ABSTRACT
Caffeine is the most widely used psychostimulant worldwide. Excessive caffeine consumption induces a series of both acute and chronic biological and physiological changes that may give rise to cognitive decline, depression, fatigue, insomnia, cardiovascular changes, and headache. Chronic consumption of caffeine promotes a pro-nociceptive state of cortical hyperexcitability that can intensify a primary headache or trigger a headache due to excessive analgesic use. This review offers an in-depth analysis of the physiological mechanisms of caffeine and its relationship with headache.
Subject(s)
Caffeine/adverse effects , Central Nervous System Stimulants/adverse effects , Headache/chemically induced , Headache Disorders/chemically induced , Headache Disorders/complications , HumansABSTRACT
Calcitonin gene-related peptide (CGRP) is a multifunctional neuropeptide produced as a consequence of alternative RNA processing of the calcitonin gene. CGRP is widely distributed in the nervous system, particularly at anatomical areas thought to be involved with migraine pathophysiology, including the trigeminovascular nociceptive system. Over the past two decades, a convergence of basic and clinical evidence has established the CGRP as a key player in migraine. CGRP enhances sensitivity to sensory input at multiple levels in both the periphery and central nervous system. Within the brain, the wide distribution of CGRP and CGRP receptors provides numerous possible targets for CGRP to act as a neuromodulator. Now, CGRP has emerged as a promising therapeutic target for a number of novel treatments for migraine. This review discusses the evidence behind the role of CGRP in migraine and the state of CGRP-based mechanism treatment development.
TITLE: Peptido relacionado con el gen de la calcitonina: un neuropeptido clave en la migraña.El peptido relacionado con el gen de la calcitonina (CGRP) es un neuropeptido multifuncional producido por el empalme alternativo del gen de la calcitonina. El CGRP esta ampliamente distribuido en el sistema nervioso, particularmente en estructuras anatomicas posiblemente implicadas en la fisiopatologia de la migraña, incluyendo el sistema trigeminovascular. En las ultimas dos decadas, el conjunto de datos de estudios clinicos y de ciencias basicas ha establecido el papel fundamental del CGRP en migraña. El CGRP aumenta la sensibilidad a los estimulos sensoriales en multiples niveles, tanto en el sistema nervioso periferico como en el central. En el cerebro, la amplia distribucion del CGRP y de sus receptores indica varios sitios posibles en los cuales este peptido actua como neuromodulador. En la actualidad, el CGRP ha surgido como un objetivo terapeutico para nuevos tratamientos en la migraña. El objetivo de la revision es exponer la evidencia detras del papel del CGRP en la migraña y el estado actual de las nuevas alternativas terapeuticas basadas en el CGRP.
Subject(s)
Brain/metabolism , Calcitonin Gene-Related Peptide/metabolism , Migraine Disorders/metabolism , Central Nervous System/metabolism , Central Nervous System/physiopathology , Humans , Migraine Disorders/physiopathologyABSTRACT
INTRODUCTION: Very few studies describe the demographic and social profile of epilepsy in vulnerable low-income populations. METHODS: Observational, descriptive, cross-sectional study prospectively recording data from all patients diagnosed with epilepsy who attended a specialist neurology consultation between January and March 2014. Data were analysed using descriptive epidemiology tools. RESULTS: A total of 107 patients were evaluated, of whom 24.2% were illiterate and only 10.2% had completed a higher education programme. Most of the patients (86.8%) had a low socioeconomic status; 73.8% were single and 76.7% were unemployed. The main risk factors for epilepsy in this population were recorded as follows: delayed psychomotor development (n=24, 22.4%), head trauma (n=16, 14.9%), and central nervous system infection (n=13, 12.1%). Most patients (70.1%) responded to antiepileptic drugs (controlled cases) and 15.4% (n=15) had drug-resistant epilepsy (refractory cases). CONCLUSION: The demographic and clinical profiles of the patients included in this study resemble those published for high-income populations; differences are mostly limited to aetiological classification and risk factors. The social profile of the patients evaluated in this study shows high rates of unemployment, illiteracy, and single marital status. These findings seem to be more frequent and prevalent in this group than in high income populations.
