ABSTRACT
The risk of cluster headache (CH) is associated with the G-allele of the G1246A polymorphism in the hypocretin receptor 2 (HCRTR2) gene. First-line medication is effective in only about 70-80% of CH patients. We hypothesized that the HCRTR2 G1246A polymorphism is also of pharmacogenetic relevance in CH and may affect treatment response. We performed a prospective cohort study among 184 unrelated White CH patients. While the HCRTR2 1246G allele was significantly associated with CH in this group, treatment outcomes with triptans, oxygen, verapamil and corticosteroids remained unaffected. Our results do not support a role of the HCRTR2 G1246A polymorphism in drug responses in CH.
Subject(s)
Analgesics/therapeutic use , Cluster Headache/drug therapy , Cluster Headache/genetics , Outcome Assessment, Health Care/methods , Polymorphism, Single Nucleotide/genetics , Receptors, G-Protein-Coupled/genetics , Receptors, Neuropeptide/genetics , Risk Assessment/methods , Adult , Cluster Headache/epidemiology , Cohort Studies , Female , Genetic Predisposition to Disease/epidemiology , Genetic Predisposition to Disease/genetics , Germany/epidemiology , Humans , Male , Orexin Receptors , Prevalence , Prognosis , Risk Factors , Treatment OutcomeABSTRACT
The G1246A polymorphism in the gene of the hypocretin receptor 2 (HCRTR2) has been linked to the risk for cluster headache (CH). The authors examined this association in a large sample of 226 patients with CH and 266 controls from Germany. The genotype and allele distribution varied significantly between patients and controls. Homozygous carriers of the G-allele had a twofold increase in risk for CH (OR 1.97; 95% CI 1.32 to 2.92; p = 0.0007).
Subject(s)
Cluster Headache/epidemiology , Cluster Headache/genetics , Genetic Testing/methods , Receptors, Neuropeptide/genetics , Risk Assessment/methods , Adult , DNA Mutational Analysis , Female , Genetic Predisposition to Disease/epidemiology , Genetic Predisposition to Disease/genetics , Genetic Variation/genetics , Germany/epidemiology , Humans , Male , Orexin Receptors , Polymorphism, Genetic , Polymorphism, Single Nucleotide/genetics , Prevalence , Receptors, G-Protein-Coupled , Risk FactorsABSTRACT
PURPOSE: Physicians are obliged to inform all patients about the diagnosis and course of their illness. Often difficulties occur in informing patients with psychiatric disorders. Psychiatrists often fear complications (worsening of the symptomatology) by the disclosure of the diagnosis, which facilitate the informed consent on the treatment. Up to now only a few data concerning this topic are available. METHODS: 255 psychiatric inpatients were given a short questionnaire about their illness, its course, and the wish for being informed about their psychiatric diagnosis and the prognosis of their psychiatric disorder. RESULTS: Most patients want to get informations about their diagnosis (88.6%) and the prognosis of their psychiatric disorder (80.4%). Only 27.8% of the patients described a fear of the disclosure of diagnosis, and some more (35.3%) were afraid to hear the prognosis of their psychiatric disorder. However, this fear did not reduce their wish to become fully informed. 60% of the patients reported a satisfactory information of their diagnosis and were able to give the correct medical diagnosis. Furthermore, our results revealed that those patients not willing to be treated were informed about their diagnosis insufficiently. CONCLUSION: The informing about their diagnosis should play a more important role in the treatment of psychiatric patients.
Subject(s)
Informed Consent/legislation & jurisprudence , Mental Disorders/diagnosis , Patient Education as Topic/legislation & jurisprudence , Adolescent , Adult , Aged , Denial, Psychological , Female , Humans , Male , Mental Disorders/therapy , Middle Aged , Patient Acceptance of Health Care , Patient Care Team/legislation & jurisprudence , Prognosis , Psychiatric Status Rating ScalesABSTRACT
In static magnetic fields as used in n.m.r. equipment for clinical diagnosis we found an increase of the beta-EEG power value at the right hemisphere when stimulating simultaneously the N. medianus of the left hand with a periodicity of 140 ms. By a sequence of 120 ms there was no change of the power in this frequency band. But when stimulating continuously and switching on and off the magnetic field, in the beta- and alpha-frequency bands the power values of the left hemisphere were increased by the influence of the magnetic field, not depending of the field vector. In contrast to these data, in the beta-band the values increased at the right hemisphere, and, additionally are influenced by the field vector. Artifacts in the single frequency bands by the stimulus frequency itself could be excluded. The increase of power value only by a 140 ms-periodicity might be a hint that a "Zeitgeber"-function is activated by this external frequency.
