Differences in visual information processing style between Idiopathic Generalized Epilepsy with and without photosensitivity.

PURPOSE: Recently, altered visual cortical processes i.e., lack of habituation to visual evoked potentials (VEP), has been highlighted in both photosensitive epilepsy and in a specific i.e., analytic mode of processing visual inputs. In this study we aimed at evaluating the relationship between photosensitivity (PS) and analytic style of processing visual information, in a sample of 30 patients with Idiopathic Generalized Epilepsy (IGE) and matched healthy controls. METHODS: At our Epilepsy unit of the Sapienza University of Rome, we consecutively enrolled 15 patients with IGE with PSand matched them with 15 patients with IGE without PS and 15 Healthy Volunteers. All patients underwent EEG recording in basal conditions during hyperventilation (3 Min), and intermittent light stimulation. The most effective frequencies comprised from 12 to 16 Hz. The instruments used to gather psychological cognitive behavioral data, consisted of participation in two tests: the Sternberg-Wagner Self-Assessment Inventory and the Mariani Learning Style Questionnaire. RESULTS: Compared to controls, both IGE groups show significantly higher scores for the analytic style (One-way ANOVA, F(2,44) = 110.3, p < 0.0001). Epilepsy groups thereby showed very distinctive cognitive styles as measured with the Sternberg test. In the visual style, scores of the photosensitive Individuals with IGE were significantly higher than the non-photosensitive individuals with IGE (p < 0.0001, Tukey's post hoc test). CONCLUSIONS: An association between analytic style of processing visual information and PS in IGE has been shown. The common neurophysiological features between these two factors, suggest the possibility to evaluate this cognitive behavior as a potential target for nonpharmacological therapeutic strategies in photosensitive epilepsy.

Analytic information processing style in epilepsy patients.

Relevant to the study of epileptogenesis is learning processing, given the pivotal role that neuroplasticity assumes in both mechanisms. Recently, evoked potential analyses showed a link between analytic cognitive style and altered neural excitability in both migraine and healthy subjects, regardless of cognitive impairment or psychological disorders. In this study we evaluated analytic/global and visual/auditory perceptual dimensions of cognitive style in patients with epilepsy. Twenty-five cryptogenic temporal lobe epilepsy (TLE) patients matched with 25 idiopathic generalized epilepsy (IGE) sufferers and 25 healthy volunteers were recruited and participated in three cognitive style tests: "Sternberg-Wagner Self-Assessment Inventory", the C. Cornoldi test series called AMOS, and the Mariani Learning style Questionnaire. Our results demonstrate a significant association between analytic cognitive style and both IGE and TLE and respectively a predominant auditory and visual analytic style (ANOVA: p values <0,0001). These findings should encourage further research to investigate information processing style and its neurophysiological correlates in epilepsy.

Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients.

Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD's symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH) and Group without Headache (GwoH). Descriptive statistics and Chi-square index were performed. Results. Sociodemographic (gender, marital status, and occupation) and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities), and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion. This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity.

Analytic information processing style in migraineurs.

Despite great advances in pathophysiological facets of migraine that have been made during recent years, as of today, migraine etiology is still not completely understood; moreover, to date the relationship between psychological factors and this primary headache must be further elucidated. However, abnormal information processing, as measured by evoked and event-related potentials, has been considered a key feature in migraine pathogenesis. The aim of this work was to study the relationships between analytic/global style of information processing and migraine, hypothesizing an analytic style, as highlighted by our previous study on cluster headache. This study applied three cognitive style tests never previously used in the context of migraine: "Sternberg-Wagner Self-Assessment Inventory", the C. Cornoldi test series called AMOS, and Brain-Dominance Questionnaire. 280 migraneurs with and without aura were tested and matched with two control groups: healthy subjects and tension-type headache patients. Our results demonstrated a strong correlation between analytic information processing style and migraine, indicating a preference toward a visual sensory approach in migraine without aura, in line with known neuroelectrophysiological data. These findings may suggest a role for this specific cognitive behavior in migraine pathogenesis, leading us to further investigate the neuroelectrophysiological, neurobiological, and epigenetic correlates.

Analytic cognitive style in cluster headache.

Previous reports on cluster headache have shown a hypothalamic dysfunction and a hitherto unrecognized defect in the information processing pathways measured by event-related potentials. As of today, the causes are still unknown; likewise, studies on the psychological factors involved in CH have not yielded relevant data. The aim of our study was to evaluate the presence of a possible correlation between CH and a specific manner of information processing, i.e., an analytic cognitive style. This study applies two cognitive style tests that have not previously been used in the context of cluster headache: "Sternberg-Wagner Self Assessment Inventory" and the C. Cornoldi AMOS test series. Twenty-three CH patients were involved in the study and were compared with two control groups: healthy subjects and tension type headache patients. Our findings clearly indicate a significant correlation between analytic cognitive style and CH, warranting further studies focusing on the underlying neurophysiological mechanisms.

Management of cluster headache in the Emergency Department.

Although cluster headache (CH) is considered one of the most distinctive and painful primary headache disorders in clinical practice because of the brevity of each attack, its management is not always ergonomic or possible in the Emergency Department. In case of a previously competent diagnosis, the Emergency Department's team should send the patient to a headache centre where specialists in the management of CH can handle the pathology in the best way. In our headache centre we treat patients with CH attacks with a hyperbaric chamber, confirming the effectiveness of hyperbaric oxygen in CH patients.

Hyperbaric oxygen therapy in cluster headache.

Preliminary reports have shown that hyperbaric oxygen (HBO) interrupts cluster headache (CH) attacks. In the present study, 6 of 7 patients with episodic cluster headache who were treated with hyperbaric oxygen experienced an interruption of the attack. In 3 of 6 responders the florid period of the cluster headache was interrupted. The other 3 patients remained without pain attacks for a period lasting from 3 to 6 days. In 6 different patients, a placebo treatment had no effect. The present findings clearly indicate that hyperbaric oxygen has not only a symptomatic effect on a single attack of cluster headache, but it also could prevent the occurrence of subsequent attacks.