bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Sumatriptan on Brain Monoamines in Rats
Authors: Mitsikostas D.D. , Papadopoulou‐Daifotis Z. , Sfikakis A. , Varonos D. 
Published: March 2003

Clinical data suggests that sumatriptan is effective in the acute treatment of migraine. The vascular sumatriptan on brain monoamines has not previously been investigated. In order to study these and 0.9 mg/kg of body weight), and 30 minutes later, all animals were decapitated Dopamine, serotonin, concentrations were measured in the frontal cortex, hypothalamus, striatum, and hippocampus, by high performance liquid chromatography. Plasm group was treated with NaCl 0.9%, given subcutaneously.Sumatriptan, at the dose of 0.3 mg/kg did not alter the brain monoamine concentrations; however, at the turnover of dopamine and serotonin in the hypothalamus and striatum, while at the dose of 0.9 mg/kg, found. This subcortical antidopaminergic and antiserotoninergic effect of sumatriptan may be involved in its antimigraine action.
SUNCT Syndrome: Duration, Frequency, and Temporal Distribution of Attacks
Authors: Pareja Juan A. , Shen Jie Ming , Kruszewski Piotr , Caballero Vicente , Pamo Manuel , Sjaastad Ottar 
Published: March 2003

Duration, frequency, and temporal distribution of attacks have been objectively estimated in 11 SUNCT patients (3 women and 8 men). The mean age at the time of the study was 69 years (range 52 to 81). The duration of a total of 348 attacks was measured from videotape records, polygraphic tracings, or by stopwatch.The duration of attacks ranged from 5 to 250 seconds, with an unweighted mean of 61 seconds. Both frequency and exact timing of attacks were assessed in four patients who filled in a time chart with the exact onset of 585 consecutive attacks. The majority of attacks occurred during daytime, with a bimodal distribution; ie, morning and afternoon/evening peaks, and only a few attacks were noted at night (ie, 1.2% of the attacks). The unweighted mean frequency of attacks was 28 per day (range 6 to 77).Duration and timing of attacks in SUNCT syndrome may be of help in the differential diagnosis versus other disorders with the same localization, especially first division trigeminal neuralgia.
The Role of Cranial Computed Tomography in the Diagnostic Work‐up of Headache
Authors: Demaerel Philippe , Boelaert Ignace , Wilms Guy , Baert Albert L. 
Published: March 2003

Approximately 18% of all patients referred for a cranial computed tomography complain of headache only.We reviewed 363 consecutive patients in order to assess the value of this examination in the diagnostic approach.Despite the vast number of normal examinations (88.4%), we advocate the routine use of a cranial computed tomography in every patient with chronic headache. The cost of the examination can significantly be reduced by performing an unenhanced scan only. An additional contrast‐enhanced scan should be obtained if a suspicious lesion is seen. Brain magnetic resonance imaging is not indicated except in the preoperative workup of a lesion visualized on computed tomography.
A Community‐Based Prevalence :Study on Headache in Malaysia
Authors: Alders E.E.A. , Hentzen A. , Tan C.T. 
Published: March 2003

This community study on headache in Malaysia was based on IHS diagnostic criteria and showed the last‐year prevalence of migraine was 9.0%. Migraine with aura accounted for only 10.6% of the migrainous population. The last‐year prevalence of tension headache was 26.5% (94.4% episodic, 5.6% chronic) and 28.2% for other types of headache. No case of cluster headache was found. Almost two thirds of the migraine subjects graded their headaches as severe, while almost 60% of the tension headache subjects and almost 70% of the other headache subjects graded their headaches as mild.Overall, there was higher prevalence in females for migraine and tension headache, and in males for the other types of headache. The prevalence of headache was lower among those younger than 15 and older than 65 years of age. No significant differences were found in the prevalence of headache among the different racial groups nor among the urban versus the rural population.All the headache types shared the same triggering factors suggesting that different physiological characteristics are responsible for the type of pain suffered. In the location of this community with its tropical climate, headache was attributed to sun exposure in 51.9% of the migraine subjects, 55.7% of the tension headache subjects, and 36.6% of the group with other headaches.
Increasing Prevalence of Headache in 7‐Year‐Old Schoolchildren
Authors: Sillanpää Matti , Anttila Pirjo 
Published: March 2003

Reports of increased prevalence of headache in adults end clinical impressions of similar trends in children prompted this epidemiological study on migraine and other headache. The first stage was carried out in 1974 In children starting school, and the second stage in 1992 using the identical study design, the same age group, and a similar urban child population.The overall prevalence of present headache (having occurred in the previous 6 months) was found to he significantly increased over time, from 14.4% in 1974 to 51.5% in 1992. Similarly, the prevalence of migraine headache had Increased from 1.9% to 5.7%. The causes of the increase are as yet unknown. The highest but not significant increases were found in schools which were situated in the districts of the city with the highest social instability, which was reflected in the high percentage of council houses and also in the higher frequency of family relocations. Increase over time in the prevalence of migraine end other headaches in children pears to be at least as dear as in adults. This should alarm the community to study the underlying stress factors and to try to relieve the children’s distress.
Sympathetic Vasoconstrictor Outflow to Extremity Muscles in Cluster Headache. Recordings During Spontaneous and Nitroglycerin‐Induced Attacks
Authors: Nordin Magnus , Fagius Jan , Waldenlind Elisabet 
Published: March 2003

To search for evidence of sympathetic dysregulation during cluster headache attacks, microneurographic recordings of muscle nerve sympathetic activity (MSA) were obtained from the peroneal nerve.In three recordings commenced after the onset of spontaneous attacks, MSA was about twice as high during the attack as afterwards. In four nitroglycerin‐induced attacks, MSA showed a rise paralleling the pain, preceded by an initial peak. The latter accompanied hypotension, whereas the rise coinciding with cluster headache was associated with rising blood pressure. The normal baroreflex‐governed pulse synchrony of MSA was preserved both during spontaneous and provoked attacks. In seven cluster headache patients in whom nitroglycerin did not cause an attack, only an initial peak in MSA occurred. Nor was any late nitroglycerin‐induced rise in MSA observed in nine healthy subjects; the initial peak in MSA and heart rate was followed by a rapid return to normal despite a falling blood pressure.It is concluded that cluster headache attacks are associated with an increase in MSA that elevates blood pressure by causing vasoconstriction, and that this increase, rather than indicating sympathetic dysregulation, is a normal pain. evoked secondary phenomenon. The findings in healthy subjects support the notion that nitroglycerin has a central sympatho‐inhibitory effect.
Comprehensive/Tertiary Care for Headache: A 6‐Month Outcome Study
Authors: Saper Joel R. , Lake Alvin E. , Madden Scott F. , Kreeger Christopher 
Published: March 2003

Objective.—To assess programwide (outpatient plus inpatient) outcome using prospective measures for the first 6 months of treatment at a comprehensive headache center.Background.—There is little published data on the overall programwide efficacy of comprehensive, multidisciplinary treatment centers for severe, refractory headache disorders.Methods.—For 1 week each month over a 2‐year period, all new patients completed an initial questionnaire noting frequency/severity of headaches and other headache‐relevant measures. A follow‐up version mailed at 6 months was returned by 218 of 421 patients (response rate 52%). Sixteen percent were treated both in and out of the hospital, with 84% treated as outpatients only. Patients had a mean of 2.50 medical visits after the initial evaluation, and 43% met with a psychologist.Results.—Mean headache frequency dropped from 5.30 to 3.45 days per week (P<.00001), with severe headaches declining from 2.31 to 1.33 days per week (P<.00001). Sixty‐seven percent of the patients had at least a 50% reduction in headaches, with a mean percentage improvement per patient in severe headaches of 56% (median 67%). Emergent care visits within 6 months dropped from 4.39 to 1.67 (P<.00001). Days with significant headache‐related work impairment declined from 2.04 to 0.67 days per week (P<.00001), a net annualized reduction of 71.24 impaired workdays per year per patient. For full‐time workers, missed work days in 6 months dropped from 5.46 to 2.68 (P<.00261). The mean percentage improvement for headache‐impaired workdays was 67% (median 88%), and for work absence was 63% (median 100%). Total days incapacitated per week dropped from 1.72 to 0.89 (P<.00001), with a mean percentage improvement of 67% (median 91%). Significant treatment satisfaction was reported by 89%. A weighted Goal Attainment Scale based on the percentage of patients showing significant improvement in pain control, functioning, work performance, reliance on emergent care, depression, and satisfaction revealed an overall Goal Attainment score of 72%.Conclusions.—Despite a mean of only 3.50 medical visits in a population of complex patients, significant improvement was demonstrated in several key economically relevant variables within 6 months of referral. If maintained over the long term, the results support the concept that matching intensity of treatment (comprehensive/tertiary care) to severity of illness (complex/refractory cases) is cost‐effective.
Intranasal Lidocaine for Migraine: A Randomized Trial and Open‐Label Follow‐up
Authors: Maizels Morris , Geiger Ann M. 
Published: March 2003

Objective.—To study the efficacy of intranasal lidocaine for the treatment of migraine when administered by subjects in a nonclinic setting.Design.—A 1‐month, randomized, controlled, double‐blind trial, followed by a 6‐month open‐label follow‐up.Setting.—Ambulatory subjects treating themselves outside of a medical setting.Subjects.—One hundred thirty‐one adult subjects with migraine, diagnosed according to International Headache Society criteria, were enrolled in the study: 113 treated at least one headache in the controlled trial, and 74 treated at least one headache in the open‐label phase. All subjects were members of the Kaiser Permanente Southern California Medical Care Program and were recruited at two urban medical centers.Intervention.—Intranasal lidocaine 4% or saline placebo 0.5 mL was dropped into the nostril on the side of the headache, or bilaterally for bilateral headache, according to study protocol.Main Outcome Measures.—Trial: percent of headaches relieved to mild or none at 15 minutes and relapse of headache within 24 hours. Open‐label: percent of headaches relieved to mild or none at 15 and 30 minutes and relapse within 24 hours.Results.—In the controlled trial, headache was relieved within 15 minutes in 34 (35.8%) of 95 subjects treated with 4% intranasal lidocaine compared with 8 (7.4%) of 108 subjects receiving placebo (P<.001). Headaches relapsed in 7 (20.6%) of 34 subjects treated with 4% intranasal lidocaine compared to 0 of 8 placebo subjects (P=.312). In the open‐label follow‐up, headaches were relieved in 129 (41.2%) of 313 episodes within 15 minutes and in 141 (57.6%) of 245 episodes after 30 minutes. Headaches relapsed in 28 (19.9%) of 140. The response did not diminish over time: 32 (62.8%) of 51 first headaches were relieved at 30 minutes and 10 (71.4%) of 14 seventh headaches were relieved. Relapse occurred in 28 (41.2%) of 129 headaches at a mean time (± SD) of 7.4 (± 6.6) hours.Conclusion.—Intranasal lidocaine 4% provides rapid relief of migraine symptoms. For those subjects who do respond, the effect does not diminish over 6‐month follow‐up.
Recurrent Headache in Adolescents: Nonreferred Versus Clinic Population
Authors: Smith Mark Scott , Martin‐Herz Susanne Pelley , Womack William M. , McMahon Robert J. 
Published: March 2003

Objective.—To compare headache activity, psychosocial measures, and cold pressor response between referred and nonreferred adolescents with frequent headache.Design.—Thirteen boys and 19 girls with a mean age of 13.4 ± 0.9 years who had been referred to a hospital‐based behavioral treatment program for recurrent headache were compared with an age‐ and sex‐matched school‐based population of nonreferred students consisting of 31 adolescents with frequent headaches and 32 adolescents with infrequent or no headaches. All subjects completed the Spielberger State‐Trait Anxiety Inventory/Trait form, the Children's Depression Inventory, the Childhood Somatization Inventory, and measures of headache activity and related functional disability. Additionally, all subjects reported interval discomfort scores on a 40‐second cold pressor test with arm immersion in a 10°± 1°C cold water bath.Results.—Subjects from both headache groups reported significantly more anxiety than those with infrequent or no headaches. The school‐based nonreferred adolescents reported more depressive symptoms than the clinic‐based referred subjects. In addition, the latter group reported headaches of longer duration and more school days missed due to headaches than both other groups. Whereas school‐based subjects and those with infrequent or no headaches reported relatively low initial cold pressor test scores and gradually reported increasing scores with time, clinic‐based subjects rated their discomfort as high at the initial interval report and maintained high levels throughout the test. No differences in somatization were found among groups.Conclusion.—Although adolescents who seek behavioral treatment for recurrent headache do not report more psychological symptoms than nonreferred adolescents with frequent headaches, they report headaches of longer duration, miss more school days due to headache, and report higher initial sustained discomfort scores to a standardized noxious stimulus.
Life Event Stress and Headache Frequency Revisited
Authors: Reynolds David J. , Hovanitz Christine A. 
Published: March 2003

Life stress is found to be related to headache frequency in some studies, but not others. Research designs that find a relationship between the two tend to evaluate young subjects and employ large sample sizes. The purpose of this study was to evaluate the relationship between headache frequency and life stress, while considering gender and age differences that may be present in the relationship. In addition, as depression or presence of headache at the time of assessment may influence the report of headache frequency, an attempt to control for these factors was employed.Several self‐report measures of headache symptomatology, headache presence, depression, and life stress were completed by 1289 subjects. Negative life event stress was found to be modestly but significantly related to headache frequency. The relationship between the 2 variables was stronger for women than for men and, after the influence of depression and headache state was removed, the relationship between life stress and headache frequency remained significant only for women. In the oldest 10% of the sample, there was no evidence of a relationship between negative life event stress and headache frequency.
Validity and Reliability of the Migraine‐Specific Quality of Life Questionnaire (MSQ Version 2.1)
Authors: Martin Bradley C. , Pathak Dev S. , Sharfman Marc I. , Adelman James U. , Taylor Frederick , Kwong W. Jackie , Jhingran Priti 
Published: March 2003

Objective.–To assess the scaling properties, reliability, and validity of the revised Migraine‐Specific Quality of Life Questionnaire (MSQ) (Version 2.1)Background.–The MSQ is a disease‐specific, quality‐of‐life instrument with three hypothesized scales that has been developed, tested, and revised.Methods.–The study used a multicenter, nondrug, prospective, parallel group, quasi‐experimental design. Patients with migraine were recruited at outpatient headache specialty practices and were administered the MSQ, the Medical Outcomes Study 36‐Item Short Form Health Survey (SF‐36), and migraine symptom questionnaires at baseline, 4 weeks, and 12 weeks. Internal consistency (Cronbach α) and 4‐week test‐retest reproducibility (intraclass correlation coefficients) were estimated to assess reliability. Construct validity was assessed using an adaptation of the Campbell and Fiske multitrait‐multimethod approach and by correlating MSQ scores with symptom measures.Results.–A total of 267 subjects enrolled in the trial. The criteria for summated rating scales were all met. The internal consistency coefficients ranged from 0.86 to 0.96, and the intraclass correlation coefficients ranged from 0.57 to 0.63 across the three dimensions. As anticipated, the MSQ dimensions had low‐to‐modest correlations with the two component scores of the SF‐36 and were modestly to moderately correlated with migraine symptoms.Conclusions.–The MSQ is a reliable instrument in the assessment of quality of life for patients with migraine with items that can be summed without weights. The MSQ has demonstrated evidence of construct validity.
Magnetic Resonance Imaging of Intracranial Hypotension Syndrome With Pathophysiological Correlation
Authors: Brightbill T.C. , Goodwin R. Scott , Ford Robert G. 
Published: March 2003

Objective.–To correlate the pathophysiology of intracranial hypotension syndrome with abnormalities in the brain and spine found through magnetic resonance imaging.Methods.–In a series of 11 patients with intracranial hypotension syndrome, brain magnetic resonance scans were evaluated for the thickness, distribution, morphology, and pattern of meningeal enhancement coincident with subdural fluid collections and the descent of the brain toward the skull base. Spinal magnetic resonance studies were reviewed for extra‐arachnoid fluid collections, meningeal enhancement, and distended epidural veins.Results.–Diffuse, continuous dural‐arachnoid enhancement was present in all patients with abnormal brain studies. The dura was thickest in patients with very low intracranial pressures. Subdural fluid collections and descent of the brain were seen in patients with the thickest meninges and were not present in the absence of meningeal enhancement. Extra‐arachnoid or paraspinal fluid collections were found in all patients who had spinal magnetic resonance scans.Conclusions.–In the brain, diffuse dural‐arachnoid enhancement is the most common imaging abnormality and is probably the earliest magnetic resonance manifestation of intracranial hypotension syndrome, while subdural fluid collections and descent of the brain are indicators of a more severe hypotensive state. Extra‐arachnoid fluid collections are common spinal imaging abnormalities.
Effect of Chronic Analgesic Exposure on the Central Serotonin System: A Possible Mechanism of Analgesic Abuse Headache
Authors: Srikiatkhachorn Anan , Tarasub Naovarut , Govitrapong Piyarat 
Published: March 2003

Objective.–To investigate the effects of chronic analgesic exposure on the central serotonin system and the relationship between the serotonin system and the analgesic efficacy of nonnarcotic analgesics.Methods.–Paracetamol was administered daily to adult male Wistar rats for a period of 15 or 30 days. Analgesic efficacy was measured by the tail flick test. After completion of the treatment protocol, the rats were humanely killed, and the frontal cortex and brain stem were isolated. Characteristics of the specific binding of the 5‐HT2A serotonin receptor and the serotonin transporter were studied using a radioligand binding technique. Platelet serotonin was determined by high‐performance liquid chromatography.Results.–Chronic paracetamol administration resulted in a significant decrease in the maximum number of 5‐HT2A binding sites and an increase in the maximum number of 5‐HT transporter binding sites in frontal cortical membrane (P<.001). Changes in the central 5‐HT system were associated with a rise in platelet 5‐HT levels. The degree of receptor downregulation, as well as transporter upregulation, became less evident after more prolonged drug administration. Readaptation of serotonin receptors and transporters coincided with the decrease in the analgesic efficacy of paracetamol, as well as a fall in platelet 5‐HT levels.Conclusions.–These findings provide further evidence in support of an involvement of the 5‐HT system in the antinociceptive activity of simple nonnarcotic analgesics. Plasticity of this neurotransmitter system after chronic analgesic exposure may lead to the loss of analgesic efficacy and, in its more extreme form, may produce analgesic‐related painful conditions, for example, analgesic abuse headache.
Prolonged Recovery From Rebound Headaches
Authors: Warner John S. 
Published: March 2003

Objective.—To document that some patients with rebound headache require prolonged complete avoidance of the pain relief medications which might cause the daily or almost daily headaches in order to achieve a goal of 6 consecutive headache‐free days.Background.—Most articles on rebound headache imply that the patient improves after stopping the offending agents, but they fail to state the pattern of recovery, the time required for recovery, or the specific end point achieved.Design.—Selected from the histories of approximately 1000 patients with suspected rebound headache who have been seen in a university headache referral clinic are the records of four patients who kept careful headache diaries, followed the treatment protocol (with minimal noncompliance by two patients), and required more than 6 months to achieve our goal of 6 consecutive headache‐free days.Conclusions.—Hopefully, other physicians treating patients with suspected rebound headache will benefit from this report and will be able to better manage their patients.