expectations from the training.
Lithium‐Triggered Chronic Cluster Headache
Authors: Brainin M. , Eisenstädter A.
Published: June 2005

SYNOPSIS

Lithium carbonate, usually helpful in the treatment of cluster headache, showed a paradoxical effect in a patient now being seen for over one year. Chronic cluster headache developed after she had been taking lithium for more than eight years for psychiatric indications. Only by total discontinuation of lithium therapy could a complete remission of the headaches be brought about. This effect was observed repeatedly. It is suggested that a chronic effect of lithium at the receptor sites of the central trigeminovascular pathways plays a role.
Basilar Migraine Manifesting as Transient Global Amnesia in a 9‐Year‐Old Child
Authors: Amit R. , Shapira Y. , Flusser H. , Aker M.
Published: June 2005

SYNOPSIS

A case of transient global amnesia in a nine year old child with a history of recurrent episodes of vertigoand a family history of migraine headache is described. The possibility that acute confusional state inchildren, presenting as transient global amnesia may represent a variant of basilar migraine is discussed.
Treatment of Intractable Cluster
Authors: Diamond Seymour , Freitag Frederick G. , Prager Jordan , Gandhi Sunil
Published: June 2005

SYNOPSISPatients with chronic cluster headache refractive to agents such as lithium carbonate, methysergide, corticosteroids, or thecalcium channel blocking agents, may respond to histamine desensitization. Intravenous histamine phosphate administeredover a 10‐day treatment course in combination therapy with prophylactic agents, including H 1 and H 2 antagonists, may resultin a marked improvement in the frequency of cluster attacks. Sixty‐four patients seen at the Diamond Headache Clinic wereadmitted to the Inpatient Headache Unit at Louis A. Weiss Memorial Hospital and followed for a period up to one year afterdischarge. Twenty‐five patients had at least a 75% reduction in cluster attacks and all but nine patients demonstrated a partialreduction in their clusters. A group of patients who were previous treatment failures with established agents for chroniccluster were retreated with the same agent following histamine desensitization and had a significant improvement in theircluster attacks.Another group of patients responded to local application of 5% or 10% cocaine solution to the sphenopalatine ganglion. Whileuseful for some patients, the results did not achieve statistical significance compared to similarly treated patients who did notreceive cocainization of the sphenopalatine ganglion.
The Headache Scale: an Examination of its Reliability and Validity
Authors: Jahanshahi M. , Hunter M. , Philips C.
Published: June 2005

SYNOPSIS

360 Migraine and tension headache sufferers attending a specialist headache clinic completed theHeadache Scale (HS), the McGill Pain Questionnaire (MPQ) and the Pain Behaviour Checklist. Mood andpersonality were also assessed. The test‐retest reliability of the HS over a one week period was examinedand found to be adequate. Cluster analysis of the HS adjectives resulted in 5 clusters labelled tight, sharp,dull (sensory), discomfort and autonomic (affective). When the severity of headaches was partialled out, asensory and an affective cluster corresponding to the two major components of subjective pain experiencewere obtained. The concurrent validity of the HS was further demonstrated by its having an identicalpattern of association as the MPQ to the Pain Behaviour Checklist, the Wakefield Depression Inventory andthe Eysenck Personality Questionnaire. Scores of the classical and common migraineurs and tensionheadache sufferers on the HS were quantitatively but not qualitatively different. Situations in which the HSmay be used instead of the MPQ are outlined and suggestions for further examination of the validity of theHS are made.
Multiple Headaches in a Case of Multiple Personality Disorder
Authors: Packard Russell C. , Brown Frank
Published: June 2005

SYNOPSIS

A female with multiple personality disorder (MPD) was referred for treatment of several different anddistinct headache problems. This case is presented in detail and the literature is reviewed in regard toheadaches occurring in cases of MPD.In an extensive review of 52 previously reported cases of MPD, headaches was the most frequent somaticcomplaint, occurring in over 60%. Headaches previously reported, however, have never been well definedas to etiology, type or treatment. This paper addresses these areas and the problems involved in makingsuch determinations in this unusual personality disorder.The curious clinical observations about the headaches observed in this case of MPD suggest that thisgroup of headache patients might prove to be a unique population for further study, especially in regard tosolving some of the biochemical and emotional mechanisms of headache, and their possible interactions.
The Diagnostic Value of High Resolution Computerized Tomography in Post‐traumatic Head Pain Patients
Authors: Tilds Barry N. , Miller Peter R. , Guidice Mary Ann
Published: June 2005

SYNOPSIS

High resolution CT scanning in patients with post‐traumatic head pain is superior to conventional radiography fordetecting fractures and other lesions of the facial structures. This is an important consideration, since suchlesions may be responsible for the post‐traumatic pain. Direct axial and coronal scanning is adequate fordiagnosis in most cases; multiplanar reconstructions can be done to obtain sagittal and other views. The radiationdose and cost of CT are comparable to those of conventional tomography.
Propranolol in the Prophylaxis of Migraine
Authors: Nadelmann J.W. , Phil. M. , Stevens J. , Saper J.R.
Published: June 2005

SYNOPSIS

This 34‐week, placebo‐controlled, single crossover study with a double‐blind randomized treatment sequence evaluated the effects of propranolol as a prophylactic agent in individualized doses ranging from 60–320 mg/day given to 62 patients who had common and/or classic migraine. Variables reflecting efficacy were the frequency, severity, and persistency of acute migraine attacks expressed as Headache Unit Index (HUI) and the therapeutic medication required for acute attacks during the study expressed as the Relief Medication Unit Index (RMUI). Both HUI and RMUI were significantly reduced from baseline after the six weeks of propranolol titration (p<0.0001) reflecting fewer and/or less severe headaches. During the crossover treatment periods, propranolol, in comparison with placebo, was significantly more effective in the reduction of HUI (p<0.01) and RMUI (p<0.05). Data at the end of the dose finding (titration) period were analyzed separately for patients whose final prescribed doses were 60‐240 mg or 320 mg/day propranolol. Significant reductions in HUI and RMUI (p< 0.0001) were shown at this time at each dose level. At all dose levels, propranolol was well tolerated. This was the first study in which the propranolol dose for migraine extended above the usual recommended 240 mg/day, i.e., up to 320 mg/day. This higher dose was administered if the drug had been well tolerated, even if only one headache in 2 weeks occurred at lower doses. The data suggest that there is an option to prescribe propranolol at higher doses as a preventive measure, thus reducing the need for ancillary medications.
Inpatient Treatment of Headache: Long‐Term Results
Authors: Diamond Seymour , Freitag Frederick G. , Maliszewski Michael
Published: June 2005

SYNOPSIS

In certain refractory cases of headache, inpatient therapy in a headache treatment unit may prove beneficial. Strict criteria for admission to this unit have been developed. To ascertain the long‐term benefits of treatment, a survey was sent to 372 consecutive patients. A 41% response rate was achieved. Fifty‐four percent of the patients had a greater than 50% reduction in headache unit index at the time of the survey and 59.6% had a greater than 50% reduction in the corrected headache unit index. Approximately 10% of those responding to the survey had become and remained completely headache‐free. Medical management and non‐drug therapies such as biofeedback and dietary instruction were viewed as being the most important treatment modalities by the patients. Psychological modalities were of benefit to 72% of the patients and biofeedback was useful to 54% of the patients. These results prompt us to believe that the multidisciplinary inpatient treatment of headache is beneficial to the majority of patients whose headaches have been refractive to traditional outpatient treatment.
Observations on Prodromes of Classic Migraine in a Headache Clinic Population
Authors: Bana Dhirendra S. , Graham John R.
Published: June 2005

SYNOPSIS

Prodromes of classic migraine were retrospectively studied from the records of 325 patients as regards their type, number, duration, frequency and sidedness in relation to the headache phase. We conclude:

1. Prodromes can affect any of the senses, but most commonly affect the visual field.

2. When more than one prodrome was present, the most common combinations were: Visual + Sensory for two prodromes; visual + sensory + speech for three prodromes; and visual + sensory + speech + motor for four prodromes,

3. Duration and Frequency of prodromes vary widely.

4. A definite statement about sidedness of headache in relation to prodrome could not be made.

We feel a prospective study of prodromes is necessary to examine prodrome phenomena in greater detail.
Copper as a Factor in the Dietary Precipitation of Migraine
Authors: Harrison Dennis R
Published: June 2005

SYNOPSIS

Substances such as chocolate and glutamate are triggers of migraine. These and some other “migrainous substances” contain little or no tyramine. This suggests that other dietary factors are involved in the precipitation of migraine. These food substances play a role in the utilization of copper, which is known to be involved in the metabolism of vasoneuroactive amines such as serotonin, tyramine and the catecholamines.

This paper suggests that it is the effects that these substances have on the copper pathway (i.e. its absorption and utilization) that is the primary consideration in the precipitation of migraine. Chocolate contains high levels of copper. Glutamate acts to bind and transport significant amounts of copper between blood and tissues. Citrate, found in “migrainous citrus fruits,” increases the intestinal absorption of copper; and both ascorbate and citrate may act to decrease oxidation of tyramine and serotonin, thereby raising the effective levels of these substances and perhaps triggering a migraine attack.

A migraine episode would be made more likely upon the ingestion of these substances by susceptible individuals with abnormal copper metabolism such as lowered levels or altered ceruloplasmin, transferrin or albumin (known to bind copper), or a change in copper transport.