Posts tagged migraine
Articles and news from the latest research reports.
Tweeting a killer migraine in real time
Not even the pain of a migraine headache keeps people from Twitter.
Over the course of a week, students collected every tweet that mentioned the word migraine. Once they cleared out the ads, the retweets and the metaphorical uses of the word, they had 14,028 tweets from people who described their migraine headaches in real time — with words such as “killer,” “the worst” (almost 15% of the tweets) and the F-word.
The Twitter users also reported the repercussions from their migraines: missing school or work, lost sleep, mood changes.
The researchers found the information to be “a powerful source of knowledge” about the headaches, because usually sufferers are providing information after the fact in clinical situations.
“The technology evolves, and our language evolves,” Dr. Alexandre DaSilva, an assistant professor at the University of Michigan School of Dentistry and lead author of the study, said Wednesday by phone. Clinical researchers’ language — such as “throbbing” or “pulsating” — might not be as apt today, to “the generation that grew up with video games.”
Migraine and Depression Together May Be Linked with Brain Size
Older people with a history of migraines and depression may have smaller brain tissue volumes than people with only one or neither of the conditions, according to a new study in the May 22, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“Studies show that people with migraine have double the risk of depression compared to people without migraine,” said study author Larus S. Gudmundsson, PhD, with the National Institute on Aging and the Uniformed Services University of the Health Sciences, in Bethesda, Md. Gudmundsson is also a member of the American Academy of Neurology. “We wanted to find out whether having both conditions together possibly affected brain size.”
For the study, 4,296 people with an average age of 51 were tested for migraine headache from 1967 to 1991; they were later assessed from 2002 to 2006 at an average age of 76 for a history of major depressive disorder (depression). Participants also underwent MRI, from which brain tissue volumes were estimated. A total of 37 participants had a history of both migraine and depression, while 2,753 had neither condition.
The study found that people with both migraine and depression had total brain tissue volumes an average of 19.2 milliliters smaller than those without either condition. There was no difference in the total brain volume when comparing people with only one of the conditions to people with neither condition.
“It is important to note that participants in this study were imaged using MRI once, so we cannot say that migraine and depression resulted in brain atrophy. In future studies, we need to examine at what age participants develop both migraine and depression and measure their brain volume changes over time in order to determine what comes first,” said Gudmundsson.
Gudmundsson noted that some of the factors leading to a joint effect of migraine and depression on brain volume may include pain, brain inflammation, genetics and differences in a combination of social and economic factors. “Our study suggests that people with both migraine and depression may represent a unique group from those with only one of these conditions and may also require different strategies for long-term treatment.”
Hologram-like 3-D brain helps researchers decode migraine pain
Wielding a joystick and wearing special glasses, pain researcher Alexandre DaSilva rotates and slices apart a large, colorful, 3-D brain floating in space before him.
Despite the white lab coat, it appears DaSilva’s playing the world’s most advanced virtual video game. The University of Michigan dentistry professor is actually hoping to better understand how our brains make their own pain-killing chemicals during a migraine attack.
The 3-D brain is a novel way to examine data from images taken during a patient’s actual migraine attack, says DaSilva, who heads the Headache and Orofacial Pain Effort at the U-M School of Dentistry and the Molecular and Behavioral Neuroscience Institute.
Different colors in the 3-D brain give clues about chemical processes happening during a patient’s migraine attack using a PET scan, or positron emission tomography, a type of medical imaging.
"This high level of immersion (in 3-D) effectively places our investigators inside the actual patient’s brain image," DaSilva said.
The 3-D research occurs in the U-M 3-D Lab, part of the U-M Library.
Can Nerve Stimulation Help Prevent Migraine?
Wearing a nerve stimulator for 20 minutes a day may be a new option for migraine sufferers, according to new research published in the February 6, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.
The stimulator is placed on the forehead, and it delivers electrical stimulation to the supraorbital nerve.
For the study, 67 people who had an average of four migraine attacks per month were followed for one month with no treatment. Then they received either the stimulation 20 minutes a day for three months or sham stimulation, where they wore the device but the stimulation given was at levels too low to have any effect.
Those who received the stimulation had fewer days with migraine in the third month of treatment compared to the first month with no treatment. The number of days with migraine decreased from 6.9 days to 4.8 days per month. The number did not change for those who received the sham treatment.
The study also looked at the number of people who had 50 percent or higher reduction in the number of days with migraine in a month. That number was 38 percent for those who had the stimulation compared to 12 percent of those who received the sham treatment.
There were no side effects from the stimulation.
“These results are exciting, because the results were similar to those of drugs that are used to prevent migraine, but often those drugs have many side effects for people, and frequently the side effects are bad enough that people decide to quit taking the drug,” said study author Jean Schoenen, MD, PhD, of Liège University in Belgium and a member of the American Academy of Neurology. The study was supported by the Walloon Region, Department of Economy, Employment and Research in Belgium.
All in the family: A genetic link between epilepsy and migraine
New research reveals a shared genetic susceptibility to epilepsy and migraine. Findings published in Epilepsia (DOI: 10.1111/epi.12072), a journal of the International League Against Epilepsy (ILAE), indicate that having a strong family history of seizure disorders increases the chance of having migraine with aura (MA).
Medical evidence has established that migraine and epilepsy often co-occur in patients; this co-occurrence is called “comorbidity.” Previous studies have found that people with epilepsy are substantially more likely than the general population to have migraine headache. However, it is not clear whether that comorbidity results from a shared genetic cause.
"Epilepsy and migraine are each individually influenced by genetic factors," explains lead author Dr. Melodie Winawer from Columbia University Medical Center in New York. "Our study is the first to confirm a shared genetic susceptibility to epilepsy and migraine in a large population of patients with common forms of epilepsy."
For the present study, Dr. Winawer and colleagues analyzed data collected from participants in the Epilepsy Phenome/Genome Project (EPGP)—a genetic study of epilepsy patients and families from 27 clinical centers in the U.S., Canada, Argentina, Australia, and New Zealand. The study examined one aspect of EPGP: sibling and parent-child pairs with focal epilepsy or generalized epilepsy of unknown cause. Most people with epilepsy have no family members affected with epilepsy. EPGP was designed to look at those rare families with more than one individual with epilepsy, in order to increase the chance of finding genetic causes of epilepsy.
Analysis of 730 participants with epilepsy from 501 families demonstrated that the prevalence of MA—when additional symptoms, such as blind spots or flashing lights, occur prior to the headache pain— was substantially increased when there were several individuals in the family with seizure disorders. EPGP study participants with epilepsy who had three or more additional close relatives with a seizure disorder were more than twice as likely to experience MA than patients from families with fewer individuals with seizures. In other words, the stronger the genetic effect on epilepsy in the family, the higher the rates of MA. This result provides evidence that a gene or genes exist that cause both epilepsy and migraine.
Identification of genetic contributions to the comorbidity of epilepsy with other disorders, like migraine, has implications for epilepsy patients. Prior research has shown that coexisting conditions impact the quality of life, treatment success, and mortality of epilepsy patients, with some experts suggesting that these comorbidities may have a greater impact on patients than the seizures themselves. In fact, comorbid conditions are emphasized in the National Institutes of Health Epilepsy Research Benchmarks and in a recent report on epilepsy from the Institute of Medicine.
"Our study demonstrates a strong genetic basis for migraine and epilepsy, because the rate of migraine is increased only in people who have close (rather than distant) relatives with epilepsy and only when three or more family members are affected," concludes Dr. Winawer. "Further investigation of the genetics of groups of comorbid disorders and epilepsy will help to improve the diagnosis and treatment of these comorbidities, and enhance the quality of life for those with epilepsy."
(Source: eurekalert.org)
Electric stimulation of brain releases powerful, opiate-like painkiller
Researchers used electricity on certain regions in the brain of a patient with chronic, severe facial pain to release an opiate-like substance that’s considered one of the body’s most powerful painkillers.
The findings expand on previous work done at the University of Michigan, Harvard University and the City University of New York where researchers delivered electricity through sensors on the skulls of chronic migraine patients, and found a decrease in the intensity and pain of their headache attacks. However, the researchers then couldn’t completely explain how or why.
The current findings help explain what happens in the brain that decreases pain during the brief sessions of electricity, says Alexandre DaSilva, the senior researcher in the study from the University of Michigan School of Dentistry. Other study authors include DaSilva’s PhD student, Marcos DosSantos, and also Dr. Jon-Kar Zubieta from the Molecular and Behavioral Neuroscience Institute.
In their current study, DaSilva and colleagues intravenously administered a radiotracer that reached important brain areas in a patient with trigeminal neuropathic pain (TNP), a type of chronic, severe facial pain. They applied the electrodes and electrically stimulated the skull right above the motor cortex of the patient for 20 minutes during a PET scan (positron emission tomography). The stimulation is called transcranial direct current stimulation (tDCS).
The radiotracer was specifically designed to measure, indirectly, the local brain release of mu-opioid, a natural substance that alters pain perception. In order for opiate to function, it needs to bind to the mu-opioid receptor (the study assessed levels of this receptor).
"This is arguably the main resource in the brain to reduce pain," DaSilva said. "We’re stimulating the release of our (body’s) own resources to provide analgesia. Instead of giving more pharmaceutical opiates, we are directly targeting and activating the same areas in the brain on which they work. (Therefore), we can increase the power of this pain-killing effect and even decrease the use of opiates in general, and consequently avoid their side effects, including addiction."
Most pharmaceutical opiates, especially morphine, target the mu-opioid receptors in the brain, DaSilva says.
The dose of electricity is very small, he says. Consider that electroconvulsive therapy (ECT), which is used to treat depression and other psychiatric conditions, uses amperage in the brain ranging from 200 to 1600 milliamperes (mA). The tDCS protocol used in DaSilva’s study delivered 2 mA, considerably lower than ECT.
Just one session immediately improved the patient’s threshold for cold pain by 36 percent, but not the patient’s clinical, TNP/facial pain. This suggests that repetitive electrical stimulation over several sessions are required to have a lasting effect on clinical pain as shown in their previous migraine study, DaSilva says.
The manuscript appears in the journal Frontiers in Psychiatry. The group just completed another study with more subjects, and the initial results seem to confirm the findings above, but further analysis is necessary.
Next, researchers will investigate long-term effects of electric stimulation on the brain and find specific targets in the brain that may be more effective depending on the pain condition and patients’ status. For example, the frontal areas may be more helpful for chronic pain patients with depression symptoms.