Headache
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Neurostimulation for primary headaches is being increasingly utilized as a treatment modality. Use of neuromoduation has generated multiple case reports as well as some controlled studies. This article is the first of 2 systematic reviews of available data regarding neurostimulation for primary headache conditions. ⋯ These peripheral targets include: percutaneous nerves, transcranial holocephalic, occipital nerves, auriculotemporal nerves, supraorbital nerves, cervical epidural, and sphenopalatine ganglia. Part 2 will focus on central stimulation, covering vagus nerve, and deep brain stimulation. Part 2 also contains an overall analysis of efficacy, safety, cost, patient selection, and suggestions for further study based on available evidence.
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Comparative Study
Differences in the personality profile of medication-overuse headache sufferers and drug addict patients: a comparative study using MMPI-2.
Medication-overuse headache (MOH) refers to headache attributed to excessive use of acute medications. The role of personality needs studies to explain the shifting from drug use to drug abuse. The main aim of this study is to study personality, according to Minnesota Multiphasic Personality Inventory, comparing MOH, episodic headache, substance addicts (SA) vs healthy controls. ⋯ The data obtained show that MOH and SA do not share common personality characteristics linked to dependence. Although further studies are needed to understand if such a difference is related to instrumental characteristics or to yet undiscovered psychobiological characteristics of MOH patients; however, we hypothesize that the detected difference may rely on the fact that drug dependence in the 2 groups is promoted by entirely different needs: pleasure seeking in the SA group, pain avoidance in the MOH group.
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Migraine is associated with an increased risk for ischemic stroke and cardiovascular disease (CVD). Recent studies have suggested vascular dysfunction in the aorta, the brachial and femoral artery. Little is known about such arterial changes in Japanese midlife migraineurs. We aimed to evaluate arterial pulse wave velocity (PWV) and ankle-brachial index (ABI) in middle-aged migraineurs at low CVD risk. ⋯ The present study indicated higher baPWV in midlife migraineurs without CVD risk factors. This pathogenesis could reflect distinct vascular reactivity rather than arterial stiffness due to atherosclerosis.
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To evaluate the number of immune cells in the peripheral blood of medication-overuse headache (MOH), chronic migraine (CM), and migraine without aura (MWA) patients, as well as from controls. ⋯ A higher lymphocyte count in the MOH group relative to the MWA group may indicate a chronic inflammatory state. Several clinical and laboratorial characteristics have a range along a spectrum extending from healthy subjects to patients suffering from chronic forms of migraine.
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Clinical Trial
Sustained effectiveness of occipital nerve stimulation in drug-resistant chronic cluster headache.
Drug-resistant chronic cluster headache (drCCH) is a devastating condition for which various invasive therapeutic procedures have been tempted without any satisfactory effect. Recent studies suggest that occipital nerve stimulation (ONS) could be an efficient preventive treatment of drCCH. ⋯ Our long-term follow-up confirms the efficacy of ONS in drCCH, which remains a safe and well-tolerated technique. The occurrence of contralateral attacks and isolated autonomic attacks in nearly 50% of ONS responders may have therapeutic and pathophysiological implications.