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Light of Intrinsically Photosensitive Retinal Ganglion Cell (ipRGC) Causing Migraine Headache Exacerbation

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... Caffeine increases light responsiveness of the mouse circadian pacemaker (173), and it has been shown that chronic exposure to caffeine interferes with the ability of the SCN to entrain normally to light, and that it potentiates phasedelays (174). Further, it has been claimed that glasses that filter out blue light can reduce the frequency of migraine attacks with short periods of usage (175), and in an experimental study light stimulation with the peak wavelength of ipRGC induced migraine attacks more frequently than extensive-wavelength (176). Based on this, it may be speculated that caffeine interferes with the ability of the biological clock to entrain to light, causing increased excitability in pathways involved in migraine headache, including the dura-sensitive thalamocortical neurons. ...
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Background: The actions of caffeine as an antagonist of adenosine receptors have been extensively studied, and there is no doubt that both daily and sporadic dietary consumption of caffeine has substantial biological effects on the nervous system. Caffeine influences headaches, the migraine syndrome in particular, but how is unclear. Materials and Methods: This is a narrative review based on selected articles from an extensive literature search. The aim of this study is to elucidate and discuss how caffeine may affect the migraine syndrome and discuss the potential pathophysiological pathways involved. Results: Whether caffeine has any significant analgesic and/or prophylactic effect in migraine remains elusive. Neither is it clear whether caffeine withdrawal is an important trigger for migraine. However, withdrawal after chronic exposure of caffeine may cause migraine-like headache and a syndrome similar to that experienced in the prodromal phase of migraine. Sensory hypersensitivity however, does not seem to be a part of the caffeine withdrawal syndrome. Whether it is among migraineurs is unknown. From a modern viewpoint, the traditional vascular explanation of the withdrawal headache is too simplistic and partly not conceivable. Peripheral mechanisms can hardly explain prodromal symptoms and non-headache withdrawal symptoms. Several lines of evidence point at the hypothalamus as a locus where pivotal actions take place. Conclusion: In general, chronic consumption of caffeine seems to increase the burden of migraine, but a protective effect as an acute treatment or in severely affected patients cannot be excluded. Future clinical trials should explore the relationship between caffeine withdrawal and migraine, and investigate the effects of long-term elimination.
Persistent headache was more common after mTBI than arm injury (28% vs. 19%), but this difference was not statistically significant
  • Servicio De Neurología
  • Universitario
  • Uanl
  • Nuevo Monterrey
  • Mexico León
Servicio de Neurología, Hospital Universitario, UANL, Monterrey, Nuevo León, Mexico. Results: Three months after injury, 43% of those with mTBI and 26% of those with arm injury had headache [RR: 1.7 (95% CI:1.2-2.3)]. Persistent headache was more common after mTBI than arm injury (28% vs. 19%), but this difference was not statistically significant [RR: 1.2 (95% CI:0.9-1.5)].