ABSTRACT
OBJECTIVE: Using surface-based morphometry we aimed to provide a detailed examination of cortical alterations in medication-overuse headache (MOH), by disentangling between altered cortical thickness and gyrification (folding). BACKGROUND: In MOH, pain modulation is probably dysfunctional at the cortical and subcortical level, resulting in a disequilibrium between pain inhibition and facilitation. Both increased and decreased cortical volumes have been reported in individuals with MOH. There is however no detailed examination to date that distinguishes between altered cortical thickness and gyrification. Such distinction would help to identify the nature and timing of neurodevelopmental mechanisms at play in affected individuals. METHODS: We investigated cortical thickness and gyrification in 29 patients with MOH according to International Headache Society criteria and 29 age- and gender-matched controls, using high-resolution structural MRIs of the brain analyzed with FreeSurfer. This is a secondary analysis of data from a previously published voxel-based morphometry study. RESULTS: In patients with MOH compared to controls, reduced cortical thickness was observed in the left prefrontal cortex. We also observed higher local gyrification in one cluster extending from the fusiform cortex to adjacent medial temporal regions, and in another cluster in the right occipital pole. Higher gyrification in the right occipital pole predicted poor response after detoxification. CONCLUSIONS: Corroborating previous volumetric results, our study adds information on the putative neurobiological mechanisms involved in MOH, suggesting neurodevelopmental changes in MOH.
Subject(s)
Cerebral Cortex/diagnostic imaging , Headache Disorders, Secondary/diagnostic imaging , Adult , Female , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Organ SizeABSTRACT
There is evidence that chronic pharmacoresistant temporal lobe epilepsy (TLE) is a progressive disorder accompanied by mental deterioration. We investigated effects of aging on cerebral N-acetyl-aspartate (NAA) concentrations in the temporal lobe of 12 patients with pharmacoresistant mesial TLE (mTLE) and 22 healthy controls by means of proton-magnetic resonance spectroscopy ((1)H-MRS) at 3 T. Furthermore, we calculated correlations between NAA concentrations and measures of verbal and figural memory in patients. In mTLE patients but not in healthy controls the concentration of NAA in the lateral temporal lobe was negatively correlated with age. In patients with mTLE NAA in left lateral temporal voxels correlated with verbal memory. NAA in medial temporal voxels did not correlate with age or neuropsychological measures. Significant decrease of NAA with age in the lateral temporal lobe of patients with mTLE provides evidence for progressive neuronal dysfunction with aging. NAA is a marker of neuronal integrity since it correlates with verbal memory.
Subject(s)
Aging/metabolism , Aspartic Acid/analogs & derivatives , Epilepsy, Temporal Lobe/metabolism , Temporal Lobe/metabolism , Adolescent , Adult , Aspartic Acid/metabolism , Choline/metabolism , Creatine/metabolism , Drug Resistance , Female , Functional Laterality/physiology , Humans , Magnetic Resonance Spectroscopy , Male , Memory/physiology , Neuropsychological Tests , Protons , Seizures/physiopathology , Temporal Lobe/physiopathology , Verbal Learning/physiologyABSTRACT
OBJECTIVE: Suicidality spans a spectrum ranging from suicidal thoughts to suicidal acts, and suicidal ideation is more prevalent in youth populations, suggesting important developmental issues. We assessed the prevalence of lifetime suicidal ideation and associated psychosocial factors among Viennese high school students. METHOD: An anonymous self-report survey assessing demographic characteristics and the major psychiatric risk factors of teenage suicide was completed by students at three Viennese high schools (n = 214; mean age 15.4 years). RESULTS: Eighty-one (37.9%) high school students reported having had suicidal thoughts at some point in their lives, girls significantly more often than boys (48.5% vs. 29.1%, P = 0.004). Furthermore, lifetime suicidal ideation in Viennese high school students was associated with living in broken-home families, cigarette smoking, substance problems (alcohol/drugs), self-reported depression, and high school type (the highest prevalence was in grammar school). After adjusting for confounders, we found that female gender, substance problems, school type and cigarette smoking were significantly associated with lifetime suicidal ideation in Viennese high school students. CONCLUSIONS: The psychosocial factors associated with adolescent suicidal ideation require attention in the contexts of suicide prevention and mental health promotion.
Subject(s)
Students/psychology , Suicide, Attempted/psychology , Suicide/psychology , Thinking , Urban Population/statistics & numerical data , Adolescent , Austria , Comorbidity , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Female , Health Surveys , Humans , Male , Risk Factors , Sex Factors , Smoking/epidemiology , Smoking/psychology , Social Environment , Statistics as Topic , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychologyABSTRACT
A 27-year-old woman had a history of migraine with aura (MWA) since aged 13 years with mostly two attacks per year. After transcutaneous closure of a secundum atrial septal defect (ASD) she suffered from almost daily recurring migraine attacks with prolonged aura symptoms. Exacerbation and new appearance of migraine attacks with aura after transcutaneous closure of ASD have been described previously.
