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Migraine is a common primary headache. At present, the rhythm of migraine attacks has been observed in some patients, but its concrete form and mechanism have not been reached a consensus. This paper reviews the research progress of migraine biological rhythm (circadian rhythm and seasonal rhythm), and expounds the distribution of attack rhythm time, the relationship with clinical characteristics and the mechanism of producing rhythm. It provides scientific basis for mastering the attack law of migraine patients, finding individualized preventive treatment time and improving the effectiveness and compliance of treatment.
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Migraine is a complex pain syndrome and the pathogenesis remains unclear. Functional neuroimaging is an indispensable tool in migraine research and helps to understand the pathogenesis of migraine. The hypothalamus is a powerful brain structure. Clinical and animal experiments have revealed the important role of the hypothalamus in the pathogenesis of migraine. In recent years, functional imaging studies have provided evidence that the hypothalamus is closely related to migraine. This article reviews the relationship between migraine and hypothalamus from the perspective of functional imaging.
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Recent research data on post-stroke seizures and epilepsy are reviewed and summarized.They are reviewed from the aspects of concept, risk factors, epidemiology, pathogenesis, clinical manifestations, diagnosis, as well as prevention and treatment.
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Objective To investigate the microstructural abnormalities of cerebral white matter in patients with medication-overuse headache with diffusion tensor imaging.Methods Diffusion tensor magnetic resonance imaging (DT-MRI) was carried out in 80 migraine patients with medication-overuse headache (case group) and 80 age-and sex-matched healthy controls (control group).Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured and the correlation between clinical characteristics and the changes was examined.Results ① The FA values at the bilateral orbitofrontal cortex,cingulate cortex,splenium of the corpus callosum and the right anterior limb of the capsula interna were significantly lower than those in the controls(P＜0.05).② The ADC values at the right orbitofrontal cortex,left inferior frontal gyrus and anterior cingulate cortex were significantly higher than those in the controls (P＜0.05).③ There were negative correlations between FA values at the bilateral orbitofrontal cortex and right hind legs of the capsula interna and headache course as well as frequency.There was negative correlation between FA values at the left hind legs of capsula interna and headache frequency.④ There were positive correlations between ADC values at the left orbitofrontal cortex and headache course as well as frequency.There were positive correlations between ADC values at the right orbitofrontal cortex and prior cingulate cortex and headache frequency.There was positive correlation between ADC values at the posterior cingulate cortex and headache course.Conclutions There might be an integrity change of neurofibrotic microstructures in the bilateral orbitofrontal cortex and cingulate cortex in patients with medication-overuse headache,FA values are negatively associated with headache course and frequency whereas ADC values are positively associated with headache course and frequency.
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Objective To examine the clinical characteristics of familial aggregation in migraineurs and to ana-lyze the risk factors. Methods Seventy-two migraineurs were recruited and divided into two subgroups according to family migraine history. The subjects were interviewed in detail with questionnaire including age, disease duration, age at migraine onset,migraine severity, frequency of headache,duration of each attack, aura, unilateral pain, pulsate pain, family history of migraine, family members and other factors. Multi-factors logistic regression analysis was performed to analysis the risk factors after single variable analysis. Results Of 72 migraine patients, 37(51.4%) reported that at least one first-degree relative had a history of migraine. There were no significant differences between migraine sub-groups with and without family migraine history in age (P=0.598), gender(P=0.675), disease duration (P=0.419), aura (P=0.669), headache severity (P=0.837), frequency of attack (P=0.465), concomitant symptoms (P=0.081), headache location (P=0.353), headache property (P=0.963), there were significant differences between migraine subgroups with and without family migraine history in age at disease onset (P=0.023), duration of headache attack (P=0.041), early age (<16 years)at disease onset (48.6% vs. 22.9%, P=0.023) and long duration (≥24 hours)of attack (35.1% vs. 14.3%, P=0.041). Multi-variables logistic regression analysis identified fist-degree relatives of probands who had ear-ly age at disease onset (OR=2.986, 95%CI:1.621~5.503) and long duration of headache attack (OR=2.320, 95%CI:1.219~4.415) had higher risk of migraine (P<0.05). Conclusion Migraineurs with family migraine history have earlier onset of migraine and longer duration of attack. Early age at headache onset and long duration of headache attack are the risk factors of family aggregation.
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Objective To evaluate the reliability and validity of a medication dependence questionnaire in mi?graineurs of the Chinese version. Methods One hundred fifteen migraine patients with drug dependence syndrome were included and their clinical data were then collected. All the subjects were interviewed with the medication dependence questionnaire in migraineurs of the Chinese version. The reliability and validity of the questionnaire were evaluated ac?cording to test-retest reliability and internal consistency reliability, and the content validity and construct validity respec?tively. Results The test-retest reliability of the questionnaire items was 0.725~1.000 except item 11 (0.558) and item16 (0.443). The internal consistency coefficient of the questionnaire was 0.820, internal consistency coefficient of each di?mension was above 0.7. Every item score was positively correlated with corresponding dimension score (r=0.595~0.962). Seven factors with latent roots greater than 1 could explain 76.3%of total variance, and these factors were relatively pow?erful in related items. Conclusions The medication dependence questionnaire in migraineurs of the Chinese version shows preferable reliability and validity. Thus, this is a promising assessment tool to evaluate the medication dependence in Chinese migraineurs in future clinical practice.
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BACKGROUND: The aim of this study was to analyze the effects of obesity and leptin levels on patients with migraine, and to observe the change of leptin levels in migraineurs. MATERIAL AND METHODS: We enrolled 52 migraine patients from the Headache Clinic in Shandong Provincial Hospital into a randomized controlled trial with another 52 age-, sex-, and BMI-matched healthy subjects as controls. Leptin levels in all subjects were determined by radioimmunoassay. RESULTS: Compared with the control group, the migraineurs revealed no significant change in leptin levels (P>0.05). Multivariate Logistic regression analysis showed that neither abdominal obesity nor leptin had significant impact on migraine clinical features. Total body obesity had a significant effect on the frequency (OR=4.248), duration (OR=3.167), and intensity (OR=5.225) of the headache. CONCLUSIONS: Total body obesity affected headache frequency, intensity, and duration, while leptin levels did not.
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Leptin/blood , Migraine Disorders/blood , Obesity/blood , Adolescent , Adult , Body Mass Index , Case-Control Studies , China , Female , Humans , Male , Middle Aged , Migraine Disorders/complications , Multivariate Analysis , Obesity/complications , Obesity, Abdominal/blood , Odds Ratio , Radioimmunoassay , Young AdultABSTRACT
Objective To analyze the clinical features and risk factors of migraine patients with white matter le-sions (WMLs). Methods One hundred ten clinically diagnosed migraine patients who underwent magnetic resonance im-aging (MRI) scans from October, 2010 to August, 2013 were enrolled in Shandong Provincial Hospital. One hundred ten migraine patients were divided into two groups:WMLs group and non-WMLs group based on the presence or absence of WMLs in MRI scans. The clinical features of the patients and location and number of WMLs were investigated. Noncondi-tional multivariate stepwise logistic regression after univariate analysis was used to analyze the data. Odds ratio (0R) and 95 confidence interval after adjustment for possible confounding variables were calculated. Results①There were 36 patients with WMLs among the 110 migraine patients. The incidence of WMLs in migraine patients was 32.7%. The WMLs in migraine patients were predominantly present in the frontal and parietal lobes (59.1%). ② Compared with non-WMLs group, there were significant increases in disease duration (5.3±3.7 vs. 7.6±4.9, P﹤0.01), frequency of head-ache attack (3.5 ± 2.3 vs. 4.6 ± 2.2, P﹤0.05), aura (18.9%vs. 36.1%, P﹤0.05) and family history of migraine (12.2%vs. 44.4%, P﹤0.01) in WMLs group.③The independent risk factors of WMLs in migraine patients were family history of mi-graine (OR=5.995), aura (OR=3.067) and long disease duration (OR=1.165). Conclusions Family history of migraine, au-ra and disease duration are the predictive risk factors of WMLs in migraineurs.
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Objective To investigate the changes of peripheral benzodiazepine receptors (PBRs)in rat spinal cord synaptosomes during ageing and to explore the correlation between PBRs in spinal cord synaptosomes and PBRs on platelet membranes.Methods A total of 24 Sprague-Dawley rats were divided into 3-month group and 24-month group (n=6 males and 6 females for each).All animals were sacrificed by decapitation and the spinal cords were immediately removed.Synaptosomal fractions from spinal cords were isolated by gradient centrifugation.The platelet membranes were prepared from venous blood by the method of hypotonic haemolysis.The specific binding of the radioactive PBRs antagonist [3H]PK11195 to membranes was determined.Results No significant differences in [3H] PK11195 binding activity in spinal cords and platelet membranes were observed between male and female rats in the same group (all P＞0.05).[3H] PK11195 binding activity in spinal cords and platelet membranes were higher in 3-month group than in 24 month group [(213.94±10.65) fmol/mg pro.vs.(50.65± 2.74) fmol/mg pro.,(104.97± 2.24) fmol/mg pro.vs.(56.20±5.36) fmol/mg pro.,respectively,t=51.418,29.041,both P＜ 0.001].There was a positive correlation between [3H]PK11195 binding activity in platelet membranes and in spinal cord synaptosomes (r=0.985,P＜0.001).Conclusions The level of PBRs is gradually decreased in rat spinal cord synaptosomes with ageing.[3H] PK11195 binding activity of platelet membranes can reflect the changes of PBRs in spinal cords.
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1he increased peripheral benzodiazepine receptors are more significant than normal ones after cerebral ischemia. Its main reactions are the multiple pathological changes,including microglial activation, participating in neuroinflammation response, and regulation of mitochondrial function. Using radionuclide-laheled specific ligands of the peripheral benzodiaz-epine receptor (such as PK11195) for in vivo imaging contribute to the location and quantitative detection for brain injury and the study of the pathophysiological changes after cerebral ischemi-a. In addition, this receptor is promising to become a new target of neuroprotective treatment.This article reviews the recent progress in research on peripheral benzodiazepine receptors and cerebral ischemia.
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Objective To investigate correlations between peripheral benzodiazepine receptors(PBRs) in mitochondria and synaptosomes in the brain and platelet membrane of rats during aging and to explore the significance of the relationships.Methods Sprague-Dawley rats of both sexes were divided into 3-,12-and(24-month) groups.All animals were sacrificed by decapitation and the brains were immediately removed.Mitochondrial components from dissected cerebral cortex and synaptosomal fractions from dissected hippocampus were isolated by gradient centrifugation.The membrane of platelets from venous blood was prepared by the method of hypotonic haemolysis.The specific binding assay of the radioactive PBRs antagonist PK11195 to membrane was performed.(Results A significant) difference about PK11195 binding activity of mitochondria was observed among three groups(F=194.6,P
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Objective:To study the reliability and feasibility of intranasal(IN)pathway bypassing the blood-brain barrier (BBB) and observe the potential neuroprotective effects of intranasal NGF on acute cerebral ischemia. Methods:A blinded, vehicle-controlled study of IN NGF and IV NGF administration was performed by intraluminal middle cerebral artery occlusion (MCAO) model. Experiment 1: Rats were randomly divided into IN NGF, IV NGF and untreated group (n=4). The concentration of NGF in different brain regions was measured by ELISA. Experiment 2: Rats were randomly assigned into 4 groups: IN vehicle, IN NGF, IV vehicle, IV NGF (n=8 each). Treatments was initiated 30 min after the onset of MCAO and then again 24 h later. Three neurologic behavioral tests were assessed at 24 h and 48h. Corrected infarct volumes were determined 48 h after the onset of MCAO. Results:Olfactory bulb in IN NGF group obtained the highest concentration among all tissues, arriving at 3 252 pg/g, followed by hippocampus. The NGF concentrations of olfactory bulb and hippocampus in IN NGF group were significantly higher than that in IV NGF and control group. The infarct volume in IN NGF group was reduced significantly by 38.8% as compared with IN vehicle. The vestibulomotor function of IN NGF improved significantly at 24 and 48 h (P=0.02 and P=0.04, respectively). Conclusion:Intranasal NGF could bypass BBB, reach the CNS, reduce infarct volume and improve neurological function in rats following MCAO. Intranasal delivery of NGF holds a promising treatment for stroke and other CNS disorders.
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Objective To analyze the clinical features and risk factors for epilepsy during the acute phase of aseptic meningitis. Methods 138 cases of aseptic meningitis with complete clinical data were retrospectively reviewed. Among them 21 had seizures, and 117 had not. All of them were inpatients in the same period after meningitis. Based on a standardized questionnaire, a database was established with Microsoft Access 2002 including 51 indexes and some subindexes. Univariate analysis and nonconditional multivariate stepwise logistic regression were carried out based on the summarization of the characters of clinical seizure. Results Fourteen cases (66.7%) manifested generalized seizures in those patients with epilepsy. Seventeen patients (80.1%) experienced epilepsy within 2 weeks after meningitis. The independent risk factors for seizures during the acute phase of aseptic meningitis were the increased contents of cerebrospinal fluid protein (OR=19.40), raised intracranial pressure (OR=8.848), and low-voltage activity in electroencephalogram (OR=5.039). Conclusions Generalized seizure is the major type of epilepsy induced by acute aseptic meningitis. Epilepsy occurred within 2 weeks in most patients with meningitis and seizures. High level of cerebrospinal fluid protein, raised intracranial pressure and low-voltage activity in electroencephalogram were the main predictive risk factors for epilepsy during the acute phase of aseptic meningitis.
