Headache: The changing migraine brain

ArticleinThe Lancet Neurology 12(1):6-8 · January 2013with7 Reads
DOI: 10.1016/S1474-4422(12)70290-9 · Source: PubMed
    • "A number of studies have reported findings which suggesting that repeated migraine attacks can result in progressive structural and functional alterations of the brain [6]. Migraine also is a risk factor for ischemic stroke and there are reports of ischemic stroke occurring during migraine attacks [6, 7]. The prevalence of dizziness and vertigo in the general population is approximately 20 % to 30 % [3]. "
    [Show abstract] [Hide abstract] ABSTRACT: There is evidence suggesting that migraine may be associated with vertigo. The aim of this study was to assess the risk of benign paroxysmal positional vertigo (BPPV), the most common form of vertigo, in patients with migraine using a population-based dataset. The National Health Insurance Research Database in Taiwan was searched for migraine patients and was also used to select an age- and sex-matched cohort of subjects without migraine. The analyses included 8266 migraine patients and 8266 controls. The incidence rates of BPPV in the two cohorts were compared. Cox proportional hazard models were used to identify risk factors for BPPV in migraine patients. In the migraine cohort, 1.11 % of the patients developed BPPV compared to 0.5 % of the controls. The incidence rate ratio was 2.03 (95 % CI 1.41-2.97; p <0.001). Cox proportional hazards analysis showed that age ≥40 years (HR 2.20; 95 % CI 1.40-3.45; p = 0.001), coronary artery disease (HR 4.62; 95 % CI 1.12-19.01; p = 0.034), and the number of outpatient department visits to neurologists because of migraine (HR 2.93; 95 % CI 2.50-3.44; p >0.001) were associated with an increased risk for BPPV. The results showed that patients with migraine had a 2.03-fold increased risk of developing BPPV compared with age- and sex-matched controls. Although BPPV may not be a common condition in migraine patients, migraine sufferers with vestibular symptoms should alert physicians to the possibility of BPPV, particularly if patients are aged ≥40 years, have a history of coronary artery disease, or have frequent visits to neurologists clinics because of migraine.
    Full-text · Article · Dec 2015
  • [Show abstract] [Hide abstract] ABSTRACT: Cortical Spreading Depression (CSD) is a key event in migraine; during a CSD a wave of depolarization spreads through the brain, starting in the visual cortex. We present the design and fabrication of a novel probe that can be functionalized to measure multiple parameters, relevant to a CSD, in-vivo simultaneously. In this work, we focus on the functionalization of the fabricated probes to measure extracellular potassium with a potentiometric sensor. The sensor response is approximately linear from 2-40 mM, and has a response of 55 mV/log[K+]. Measurements where performed in-vivo in a WT mouse and clearly indicated raised potassium levels during the evoked CSD.
    Conference Paper · Jun 2013 · The journal of pain: official journal of the American Pain Society
  • [Show abstract] [Hide abstract] ABSTRACT: To assess the longitudinal gray matter (GM) and white matter (WM) changes between repeated observations 1 year apart in a group of the early clinical stage of migraine patients without aura, and to explore the relationship of such structural changes with headache activity, we studied patients newly diagnosed with episodic migraine lasting 8 to 14 weeks. Optimized voxel-based morphometry and tract-based spatial statistical analyses were used to evaluate changes in GM and WM by using 3-dimensional T1-weighted and diffusion-tensor imaging, respectively. At the 1-year follow-up examination, GM reduction was observed in the dorsolateral and medial part of the superior frontal gyrus, orbitofrontal cortex, hippocampus, precuneus, and primary and secondary somatosensory cortices. No significant differences were found in the fractional anisotropy and longitudinal, radial, and mean diffusivity of WM in migraine patients without aura within a year. Negative results were found for the association between changes in headache activity parameters and GM. Our results indicated that the GM and WM changed in different pathophysiological conditions of migraine patients without aura. The WM probably evolves slowly in the course of migraine chronicity. Our study found early involvement of GM reduction of sensory-discriminative brain regions in the pathologic process of migraine, but the WM did not exhibit significant changes in the same time interval. GM reduction in sensory-discriminative brain regions may characterize the pathophysiological features of migraine patients without aura in its early stage.
    Article · Dec 2013
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