bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mast Cell Activation in Children With Migraine Before and After Training in Self‐regulation
Authors: Olness Karen , Hall Howard , Rozniecki Jacek J. , Schmidt Wendy , Theoharides T.C. 
Published: March 2003

Migraine may affect as many as 9% of all schoolchildren and often presents with abdominal symptoms of pain, nausea, and vomiting. Even though the pathophysiology of migraine remains unknown, self‐regulation techniques appear to be more effective in prevention of childhood migraine than conventional pharmacotherapy which is often associated with adverse effects. Mast cells have been implicated in the pathogenesis of migraine in adults, but have not been previously studied in children with migraine.Mast cells are found close to the vessels and nerves in the meninges where they can release multiple vasoactive, neurosensitizing, and pro‐inflammatory mediators. Therefore, we investigated whether children with migraine may have increased urinary levels of mast cell mediators and whether practicing relaxation imagery exercises has an effect on the frequency of headache, as well as on mast cell activation.Urine was collected for 24 hours from children with and without migraine after a 5‐day amine‐restricted diet. Children with migraine also collected urine during migraine episodes. The mean levels of urinary histamine, its main metabolite, methylhistamine, and the mast cell enzyme, tryptase, were higher in children than generally found in adults, but they did not differ statistically in any of the categories studied. However, in 8 of 10 children who practiced relaxation imagery techniques and successfully reduced the number of migraines, the urine tryptase levels were also significantly lower. There was no relationship between successful practice and sex or age of the child. These results suggest that stress may activate mast cells which could be involved in the pathophysiology of migraine.
Tension‐Type Headache: Pain, Fatigue, Tension, and EMG Responses to Mental Activation
Authors: Bansevicius Dalius , Westgaard Rolf H. , Sjaastad Ottar M. 
Published: March 2003

Twenty patients with tension‐type headache (14 chronic and 6 episodic) and 20 group‐matched controls were selected for this study. They participated in a 1‐hour, complex, two‐choice, reaction‐time test, as well as 5‐minute pretest and 20‐minute posttest periods. Subjects reported any pain in the forehead, temples, neck, and shoulders, as well as any feelings of fatigue and tension during the pretest, and every 10 minutes during the test and posttest by visual analog scales. Superficial electromyography was recorded simultaneously from positions representing the frontal and temporal muscles, neck (mostly splenius), and trapezius muscles. The location of pain corresponded to the position of the electrodes, but extended over a larger area. The test provoked pain in the forehead, neck, and shoulders of patients, ie, pain scores from these regions increased significantly during the test. The pain scores continued to increase posttest. In patients, the EMG response of the trapezius (first 10 minutes of the test) was elevated relative to pretest. In controls, only the frontal muscles showed an EMG test response. Patients showed significantly higher EMG responses than controls in the neck (whole test period) and trapezius (first 10 minutes of the test period).There were significant differences in pain and fatigue scoring between patients and controls in all three periods and in tension scoring posttest. Fatigue correlated with pain, with increasing significance for all locations examined, while tension was mainly associated with the neck pain. The meaning of the variables “tension” and “fatigue” in headache, and their association with recorded muscle activity in various regions is discussed. The EMG response of the trapezius muscle to the test is discussed in comparison with similar responses observed in patients with other pain syndromes.
Incidence of Medically Recognized Migraine: A 1989‐1990 Study in Olmsted County, Minnesota
Authors: Rozen Todd D. , Swanson Jerry W. , Stang Paul E. , McDonnell Shannon K. , Rocca Walter A. 
Published: March 2003

Objective.–To investigate the incidence of medically recognized migraine in Olmsted County, Minnesota, during the years 1989 to 1990.Methods.–We used the records‐linkage system of the Rochester Epidemiology Project to identify all subjects who sought medical attention for their headache and had their initial visit for migraine within the study period. Incident cases were classified using specified criteria.Results.–From 9837 records screened, we found 713 incident cases. The average annual incidence rate (new cases per 100 000 person‐years) was 343.0 in both sexes combined, 481.6 in women, and 194.4 in men. In women, incidence rates were low at the extremes of age and higher among those aged between 10 and 49 years, with a striking peak at the age of 20 to 29 years. Migraine without aura was the most common type of migraine in women. Men had a more constant risk of migraine throughout life with a lesser peak at the age of 10 to 19 years, and they were equally affected by all types of migraine. Women had consistently higher incidence rates than men at all ages, and there were strikingly higher incidence rates of migraine without aura in women than in men.Conclusions.–Although our incidence rates were restricted to medically recognized cases of migraine, we confirmed previously reported epidemiological patterns.
Cluster Headache Is Not Associated With Signs of a Systemic Inflammation
Authors: Remahl Ingela Nilsson , Waldenlind Elisabet , Bratt Johan , Ekbom Karl 
Published: March 2003

Objective.–To investigate whether there is clinical or biochemical evidence for a transient systemic inflammation during active periods of cluster headache.Methods.–Twenty‐seven male and female consecutively selected patients with episodic cluster headache filled in questionnaires aiming at detecting any concurrent systemic vasculitic or rheumatoid disease. They were physically examined by both a neurologist and a rheumatologist independent of each other. Blood and urine samples were taken one to three times during an active cluster period and once in remission. The following analyses were performed: hemoglobin, erythrocyte sedimentation rate, C‐reactive protein, complete blood counts including differential counts, creatinine, albumin, creatine kinase, electrophoreses of serum (with haptoglobin, orosomucoid, IgG, IgM), von Willebrand's factor, antinuclear antibodies, rheumatoid factor, cytoplasmic antineutrophil cytoplasmic autoantibodies, perinuclear antineutrophil cytoplasmic autoantibodies, and routine urinary tests. An age‐ and sex‐matched control group of 99 consecutive patients attending the Outpatient Department of Neurology for symptoms/diseases other than severe headache completed the same questionnaire as the patient group.Results.–Only one patient with cluster headache showed clinical signs (livedo reticularis) that could have been due to an ongoing systemic vasculitis. Most symptoms were equally or even more prevalent in the control group than among the patients with cluster headache. However, cold feet were about twice as prevalent among female patients with cluster headache than in the control group. This was considered due to their smoking habits. Laboratory tests showed no statistically significant differences between the active cluster periods and remission. There were some slightly abnormal values in single laboratory tests, some of which were probably due to concurrent upper respiratory infections. The findings of laboratory tests for one patient could have been due to nephritis. All patients were negative for cytoplasmic antineutrophil cytoplasmic autoantibodies and perinuclear antineutrophil cytoplasmic autoantibodies.Conclusions.–These results were taken as evidence that no systemic inflammation is present during the active cluster headache period. However, whether a local retro‐orbital inflammation underlies the pathophysiology of cluster headache remains obscure.
Prevalence and Predictors of Headaches in US Adolescents
Authors: Rhee Hyekyun 
Published: March 2003

Objectives.—To examine the prevalence of headaches among US adolescents; to explore the differences in prevalence by sex, race, and age; and to test the nature of the association between headaches and depression, self‐esteem, and insomnia. Methods.—This longitudinal study used a nationally representative sample of adolescents (n = 6072) who were interviewed in 1995 (wave 1) and then interviewed a year later in 1996 (wave 2). Path analyses were used to test for the relationships among headaches, insomnia, depression, and self‐esteem. Results.—More than 90% of subjects had experienced one or more headaches during the past 12 months. Of that 90%, about 30% reported recurrent headaches occurring weekly or more frequently. Girls tended to report more recurrent headaches (37.6%) than boys (21.3%). American Indians experienced the highest rate (35.6%) of recurrent headaches followed by white adolescents (32.1%). Depression and low self‐esteem in wave 1 were found to precede the headaches in wave 2 in girls, but not in boys. No causal relationship was found between insomnia and headaches. Conclusions.—Headaches are prevalent among US adolescents, especially in girls and American Indians. This study suggests the existence of different paths involving different factors in headache‐presenting behavior for boys and girls. Further studies are needed to illustrate the different mechanisms of headache in the two sexes.
Traumatic Intracerebral Venous Thrombosis Associated With an Abnormal Golf Swing
Authors: Saneto Russell P. , Samples Stephen , Kinkel R. Philip 
Published: March 2003

Objectives.—To describe the occurrence of cerebral venous thrombosis in a 40‐year‐old man whose cerebral event was induced by a poor golf swing, to review the literature on possible mechanisms producing venous thrombosis, and to compare this case with the literature. Background.—Headache is the most frequent symptom in patients with cerebral venous thrombosis. However, patients presenting with a headache due to cerebral venous thrombosis are uncommon. The known risk factors for thrombosis include both acquired and genetic factors. When the interaction of these two groups occurs, the magnitude of this interaction is thought to produce a dynamic state that can favor thrombosis. Our case report illustrates that moderate levels of anticardiolipin antibodies together with the mild trauma of a golf swing can induce a cerebral venous thrombosis. This case also suggests that although headache is rarely due to cerebral venous thrombosis, it should be excluded by good medical acumen and testing. Results.—Minor trauma induced by a poor golf swing was chronologically related to the development of a progressive cerebral venous thrombosis. The patient had none of the risk factors associated with a predisposition to venous thrombosis: hypercoagulable state, concurrent infection, pregnancy/puerperium, collagen vascular disorder, malignancy, migraine, false‐positive VDRL, previous deep vein thrombosis, renal disease, factor V Leiden, or a hematological disorder. There was no anatomical abnormality that would predispose the patient to a cerebral venous thrombosis. The only laboratory abnormality was a moderate anticardiolipin antibody level (25 GPL). The patient was placed on warfarin sodium therapy and is currently without clinical sequela from the venous thrombotic event. Conclusions.—Under certain circumstances, minor trauma can induce cerebral venous thrombosis. A review of the literature indicates that cerebral venous thrombosis in the presence of anticardiolipin antibodies and in the absence of systemic lupus erythematosus is a rare event. Previously, only major traumatic events have been reported to be associated with cerebral venous thromboses. The chronological development of cerebral venous thrombosis after a faulty golf swing strongly indicates that given a background of moderate levels of anticardiolipin antibodies, even minor trauma can induce a venous thrombotic event.
Is Blood Homocysteine Elevated in Migraine?
Authors: Hering‐Hanit R. , Gadoth N. , Yavetz A. , Gavendo S. , Sela B. 
Published: March 2003

Objective.—To determine total serum homocysteine levels in a large group of patients with migraine with and without aura.Background.—Hypercoagulable state is a known risk factor for stroke in the young. The existence of a hypercoagulable state has been postulated in migraine and homocysteinemia with young‐onset stroke. To the best of our knowledge, blood homocysteine has not been studied in a significant number of patients with various forms of migraine.Methods.—Total serum homocysteine was measured with high‐performance liquid chromatography in 78 patients with migraine and in 126 age‐ and sex‐matched healthy volunteers.Results.—Seventy‐eight patients aged 18 to 65 years were studied: 22 with migraine with aura and 56 with migraine without aura. Only 1 man had significantly elevated blood homocysteine (38.6 μmol/L), while another had a borderline elevation (15.8 μmol/L) (reference value for both sexes in our laboratory is 4 to 14 μmol/L). Both patients suffered from migraine without aura.Conclusions.—Blood homocysteine is not elevated in migraine.
Comparative Study of a Combination of Isometheptene Mucate, Dichloralphenazone With Acetaminophen and Sumatriptan Succinate in the Treatment of Migraine
Authors: Freitag Frederick G. , Cady Roger , DiSerio Frank , Elkind Arthur , Gallagher R. Michael , Goldstein Jerome , Klapper Jack A. , Rapoport Alan M. , Sadowsky Carl , Saper Joel R. , Smith Timothy R. 
Published: March 2003

Objective.—To compare the safety and efficacy of isometheptene mucate, dichloralphenazone with acetaminophen to sumatriptan succinate for the treatment of mild‐to‐moderate migraine, with or without aura, when taken at the first sign of an attack.Background.—The Food and Drug Administration approved sumatriptan succinate and the combination of isometheptene mucate, dichloralphenazone with acetaminophen for the treatment of migraine. As part of the stratified treatment of migraine, those patients whose headaches are mild or moderate may benefit from nontriptan medications. Additionally, early treatment of acute migraine before the headache has become moderate or severe may improve response to treatment.Methods.—This was a multicenter, double‐blind, randomized, parallel‐group study to assess the safety and efficacy of the combination of isometheptene mucate, dichloralphenazone with acetaminophen and sumatriptan succinate in the early stages of a single migraine attack. Patients diagnosed with migraine, with or without aura, as defined by the International Headache Society diagnostic criteria were enrolled.Results —One hundred thirty‐seven patients were enrolled in the study. Data for efficacy were available for 126 patients; safety data were available for 128 patients. No statistically significant difference between the two active agents in the patient's response to treatment was demonstrated. Headache recurrence was not significantly different over the 24‐hour evaluation period for those patients responding in the first 4 hours. In those with headache recurrence, it was statistically significantly more severe in those patients treated with sumatriptan succinate. Improvement in functional disability was, in general, better among those treated with isometheptene mucate, dichloralphenazone with acetaminophen. Global analysis of efficacy was similar in the two active groups. Patients treated with sumatriptan succinate were somewhat more likely to have adverse effects than the isometheptene mucate, dichloralphenazone with acetaminophen group.Conclusions.—Both isometheptene mucate, dichloralphenazone with acetaminophen and sumatriptan succinate are safe and effective when used early in the treatment of an acute migraine. Several parameters suggest that isometheptene mucate, dichloralphenazone with acetaminophen may have a slight advantage compared with sumatriptan succinate in the early treatment of mild‐to‐moderate migraine.
Oral Magnesium Load Test in Patients With Migraine
Authors: Trauninger Anita , Pfund Zoltán , Koszegi Tamás , Czopf József 
Published: March 2003

Objective.—To determine whether migraineurs may have a systemic deficiency of magnesium.Background.—Magnesium deficiency has been shown to play a potential role in the pathogenesis of migraine, but there are no data on total body magnesium status in migraineurs.Methods.—An oral magnesium load test was performed by giving 3000 mg of magnesium lactate during a 24‐hour interictal period to 20 patients with migraine (15 women and 5 men; mean age, 37.9 years) and 20 healthy volunteers (16 women and 4 men; mean age, 39.6 years). Baseline and postload magnesium concentrations were determined from serum and 24‐hour urine specimens.Results.—There was no significant difference between the groups in the baseline serum and urine magnesium concentrations, although the latter tended to be lower (P = .064) in the migraine group. The postload magnesium concentrations were significantly higher within both the migraine (P  <  .0001 and P < .0001) and the control (P = .0009 and P < .0001) groups compared to the baseline values. After loading, the 24‐hour urinary magnesium excretions were significantly lower (P = .0007) in the patients with migraine than in the controls, but serum values did not differ.Conclusions.—Magnesium retention occurs in patients with migraine after oral loading, suggesting a systemic magnesium deficiency.
Low‐Dose Tizanidine With Nonsteroidal Anti‐inflammatory Drugs for Detoxification From Analgesic Rebound Headache
Authors: Smith Timothy R. 
Published: March 2003

Objective.—To describe an outpatient regimen for analgesic detoxification and resolution of analgesic rebound headache.Background.—Frequent analgesic use is believed to promote the transformation of episodic migraine into a chronic, pervasive headache syndrome. Management of pain precipitated by analgesic withdrawal is crucial to treatment success. Outpatient treatment protocols designed to achieve successful withdrawal will reduce costs and potentially lead to more widespread implementation of therapy.Methods.—Patients with appropriate histories were managed on an outpatient basis for detoxification by discontinuation of the offending analgesic and initiation of treatment with tizanidine and a long‐acting nonsteroidal anti‐inflammatory drug. Patients kept diaries of pain and medication use. Results were evaluated at 6 and 12 weeks. Patients able to tolerate no or trivial analgesic use (ie, 4 or fewer doses in each 2‐week period) were considered responders.Results.—At 6 weeks, 36 patients (65%) were responders. At 12 weeks, 38 patients (69%) were responders. The chronic daily headache pattern had resolved at 12 weeks in 34 patients (62%).Conclusions.—This treatment protocol was well tolerated and yielded a high degree of efficacy, demonstrating that outpatient management can be effective for achieving analgesic withdrawal and resolution of analgesic rebound headache.
Depression, Automatic Thoughts, Alexithymia, and Assertiveness in Patients With Tension‐type Headache
Authors: Yücel Basak , Kora Kaan , Özyalçín Süleyman , Alçalar Nilüfer , Özdemir Özay , Yücel Aysen 
Published: March 2003

Objective.—The role of psychological factors related to headache has long been a focus of investigation. The aim of this study was to evaluate depression, automatic thoughts, alexithymia, and assertiveness in persons with tension‐type headache and to compare the results with those from healthy controls.Methods.—One hundred five subjects with tension‐type headache (according to the criteria of the International Headache Society classification) and 70 controls were studied. The Beck Depression Inventory, Automatic Thoughts Scale, Toronto Alexithymia Scale, and Rathus Assertiveness Schedule were administered to both groups. Sociodemographic variables and headache features were evaluated via a semistructured scale.Results.—Compared with healthy controls, the subjects with headache had significantly higher scores on measures of depression, automatic thoughts, and alexithymia and lower scores on assertiveness. Subjects with chronic tension‐type headache had higher depression and automatic thoughts scores than those with episodic tension‐type headache.Conclusions.—These findings suggested that persons with tension‐type headache have high depression scores and also may have difficulty with expression of their emotions. Headache frequency appears to influence the likelihood of coexisting depression.
Tumor Necrosis Factor Gene Polymorphism in Migraine
Authors: Trabace Simonetta , Brioli Gloria , Lulli Patrizia , Morellini Marina , Giacovazzo Mario , Cicciarelli Germana , Martelletti Paolo 
Published: March 2003

Objective.—To better define the involvement of human leukocyte antigen region (HLA) genes in migraine via an association study of the tumor necrosis factor (TNF) genes, located in the HLA class III region, with migraine with and without aura.Background.—Migraine without aura and migraine with aura are disorders involving multiple factors—environmental and genetic. In a previous study, we hypothesized a protective role for the HLA‐DR2 antigen, providing additional basis for the proposed genetic heterogeneity between migraine without aura and migraine with aura. The cytokines produced by TNF genes are polypeptide effectors of inflammatory reaction and endothelial function.Methods.—Tumor necrosis factor (TNF)‐308 (TNF−308A and TNF−308G alleles) and lymphotoxin α (TNFB*1 and TNFB*2 alleles) polymorphisms were analyzed by the NcoI‐cleaved polymerase chain reaction‐amplified fragments in 47 patients with migraine without aura, 32 patients with migraine with aura, and 101 migraine‐free controls.Results.—The frequency of TNFB*2 allele was significantly increased in our patients with migraine without aura as compared with the control group (78.72% versus 61.4%, Pc = .004), but no significant differences were found between patients with migraine with aura and controls. Additionally, there was a significant decrease of TNFB*1 homozygotes in patients with migraine without aura compared with the control group (2.13% versus 16.8%, Pc = .0201). Carriage of the TNFB*2 allele confers a high risk for the development of migraine without aura. No significant association was found at TNF‐308 polymorphism.Conclusion.—These data support the hypothesis that lymphotoxin α could be a susceptibility gene in migraine without aura and confirm previous data indicating that migraine with and without aura are distinct entities with different genetic backgrounds.
Auditory Hallucinations Associated With Migraine
Authors: Rubin David , McAbee Gary N. , Feldman‐Winter Lori B. 
Published: March 2003

Objective.—Two children experienced auditory hallucinations during migraine (one with migraine without aura and one with migraine with aura). These hallucinations only occurred during headache. Background.—Auditory hallucinations are rarely reported in patients with migraine. These patients often have other psychiatric or neurologic disorders such as affective disorder or epilepsy. Methods.—Case report and a review of the literature. Results.—No other neuropsychiatric disorder was identified in either patient at presentation or upon follow‐up. Conclusions.—Auditory hallucinations can rarely occur in patients with migraine. Further study of this association might provide insight to any relationship between migraine, auditory hallucinations, and the temporal lobe.