bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
Target‐specific Catecholamine Elevation Induced by Anticonvulsant Thalamic Deep Brain Stimulation
Authors: Ziai Wendy C. , Sherman David L. , Bhardwaj Anish , Zhang Ning , Keyl Penelope M. , Mirski Marek A. 
Published: June 2005

Summary:  Purpose: Anterior thalamic nucleus (AN) deep brain stimulation (DBS) is effective in raising EEG and clonic seizure threshold in experimental models. Little is known about the specific properties of DBS that afford its anticonvulsant effect. We sought to test the hypothesis that experimental seizures and the anticonvulsant action of AN DBS alter the underlying regional neurochemistry of AN, specifically with facilitation of the serotonergic system to local electrical stimulation. Methods: Halothane‐anesthetized adult Sprague–Dawley male rats underwent stereotactically guided bilateral placement of bipolar stimulating steel electrodes and dialysis probes–guide cannulae in AN and posterior thalamus (PT), and placement of four epidural EEG screw electrodes 48 h before experiments. Both stimulated (AN DBS) and nonstimulated (NO DBS) animals (n = 7 per group) were infused with i.v. pentylenetetrazol (PTZ, 5.5 mg/kg/min). Simultaneous thalamic and cortical EEG were recorded, and microdialysis samples were collected from AN and PT in 20‐min epochs. AN stimulation was delivered (150 μA; 0.1‐ms pulse duration) 40 min before and continued during PTZ infusion. Results: Bilateral AN stimulation delayed the onset of EEG seizures compared with controls: 82 ± 8 vs. 58 ± 5 min (p = 0.02). PTZ infusion alone, or together with stimulation, resulted in a steady increase in norepinephrine (NE), but not dopamine, at AN and PT sites (p < 0.001). Although extracellular serotonin was measured at very low levels, the metabolite, 5‐hydroxyindoleacetic acid (5‐HIAA) increased selectively in AN after stimulation and during preconvulsant infusion of PTZ (p < 0.001), returning to baseline after the first generalized seizure. Conclusions: These data suggest that PTZ and DBS together enhance the nonselective release of NE in thalamic nuclei while specifically stimulating AN‐localized serotonin. Low serotonin levels at baseline and during STIM alone or PTZ infusion may indicate efficient reuptake systems for serotonin, with 5‐HIAA serving as a surrogate marker for serotonergic activity. Modulation of the AN‐specific serotonergic activity may be critical in altering PTZ seizure threshold and be an important neurotransmitter system underlying the efficacy of AN DBS.
Gender Differences in Epilepsy
Authors: Christensen Jakob , Kjeldsen Marianne Juel , Andersen Henning , Friis Mogens Laue , Sidenius Per 
Published: June 2005

Summary:  Purpose: The aim of this study was to look at gender differences in unselected populations of patients with epilepsy classified according to the 1989 International League Against Epilepsy (ILAE) criteria. Methods: Data were obtained from two sources: (a) the EpiBase database at the outpatient clinic at the Department of Neurology, Aarhus University Hospital, Denmark, confined to adults with epilepsy (n = 2,170), and (b) the Danish Twin Registry (n = 318). Results: In localization‐related epilepsy, no overall gender difference was found in either the EpiBase population (n = 1,511; w = 750 (50%), m = 761 (50%); p = 0.80) or in the twin population (n = 172; w = 86 (50%), m = 86 (50%); p = 1.00). However, in the EpiBase population, localization‐related symptomatic epilepsies were more frequent in men (n = 939; w = 426 (45%), m = 513 (55%); p = 0.005); and cryptogenic localization‐related epilepsies were more frequent in women (n = 572; w = 324 (57%), m = 248 (43%); p = 0.002). In generalized epilepsy, more women than men were diagnosed in both populations [EpiBase: n = 480, w = 280 (58%), m = 200 (42%); p < 0.001; twin population: n = 105, w = 63 (60%), m = 42 (40%); p = 0.05]. The difference was confined to idiopathic generalized epilepsy [EpiBase: n = 437, w = 259 (59%), m = 178 (41%); p < 0.001; twin population: n = 94, w = 60 (64%), m = 34 (36%); p = 0.01]. Conclusions: More women than men were diagnosed with idiopathic generalized epilepsy in two epilepsy populations. Overall, no gender difference was found in localization‐related epilepsy, but localization‐related symptomatic epilepsies were more frequent in men, and cryptogenic localization‐related epilepsies were more frequent in women The results suggest a gender susceptibility to the development of specific epilepsy subtypes.
Vigabatrin in Low Doses Selectively Suppresses the Clonic Component of Audiogenically Kindled Seizures in Rats
Authors: Vinogradova Ludmilla V. , Kuznetsova Galina D. , Shatskova Alla B. , Van Rijn Clementina M. 
Published: June 2005

Summary:  Purpose: The effect of systemic administration of the γ‐aminobutyric acid (GABA)‐transaminase inhibitor vigabatrin (VGB) on different components of convulsions was tested in the model of audiogenically kindled seizures, which consist of brainstem (running, tonus) and forebrain (clonus) elements. Methods: Audiogenically susceptible rats of Krushinsky‐Molodkina (KM), Wistar, and WAG/Rij strains received repeated sound stimulation (60 dB, 10–80 kHz) until kindled audiogenic seizures were reliably elicited. Kindled audiogenic seizures consisted of running, tonic, and generalized clonic phases in KM rats (severe audiogenic seizures) and of running and Racine stage 5 facial/forelimb clonus in Wistar and WAG/Rij rats (moderate seizures). Vehicle, 100, or 200 mg/kg of VGB was intraperitoneally injected 2, 4 and 24 h before the induction of kindled audiogenic seizures. Results: At both doses, VGB did not change the seizure latency and the duration of running and tonic convulsions, but suppressed clonic ones in all rat strains. In KM rats, the mean duration of posttonic clonus was significantly reduced at 24 h after 100 mg/kg and from 4 h after 200 mg/kg. In Wistar and WAG/Rij rats, the mean duration of facial/forelimb clonus was reduced from 4 and 2 h after 100‐ and 200‐mg/kg administration, respectively; 24 h after the high‐dose injection, clonus was completely blocked in all rats of both strains. No difference in efficacy of VGB between Wistar and WAG/Rij rats was observed. Conclusions: VGB more effectively suppresses clonic convulsions than running and tonic ones in audiogenically kindled rats. It is supposed that this selective anticonvulsive effect of VGB results from different sensitivities of forebrain and brainstem epileptic networks to the presumed GABA enhancement.
Epilepsies after Pocket Monster Seizures
Authors: Okumura Akihisa , Watanabe Kazuyoshi , Negoro Tamiko , Ishikawa Tatsuya , Ishiguro Yoshiko , Takenaka Junko , Takada Hiroyuki 
Published: June 2005

Summary:  Background: We conducted a 5‐year follow‐up study in patients with a seizure induced by animated cartoon “Pocket Monster.” Methods: A recurrence of seizures was observed in 25 of 91 patients with a Pocket Monster seizure. The patients were divided into two groups: Epilepsy group of 12 patients with a history of epilepsy and Nonepilepsy group of 13 patients without a history of epilepsy. Results: Age below 12 years and generalized seizures were more often in Nonepilepsy group than in Epilepsy group. Seizure recurrence was earlier in Epilepsy group than in Nonepilepsy group. Photoparoxysmal response was relatively infrequent in Epilepsy group. The majority of patients were classified into idiopathic generalized epilepsies in Nonepilepsy group, whereas most patients were categorized into localization‐related epilepsies in Epilepsy group. Conclusions: Epilepsies after Pocket Monster seizures were different according to the presence or absence of a history of epilepsy. These results will be useful in order to determine the treatment of a patient with a visually induced seizure.
Hippocampal Malformations Do Not Necessarily Evolve into Hippocampal Sclerosis
Authors: Sen Arjune , Thom Maria , Martinian Lillian , Dawodu Stephen , Sisodiya Sanjay M. 
Published: June 2005

Summary: Purpose:Hippocampal malformations have been proposed to underlie or evolve into hippocampal sclerosis, a common cause of refractory partial epilepsy. We report two patients with chronic epilepsy and developmental abnormalities of the hippocampus and cortex. We seek to address, in patients with recurrent convulsive seizures over many decades, whether hippocampal malformations necessarily progress to hippocampal sclerosis.Methods:The first patient died at age 76 years and had experienced convulsive seizures for 43 years. The second patient, aged 64 years at death, had experienced convulsive seizures for 49 years. The brains were processed routinely. Immunohistochemistry for dynorphin and neuropeptide Y was performed.Results:The first case exhibited bilateral perisylvian polymicrogyria. Both hippocampi demonstrated abnormal convolution in the CA1 subfield and subiculum. In the second case, periventricular heterotopia was found in the wall of the right lateral ventricle. The right hippocampus was abnormally oriented with excessive convolutions of the pyramidal cell layer between CA1 and the subiculum. In neither patient did the hippocampi exhibit neuronal loss. Furthermore, dynorphin immunohistochemistry revealed no reactivity in the molecular layers, and staining with neuropeptide Y confirmed normal numbers of hilar interneurons.Conclusions:These two cases demonstrate histologically that, even in long‐standing epilepsy, malformations of the hippocampus do not necessarily develop into hippocampal sclerosis.
The Neuropsychological and Language Profile of Children with Benign Rolandic Epilepsy
Authors: Northcott Ellen , Connolly Anne M. , Berroya Anna , Sabaz Mark , McIntyre Jenny , Christie Jane , Taylor Alan , Batchelor Jennifer , Bleasel Andrew F. , Lawson John A. , Bye Ann M. E. 
Published: June 2005

Summary:  Purpose: Benign rolandic epilepsy (BRE) has an excellent prognosis for seizures, but recent research has raised concerns using cognition as an outcome measure. Methodologic problems related to recruitment bias and assessment processes are evident in previous studies. With well‐defined criteria for inclusion and comprehensive assessment, the aim of this study was to define the cognitive profile of children with BRE and to assess the effect of interictal EEG activity. Methods: Patients (n = 42) were recruited from six EEG laboratories. The EEG features analyzed were spike frequency, trains, and laterality. Comprehensive neuropsychological and language assessments were conducted. Group means on cognitive measures were compared with normative means. Tests were correlated with EEG features. Results: The study demonstrated that children with BRE have normal intelligence and language ability. However, a specific pattern of difficulties in memory and phonologic awareness was found. Furthermore, a large proportion of children had disproportionate scores in these areas compared with intellectual and language ability. EEG features were minimally associated with cognitive difficulties, and no correlation was found with memory indices and tests of phonologic awareness. Conclusions: Some children with BRE have specific difficulties in memory and phonologic processing skills, not explained by interictal activity. We recommend that pediatricians ask about academic performance specifically in areas of prereading, reading, spelling, and memory. If difficulties are suspected, assessment targeting phonologic awareness and memory are recommended, as they may not be reflected in overall intellectual and language ability. Difficulties in phonologic awareness affect literacy, and memory problems affect academic performance.