Migraine and left-handedness are not associated. A new case-control study and meta-analysis.

To investigate the possible association between migraine and left-handedness, we enrolled 100 patients with a diagnosis of migraine according to the International Headache Society diagnostic criteria and 100 age- and sex-matched control subjects into a case-control study. Handedness was determined by the Edinburgh Handedness Inventory. There was no significant difference in the frequency or grade of left-handedness between the two groups. Additionally, we pooled our data with those from five similar studies, which did not alter the result. Thus, neither our study nor the meta-analysis support Geschwind and Behan's hypothesis of an association between migraine and left-handedness.

Headache associated with sexual activity: prognosis and treatment options.

The aim of this study was to provide data on the prognosis and treatment options of headache associated with sexual activity (HSA). Sixty patients diagnosed with HSA between 1996 and 2004 were followed up between 2003 and 2006 at least 12 months after the first interview. The further course of the disease and their contentedness with therapy were requested. On average, the second interview was performed 35.9 months after the first examination. Of the 45 patients who had suffered from single attacks or bouts prior to baseline examination, 37 had no further attacks. Seven patients suffered from at least one further bout with an average duration of 2.1 months. One patient developed a chronic course of the disease after an episodic start. Of the 15 patients with chronic disease at the first examination, seven were in remission and five had ongoing attacks at follow-up. Ten patients received indomethacin for preemptive therapy, with good results in nine patients. Eighteen patients received beta-blockers for prophylaxis, with good results in 15 patients. Episodic HSA occurs in approximately three-quarters and chronic HSA in approximately one-quarter of patients. Even in chronic HAS, the prognosis is favourable, with remission rates of 69% during an observation period of 3 years. For patients with longer-lasting bouts or with chronic HSA, prophylactic treatment with beta-blockers or preemptive therapy with indomethacin are often successful.

Comorbidity of migraine and restless legs syndrome--a case-control study.

In order to evaluate a possible association between migraine and restless legs syndrome (RLS), we performed a case-control study on the comorbidity of RLS and migraine. Patients with migraine (n = 411) and 411 sex- and age-matched control subjects were included. Migraine was diagnosed according to International Headache Society criteria, RLS according to the criteria of the International Restless Legs Syndrome Study Group. Furthermore, all patients had to fill out a self-assessment test performance on depression [Beck's Depression Inventory (BDI)]. RLS frequency was significantly higher in migraine patients than in control subjects (17.3% vs. 5.6%, P < 0.001; odds ratio 3.5, confidence interval 2.2, 5.8). In our sample, there was no significant association between migraine and depression as defined by the BDI score (9.6% in migraine vs. 4.0% in control subjects, P = 0.190). Depression was, however, not significantly more frequent in migraine patients with RLS (13.6%) than in migraine patients without RLS (8.7%). In addition, migraine patients with RLS had a significantly higher BDI score. RLS features did not differ significantly between migraine patients with RLS and control subjects with RLS. There is an association between RLS and migraine and, in addition, a co-association with depression. The underlying mechanism, however, remains undetermined and might be related to a dysfunction of dopaminergic metabolism in migraine.

Comorbidity of migraine and headache associated with sexual activity.

In order to investigate the comorbidity of migraine and headache associated with sexual activity (HSA), we performed a case-control study based on migraine patients. By means of a questionnaire and a personal interview, 100 migraine patients and 100 control subjects were examined regarding a diagnosis of HSA. In five subjects from the migraine group vs. none from the control group, a diagnosis of HSA could be established (P = 0.021). Previous studies that have demonstrated comorbidity of migraine and HSA were all based on HSA patients. Thus, it can now be concluded that the association between the two headache disorders is bilateral. In addition, the prevalence of HSA in the general population can be estimated to average around at least 0.9%, which concurs with previously published data.

On the way to expert systems. Comparing DSM-III computer diagnoses with CATEGO (ICD) diagnoses in depressive and schizophrenic patients.

Operationalized diagnostics deal with the standardized assessment of psychiatric symptoms as well as diagnostic criteria. As a diagnostic system based on criteria, the DSM-III was chosen to identify operationalized diagnoses based on the Present State Examination (PSE-9) and some additional DSM-III specific items. By relating PSE symptoms to the diagnostic criteria of DSM-III, an easily applicable expert system leading to DSM-III diagnoses was developed. In two samples of 30 schizophrenic and 51 depressive patients the DSM-III computer diagnoses are contrasted with the ICD-8 diagnoses of the PSE/CATEGO system. In defining a "case", only minimal differences between the two computer programs were found. In the sample of schizophrenics, CATEGO led to 114 (81%) diagnoses and the DSM-III program to 112 (79%) diagnoses; for the depressive patients 43% cases were identified by CATEGO and 45% by the DSM-III algorithm. Comparing the diagnosis of "acute schizophrenic disorders", both programs arrived at similar percentages. (CATEGO: 51%; DSM-III: 57%). However, CATEGO is limited to two different subtypes (295.2 and 295.3), whereas the DSM-III program covers the total range of possible schizophrenic subtypes. Furthermore, the DSM-III program identified residual subtypes of schizophrenia in 23% of the diagnostic decisions. In the short-term course of the schizophrenic patients, CATEGO identified 27%-43% with affective diagnoses with high stability per cross-section. Using the DSM-III algorithm affective diagnoses were rather rare (maximum of 17%), marking unstable changes from acute to residual states of the psychosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Diminished insulin receptors on monocytes and erythrocytes in hypertriglyceridemia.

Carbohydrate intolerance is a common observation in endogenous hypertriglyceridemia (HL). So far the nature of this metabolic defect, which accompanies postprandial hyperinsulinemia and a reduced hypoglycemic action of insulin, has not been elucidated. We have examined cellular insulin binding in 20 subjects affected with HL (average plasma triglyceride level, 437 +/- 311 mg/dL) to test the possibility that a receptor defect is involved in peripheral insulin resistance. Monocytes from the HL subjects bound, on the average, 34% less insulin than cells from eight normotriglyceridemic controls of comparable age and body weight (average plasma TG level, 169 +/- 34 mg/dL). Likewise, erythrocytes from the HL group bound 29.6% less insulin than did those from control subjects. Scatchard analysis of the binding data revealed that the number of insulin receptors was reduced for both types of cells. To test if the abnormality in cellular insulin-binding capacity in these subjects is an inherent defect or secondary to the hypertriglyceridemia, 11 of the subjects participated in a 4-month training program (120 minutes weekly of moderate exercise at 60% VO2 max), while the remaining nine persons served as controls. Training reduced the average plasma TG level from 373 +/- 270 to 277 +/- 139 mg/dL (P less than 0.01), but cellular insulin binding was not significantly affected. In addition, no correlation was found between the individual TG plasma concentration and cellular insulin binding. Thus, training itself also proved ineffective in enhancing insulin binding, most probably due to exertion of insufficient intensity.(ABSTRACT TRUNCATED AT 250 WORDS)