Differential Expression of NME4 in Trophoblast Stem-Like Cells and Peripheral Blood Mononuclear Cells of Normal Pregnancy and Preeclampsia

Background@#Preeclampsia (PE) is known to arise from insufficient trophoblast invasion as uterine spiral arteries lack remodeling. A significant reduction in placental perfusion induces an ischemic placental microenvironment due to reduced oxygen delivery to the placenta and fetus, leading to oxidative stress. Mitochondria are involved in the regulation of cellular metabolism and the production of reactive oxygen species (ROS). NME/NM23 nuceloside diphosphate kinase 4 (NME4) gene is known to have the ability to supply nucleotide triphosphate and deoxynucleotide triphosphate for replication and transcription of mitochondria. Our study aimed to investigate changes in NME4 expression in PE using trophoblast stem-like cells (TSLCs) from induced pluripotent stem cells (iPSCs) as a model of early pregnancy and peripheral blood mononuclear cells (PBMNCs) as a model of late preterm pregnancy. @*Methods@#Transcriptome analysis using TSLCs was performed to identify the candidate gene associated with the possible pathophysiology of PE. Then, the expression of NME4 associated with mitochondrial function, p53 associated with cell death, and thioredoxin (TRX) linked to ROS were investigated through qRT-PCR, western blotting and deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick end labelling (TUNEL) assay. @*Results@#In patients with PE, NME4 was significantly downregulated in TSLCs but upregulated in PBMNCs. p53 was shown to be upregulated in TSLCs and PBMNCs of PE. In addition, western blot analysis confirmed that TRX expression had the tendency to increase in TSLCs of PE. Similarly, TUNEL analysis confirmed that the dead cells were higher in PE than in normal pregnancy. @*Conclusion@#Our study showed that the expression of the NME4 differed between models of early and late preterm pregnancy of PE, and suggests that this expression pattern may be a potential biomarker for early diagnosis of PE.

Clinicopathological differences in radiation-induced organizing hematomas of the brain based on type of radiation treatment and primary lesions

Background@#Radiation-induced organizing hematoma (RIOH) is a sporadic form of cavernous hemangioma (CH) that occurs after cerebral radiation. RIOH lesions are distinct histologically from de novo CH; however, detailed research on this subject is lacking. In the present study, the clinical and histological features of RIOHs were evaluated based on causative lesions. @*Methods@#The present study included 37 RIOHs confirmed by surgical excision from January 2009, to May 2020, in Yonsei Severance Hospital. All cases were divided into subgroups based on type of radiation treatment (gamma knife surgery [GKS], n = 24 vs. conventional radiation therapy [RT], n = 13) and pathology of the original lesion (arteriovenous malformation, n = 14; glioma, n = 12; metastasis, n = 4; other tumors, n = 7). The clinicopathological results were compared between the groups. @*Results@#Clinical data of multiplicity, latency, and size and wall thickness of the original tumors and RIOHs were analyzed. The GKS group showed shorter latency (5.85 ± 4.06 years vs. 11.15 ± 8.27 years, p = .046) and thicker tumor wall (693.7 ± 565.7 μm vs. 406.9 ± 519.7 μm, p = .049) than the conventional RT group. Significant difference was not found based on original pathology. @*Conclusions@#RIOH is more likely to occur earlier with thick tumor wall in subjects who underwent GKS than in patients who underwent conventional RT. These results indicate the clinical course of RIOH differs based on type of treatment and might help determine the duration of follow-up.

Calcific tendinitis of the shoulder in the Korean population: demographics and its relation with coexisting rotator cuff tear

Background@#To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear. @*Methods@#Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. @*Results@#There were 402 female patients (79%) with mean age of 55 years (range, 31–87 years). Mean duration of symptoms was 16 months. Mean size of calcific materials was 11.4 mm (range, 0–35 mm). Mean value of VAS and ASES scores were 6.5 (range, 1–10) and 47 (range, 8–95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all p<0.05). @*Conclusions@#This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.

Calcific tendinitis of the shoulder in the Korean population: demographics and its relation with coexisting rotator cuff tear

Background@#To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear. @*Methods@#Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. @*Results@#There were 402 female patients (79%) with mean age of 55 years (range, 31–87 years). Mean duration of symptoms was 16 months. Mean size of calcific materials was 11.4 mm (range, 0–35 mm). Mean value of VAS and ASES scores were 6.5 (range, 1–10) and 47 (range, 8–95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all p<0.05). @*Conclusions@#This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.

Relationship between Clock-Drawing Performance and Neuropsychological Functions in Patients with Chronic Schizophrenia / 대한정신분열병학회지

Objectives@#This study investigated the relationship between clock-drawing test (CDT) performance and neuropsychological functions in patients with chronic schizophrenia. @*Methods@#Thirty-one patients with schizophrenia and 30 healthy controls participated in this study. The CDT was administered in three conditions and analyzed using both quantitative and qualitative scoring systems. Comprehensive neuropsychological tests were administered. @*Results@#The results of the quantitative analysis showed that the schizophrenia group performed significantly worse in all three conditions of the CDT compared with the control group. However, no significant differences were observed between the two groups, when the IQ and educational level were controlled. The qualitative analysis showed that the schizophrenia group exhibited significantly more errors in “graphic difficulty” compared with the control group. In addition, CDT quantitative scores were significantly correlated with visuospatial function, memory, attention and executive functions in patients with schizophrenia. Conversely, each qualitative error type was correlated with specific cognitive domains. Furthermore, “graphic difficulty” and “spatial/ planning deficit” were identified as predictors of depression symptoms in patients with schizophrenia. @*Conclusion@#The present study demonstrated that the CDT is useful for assessing cognitive dysfunctions in patients with schizophrenia, while qualitative analyses provide more specific information about cognitive deficits compared with quantitative analyses.

An Event-related Potential Study of Error-monitoring Deficits in Female College Students Who Participate in Binge Drinking

OBJECTIVE: This study investigated error-monitoring deficits in female college students with binge drinking (BD) using event-related potentials (ERPs) and the modified Flanker task. METHODS: Participants were categorized into BD (n=25) and non-BD (n=25) groups based on the scores of the Korean-version of the Alcohol Use Disorder Identification Test (AUDIT-K) and the Alcohol Use Questionnaire (AUQ). The modified Flanker task, consisting of congruent (target and flanker stimuli are the same) and incongruent (target and flanker stimuli are different) conditions, was used to evaluate error-monitoring abilities. RESULTS: The BD group exhibited significantly shorter response times and more error rates on the Flanker task, as well as reduced error-related negativity (ERN) amplitudes compared with the non-BD group. Additionally, ERN amplitudes measured at FCz and Cz were significantly correlated with scores on the AUDIT-K and AUQ in the whole participants. The BD and non-BD groups did not show any significant differences in error positivity amplitudes. CONCLUSION: The present results indicate that college students with BD have deficits in error-monitoring, and that reduced ERN amplitudes may serve as a biological marker or risk factor of alcohol use disorder.

Corrigendum: Inflammatory Cytokine Expressions of the Subacromial Bursitis and Glenohumeral Joint Synovitis in the Patients with Full Thickness Rotator Cuff Tear

This correction is being published to correct the order of the first and second authors' names in the above article.

Neurocognitive Characteristics According to Depression Severity in Patients with Major Depressive Disorder

OBJECTIVES: This study investigated associations between symptom severity and neurocognitive functions in patients with major depressive disorder using comprehensive neuropsychological tests. METHODS: Ten patients with low depression (LD) and 22 patients with high depression (HD) participated. Symptom severity was determined by both the Beck Depression Inventory and the Hamilton Depression Rating Scale. Additionally, anxiety was measured by the Korean version of the State-Trait Anxiety Inventory (STAI-KYZ). Ten subtests of the Korean-Wechsler Adult Intelligence scale (K-WAIS), Stroop test, the word/design fluency tests were administered to assess cognition. RESULTS: The LD and HD groups did not differ in any of cognitive measures but anxiety level. Namely, the HD group obtained significantly higher scores on the state (U = 29.50, p < 0.01) and trait (U = 28.50, p < 0.001) anxiety scales than the LD group. A significant interaction effect between trait anxiety and depression severity was observed on the picture arrangement subtest of the K-WAIS [F (1, 27) = 5.09, p < 0.05]. CONCLUSIONS: Cognitive deficits observed in patients with major depressive disorder may be related to other factors rather than current symptom severity. Trait anxiety possibly moderates the effect of current symptom severity on social judgment in these patients.

Results of Iliac Bone Graft with Kirschner Wire Fixation for Scaphoid Nonunions

PURPOSE: To determine clinical and radiographic results of iliac bone grafting with Kirschner wire fixation for treatment of scaphoid nonunions. METHODS: A total of 13 patients who had scaphoid nonunion treated with iliac bone grafting and Kirschner wire fixation between October 2007 and January 2016 were enrolled as subjects of this study. Their clinical results were evaluated, including range of motion of the wrist joint and modified Mayo wrist score. Radiographic results including lateral intrascaphoid angle and scapholunate angle were also assessed. RESULTS: Bony union was achieved in 11 (84.6%) of 13 cases. Modified Mayo wrist score was improved from 64.0 preoperatively to 87.5 postoperatively. Average intrascaphoid angle was improved from 39.5° preoperatively to 27.2° postoperatively while scapholunate angle was improved from 66.0° preoperatively to 55.1° postoperatively. CONCLUSION: Iliac bone graft with Kirschner wire fixation provided good clinical and radiographic results. Therefore, iliac bone graft with Kirschner wire fixation can be considered as a good treatment option for scaphoid nonunion.

New Fixation Method Using Two Crossing Screws and Locking Plate for Cubitus Varus Deformity in Young Adult Elbow: Case Report

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months follow-up, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

New Fixation Method Using Two Crossing Screws and Locking Plate for Cubitus Varus Deformity in Young Adult Elbow: Case Report

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months follow-up, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

Deficits in Verbal Working Memory among College Students with Attention-Deficit/Hyperactivity Disorder Traits: An Event-related Potential Study

OBJECTIVE: This study investigated verbal working memory in college students with traits of attention-deficit/hyperactivity disorder (ADHD) using event-related potentials and the 2-back task. METHODS: Based on scores on the Adult ADHD Self-Report Scale and Conners' Adult ADHD Rating Scale, participants were assigned to the normal control (n=28) or ADHD-trait (n=29) group. The 2-back task, which was administered to evaluate working memory, consists of a congruent condition, under which the current stimulus is the same as the one presented two trials earlier, and an incongruent condition, under which the current stimulus is not the same as the one presented two trials earlier. The numbers 1, 2, 3, and 4 were used as stimuli. RESULTS: On the 2-back task, the ADHD-trait group committed significantly more errors in response to congruent stimuli and showed a smaller P300 amplitude than did the control group. CONCLUSION: These results indicate that college students with ADHD traits have deficits in verbal working memory, possibly due to difficulties in memory updating or attentional allocation.

The Role of Lunate Morphology on Scapholunate Instability and Fracture Location in Patients Treated for Scaphoid Nonunion

BACKGROUND: To determine the association between lunate morphology and the scapholunate instability using radiographic images, and investigate the association between lunate morphology and scaphoid fracture location. METHODS: Between January 2003 and December 2011, we retrospectively evaluated the plain radiographs and computed tomography (CT) images of 70 patients who underwent surgical intervention for a scaphoid nonunion, in order to determine the association between lunate type (I or II) and scapholunate instability or scaphoid fracture location. We determined the scaphoid fracture location using the fragment ratio and measured the radiolunate angle and capitate-triquetrum (C-T) distance. RESULTS: A type II lunate was present in 68.6% (48 of 70 cases). Mean fragment ratio of fracture location was 50.6% in the type II lunate group and 56.2% in the type I lunate group (p = 0.032). Sixteen of the 70 patients had dorsal intercalated segmental instability (DISI) deformities. Nine of 22 cases showed DISI deformity in type I lunate and 7 of 48 cases showed DISI deformity in type II lunate (p = 0.029). However, there were no significant differences between the presence of DISI deformity and fracture location (p = 0.15). Morphologic comparisons by both plain radiography and CT indicated a mean C-T distance in the type I lunate group (22 cases) of 2.3 mm and 5.0 mm in the type II lunate group (48 cases). The C-T distances were significantly correlated with lunate morphology (p = 0.001). CONCLUSIONS: A type II lunate was associated with low incidence of DISI deformity and proximal location of fracture in patients presenting with a scaphoid nonunion.

The Role of Lunate Morphology on Scapholunate Instability and Fracture Location in Patients Treated for Scaphoid Nonunion

BACKGROUND: To determine the association between lunate morphology and the scapholunate instability using radiographic images, and investigate the association between lunate morphology and scaphoid fracture location. METHODS: Between January 2003 and December 2011, we retrospectively evaluated the plain radiographs and computed tomography (CT) images of 70 patients who underwent surgical intervention for a scaphoid nonunion, in order to determine the association between lunate type (I or II) and scapholunate instability or scaphoid fracture location. We determined the scaphoid fracture location using the fragment ratio and measured the radiolunate angle and capitate-triquetrum (C-T) distance. RESULTS: A type II lunate was present in 68.6% (48 of 70 cases). Mean fragment ratio of fracture location was 50.6% in the type II lunate group and 56.2% in the type I lunate group (p = 0.032). Sixteen of the 70 patients had dorsal intercalated segmental instability (DISI) deformities. Nine of 22 cases showed DISI deformity in type I lunate and 7 of 48 cases showed DISI deformity in type II lunate (p = 0.029). However, there were no significant differences between the presence of DISI deformity and fracture location (p = 0.15). Morphologic comparisons by both plain radiography and CT indicated a mean C-T distance in the type I lunate group (22 cases) of 2.3 mm and 5.0 mm in the type II lunate group (48 cases). The C-T distances were significantly correlated with lunate morphology (p = 0.001). CONCLUSIONS: A type II lunate was associated with low incidence of DISI deformity and proximal location of fracture in patients presenting with a scaphoid nonunion.

Demographic and Clinical Characteristics of Primary Frozen Shoulder in a Korean Population: A Retrospective Analysis of 1,373 Cases

BACKGROUND: The aim of this study was to investigate the demographic and clinical characteristics of patients with primary frozen shoulder in a Korean population. METHODS: A total of 1,373 patients whose shoulders were diagnosed with primary frozen shoulder across 11 resident-training hospitals were reviewed retrospectively. Various demographic characteristics and clinical characteristics according to gender and presence of diabetes were evaluated. RESULTS: The average age of patients was 55.4 years. Gender proportion was 58.3% females and 41.7% males. The frozen shoulder involved the non-dominant arm in 60.7% of patients and the bilateral arms in 17.6% of patients. The average duration of symptoms was 8.9 months, and 51.3% of patients had experienced nocturnal pain. Comorbidities associated with frozen shoulder in our sample of patients included diabetes (18.7%), cardiovascular diseases (17.7%), thyroid diseases (5.4%), and cerebrovascular diseases (3.6%). The diabetic group was correlated with the following demographic and clinical characteristics: old age, involvement of the dominant arm, nocturnal pain, long duration of symptoms, and no history of trauma. Further, we found that, in males, having a frozen shoulder was significantly correlated with a history of trauma; in females, having a frozen shoulder was significantly correlated with having thyroid diseases. CONCLUSIONS: These demographic data of primary frozen shoulder in the Korean population were consistent with those of previously reported epidemiologic studies. Primary frozen shoulder with diabetes was correlated with old age, bilateral involvement, long duration of symptoms, and nocturnal pain.

Characteristics of Animal Shoulder Models for Rotator Cuff Experiments

Animal shoulder models are important in the investigation of the natural history of various pathologic conditions and for evaluation of the effectiveness of different treatments and biomaterials. The characteristics of animal shoulder models that may be used for rotator cuff related experiments are different with regard to the anatomy, behavioral pattern, advantages and disadvantages in application to each other. The lower primates and all the non-primate species, except the tree kangaroo, were neither functional overhead nor had a true rotator cuff. Utilizing more advanced primates, or perhaps even the tree kangaroo would be ideal and the most relevant to man as they possess a true rotator cuff. However, ethical concerns, costs, and many limitations in obtaining primates generally preclude the use of these animals for such research. Finally we should consider the differences in comparative anatomy and behavioral pattern of each animal model during performance or interpretation of rotator cuff experiments.

Characteristics of Animal Shoulder Models for Rotator Cuff Experiments

Animal shoulder models are important in the investigation of the natural history of various pathologic conditions and for evaluation of the effectiveness of different treatments and biomaterials. The characteristics of animal shoulder models that may be used for rotator cuff related experiments are different with regard to the anatomy, behavioral pattern, advantages and disadvantages in application to each other. The lower primates and all the non-primate species, except the tree kangaroo, were neither functional overhead nor had a true rotator cuff. Utilizing more advanced primates, or perhaps even the tree kangaroo would be ideal and the most relevant to man as they possess a true rotator cuff. However, ethical concerns, costs, and many limitations in obtaining primates generally preclude the use of these animals for such research. Finally we should consider the differences in comparative anatomy and behavioral pattern of each animal model during performance or interpretation of rotator cuff experiments.

Demographic and Clinical Characteristics of Primary Frozen Shoulder in a Korean Population: A Retrospective Analysis of 1,373 Cases

BACKGROUND: The aim of this study was to investigate the demographic and clinical characteristics of patients with primary frozen shoulder in a Korean population. METHODS: A total of 1,373 patients whose shoulders were diagnosed with primary frozen shoulder across 11 resident-training hospitals were reviewed retrospectively. Various demographic characteristics and clinical characteristics according to gender and presence of diabetes were evaluated. RESULTS: The average age of patients was 55.4 years. Gender proportion was 58.3% females and 41.7% males. The frozen shoulder involved the non-dominant arm in 60.7% of patients and the bilateral arms in 17.6% of patients. The average duration of symptoms was 8.9 months, and 51.3% of patients had experienced nocturnal pain. Comorbidities associated with frozen shoulder in our sample of patients included diabetes (18.7%), cardiovascular diseases (17.7%), thyroid diseases (5.4%), and cerebrovascular diseases (3.6%). The diabetic group was correlated with the following demographic and clinical characteristics: old age, involvement of the dominant arm, nocturnal pain, long duration of symptoms, and no history of trauma. Further, we found that, in males, having a frozen shoulder was significantly correlated with a history of trauma; in females, having a frozen shoulder was significantly correlated with having thyroid diseases. CONCLUSIONS: These demographic data of primary frozen shoulder in the Korean population were consistent with those of previously reported epidemiologic studies. Primary frozen shoulder with diabetes was correlated with old age, bilateral involvement, long duration of symptoms, and nocturnal pain.

Pure Cancellous Iliac Bone grafting for the Treatment of Scaphoid Waist Nonunions with Humpback Deformity

PURPOSE: We evaluated clinical and radiographic results of the pure cancellous bone grafting and internal fixation for the treatment of scaphoid waist nonunions with humpback deformity. METHODS: The subject of this study were 46 patients who had a scaphoid waist nonunion with humpback deformity treated with bone grafting between January 2005 and December 2011. The average follow-up period was 18.6 months (range, 12-26 months). We performed open reduction through an anterior approach with correction of the deformity and insertion of a screw from distal to proximal. We filled the resultant defect with pure cancellous autograft. The clinical results were evaluated with range of motion of the wrist joint, Disabilities of the Arm, Shoulder, and Hand (DASH) score, modified Mayo wrist score and visual analogue scale. For radiographic evaluation, we assessed lateral scapholunate angle and intrascaphoid angle. RESULTS: Bony union was achieved in 39 out of 46 patients (84.8%). DASH score significantly improved from 24.0 to 7.3 postoperatively. The modified Mayo wrist score also increased from 64.8 to 88.6 postoperatively. There were 17 excellent results 18 good results. The average scapholunate angle and intrascaphoid angle improved from 70.6degrees, 51.5degrees to 52.4degrees, 33.9degrees postoperatively. CONCLUSION: Pure cancellous bone grafting and internal fixation provide good clinical result in patients with a scaphoid waist nonunion with successful restoration of the humpback deformity.

Reduced Frontal P3a Amplitude in Migraine Patients during the Pain-Free Period

BACKGROUND AND PURPOSE: Neuropsychological and neuroimaging studies both suggest that frontal lobe dysfunction is present in migraineurs. Since P3a abnormalities manifest in other diseases associated with attention problems, such as attention deficit hyperactivity disorder, we hypothesized that migraine patients have P3a abnormalities, particularly in the frontal region. METHODS: Event-related potentials were measured using a passive auditory oddball paradigm in 16 female migraineurs (aged 22.9+/-2.0 years, mean+/-SD) during the interictal period and in 16 age-matched healthy females (22.6+/-2.0 years). The amplitudes and latencies were analyzed independently using repeated-measures analysis of variance. Nonparametric statistical testing using a cluster-level randomization method was performed to localize the abnormalities. RESULTS: The mean P3a amplitude at frontal areas during the third trials was significantly lower in migraineurs (1.06 microV) than in controls (1.69 microV, p=0.026). P3a amplitudes were negatively correlated with the duration of the migraine history (r=-0.618, p=0.014). Cluster-based nonparametric statistical analysis showed that the amplitudes over left frontal areas were significantly lower in migraine patients than in controls. CONCLUSIONS: A reduced P3a amplitude of migraineurs reflects attentional deficits and frontal dysfunction. The negative correlation between P3a amplitude and the duration of the migraine history suggests that attentional deficits and frontal dysfunction are either the cause or the result of headache.