bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Non‐Pharmacological Treatment of Vascular Headache During Pregnancy
Authors: Hickling Edward J. , Silverman Daniel J. , Loos Warren 
Published: May 2005

SYNOPSISThis study investigates the use of biofeedback, relaxation and psychotherapy on five patients with severe, vascular headaches that occurred during the course of pregnancy. The subjects received between four and twelve sessions of treatment overall. The subjects all showed a marked reduction or complete cessation of headaches during treatment, the term of pregnancy, and during a follow‐up evaluation months after the birth of the child. Possible alternate explanations for improvement are discussed along with the study's limitations. This preliminary investigation strongly suggests that psychological treatment may be a particularly useful intervention for management of headaches that occur in pregnant women.
Double Blind Comparison of Lithium and Verapamil in Cluster Headache Prophylaxis
Authors: Bussone G. , Leone M. , Peccarisi C. , Micieli G. , Granella F. , Magri M. , Manzoni G.C. , Nappi G. 
Published: May 2005

SYNOPSISChronic Cluster Headache (CCH) treatment is troublesome; since there are no pain‐free periods, it must be continuous. The most effective CCH prophylactic drug today is lithium carbonate but long‐term use of this drug is limited by the possibility of side effects. Recently, calcium antagonists have been successfully employed to prevent migraine, and preliminary studies also indicate that verapamil in particular is an efficacious treatment for CCH. We have conducted a multicenter trial employing a double‐dummy, double blind, cross‐over protocol, comparing verapamil with the established efficacy of lithium carbonate, inpreventing CCH attacks. Both lithium carbonate and verapamil were effective in preventing CCH butverapamil caused fewer side effects and had a shorter latency period. We did not observe any correlation between plasma levels of the two drugs and their clinical efficacy. Both the drugs tested here may exert their effect by restoring a normal inhibitory tone to the pain modulating pathways from the trigemino‐vascular system, a circuit putatively implicated in CCH.
Circadian Variation of Pain Sensitivity in Pericranial Musculature
Authors: Göbel Hartmut , Cordes Peter 
Published: May 2005

SYNOPSISThis study investigated whether pain sensitivity of the pericranial musculature remains constant over the course of the day. Changes in the entire, uniformly metrically divided supra‐threshold sensitivity range were measured. In 24 healthy volunteer subjects, pain was induced experimentally at 0200, 0600, 1000,1400, 1800, and 2200 hours in the pericranial musculature. Blood circulation in both superficial temporal and occipital arteries was reduced by applying a cuff to the head pumping up to 200 mmHg during rhythmic chewing on a spring, thereby producing a continuously increasing bilateral, dull, frontal headache. The subjects rated the intensity continuously using a category sub‐dividing procedure ranging from pain threshold to pain tolerance limit. At low levels of headache intensity there were no significant diurnal differences in pain sensitivity. Sensitivity to very intense headache, however, varied significantly over the course of the day: sensitivity was greatest at 0200 hours; it decreased at a constant rate until1400 hours, and increased again continuously until 2200 hours (pó.05). Also the findings showed significant effects of sex on the pain sensitivity of pericranial musculature for all pain intensities: women are approx. twice as sensitive as men (pó.0.05). These results suggest that not only sex, but also time of day, must be taken into consideration in the clinical determination of pain sensitivity of pericranial musculature in the course of headache diagnostics.
Cognitive Correlates of Headache Intensity and Duration
Authors: Demjen Stefan , Bakal Donald A. , Dunn Bruce E. 
Published: May 2005

SYNOPSISCognitive processes and cognitive styles of persistent headache sufferers were examined in relation to indices of intensity and duration of head pain. One hundred and eight persistent headache patients, referred for cognitive‐behavioral management of their disorder, completed questionnaires designed to assess: distressing thoughts and feelings experienced during headache attacks, evaluation of the experienced pain, perceived influence of stress and worry on headaches, and capacity to verbally express emotions.The results showed that the intensity of head pain correlated with measures of headache‐related distress and‐with the proportion of headache‐related distress to situation‐related distress. Duration of head pain was also associated with the proportion of headache‐related distress to situation‐related distress, and additionally with a tendency to deny the influence of stress and worry on headaches and with difficulty in expressing emotions.These findings were taken as support of our previously stated hypothesis that head pain of increased severity is associated with a cognitive shift whereby the patient's primary concern moves from situational and interpersonal distress to distress associated with the disorder itself.1 In addition, these findings point to affective distress and lack of emotional expressiveness as correlating differentially with the headache dimensions of intensity and duration.
A New 5‐HT2 Antagonist (Ritanserin) in the Treatment of Chronic Headache With Depression. A Double‐Blind Study vs Amitriptyline
Authors: Nappi Giuseppe , Sandrini Giorgio , Granella Franco , Ruiz Luigi , Cerutti Giorgio , Facchinetti Fabio , Blandini Fabio , Manzoni Gian Camillo 
Published: May 2005

SYNOPSISThe exact relationship between depression and chronic headache remains unclear. Considerable clinical and pharmacological evidence suggests the existence of a common biological terrain. Many antidepressant drugs are effective in the treatment of migraine and chronic headache disorders.Ritanserin, a new very selective serotonin‐2 (5‐HT2) antagonist, has recently shown both analgesic and antidepressant properties. The present study compares in a double‐blind design, the effectiveness of ritanserin and amitriptyline, a well‐known antidepressant extensively used in migraine prophylaxis.Thirty‐eight patients (30 females and 8 males ranging in age from 20 to 50 yrs) were classified according to the International Headache Society criteria as: patients with chronic tension‐type headache (CTH) (11 cases) and patients with coexisting migraine and CTH (MCTH) (27 cases).Only patients with a score equal to or higher than 18 on the Hamilton Rating Scale for Depression (HRSD) were included.Ritanserin was highly effective in reducing Pain Total Index and analgesic consumption in chronic headache, and its activity was similar to that observed during amitriptyline treatment. A significant improvement of HRSD and HRSA(Hamilton Rating Scale for Anxiety) scores was observed during both treatments. The main results of our study concern the demonstration of antiheadache and antidepressive properties of ritanserin.To better define the profile of the patients and their clinical responsiveness to the treatment, dexamethasone suppression test, clonidine test and nociceptive flexion reflex were investigated in our patients.Our data confirm the usefulness of these methods as markers of chronic headache with depression.
Prediction of Migraine Using Psychophysiological and Personality Measures
Authors: Leijdekkers Marijke L.A. , Passchier Jan 
Published: May 2005

SYNOPSISThe topics of interest in this study are whether migraine patients exhibit a stereotypic reaction to a stressful stimulus which is different from the reaction of non headache controls and whether it is possible to predict headache activity within the migraine population.Our study population comprised 37 female migraine patients and 34 matched controls. Heart rate, skin conductance, pulse amplitude of the temporal artery and an EMG of the temporal muscle were registered during a baseline situation and during a mental stressor. In addition, state anxiety, trait anxiety, facilitating anxiety and stress tolerance were assessed.Migraine patients reported higher levels of trait anxiety, greater fear of failure, lower stress tolerance and higher levels of state anxiety than non headache controls. Physiological baseline levels and stress reactions did not differbetween migraine patients and controls.Linear combinations of psychological and psychophysiological data sets did not show an acceptable degree of accuracy in the classification of individual response profiles into groups.Within the migraine group, 54% of the average duration of migraine attacks and 33% of the variation in average maximum headache intensity could be explained by a combination of psychological, psychophysiological and socio‐demographic variables.It is concluded that measures from both the psychological and the physiological domain should be included when studying the effects of stress in migraine.
Association of Sustained Oxyhemoglobin Desaturation and Onset of Cluster Headache Attacks
Authors: Kudrow Lee , Kudrow David B. 
Published: May 2005

SYNOPSISTen episodic cluster headache patients in their active cluster period, ten patients in remission and five control subjects were monitored for minute to minute changes in oxygen saturation (SaO2) and pulse rate before and after nitroglycerin (NTG) administration.A transient but significant decrease in SaO2 and increase in pulse rate of 25 minutes duration occurred following NTG in all groups. These changes may reflect physiologic hemodynamic effects of NTG as a smooth muscle relaxant. Subsequently, SaO2 levels and pulse rate recovered to baseline values in remission and control groups. In contrast, SaO2 values in the active cluster group decreased further and after an extended period culminated in cluster headache attacks in 10/10 patients.Three major changes, therefore, distinguished active cluster patients from remission and control groups. First, the magnitude of oxygen desaturation increased after the physiological effects of NTG ceased. Second, oxygen desaturation was sustained for an additional 9 to 30 minutes duration. Third, the hypoxemic state culminated in attacks in all cases.Our findings suggest that the active cluster period may be characterized by an impaired mechanism to autoregulate, and thus compensate, for hypoxemia. It is further proposed that persistence of hypoxemia and the cluster attack onset may share a common mechanism, coupling the two events. We suggest that abnormal central and/or peripheral chemoreceptor activity may be responsible for these events.
Serious Migraine: A Study of Some Epidemiological Aspects
Authors: Pascual J. , Polo J. M. , Berciano J. 
Published: May 2005

SYNOPSISData are scant concerning some epidemiological aspects of those severe headaches which cause serious personal and economic morbidity. Our purpose was to study the incidence and other epidemiological features of patients suffering from severe migraine exacerbations, in an unselected population. The 64 patients who suffered from severe migraine bouts represented 10.5% of all the new walk‐in neurological consultations in the area covered in this study. 70% of these patients were between 10 and 39 years old. Although females clearly predominated in all ages after fifteen, below this age there was a slight male predominance. The calculated incidence of serious migraine exacerbations was 90 per 100,000 people per year, the corrected incidence for females being 143/100,000 and for males 37/100,000. The highest incidence for females was in 15–19 year‐olds (377/100,000) and for males in 10–14 year‐olds (166/100,000). Our data seem to confirm the periodic nature of this condition since in 80% of patients the migraine bouts (ie: groups of attacks) lasted between two and nine months. Also they support the reported existence of genetic and hormonal factors in the susceptibility to migraine exacerbations. Our results may help in planning the public health aspect of migraine and add some light to the natural history of this common condition.
Platelet Monoamine Oxidase Activity in Female Migraine Patients
Authors: Mosnaim Aron D. , Huprikar Shankar , Wolf Marion E. , Diamond Seymour 
Published: May 2005

SUMMARYPlatelet monoamine oxidase activity (MAO) in a group (n = 17) of white, female migraineurs during an acute migraine attack was similar to both the values obtained for the same group of patients two to three weeks after the headache episode (pain‐free period) and to the results obtained for a group (n = 18) of sex and race‐matched, age‐comparable, drug‐free healthy volunteers (blind study; substrate p‐tyramine, 38.7 ± 5.7, 41.9 ± 8.8 and 43.0 ± 3.4 or p‐methoxybenzylamine, 178.9 ± 11.3, 177.2 ± 6.9 and 181.0 ± 9.7 nmole/hr/10 9 platelets ± SD, respectively). With each patient serving as its own control, MAO activity during the migraine episode and when pain‐free failed to show a significant trend. Neither a number of other medical conditions nor the use of several medications appeared to significantly influence our results. The present work, while dealing only with a small but well defined patient population, argues against the possible usefulness of platelet MAO activity as a biological marker for migraine headaches.
A Protocol for Butalbital, Aspirin and Caffeine (BAC) Detoxification in Headache Patients
Authors: Sands George H. 
Published: May 2005

SYNOPSISThe abuse of the combination drug containing butalbital 50 mg, aspirin 325 mg and caffeine 40 mg (or BAC), is commonly recognized by headache specialists as causing headaches. Despite this widespread problem, there is not a published treatment regimen for the BAC detoxification of patients. I describe such a protocol which was used four times in three patients. These patients fulfilled the diagnostic criteria of the IHS Headache Classification for headaches induced by chronic substance abuse (8.2) and analgesics abuse headache (8.2.2). These patients took between 150 and 420 BAC/month for 2–15 years. Two patients had previously undergone inpatient detoxification. One patient unsuccessfully tried detoxification twice as an outpatient.All patients were required to have psychological support prior to hospitalization for this protocol. BAC was discontinued. A pentobarbital challenge test corroborated butalbital dosage. The patients were given phenobarbital and caffeine which were tapered over several days. Dihydroergotamine (DHE) with metoclopramide was used (Raskin). Propranolol 60 mg bid was started. No narcotics were permitted. After hospital discharge, patients were allowed to continue subcutaneous DHE, as needed. One patient restarted BAC use after 8 months without it. The other two patients were still BAC free 18 and 14 months after detoxification.
Dissociation between Pain and Autonomic Disturbances in Cluster Headache
Authors: Drummond Peter D. 
Published: May 2005

SYNOPSISThe relationship between pain and autonomic disturbances in cluster headache was studied in 54 patients whose attack always recurred on the same side, and in 7 others whose attack had affected either side on different occasions. In one of these seven patients, facial flushing and ocular sympathetic deficit was observed on the original side of headaches. In most patients, the orbital region was warmer on the painful side but in three cases this region was cooler during and between attacks. Lacrimation and rhinorrhoea were more common in severe attacks, and the temperature difference between the orbits increased with increasing severity of pain. These findings support the view that certain autonomic disturbances in cluster headache are provoked by pain. Residual autonomic dysfunction could influence autonomic activity during cluster headache. If so, residual dysfunction on the pain‐free side could explain the dissociation between autonomic disturbances and pain observed in a few cases.
Sinus Bradycardia, Junctional Rhythm and Blood Pressure Increase During Repeated Cluster Headache Attacks
Authors: Attanasio A. , Capria A. , Quatrana M. , Piccolo C.G.C. , Bisceglia A. , Formisano R. , Cerbo R. 
Published: May 2005

SYNOPSISWe have observed in a patient, during four subsequent spontaneous attacks of cluster headache, recurrence of marked bradycardia and junctional rhythm constantly associated with systolic and diastolic blood pressure increase.
Analgesic Use: A Study of Treatments Used by Patients for Migraine Prior to Attending the City of London Migraine Clinic
Authors: MacGregor E.A. , Vohrah C. , Wilkinson M. 
Published: May 2005

SYNOPSISEighty‐three unselected patients attending the City of London Migraine Clinic for the first time were askedabout their drug intake and use of alternative treatment.Thirty‐one of those questioned took regular daily doses of medication. Fifteen were taking a combination of drugs bought 'over the counter' (OTC) and drugs prescribed by their GP; eleven took OTC drugs only; and 5 took prescription drugs only. It was noticeable that those taking drugs prescribed both by the GP and obtainable over the counter were more likely than the other groups to be taking several drugs rather than a single type. Thirty five of the 83 (42.2%) had tried alternative treatments for their attacks.
Vasospasm Contributes to Monosodium Glutamate‐lnduced Headache
Authors: Merritt James E. , Williams Patricia Bell 
Published: May 2005

SYNOPSISConsumption of monosodium glutamate has long been considered to precipitate headaches in susceptible patients. In this study the direct effects of glutamate and its metabolite, glutamine, on arterial contractility were examined using rings of rabbit aorta. In a high concentration glutamate caused significant concentration‐dependent contractions (EC 50 , 10 ‐1 M; maximum tension, 188.4±33.3 mg wt tension/mg tissue). Agonists and antagonists for a‐adrenergic, histaminergic, serotonergic, cholinergic, and GABA‐nergic receptors as well as inhibition of prostaglandin synthesis failed to influence glutamate contractions. At high concentrations (10 ‐5 M) the calcium channel blocker, verapamil, inhibited the glutamate response. Glutamate and glutamine both exhibited concentration dependent relaxation of norepinephrine (NE), phenylephrine (PE), histamine, serotonin (5‐HT), and prostaglandin F 2a (PGF 2a )‐induced contractions. Kainic acid (10 ‐4 M), an agonist of one subpopulation of central glutamate receptor, potentiated glutamate‐induced vasoconstriction; a higher concentration (10 ‐3 M) produced an irreversible inhibition of glutamate contractility. Only the central glutamate receptor antagonist, ketamine (10 ‐4 ‐10 ‐2 M), induced a reversible, concentration dependent inhibition of glutamate‐induced contractions. Glutamate contractility was not dependent on extracellular calcium, an intact endothelium or neuronal function. These results demonstrate a direct effect of glutamate on peripheral arterial tone. Dietary consumption of large quantities of MSG may represent a serious health hazard to certain individuals with pre‐existing vascular disease.
Health Status in Patients with Tension Headache Treated with Acupuncture or Physiotherapy
Authors: Carlsson Jane , Augustinsson Lars‐Erik , Blomstrand Christian , Sullivan Marianne 
Published: May 2005

SYNOPSISSixty‐two female patients with chronic tension headache were randomly divided into two treatment groups ‐ acupuncture and physiotherapy. Their overall function (Sickness Impact Profile), and mental well‐being (Mood Adjective Check List) and the intensity and frequency of headache were assessed before and after treatment. Before treatment the patients showed significantly more dysfunction and less positive mental well‐being than a general population sample. Both treatment groups improved in overall function, the physiotherapy group somewhat more, The mental well‐being increased only in the physiotherapy group. The intensity and frequency of headache was significantly reduced in both the physiotherapy group and the acupuncture group. The intensity of headache was significantly more improved in the physiotherapy group. The improvement of headache intensity persisted unchanged 7–12 months after treatment.
Contingent Negative Variation in Migraine
Authors: Böcker K.B.E. , Timsit‐Berthier M. , Schoenen J. , Brunia C.H.M. 
Published: May 2005

SYNOPSISThe Contingent Negative Variation (CNV) is an event‐related slow potential. It was recorded in healthy volunteers (n = 8) and in patients suffering from migraine without (n = 12) or with (n = 5) aura, during one (CNV1) and three second (CNV3) foreperiods in a forewarned reaction time task. CNV1 was recorded at the vertex while CNV3 was recorded at multiple electrode sites to assess topographical differences. Seven out of twelve migraine patients without aura had increased CNV1 amplitudes. CNV3 amplitudes were increased as well, but only at electrode positions C3 and C4 and not at F 2 . CNV3, which allows for analysis of both an early and a late CNV component, could improve the discrimination of migraine without aura beyond that of CNV1. In migraine with aura all CNV parameters were at control levels, confirming previous results.The data obtained are discussed in terms of arousal, activation and stress and the “biobehavioral medal of migraine” (Welch, 1986).
Drug Induced Refractory Headache ‐ Clinical Features and Management
Authors: Mathew Ninan T. , Kurman Rochelle , Perez Francisco 
Published: May 2005

SYNOPSISTwo hundred patients who were taking daily symptomatic or immediate relief medications, often in excessive quantities, yet suffering from daily or near daily severe headaches were studied. One hundred and sixteen (58%) of them were also taking concomitant prophylactic medications and they were ineffective. Low tyramine, low caffeine dietary instructions and biofeedback training were given to all patients. The effect of continuing symptomatic medications, discontinuing symptomatic medications, and adding or changing prophylactic medi‐cations were studied in the various treatment groups. It is concluded that; 1.) Daily use of symptomatic or immediate relief medications result in chronic daily headache. 2.) Discontinuing daily symptomatic medications itself result in improvement of headache. 3.) Concomitant use of symptomatic medications nullifies the effect of prophylactic medi‐cations. 4.) Discontinuing daily symptomatic medications enhances the beneficial effect of prophylactic medications.
The VER as a Diagnostic Marker for Childhood Abdominal Migraine
Authors: Mortimer M.J. , Good P.A. 
Published: May 2005

SYNOPSISAbdominal migraine is a common childhood migraine equivalent, for which diagnostic criteria have not been defined. As in other children with migraine equivalents this leads to difficulties in diagnosis and determination of prevalence. By recording the fast wave activity (beta rhythmn) in the visual evoked response (VER) to red and white flash, the pattern stimulation, 27 out of 28 children with clinically diagnosed abdominal migraine revealed significant differences compared with normal controls, outside the attack phase. Comparisons with children diagnosed as migraine with or without aura revealed, from the VER findings of higher amplitude fast wave activity and the presence of paroxysmal sharp wave activity, that abdominal migraine appears to be a specific form of childhood migraine. We found that both clinically and electrophysiologically, abdominal migraine changes with age; older children exhibiting a shorter duration of abdominal pain during attacks, and less evidence of sharp wave activity in the VER.