bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Relative Incidence of Mitochondrial DNA A3243G in Migraine Without Aura With Maternal Inheritance
Authors: Di Gennaro G. , Buzzi M.G. , Ciccarelli O. , Santorelli F.M. , Pierelli F. , Fortini D. , D'onofrio M. , Costa A. , Nappi G. , Casali C. 
Published: March 2003

Objective.—To determine whether patients with migraine without aura with maternal “inheritance” are affected by a monosymptomatic form of the MELAS syndrome (mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes) or carry the most common mitochondrial DNA (mtDNA) mutation associated with MELAS, namely the A3243G transition in the transfer RNA (tRNA)Leu(UUR) gene. Background.—The association between migraine and abnormal mitochondrial function has been suggested on clinical, biochemical, and neuroradiological grounds. Migraine attacks with vomiting and cerebral infarctions, most often in the posterior cerebral regions, which are reminiscent of complicated migraine, are typical features of MELAS. The observation that migrainous patients have affected mothers more often than affected fathers suggests a possible role for maternally transmitted genetic factors. Methods.—We studied 25 patients with migraine with aura whose mothers were also affected. A sensitive polymerase chain reaction restriction fragment length polymorphism analysis was used to detect mutated genomes. Conclusions.—We failed to detect the MELAS mutation, but migraine may still be associated with point mutations of mtDNA other than A3243G or with as‐yet‐unidentified nuclear DNA factors related to mitochondrial function.
Repetitive Intravenous Prochlorperazine Treatment of Patients With Refractory Chronic Daily Headache
Authors: Lu Shiang‐Ru , Fuh Jong‐Ling , Juang Kai‐Dih , Wang Shuu‐Jiun 
Published: March 2003

Objectives.—To investigate the efficacy and long‐term outcome of intravenous prochlorperazine for the treatment of refractory chronic daily headache.Background.—Unlike dihydroergotamine, the treatment results of intravenous neuroleptics as first‐line agents for refractory chronic daily headache have rarely been reported.Methods.—We retrospectively analyzed the data of inpatients with refractory chronic daily headache who received intravenous repetitive prochlorperazine treatment from November 1996 to March 1999. A semistructured telephone follow‐up interview was done in September 1999.Results.—A total of 135 patients (44 men, 91 women) were recruited, including 95 (70%) with analgesic overuse. After intravenous prochlorperazine treatment, 121 (90%) achieved a 50% or greater reduction of headache intensity, including 85 (63%) who became headache‐free. The mean hospital stay was 6.2 ± 2.7 days, and mean total prochlorperazine used was 98 ± 48 mg. Acute extrapyramidal symptoms occurred in 21 patients (16%). One hundred twenty‐four patients (92%) were successfully followed up, with a mean duration of 14.3 ± 7.5 months. Compared with pretreatment status, 93 patients (75%) considered their headache intensity decreased, and 86 patients (69%) considered their headache frequency decreased, although 40 (32%) still had a daily headache. Of the 87 patients with analgesic overuse who could be followed, 61 (70%) no longer overused analgesics. Poor response to prochlorperazine treatment (relative risk, 1.8) and presence of major depression (relative risk, 1.8) were predictors of persistent chronic daily headache at follow‐up.Conclusions.—Prochlorperazine was effective and safe in the treatment of patients with refractory chronic daily headache with or without analgesic overuse. Compared with dihydroergotamine, prochlorperazine seemed less effective at achieving “freedom from headache” during hospitalization, but had a similar outcome at follow‐up.
Reduction in the Intensity of Abortive Migraine Drug Use During Coumarin Therapy
Authors: Rahimtoola H. , Egberts A.C.G. , Buurma H. , Tijssen C.C. , Leufkens H.G. 
Published: March 2003

Objective.—To investigate the impact of coumarin therapy on migraine attack frequency.Background.—Sporadic case reports and clinical studies have described beneficial effects of coumarin therapy on migraine severity.Design and Methods.—A retrospective follow‐up study based on a prescription database covering a population of 450 000 was conducted. All patients using an abortive migraine drug (ergotamine or sumatriptan) and subsequently treated with either coumarin (index group) or low‐dose acetylsalicylic acid (control group) were analyzed. The impact of coumarin and low‐dose acetylsalicylic acid on the frequency of migraine attacks was assessed by measuring the intensity of ergotamine and sumatriptan use, in defined daily doses per month per patient, before and during coumarin or acetylsalicylic acid treatment. In addition, a “therapeutic intensity reduction” was determined for each patient.Results.—The study population consisted of 92 patients; 35% had been prescribed coumarin and 65% had been prescribed low‐dose acetylsalicylic acid after the initiation of ergotamine or sumatriptan. Two thirds of the study population was treated with ergotamine. Overall, ergotamine and sumatriptan use for the coumarin cohort decreased from 6.4 defined daily doses per month prior to coumarin treatment to 3.0 defined daily doses during coumarin treatment, compared with a reduction from 5.2 defined daily doses per month to 4.4 defined daily doses per month for the low‐dose acetylsalicylic acid cohort (P>.05). The therapeutic intensity of ergotamine and sumatriptan use was significantly decreased by 40% for the coumarin cohort, compared with 4.7% for the low‐dose acetylsalicylic acid cohort (P=.004).Conclusions.—We observed that coumarin treatment was clearly associated with a reduction in the therapeutic intensity of abortive migraine drug use in comparison with low‐dose aspirin treatment. This suggests that, overall, the coumarin cohort had experienced a substantial reduction in the frequency of migraine attacks during anticoagulation treatment. Our findings, as well as those of others, justify a controlled clinical trial to further establish the effects of coumarin therapy on migraine severity and its possible role in the prophylactic management of patients suffering from migraine.
Spectral Analysis of Visual Potentials Evoked by Pattern‐Reversal Checkerboard in Juvenile Patients With Headache
Authors: Marrelli Alfonso , Tozzi Elisabetta , Porto Claudio , Cimini Nicola , Aloisi Paolo , Valenti Marco 
Published: March 2003

Changes in visual evoked potentials, mainly affecting the amplitude of the major positive wave, are referred to by many authors and are related to the pathophysiological basis of primary headache.We performed both transient pattern‐reversal visual evoked potentials and spectral analysis by means of fast Fourier transform of 8‐Hz steady‐state pattern‐reversal visual evoked potentials in 34 children affected with migraine (14 with aura, 20 without aura), and compared them with 14 patients with tension‐type headache and 10 healthy subjects. The amplitude of the response to the transient stimulation (P100) was higher and the latency shorter in the patients with headache compared with the controls, but the difference was not statistically significant. The absolute power of the first harmonic (1F) obtained by the spectral analysis of the steady‐state stimulation was increased in all the patients with headache compared with the controls, and the increase was significant in patients with migraine.These data seem to confirm the hypothesis of abnormal processing of visual input in migraineurs and could be interpreted as neurophysiological support for the theory that different headache types are related conditions.Furthermore, the spectral analysis of steady‐state pattern‐reversal visual evoked potentials could be proposed as a test to diagnose migraine.
Topiramate in Migraine Prevention: A Double‐Blind, Placebo‐Controlled Study
Authors: Storey J. R. , Calder C. S. , Hart D. E. , Potter D. L. 
Published: March 2003

Objective.—To evaluate the efficacy of topiramate in the preventative treatment of episodic migraine.Background.—Topiramate is a broad‐spectrum antiepileptic drug effective for treatment of multiple seizure types in adults and children. Antiepileptic agents have demonstrated efficacy in migraine prevention, and open‐label experience from our clinic has suggested that topiramate might be effective for this use. We consequently conducted a single‐center, double‐blind, placebo‐controlled trial to evaluate the efficacy and safety of topiramate for the preventative treatment of migraine.Methods.—Forty patients, aged 19 to 62 years (mean, 38.2 years), were randomly assigned in a 1:1 ratio to receive topiramate (n = 19; all women) or placebo (n = 21; 20 women, 1 man). Following a prospective baseline phase of 4 weeks, the study drug dose was titrated weekly in 25‐mg increments over 8 weeks to 200 mg per day or to the maximum tolerated dose. The titration phase was followed by an 8‐week maintenance phase.Results.—During the entire double‐blind phase, topiramate‐treated patients experienced a significantly lower 28‐day migraine frequency (3.31 ± 1.7 versus 3.83 ± 2.1; P = .002) compared to placebo, irrespective of use of concomitant migraine prevention medications. The mean 28‐day migraine frequency was reduced by 36% in patients receiving topiramate as compared with 14% in patients receiving placebo (P = .004). Twenty‐six percent of the patients on topiramate and 9.5% of the patients on placebo achieved a 50% reduction in migraine frequency (P > .05). The mean dose of topiramate was 125 mg per day (range, 25 to 200 mg per day). Topiramate was well tolerated; 2 of 19 topiramate‐treated patients discontinued treatment due to adverse events. Adverse effects that occurred more frequently in topiramate‐treated patients included paresthesia, weight loss, altered taste, anorexia, and memory impairment.Conclusions.—Preventative therapy with topiramate significantly reduced migraine frequency. Larger multicenter clinical studies may further delineate the role of topiramate in migraine prevention.
Aminergic Tone Correlates of Migraine and Tension‐type Headache: A Study Using the Tridimensional Personality Questionnaire
Authors: Di Piero V. , Bruti G. , Venturi P. , Talamonti F. , Biondi M. , Di Legge S. , Lenzi G.L. 
Published: March 2003

Background.—Aminergic neurotransmitter activity has been studied in many neuropsychiatric diseases by means of a self‐administered questionnaire proposed by Cloninger. Given that central aminergic modulation plays a major role in the pathophysiology of primary headaches, we investigated the personality dimensions related to aminergic neurotransmitter activity in patients with migraine and tension‐type headache.Methods.—From a consecutive series of 230 patients, we selected those presenting with migraine and tension‐type headache according to the International Headache Society criteria. All patients were assessed by means of the Cloninger 100‐item self‐report Tridimensional Personality Questionnaire and a depression scale. The four dimensions of personality are novelty seeking (dopaminergic), harm avoidance (serotonergic), reward dependence (noradrenergic), and persistence (glutaminergic).Results.—One hundred twenty‐one patients presenting with migraine and 42 with tension‐type headache were recruited. The results indicate significantly higher harm avoidance scores (P<.001) in both patients with migraine and those with tension‐type headache than in controls. Furthermore, patients with migraine had a significantly low score in the novelty seeking dimension (P<.001). When we compared only the two groups of patients with headache, we found that the persistence dimension alone was significantly higher in patients with migraine than in those with tension‐type headache (P<.05). No differences were observed either in the overall scores of the other personality dimensions or in the depression scale scores.Conclusions.—The Tridimensional Personality Questionnaire results support a role of the serotonergic system in both migraine and tension‐type headache pathophysiology. A dysfunction of dopaminergic and glutaminergic tone seems to be a specific feature of migraine.
Opiate Use to Control Bowel Motility May Induce Chronic Daily Headache in Patients With Migraine
Authors: Wilkinson S.M. , Becker W.J. , Heine J.A. 
Published: March 2003

Objectives.—To investigate whether opiate overuse might cause chronic daily headache in those with migraine, we studied patients who were taking codeine (or other opiates) for control of bowel motility after colectomy for ulcerative colitis.Background.—Analgesic overuse is considered by many to be one factor which can result in the transformation of migraine into a chronic daily headache pattern. Most of the evidence for this comes from patients with migraine who are taking increasing amounts of analgesia for headache. Many of these patients revert to an intermittent migraine pattern once the analgesics are stopped.Methods.—Women who were 1 year postcolectomy for ulcerative colitis were identified in several colorectal surgery practices in Calgary. They were sent a questionnaire designed to determine if they had a history of migraine prior to surgery, if they currently had chronic daily headache, what medications they were taking to control bowel motility, and what medications they were taking for headache.Results.—Twenty‐eight patients who met our inclusion criteria returned completed questionnaires. Eight of these exceeded the recommended limits for opiate use in patients with headache. Eight patients met diagnostic criteria for migraine. Two patients had chronic daily headache starting after surgery. Both used daily opiates beginning after their surgery, and both had a history of migraine. The other six patients who used opiates daily did not have a history of migraine and did not have chronic daily headache. All patients with migraine who used daily opiates to control bowel motility following surgery developed chronic daily headache after surgery.Conclusions.—Patients with migraine who use daily opiates for any reason are at high risk of developing transformed migraine with chronic daily headache. This risk appears much lower in patients without a history of migraine who use opiates for nonpain indications.
Coping Style and Social Support in Men and Women Suffering From Cluster Headache or Migraine
Authors: Blomkvist Vanja , Hannerz Jan , Katz Lillemor , Theorell Töres 
Published: March 2003

Objective.—To investigate similarities and differences between patients with cluster headache and patients with migraine.Background.—Patients with migraine and patients with cluster headache are considered, by many clinical neurologists, to be different psychologically and socially.Methods.—Twenty‐five age‐matched pairs of men and 24 age‐matched pairs of women with either migraine or episodic cluster headache (men aged 31 to 62 years; mean, 47 years; women aged 23 to 72 years; mean, 44 years) were compared with regard to coping profiles as reflected in two “coping wheels,” one for the present situation and one for the future. In addition, availability of attachment and social interaction was assessed by means of the ISSI (Interview Schedule for Social Interaction).Results.—Women with cluster headache anticipated fewer activities for themselves than women with migraine, and findings were similar in the male pairs. The men with cluster headache also anticipated significantly fewer activities for themselves in the present and with others in the present and in the future than the men with migraine. There was no significant difference as to emotional loading between the two groups. A tendency to more optimistic anticipation was found in the women with cluster headache. There were highly significant differences between the two groups in the “future” wheel. The group with migraine expected more concrete activities and more activities with their families in the future, and they also described their present situation to involve more activities with others.Conclusion.—Results from the present study differ from those from studies utilizing more conventional questionnaires. In particular, we found that patients with cluster headache have fewer close social contacts than patients with migraine.
Health Resource Utilization of the Emergency Department Headache “Repeater”
Authors: Maizels Morris 
Published: March 2003

Objective.—To document the health resource utilization of patients who repeatedly use emergency department services for headache care.Background.—Patients with headache who frequently use emergency department services may differ from patients with more typical, episodic migraine. Previous studies of health resource utilization have often failed to distinguish the high utilizer as a specific subset of the migraine population.Design.—Retrospective review of urgent care/emergency department charts, clinic charts, and pharmacy rosters.Patients and Methods.—Patients who made three or more visits for headache to an urgent care/emergency department (UC/ED) facility for headache over a 6‐month study period were identified and designated as “repeaters” for this study. Pharmacy profiles and appointment histories of 52 of the 54 repeaters whose records were available were reviewed for the 12 months prior to the study period.Results.—Over the 6‐month study period, 518 patients visited the UC/ED 1004 times for primary headache complaints. Fifty‐four (10%) repeaters made 502 visits (50% of total visits; mean 9.3, range 3‐50). In the 12 months prior to the study period, 52 of these repeaters made 1832 visits to the UC/ED or clinic (mean 35.2, range 0‐178): 1458 (79.6%) were headache related, and 1271 (69.4%) of all visits were to the UC/ED. An estimated 12‐month cost for all visits was $183,760. Pharmacy rosters showed use of narcotics in 41 of the 52 patients (annual mean ± SD, 613 ± 670 tablets), benzodiazepines in 30 patients (500 ± 486 tablets), and butalbital products in 27 patients (395 ± 590 tablets). Mean daily use of all symptomatic medications combined was 3.9 ± 3.2 doses/day.Conclusion.—Health resource utilization of emergency department headache repeaters is predominantly headache‐related acute care. Associated medication overuse is frequently present. Efforts to improve care for patients with headache will benefit from distinguishing the high utilizer as a subset of the migraine population.
Prevalence of Migraine Among Mexican Americans in San Diego, California: Survey 1
Authors: Molgaard Craig A. , Rothrock John , Stang Paul E. , Golbeck Amanda L. 
Published: March 2003

Objective.—To determine the population‐based prevalence of migraine in a cross‐sectional random sample of Mexican Americans aged at least 45 years in San Diego County, California. Background.—The prevalence of migraine has been assessed in various populations in the United States and Mexico, but no study of migraine prevalence in Mexican Americans has been reported in the literature to date. Design/Methods.—Using an epidemiological cross‐sectional research design, the population‐based prevalence and associated descriptive epidemiology of self‐reported migraine was estimated in Mexican Americans aged at least 45 years in San Diego County, California from a random sample of size 657. Results.—The lifetime migraine prevalence was 9.2% (95% confidence interval, 6.8 to 11.6) and current prevalence was 7.4% (95% confidence interval, 5.3 to 9.5). The prevalence of migraine was higher in women than in men, higher in low income groups than in high income groups, and decreased with increasing age. Prevalence among Mexican Americans born in Mexico was twice that of American‐born Mexican Americans. Conclusions.—These population‐based data on migraine prevalence in Mexican Americans aged 45 and over contribute substantially to the understanding of this disease. A second study addressing migraine prevalence in Mexican Americans younger than 45 years in San Diego County will be reported.
American Headache Society Members' Assessment of Headache Diagnostic Criteria
Authors: Nash Justin M. , Lipchik Gay L. , Holroyd Kenneth A. , McCool Heidi , Stensland Michael 
Published: March 2003

Objective.—We assessed the views of physicians interested in headache as to the diagnosis of the most commonly occurring and currently controversial headaches.Background.—The International Headache Society (IHS) classification system has received wide professional endorsement and considerable empirical support, but in the United States, their adoption by clinicians may be proceeding more slowly. Questions remain, including what diagnostic criteria for migraine and tension‐type headache clinicians may continue to favor over those outlined by the IHS, to what extent is the “transformed migraine” diagnosis used in clinical practice, and how is analgesic rebound headache diagnosed with regard to the various quantitative measures of analgesic use.Methods.—Members of the American Headache Society rated the importance of IHS and non‐IHS diagnostic criteria for migraine and tension‐type headache and for analgesic rebound headache. Respondents also described their use of the proposed transformed migraine diagnosis.Results.—Two‐thirds (67.3%) of the respondents reported use of the IHS criteria or the IHS criteria in conjunction with clinical judgment. For migraine and tension‐type headache, IHS criteria were rated with high importance, but some respondents reported using additional non‐IHS diagnostic criteria and de‐emphasizing certain IHS criteria. For chronic headache, almost two‐thirds (63%) of respondents reported using the transformed migraine diagnosis. For analgesic rebound headache, respondents preferred to make the diagnosis based on medication consumption that is lower than amounts stipulated in the IHS classification system.Conclusions.—There remains a number of physicians interested in headache who do not use the IHS classification system, who modify the IHS criteria in practice, and who use the “transformed migraine” diagnosis for patients with chronic daily headache.
Pharmacology of the Selective 5‐HT1B/1D Agonist Frovatriptan
Authors: Comer M.B. , Hons  
Published: March 2003

Objective.—To determine the pharmacological profile of frovatriptan.Background.—Frovatriptan is a new 5‐HT1B/1D agonist developed for the treatment of migraine.Methods.—Pharmacological studies were performed using in vitro and in vivo techniques.Results.—Radioligand‐binding studies showed that frovatriptan has a high affinity for 5‐HT1B and 5‐HT1D receptors, and moderate affinity for 5‐HT1A, 5‐HT1F, and 5‐HT7 receptors. In vitro, frovatriptan acts as a potent full agonist at human cloned 5‐HT1B and 5‐HT1D receptors, and as a moderately potent full agonist at 5‐HT7 receptors. Studies of frovatriptan in isolated human arteries demonstrated a lower threshold for constriction of cerebral than coronary vasculature and a bell‐shaped dose‐response curve was apparent in the coronary arteries. In anesthetized dogs, frovatriptan administration produced no measurable effect on cardiac function or on blood pressure. Frovatriptan had no effects on coronary blood flow following transient coronary artery occlusion, whereas sumatriptan produced a prolonged and significant decrease in coronary blood flow.Conclusion.—The pharmacology of frovatriptan suggests that it should be an effective agent for the acute treatment of migraine, with a low potential for undesirable peripheral effects.