bluuebunny/crossref_metadata_2025 huggingface dataset:
Conservation of Terrestrial Invertebrates and Their Habitats in Brazil
Authors: LEWINSOHN THOMAS M. , FREITAS ANDRÉ VICTOR LUCCI , PRADO PAULO INÁCIO
Published: June 2005

Abstract:  As one of the world's prime megadiverse countries, Brazil holds an immense number of terrestrial invertebrates. Current knowledge of this biota is very heterogeneous. Several taxa are sufficiently well known to be used as indicators of ecological integrity or of endemism. The current Brazilian national and regional red lists include 130 terrestrial invertebrate species, of which 42% are butterflies. These lists are contingent on available knowledge, and many taxa that are omitted certainly include species at risk. Knowledge of various biomes and habitats is also quite irregular, with the Caatinga and Pantanal in need of more study, compared with the Atlantic Forest, the Amazon, and Cerrado. Canopy, host‐associated, and soil faunas also need further intensive study. Invertebrate conservation will be promoted more effectively by habitat preservation and management rather than single‐species initiatives. To this end, better geographic surveys of entire taxonomic or functional assemblages are needed. An improved understanding of the invertebrate role in ecosystem processes will strengthen enormously the case for their conservation.
The Conservation of Brazilian Reptiles: Challenges for a Megadiverse Country
Authors: RODRIGUES MIGUEL TREFAUT
Published: June 2005

Abstract:  About 650 species—330 snakes, 230 lizards, 50 amphisbaenids, 6 caimans, and 35 turtles—comprise the known reptile fauna of Brazil. Only 20 are considered threatened. Except for the marine and freshwater turtles, which suffer from overexploitation and habitat destruction, they are threatened because of their rarity and extremely restricted ranges. Despite its richness and diversity, research on Brazil's reptile fauna is still largely restricted to alpha taxonomy. Surveys, an electronic database of all herpetological collections, and phylogeographic studies based on molecular genetic techniques are needed to improve our understanding of the biogeography of this group and to delineate effective conservation strategies to preserve the evolutionary potential of existing lineages. Autecological, population, and community studies that monitor effects of habitat degradation, fragmentation, and loss, pollution, and exploitation are needed for a better understanding of the effects of the widespread and ever‐worsening degradation of Brazil's natural ecosystems.
Why We Need Megareserves in Amazonia
Authors: PERES CARLOS A.
Published: June 2005

Abstract: Brazilian Amazonia faces one of the greatest threats and opportunities for tropical biodiversity conservation of our times. I consider several large‐scale issues in biodiversity conservation planning (e.g., resource extraction, large areas needed for top predators, species migration, fire, and carbon sequestration) in light of our severely deficient understanding of basinwide patterns of species distribution and little‐known Amazonian biota. The long‐term persistence of this biota is best served by strictly protected and sustainable development forest reserves that are both embedded in a benign forest matrix and sufficiently large to support a full complement of species and landscape‐scale ecological processes. Given rapidly accelerating trends in agricultural frontier expansion into previously unclaimed public lands, protection and controlled development of forests is urgent.
Conservation of Marine and Coastal Biodiversity in Brazil
Authors: AMARAL ANTÔNIA CECÍLIA Z. , JABLONSKI SÍLVIO
Published: June 2005

Abstract:  The invertebrate benthos, especially the micro‐ and mesofaunal components, of the Brazilian seas is still poorly known. Relatively few species have been recorded, reflecting the lack of research in this field. The intertidal zone, to depths of about 20 m, has been studied the most, and there the numbers of endemic species are relatively high. The diversity of demersal and pelagic fishes is similar among the major marine regions, and endemism is typically low (<5%) and restricted to reef species. Surveys in southeastern Brazil (depths of up to 2000 m) have recorded more than 1300 species of benthic animals, of which the Porifera, Cnidaria, Sipuncula, Gastropoda, Bivalvia, Scaphopoda, Polychaeta, Crustacea, Ophiuroidea, Bryozoa, and Brachiopoda were the most abundant or frequent. Excepting the molluscs, decapods (brachiurans), cirripeds, and echinoderms, the faunas of salt marshes, coral reefs, and islands remain poorly known. Marine and estuarine demersal teleosts include 617 species in 26 orders and 118 families. Just over half the species (337) are Perciformes. Overexploitation, for food and by the aquarium fish trade, habitat degradation and destruction, alien species introductions, pernicious tourism, and pollution are the principal threats to Brazil's marine biodiversity. The Ministry of the Environment lists 34 threatened and 10 overexploited or at risk of being overexploited benthic species. Fishes officially listed as threatened include 15 species of sharks and rays and 7 teleosts. Another six elasmobranchs and 27 teleosts are currently or potentially being overexploited. Conservation of marine biodiversity in Brazil is still broadly inadequate despite existing legislation and several protected areas. The number and size of marine protected areas are insufficient, and some still lack management plans or have yet to receive the appropriate measures and infrastructure to make them effective. Fisheries administration and management is still precarious and in many areas lacks effective participation of local communities. Major conservation initiatives include the identification of keys areas for biodiversity conservation, surveys, intensified monitoring of fisheries, environmental education, and the creation and improved management of protected areas.
Financial Mechanisms for Conservation in Brazil
Authors: YOUNG CARLOS EDUARDO FRICKMANN
Published: June 2005

Abstract:  I reviewed some of the financial mechanisms for biodiversity conservation activities in Brazil. There is a heavy dependence on the public sector, but macroeconomic policies aimed at reducing government spending have resulted in reduced budgets dedicated to public conservation measures. The financial constraints for environmental protection have also increased because of a reduction in foreign aid. Positive signs for the immediate future, however, come from new initiatives that create economic instruments to finance conservation. The most important initiatives include conservation criteria for tax redistribution; environmental compensation; water charges; royalties for electricity, petroleum, and natural gas; tradable obligations for forest reserves; and voluntary measures on the part of the business sector. Resources created from these initiatives have different origins and are managed by different public agencies according to varying laws and policies, so their efficient implementation will require that the institutions involved in biodiversity conservation in Brazil establish a minimum set of common priorities and objectives.
Infrastructure and Conservation Policy in Brazil
Authors: REID JOHN , DE SOUSA WILSON CABRAL
Published: June 2005

Abstract:  The development of transportation and energy infrastructure has been a major driver in the conversion of natural ecosystems in Brazil since the nineteenth century. Although this pattern is present in most countries, Brazil differs in the scale of opportunities that are still available to build its physical infrastructure while pursuing an ambitious conservation agenda. This advantage stems from the magnitude of intact ecosystems, a dynamic policy environment, and the increasing availability of biological and economic data needed to harmonize conservation with public works. Success depends on integrating conservation and infrastructure planning, rather than relying on the project based, largely ineffective environmental assessment process. Front‐loading environmental mitigation and compensation will also help, as will improving public access to, and understanding of, information on the environmental and economic values at stake in major infrastructure decisions.
Land Reform and Biodiversity Conservation in Brazil in the 1990s: Conflict and the Articulation of Mutual Interests
Authors: CULLEN LAURY , ALGER KEITH , RAMBALDI DENISE M.
Published: June 2005

Abstract:  Land‐reform and environmental movements, revitalized by the democratization of civil society in Brazil in the 1990s, found their objectives in conflict over forested parcels that settlers want for conversion to agriculture but that are important for wildlife conservation. In the Atlantic Forest, where 95% of the forest is gone, we reviewed three cases of Brazilian nongovernmental organization (NGOs) engagement with the land‐reform movement with respect to forest remnants neighboring protected areas that have insufficient habitat for the long‐term survival of unique endangered species. In the Pontal do Paranapanema (São Paulo), Poço das Antas (Rio de Janeiro), and southern Bahia, environmental NGOs have supported agricultural alternatives that improve livelihood options and provide incentives for habitat conservation planning. Where land‐reform groups were better organized, technical cooperation on settlement agriculture permitted the exploration of mutual interests in conciliating the productive landscape with conservation objectives. Processes of regular consultation among NGOs, environmental agencies, and the private sector revealed that there was less zero‐sum conflict over the same lands than commonly perceived. In both groups, technicians found forested lands less suitable for small‐scale agriculture, and leaders took risks to justify and support claims to alternative existing agricultural lands. Based on the cases we examined, the construction of landscapes with both forest stewardship and poverty‐reducing agrarian reform faces continued obstacles from contradictory agrarian and environmental sector policies and inadequate economic incentives for forest stewardship on private lands.
Changing the Course of Biodiversity Conservation in the Caatinga of Northeastern Brazil
Authors: LEAL INARA R. , DA SILVA JOSÉ MARIA CARDOSO , TABARELLI MARCELO , LACHER THOMAS E.
Published: June 2005

Abstract:  The 735,000‐km2 Caatinga is a mosaic of thorn scrub and seasonally dry forests, with more than 2000 species of vascular plants, fishes, reptiles, amphibians, birds, and mammals. Endemism in these groups varies from 7% to 57%. Inappropriate land use has already caused serious environmental damage and accelerating desertification, which is currently threatening about 15% of the region. Moreover, the rich and diversified biota of the Caatinga is poorly protected: only 11 reserves (<1% of the region) are strictly protected areas. A conservation strategy for the Caatinga biota should be designed to (1) avoid further habitat loss and desertification, (2) maintain key ecological services necessary for improving the living standards of the rural population, and (3) promote the sustainable use of the region's natural resources. Implementing an effective conservation agenda for the Caatinga is not an easy task but, with creativity and consistent financial support, it should be possible to nurture this unique biome and guarantee the preservation of its rich and diversified fauna and flora, and, with this, the well‐being of its rural populations.
Biodiversity and Conservation of Plants in Brazil
Authors: GIULIETTI ANA MARIA , HARLEY RAYMOND M. , DE QUEIROZ LUCIANO PAGANUCCI , WANDERLEY MARIA DAS GRAÇAS LAPA , VAN DEN BERG CASSIO
Published: June 2005

Abstract:  With more than 56,000 species (excluding fungi), Brazil has one of the richest floras in the world—nearly 19% of the world flora. Our knowledge of the diversity and status of nonvascular plants in Brazil is still fragmentary, although localized studies on algae have revealed loss of species resulting from environmental pollution. Emphasis on local floral surveys, rather than wider taxonomic studies, has obscured estimates of national totals for most taxonomic groups. Knowledge of angiosperms, especially monocotyledons (of which 45% of the species are endemic), is more complete than most. For this group figures are more reliable, with some distribution patterns, endemism levels, and centers of diversity identified. Much, however, still awaits discovery. Coordinated efforts to catalog Brazil's flora are in progress and include projects such as the conservation priority‐setting workshops of the Brazilian Ministry of the Environment, which have identified key conservation areas in the major biomes; development of threatened species lists for plants; and the assembly of type data on species of northeastern Brazil through the Darwin Initiative—all of which greatly assist in increasing our knowledge. These initiatives also underline the urgent need to expand the numbers and geographic spread of projects on plant systematics and taxonomy in Brazil, a measure that demands adequate provision of funding and training programs for plant specialists. Finally, Brazil's environmental agency (IBAMA) could play a proactive role in opening protected areas under its jurisdiction, thereby facilitating botanical research by university departments and research institutes.
The Fate of the Amazonian Areas of Endemism
Authors: DA SILVA JOSÉ MARIA CARDOSO , RYLANDS ANTHONY B. , Da FONSECA GUSTAVO A. B.
Published: June 2005

Abstract:  Amazonia is the largest and most diverse of the tropical forest wilderness areas. Recent compilations indicate at least 40,000 plant species, 427 mammals, 1294 birds, 378 reptiles, 427 amphibians, and around 3,000 fishes. Not homogeneous in its plant and animal communities, it is an archipelago of distinct areas of endemism separated by the major rivers. Biogeographic studies of terrestrial vertebrates have identified eight such areas in the Brazilian Amazon: Tapajós, Xingú, and Belém (all in Brazil); Rondônia (mostly in Brazil); and portions of Napo, Imeri, Guiana, and Inambari. They range in size from more than 1.7 million km2 (Guiana) to 199,211 km2 (Belém). Forest loss in each ranges from 2% to 13% of their area, except for Xingu (nearly 27% lost) and Belém, (now only about one‐third of its forest remains). Napo, Imeri, and Guiana have >40% of their lands in protected areas, Inambari, Rondônia, Tapajós, and Xingu between 20% and 40%, and Belém <20%. Strictly protected areas in each, however, are limited—from 0.28% to 11.7%. Areas of endemism should be the basic geographic unit for the creation of conservation corridors of contiguous protected areas, providing broad connectivity on both margins and within the interior of areas of endemism. The aim is to build a conservation system that is large and resilient enough to circumvent global changes, accommodate improved living standards for local populations, conserve biodiversity, and safeguard the ecological services forests and rivers provide. Elected leaders are now realizing that the traditional economy based on cattle ranching and logging is unsustainable. Deforestation proceeds apace, but the federal government is implementing the Protected Areas Programme for Amazonia, which seeks to protect 50 million ha, and a number of state governments are now active in creating protected areas and incorporating appropriate conservation measures in their development plans.
Bird Conservation in Brazil
Authors: MARINI MIGUEL ÂNGELO , GARCIA FREDERICO INNECCO
Published: June 2005

Abstract: Brazil has one of the richest avifaunas in the world, with recent estimates varying from 1696 to 1731 species. About 10% (193 taxa) of these are threatened. The Amazon has the highest number of species, followed by the Atlantic Forest and the Cerrado; most of Brazil's endemic birds, however, are in the Atlantic Forest. Brazil's threatened species occur mostly in the Atlantic Forest, especially in the southeast lowlands and the northeast. The Cerrado has the second highest number of threatened species. The two major threats to Brazilian birds are habitat loss, degradation, and fragmentation and hunting, most especially for illegal commerce. A number of conservation and research initiatives over the last 20 years have significantly improved our capacity to address and resolve major issues for bird conservation. Brazil requires a National Bird Conservation Plan to draw up priorities for research and conservation over the next decade.
Safeguarding the Pantanal Wetlands: Threats and Conservation Initiatives
Authors: HARRIS MÔNICA B. , TOMAS WALFRIDO , MOURÃO GUILHERME , DA SILVA CAROLINA J. , GUIMARÃES ERIKA , SONODA FÁTIMA , FACHIM ELIANI
Published: June 2005

Abstract: The Pantanal, one of the largest wetlands on the planet, comprises 140,000 km2of lowland floodplain of the upper Rio Paraguai basin that drains the Cerrado of central Brazil. The diverse mosaics of habitats resulting from the varied soil types and inundation regimes are responsible for an extraordinarily rich terrestrial and aquatic biota, exemplified by the bird richest wetland in the world—463 birds have been recorded there—and the largest known populations of several threatened mammals, such as Pampas deer (Ozotoceros bezoarticus), marsh deer (Blastocerus dichotomus), giant otter (Pteronura brasiliensis), and jaguar (Panthera onca). Until recently, deforestation of the adjoining Brazilian central plateau was considered the major threat to this area, but now deforestation is a critical problem within the floodplain itself. More than 40% of the forest and savanna habitats have been altered for cattle ranching through the introduction of exotic grasses. And there are other threats that lead to large‐scale disruption of ecological processes, severely affecting biodiversity. Although the Pantanal wetland is a Biosphere Reserve and is considered a Wetland of International Importance, only 2.5% of the upper Paraguai River basin is formally protected. To date, protected areas have been created opportunistically and as such, although of undoubted value, protect only a fraction of the Pantanal's wildlife and habitats. Among the conservation initiatives in the area, the private sector is increasingly participating in the establishment of private reserves. The prospects are far from optimistic, however, and the major challenge is to find alternative socioeconomic models that allow for conservation and economic uses of the land in association with the development of specific environmental legislation that reflects the unique characteristics of the region.
Brazilian Protected Areas
Authors: RYLANDS ANTHONY B. , BRANDON KATRINA
Published: June 2005

Abstract:  Although Brazil's first park was established in 1937, the past two decades have witnessed an explosion of protected areas. Until 1989 federal parks and reserves were created by the Brazilian Forest Development Institute (IBDF) and the Special Secretariat for the Environment (SEMA). In 1989 SEMA and IBDF were united to form the Brazilian Institute for the Environment and Renewable Natural Resources (IBAMA). A formal, unified system for federal, state, and municipal parks, the National System for Protected Areas, was made law in 2000. In 1976 IBDF drew up a biogeographical model for siting protected areas for biodiversity conservation in the Amazon, based on representation of phytogeographic regions. There are three ongoing initiatives to determine the location of new protected areas: (1) protected areas were recommended for the majority of 900 priority areas for biodiversity conservation identified in workshops held for Brazil's major biomes (1998–2000); (2) establishment of biodiversity corridors with parks and reserves as key elements; and (3) the creation of protected areas in the 23 Amazonian ecoregions identified by World Wildlife Fund—Brazil (the ARPA program). Federal and state strictly protected areas now number 478 and total 37,019,697 ha, and there are 436 sustainable‐use areas totalling 74,592,691 ha. Other categories of protected areas in Brazil include private natural heritage reserves (RPPNs), which are generally small but proving important for the conservation of restricted‐range and highly threatened species, and indigenous reserves, which are increasingly recognized as vital for biodiversity conservation because of their enormous size. Although Brazil has created an enormous number of protected areas over the last two decades, enormous challenges remain—not only for their administration and management—but also to protect the parks themselves as Brazil continues with its ambitious developmental programs for energy, infrastructure, industry, and agriculture.
Statistical Power and Sample Size Estimation for Headache Research: An Overview and Power Calculation Tools
Authors: Houle Timothy T. , Penzien Donald B. , Houle Chris K.
Published: June 2005

The present article reviews the concept of statistical power analysis for research designs in headache. First, we present a basic overview of the concepts of statistical hypothesis testing. Then we discuss the elements of power analysis and, where appropriate, we address conventions for power calculations. We offer, for public use, an applied power calculator for two applications that are often encountered in headache research. We intend to help headache researchers design trials with adequate statistical power by offering a conceptual overview and the power calculators. In closing, we briefly address the implications of the present trend toward reporting point estimates of effect sizes with confidence levels.
The Examination of Headache Activity Using Time‐Series Research Designs
Authors: Houle Timothy T. , Remble Thomas A. , Houle Thomas A.
Published: June 2005

The majority of research conducted on headache has utilized cross‐sectional designs which preclude the examination of dynamic factors and principally rely on group‐level effects. The present article describes the application of an individual‐oriented process model using time‐series analytical techniques. The blending of a time‐series approach with an interactive process model allows consideration of the relationships of intra‐individual dynamic processes, while not precluding the researcher to examine inter‐individual differences. The authors explore the nature of time‐series data and present two necessary assumptions underlying the time‐series approach. The concept of shock and its contribution to headache activity is also presented. The time‐series approach is not without its problems and two such problems are specifically reported: autocorrelation and the distribution of daily observations. The article concludes with the presentation of several analytical techniques suited to examine the time‐series interactive process model.
Behavioral Headache Research: Methodologic Considerations and Research Design Alternatives
Authors: Hursey Karl G. , Rains Jeanetta C. , Penzien Donald B. , Nash Justin M. , Nicholson Robert A.
Published: June 2005

Behavioral headache treatments have garnered solid empirical support in recent years, but there is substantial opportunity to strengthen the next generation of studies with improved methods and consistency across studies. Recently, Guidelines for Trials of Behavioral Treatments for Recurrent Headache were published to facilitate the production of high‐quality research. The present article compliments the guidelines with a discussion of methodologic and research design considerations. Since there is no research design that is applicable in every situation, selecting an appropriate research design is fundamental to producing meaningful results. Investigators in behavioral headache and other areas of research consider the developmental phase of the research, the principle objectives of the project, and the sources of error or alternative interpretations in selecting a design. Phases of clinical trials typically include pilot studies, efficacy studies, and effectiveness studies. These trials may be categorized as primarily pragmatic or explanatory. The most appropriate research designs for these different phases and different objectives vary on such characteristics as sample size and assignment to condition, types of control conditions, periods or frequency of measurement, and the dimensions along which comparisons are made. A research design also must fit within constraints on available resources. There are a large number of potential research designs that can be used and considering these characteristics allows selection of appropriate research designs.
Behavioral Research and the Double‐Blind Placebo‐Controlled Methodology: Challenges in Applying the Biomedical Standard to Behavioral Headache Research
Authors: Rains Jeanetta C. , Penzien Donald B.
Published: June 2005

The randomized, double‐blind, placebo‐controlled experimental design has prevailed as the “gold standard” in biomedical research, intended to control potential bias in patient/group assignment, investigator allegiance, patient expectations, and nonspecific therapeutic effects. Properly executed, such designs ensure a study's internal validity and allow differential group outcomes to be attributed to the active treatment. These controlled trials generally yield more conservative outcomes than open trials and case reports and establish efficacy in pharmaceutical research. In meta‐analytic reviews, studies are often assigned quality scores based in part on the degree to which they meet this scientific standard. Applying the biomedical research design standards for blinding and placebo control to clinical trials evaluating behavioral and other nonpharmacologic headache treatment nearly always is either infeasible or simply not possible. Only rarely is blinding meaningfully achievable in administration of behavioral or psychological therapies. Various “psychological placebo” control conditions have been forwarded in behavioral studies (eg, sham treatments, pseudomeditation), but these controls are incapable of emulating an inert control condition comparable to that of the pill placebo in pharmacologic research, and they are best reserved for studies examining the mechanisms whereby an intervention produces improvement. This article reviews the conceptual and procedural challenges in applying the standard pharmaceutical clinical trials research design to behavioral headache research as well as implications for meta‐analyses across studies of various treatment modalities.
Methodological Issues in Clinical Trials of Drug and Behavior Therapies
Authors: Holroyd Kenneth A. , Powers Scott W. , Andrasik Frank
Published: June 2005

Trials that compare drug and behavior therapies or evaluate combination therapy raise special methodological issues. This article reviews these methodological issues and, where possible, offers guidelines for addressing them. Sources of bias in the selection and recruitment of participants and in the measurement of treatment outcomes are discussed. In addition, methodological problems presented by the differing structures of behavior and drug therapy, by confounding variables, such as allegiance effects, differential expectations and preferences for drug or behavior therapy, and differential adherence with drug or behavior therapy also are reviewed. Issues in the selection of appropriate control groups are also discussed.
Headache and Psychiatric Comorbidity: Historical Context, Clinical Implications, and Research Relevance
Authors: Lake Alvin E. , Rains Jeanetta C. , Penzien Donald B. , Lipchik Gay L.
Published: June 2005

The comorbidity of headache and psychiatric disorders is a well‐recognized clinical phenomenon warranting further systematic research. Affective disorders occur with at least three‐fold greater frequency among migraineurs than among the general population, and the prevalence increases in clinical populations, especially with chronic daily headache. When present, psychiatric comorbidity complicates headache management and portends a poorer prognosis for headache treatment. However, the relationship between headache and psychopathology has historically been misunderstood, and measures of psychopathology have not always met the standard of formal Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM‐IV) criteria. In some cases, headache has been inappropriately attributed to psychological or psychiatric features, based on anecdotal observations. The challenge for future studies is to employ research methods and designs that accurately identify and classify the subset of headache patients with psychiatric disorders, evaluate their impact on headache symptoms and treatment, and identify optimal behavioral and pharmacologic treatment strategies. This article offers methodological considerations and recommendations for future research including: (i) ascribing dual‐International Classification of Headache Disorders, 2nd ed. (ICHD‐2) headache and DSM‐IV psychiatric diagnoses according to reliable and valid diagnostic criteria, (ii) differentiating subclinical levels of depression and anxiety from major psychiatric disorders, (iii) encouraging validation studies of the recently published ICHD‐2 diagnoses for “headache attributed to psychiatric disorder,” (iv) expanding epidemiological research to address the range of DSM‐IV Axis I and II psychiatric diagnoses among various headache populations, (v) identifying relevant psychiatric and behavioral mediator/moderator variables, and (vi) developing empirically based screening and treatment algorithms.
Efficacy and Effectiveness Approaches in Behavioral Treatment Trials
Authors: Nash Justin M. , McCrory Douglas , Nicholson Robert A. , Andrasik Frank
Published: June 2005

The objective is to clarify the distinction between efficacy and effectiveness approaches and to discuss how these approaches can be used in a complementary way in the development, evaluation, and implementation of behavioral treatments for primary headache in various settings. Efficacy studies, with an emphasis on internal validity, are experiments that evaluate treatment response in an ideal, highly controlled research environment. Despite their methodological strengths, efficacy studies are limited in their ability to estimate the treatment effects that can be expected in clinical practice settings. Effectiveness studies, with an emphasis on external validity, are outcome studies with less controls that evaluate treatment response in settings more representative of clinical practice. Effectiveness studies, however, are limited in their ability to determine the causal link between treatment and response. Based on the four‐phase model used in new drug development, a three‐phase linear progression model is presented for behavioral treatment studies. This model provides for pilot testing, efficacy testing, and effectiveness testing of behavioral treatments so that there is appropriate evaluation from initial promise of a developing treatment to implementation and dissemination to various treatment delivery settings.
Moderators and Mediators of Behavioral Treatment for Headache
Authors: Nicholson Robert A. , Hursey Karl G. , Nash Justin M.
Published: June 2005

Although work has been done establishing the efficacy of behavioral treatments for headache, almost no work has been done using appropriate methodology to evaluate what types of patients in which settings (termed “moderators”) are likely to benefit from treatment and what treatment components account for treatment response (termed “mediators”). The current article provides an overview of moderators and mediators and their assessment and analysis as they pertain to clinical trials. The article also discusses the need for moderator and mediator hypotheses to be theory driven. A brief consideration of potential moderators and mediators of behavioral treatment for headache is then presented. The article concludes with a discussion of methodological issues to be addressed when conducting moderator and mediator analysis for behavioral treatment for headache.
Methodological Considerations in Research With Special Populations: Children and Adolescents
Authors: Andrasik Frank , Powers Scott W. , McGrath Patrick J.
Published: June 2005

Headache occurs across the lifespan, but limited attention has been devoted to children and adolescents. This article discusses pertinent methodological considerations when conducting behavioral research with pediatric populations. Issues needing special consideration when working with children and adolescents involve ethics, sample characterization, headache diagnosis, treatment administration, and outcome measurement. Available literature is reviewed and specific recommendations are offered when possible.
Disability Pattern in Chronic Migraine With Medication Overuse: A Comparison With Migraine Without Aura
Authors: D'Amico Domenico , Grazzi Licia , Usai Susanna , Rigamonti Andrea , Curone Marcella , Bussone Gennaro
Published: June 2005

Objectives.—To assess headache‐related disability in chronic migraine with medication overuse (CMO), as defined by Silberstein and Lipton (1996, 2001) in comparison to that caused by migraine without aura, investigating similarities and differences in disability patterns in these two conditions.

Background.—It is well known that migraine has a marked impact on daily activities. Less information is available on the functional consequences of chronic migraine.

Methods.—This was a prospective study on 247 patients with CMO and 264 with migraine without aura. All completed the validated Italian version of the Migraine Disability Assessment questionnaire (MIDAS). The MIDAS total score and scores of each question (investigating total or partial inability to perform different daily activities) were evaluated, and compared in the two groups using the Mann‐Whitney rank sum test. We also evaluated the number of missed days (question 1) and days with significantly reduced effectiveness at work (question 2) and in nonwork activities (questions 3, 4, and 5), using descriptive statistics.

Results.—MIDAS total score in the CMO group was rather high (mean 84.1, median 70) and significantly higher than in the migraine group (mean 23.4, median 19). CMO patients also reported higher scores than migraine patients in MIDAS questions investigating disability in different domains, the differences being highly significant for questions 3, 4, and 5. In both CMO and migraine the number of days with total or significant disability in nonwork activities was higher than the number of days with total or significant disability in work activities, and days spent at work with significantly reduced effectiveness were more than work days missed.

Conclusions.—Our findings show that CMO has a profound effect on patients' daily functioning. They suggest that differences between CMO and migraine are mainly quantitative, while the two groups are similar in terms of disability pattern. These results are consistent with the fact that CMO may be an evolution of episodic migraine, characterized by increase in headache frequency and more evident disability in performing different daily duties.
Depressive Symptoms and Insecure Attachment as Predictors of Disability in a Clinical Population of Patients With Episodic and Chronic Migraine
Authors: Rossi Paolo , Di Lorenzo Giorgio , Malpezzi Maria Grazia , Di Lorenzo Cherubino , Cesarino Francesco , Faroni Jessica , Siracusano Alberto , Troisi Alfonso
Published: June 2005

Objectives.—To define predictors of migraine‐related disability in patients with episodic and chronic migraine referred to a specialty migraine clinic, focusing on depressive symptoms and insecure attachment style that, because of their association with responses to pain and physical illness, might be predictive of greater migraine‐related disability.

Background.—The Migraine Disability Assessment questionnaire (MIDAS) has proved to be a reliable and easy‐to‐use instrument to assess migraine‐related disability. As clinicians are increasingly using MIDAS in their diagnostic and treatment decisions for patient care, an understanding of the factors influencing migraine‐related disability is essential for a rationale use of such an instrument.

Methods.—Two‐hundred patients suffering from episodic migraine without aura (EM), and chronic migraine (CM) with and without medication overuse, and referred to a specialty headache clinic were evaluated using the MIDAS, the Beck Depression Inventory (BDI), and the Attachment Style Questionnaire (ASQ). Diagnosis of episodic and chronic migraine was operationally defined according to the International Headache Society (IHS) and Silberstein–Lipton criteria.

Results.—Multiple regression analysis showed that, in the total sample, disability was higher in those patients with CM, more severe depressive symptoms, an insecure style of attachment (as reflected by a lower score on the ASQ confidence scale), and experiencing more severe headache pain intensity. In the subgroup of patients with episodic migraine, an insecure style of attachment emerged as the most significant predictor of disability (other significant predictors were female sex and number of headache days per month). In contrast, in the subgroup of patients with CM, the only significant predictor of the total MIDAS score was a greater severity of depressive symptoms.

Conclusions.—Our findings demonstrate the relevance of attachment style, an enduring psychological trait not evaluated in previous studies, in influencing the disability level in patients with migraine and confirm the role of comorbid depressive symptoms in modulating the impact of migraine on every day functioning.
Comorbidity of Psychiatric and Behavioral Disorders in Pediatric Migraine
Authors: Pakalnis Ann , Gibson Jessica , Colvin Andrew
Published: June 2005

Objective.—To determine whether behavioral and psychiatric disorders occur more frequently in school‐age children with migraine headache. To also elucidate treatment response related to comorbid psychiatric or behavioral diagnosis.

Background.—Recurrent migraine headaches are common in school‐age children. Concurrent behavioral or psychiatric diagnoses could significantly impact headache frequency, severity, and response to treatment.

Methods.—Healthy children from 6 to 17 years of age presenting to our headache clinic with migraine headache according to International Headache Society (IHS) criteria were identified. Parents/guardians were asked to complete the Child Symptom Inventory, 4th edition (CSI‐4) after written informed consent. Children with positive rating scales underwent psychological interviews for confirmatory diagnosis. Results were compared to controls. Headache patients were assigned our usual treatment paradigm. Response regarding headache frequency was assessed at 3 months.

Results.—A total of 47 patients were diagnosed with migraine headaches. The mean age was 10.55 years. Thirty controls were identified. After completing the CSI‐4 and confirmatory psychological interview, 14 of 47 headache patients fulfilled Diagnostic and Statistical Manual (DSM‐4) criteria for a psychiatric or behavioral disorder. Oppositional defiant disorder (ODD) was significantly represented among children with migraine compared to the control group of children. Headache patients improved significantly post‐treatment regarding their headache frequencies regardless of comorbid psychiatric or behavioral disorder. No significant differences were noted between boys and girls regarding diagnoses or treatment outcome.

Conclusion.—ODD was a significant comorbidity in our headache population. Although families complained of significant behavioral symptomatology in their children, most of these symptoms did not qualify their children for a psychiatric diagnosis and may be related to the stressors of headache on social/school disruption.
The Headache of SAH Responds to Sumatriptan
Authors: Rosenberg Jay H. , Silberstein Stephen D.
Published: June 2005

We report the first case of the headache of subarachnoid hemorrhage (SAH) possibly responding to a triptan. Recent evidence suggests that triptans block transmission from the trigeminal nerve to second‐order neurons in the trigeminal nucleus caudalis; thus, any meningeal nociceptive process would be aborted. The triptans and ergots are not specific for migraine, but for any process that activates trigeminal fibers, including migraine, cluster headache, SAH, and meningitis. The failure to respond in the reported cases of meningitis may be due to sensitization.
A Case of Postprandial Cluster‐Like Headache With Prolactinoma: Dramatic Response to Cabergoline
Authors: Negoro Kiyoshi , Kawai Motoharu , Tada Yukiko , Ogasawara Jun‐Ichi , Misumi Shungo , Morimatsu Mitsunori
Published: June 2005

A 17‐year‐old boy without a significant past medical history presented with recurrent cluster‐like headaches induced by meals for 3 years. Magnetic resonance images showed a pituitary tumor. Just after starting treatment with cabergoline, the headaches resolved completely and the patient has been absolutely free from such headache attacks for 2 years.
Filum Ependymoma Mimicking Spontaneous Intracranial Hypotension
Authors: Schievink Wouter I. , Akopov Sergey E.
Published: June 2005

A 34‐year‐old man with a 2‐week history of orthostatic headaches and a “dry tap” at lumbar puncture was found to have a lumbar intradural mass on magnetic resonance imaging (MRI) examination. A myxopapillary ependymoma was resected and the patient's headache completely resolved. The combination of spontaneous orthostatic headaches and a “dry tap” at the time of lumbar puncture does not always indicate the presence of a spontaneous cerebrospinal fluid (CSF) leak and intracranial hypotension.
Ocular Compression Maneuver Aborts Benign Cough‐Induced Headache
Authors: Gupta Vinod Kumar
Published: June 2005

Benign cough‐induced headache is a short‐lasting cranial discomfort. The therapeutic role of lumbar puncture (LP) or indomethacin in benign patients with benign cough‐induced headache patients is debatable. Transient ocular compression (OC) raises intraocular pressure (IOP) and can limit the impact of cough‐induced choroidal venous congestion. A self‐applied maneuver that instantaneously aborts cough‐induced headache is described in two patients. The effect of this maneuver supports a recent hypothesis that cough‐induced headache may be due to ocular choroidal venous congestion and mechanical antidromic trigeminal nerve activation. The OC maneuver has several potential complications and its self‐application in benign cough‐induced headache should be regarded as an experimental procedure until more data regarding its efficacy and safety become available.
Anticonvulsant Activity of Androsterone and Etiocholanolone
Authors: Kaminski Rafal M. , Marini Herbert , Kim Won‐Joo , Rogawski Michael A.
Published: June 2005

Summary:  Purpose: Men with epilepsy often have sexual or reproductive abnormalities that are attributed to alterations in androgen levels, including subnormal free testosterone. Levels of the major metabolites of testosterone—androsterone (5α‐androstan‐3α‐ol‐17‐one; 5α,3α‐A), a neurosteroid that acts as a positive allosteric modulator of GABAA receptors, and its 5β‐epimer etiocholanolone (5β‐androstan‐3α‐ol‐17‐one; 5β,3α‐A)—also may be reduced in epilepsy. 5α,3α‐A has been found in adult brain, and both metabolites, which also can be derived from androstenedione, are present in substantial quantities in serum along with their glucuronide and sulfate conjugates. This study sought to determine whether these endogenous steroid metabolites can protect against seizures.

Methods: The anticonvulsant activity of 5α,3α‐A and 5β,3α‐A was investigated in electrical and chemoconvulsant seizure models in mice. The steroids also were examined for activity against extracellularly recorded epileptiform discharges in the CA3 region of the rat hippocampal slice induced by perfusion with 55 μM 4‐aminopyridine (4‐AP).

Results: Intraperitoneal injection of 5α,3α‐A–protected mice in a dose‐dependent fashion from seizures in the following models (ED50, dose in mg/kg protecting 50% of animals): 6‐Hz electrical stimulation (29.1), pentylenetetrazol (43.5), pilocarpine (105), 4‐AP (215), and maximal electroshock (224). 5β,3α‐A also was active in the 6‐Hz and pentylenetetrazol models, but was less potent (ED50 values, 76.9 and 139 mg/kg, respectively), whereas epiandrosterone (5α,3β‐A) was inactive (ED50, ≤300 mg/kg). 5α,3α‐A (10–100 μM) also inhibited epileptiform discharges in a concentration‐dependent fashion in the in vitro slice model, whereas 5β,3α‐A was active but of lower potency, and 5α,3β‐A was inactive.

Conclusions: 5α,3α‐A and 5β,3α‐A have anticonvulsant properties. Although of low potency, the steroids are present in high abundance and could represent endogenous modulators of seizure susceptibility.
GABAB Receptor 1 Polymorphism (G1465A) and Temporal Lobe Epilepsy
Authors: Salzmann Annick , Moulard Bruno , Crespel Arielle , Baldy‐Moulinier Michel , Buresi Catherine , Malafosse Alain
Published: June 2005

Summary:  Purpose: To reevaluate the genetic contribution of the polymorphism G1465A of the gene coding for γ‐aminobutyric acid (GABA)B receptor 1 subunit [GABAB(1)] in a sample of French patients with temporal lobe epilepsy (TLE) and to perform an exploratory analysis in other phenotypic subgroups.

Methods: The 134 patients were genotyped for the polymorphism G1465A. This sample was divided in two groups. The first one had patients with nonlesional TLE, and the second one, with lesional TLE. Then these two groups were compared with a sample of 145 healthy individuals.

Results: The genotype and allele distributions for the polymorphism G1465A showed no difference between patients and controls.

Conclusions: The association between the variant G1465A and the sample of patients could not be replicated, so these results exclude a major effect of this polymorphism in the susceptibility to nonlesional TLE. Larger samples should be tested to determine whether the G1465A in exon 7 of the GABAB(1) receptor gene is a susceptibility factor for nonlesional TLE.
Speech‐induced Aphasic Seizures in Epilepsy Caused by LGI1 Mutation
Authors: Brodtkorb Eylert , Michler Ralf P. , Gu Wenli , Steinlein Ortrud K.
Published: June 2005

Summary:  Purpose: Patients with autosomal dominant lateral temporal lobe epilepsy (ADTLE) may have seizures precipitated by sound or speech. We have examined a patient with speech‐induced seizures caused by an LGI1 mutation (C46R).

Methods: A clinical study and a video‐EEG recording using interrogative speech as the activation procedure was performed in a 23‐year‐old man.

Results: He had experienced short episodes of sensory aphasia in situations in which he was suddenly verbally addressed. Voices became distorted, and he could not comprehend despite hearing words. The day after a late party, his girlfriend unexpectedly spoke to him. Her speech became unintelligible to him. He did not reply and had a generalized tonic–clonic (GTC) seizure. During an EEG, he was suddenly asked for the names of his siblings. He answered, but lost understanding of the further conversation and described how syllables floated together with an echoing character. With a versive movement to the right, another GTC occurred. In the EEG, rhythmic 6‐Hz activity built up in the frontotemporal areas starting on the left side with bilateral and posterior spreading. Postictal slowing was symmetrical, and no aphasia was noted on awakening.

Conclusions: To our knowledge, this is the first video‐EEG recorded seizure in LGI1‐caused ADTLE. This peculiar seizure semiology and precipitating effect of speech may serve as a marker for identifying further individuals with this particular phenotype and genotype and may indicate that the LGI1 gene may have a physiologic function connected to the human capacity for speech and language.