Different Types Of Headache Research Articles

TRPM8 channels, cold and headache: data of experimental and clinical studies

Abstract – Different types of headaches, including migraine, may have a causal relationship with cold exposure, and this relationship can be either positive or negative, i.e. cold can both provoke and alleviate cephalalgia. Various representatives of the transient receptor potential ion channel superfamily, in particular TRPM8, act as molecular thermoreceptors that provide signal transduction in the response to low temperatures. These channels, which are known to mediate the normal cold sensation and play a role in both cold-induced pain and cryoanalgesia, are often considered as a promising target for the development of principally new anti-migraine drugs. This review summarizes recently obtained data on the TRPM8 structure and function, and their role in the pathogenesis of migraine, as well as discusses the intriguingly inconsistent results of studying TRPM8 agonists and antagonists in experimental headache models and clinical trials. Analyzing data from various studies allows to conclude that TRPM8 activation can be both pro- and antinociceptive; this correlates with the reported dual effect of cold exposure on the induction and resolution of headaches, leaving open the question on the vector of the TRPM8 pharmacological modulation required to produce anticephalgic effect.

Effect of fasting-induced headache on calcitonin gene related peptide (CGRP) and other clinical biomarkers on the first day of Ramadan: Sub-analysis from a randomized open label clinical trial

BackgroundFasting-induced headaches (FIHs) have been shown to occur on the first day of Ramadan and clearly decline thereafter. Despite the wealth of knowledge about different types of headaches (e.g., migraine-, cluster-, and tension-type headaches), research on the mechanism underlying FIHs, as well as their treatment, remains scarce. Our study aimed to investigate any association between FIHs during the first day of Ramadan and potential headache-related biomarkers, including fasting blood glucose (FBG), C-reactive protein (CRP), magnesium, vitamin B9, vitamin B12, homocysteine, and calcitonin gene related peptide (CGRP), and to assess whether a prophylactic use of paracetamol may influence these biomarkers.MethodsAs part of a randomized, open-label clinical trial that evaluated the effect of paracetamol as a prophylactic therapy for FIH, blood samples from stratified subjects in the prophylaxis and control groups were withdrawn while fasting after the 1st dose of paracetamol (in the prophylaxis group) and prior to reporting headache occurrence.ResultsPlasma and serum were separated for 61 subjects; 31 and 30 subjects from the prophylaxis and control groups, respectively. Overall, no significant differences were found in the levels of FBG, CRP, magnesium, vitamin B9, and vitamin B12 in headache-suffering subjects compared to those without headache despite the use of paracetamol for prophylaxis. Homocysteine, however, was significantly reduced in all subjects who experienced FIH compared to those without headache (median 6.9 [1.6] vs. 7.7 [2.7] umol/L; p = 0.041). On the contrary, when the CGRP was measured using immunoassay, it was found to be significantly elevated in all headache-suffering subjects compared to those without headache (median 126.1 [17.7] vs. 105.8 [19.6] pg/mL; p ≤ 0.0001). This difference was maintained upon comparing the headache to non-headache subjects in both the prophylaxis (median 121.5 [15.4] vs. 105.8 [9.4] pg/mL; p < 0.01) and control groups (median 128.5 [28.3] vs. 105.8 [23.8] pg/mL; p < 0.01). Additionally, an elevated CGRP level was found to increase the odds of having a FIH [OR = 1.32; 95%CI 1.06–1.22].ConclusionsOur findings revealed the role of CGRP in FIHs for the first time and suggest further investigation in signaling pathways downstream CGRP receptors. Furthermore, the modulation CGRP or CGRP receptors could have a clinical application in the prevention of FIHs.Trial registrationThis study was registered with the Saudi Food and Drug Authority in the Saudi Clinical Trials Registry (SCTR; No. 22122102).

Seronegative brucella meningitis diagnosed by CSF PCR: report on seven cases

IntroductionNeurobrucellosis (NB) can be associated with meningitis and present as a headache with or without meningeal signs. Pseudotumor presentation of NB has been reported to be accompanied by lymphocytic predominant cerebrospinal fluid(CSF) pleocytosis. NB is diagnosed by means of isolation of Brucella from blood or CSF and/or the presence of anti-Brucella antibodies in the CSF. Molecular techniques have been used in chronic or challenging cases of NB.Clinical findingsWe report on seven cases of NB presenting with different types of headache and signs of meningeal involvement. In five cases, signs of intracranial hypertension were evident in the form of papilledema, sixth nerve palsy and blurred vision.DiagnosisMRIs of the brain revealed signs of intracranial hypertension in three patients, basal meningeal enhancement in one patient and white matter lesions in one patient. Brucella serology in the blood and CSF was negative in all patients. It was interesting that four patients had normocellular CSF analysis with normal glucose and protein results. The diagnosis was made by Brucella PCR in all patients.ConclusionNB should be considered in the differential diagnoses of pseudotumor cerebri syndrome in endemic areas. It is important to employ molecular techniques using sterile CSF samples in the investigation of Brucella.

Prevalence and characteristics of headache among medical students in Egypt: a multicentric cross-sectional study

BackgroundHeadaches are one of the most common neurological disorders, ranging in severity from mild discomfort to a severe, debilitating condition. Headaches are particularly prevalent among medical students, which can be...

Dry needling techniques as a treatment for improving disability and pain in patients with different types of headache: A systematic review and meta-analysis

BackgroundHeadaches, a widespread neuromuscular ailment, pose a significant burden on individuals and society, necessitating both pharmacological and non-pharmacological interventions. Dry needling (DN) has surfaced as a notable non-pharmacological alternative for addressing headaches. We aim to compare DN intervention with the control group in the management of different types of headaches. MethodsA comprehensive meta-analysis was conducted, encompassing a systematic exploration of five electronic databases up to May 2023, with studies assessed for validity using the Cochrane risk of bias tool. Eligible studies included those with a control group, which could consist of sham interventions, physiotherapy, or pharmacological treatments. Outcomes related to disability, headache intensity, and frequency were extracted and analyzed. ResultsOut of 4304 studies screened, 13 randomized controlled trials (RCTs) were included in this systematic review, of them 10 RCTs were included in the meta-analysis. A significant decline in the disability score and headache intensity was evident in the DN group compared to the control group, one and three-month follow-ups. Specifically, substantial reductions in headache frequency were prominent after one and three months post-intervention. ConclusionDry needling manifests as a potent intervention, diminishing headache intensity and frequency, albeit with lower impact on disability scores. The observed benefits were especially pronounced after one and three months, though the heterogeneous nature of some data analyses mandates further detailed studies to gain a clearer understanding of DN's efficacy on the assessed outcomes.

Enhancing chronic migraine preventive therapy: low-level 810 nm laser acupuncture as an add-on treatment for patients with unsatisfactory pharmacological effect, a pilot single-blind randomized controlled trial

BackgroundLaser acupuncture is a proven non-invasive treatment with effects comparable to traditional acupuncture in different types of headaches, but there is still insufficient evidence for chronic migraine (CM) in adults. We aim to investigate the efficacy and safety of laser acupuncture (LA) as an add-on preventive therapy on CM.MethodsA single-blind randomized controlled trial was conducted from January 2022 to November 2023. CM patients with unsatisfactory pharmacological effects were randomly assigned in a 1:1 ratio to receive either LA or sham treatment over a course of 8 sessions spanning 4 weeks. The co-primary outcomes were changes in monthly migraine days (MMD) and acute headache medications usage days per month from baseline. Evaluations were taken at baseline (12 weeks before randomization), at 4th week (treatment completed), 8th week and 12th week from baseline.ResultsA total of 60 patients (30 in each group) were included in the intention-to-treat analyses. Baseline headache characteristics between trial groups were similar. Compared with the sham group, the LA group had a significant reduction in MMD (5.2 vs. 1.5 days at 8th week, p = 0.015; 7.3 vs. 1.8 days at 12th week, p = 0.001), and acute headache medications usage days per month (3.1 vs. 0.4 days at 4th week, p = 0.007; 3.2 vs. 0.0 days at 8th week, p = 0.005; 3.9 vs. 0.0 days at 12th week, p < 0.001). No serious adverse event was observed in both groups.ConclusionsLaser acupuncture was effective in reducing MMD and acute headache medications usage with promising safety. Specifically, the efficacy of LA exhibited a progressively more pronounced effect within the follow-up period. We suggested that LA is a promising add-on preventive therapy for CM, and trials focused on investigating the mechanism of LA’s effect and its long-term effects on CM prevention are justified.Trial registrationThe study was retrospectively registered at ISRCTN.org Identifier: ISRCTN11208146 (https://doi.org/10.1186/ISRCTN11208146). The registration date: 19, January, 2024.The date of first participant registration: 04, May, 2022.

A Review on Osteopathic Manipulation in Patients With Headache.

Headaches are a common neurological disorder, significantly impacting patients' quality of life. Traditional treatments include pharmacological and nonpharmacological approaches. Osteopathic manipulative treatment (OMT) is a holistic, hands-on technique used by osteopathic physicians to alleviate pain and improve function by addressing musculoskeletal dysfunctions. This review aims to evaluate the effectiveness of osteopathic manipulation in managing headaches, focusing on the different types of headaches, the specific techniques used, and the overall outcomes reported in clinical studies. A comprehensive literature search was conducted across multiple databases, including PubMed, Google Scholar, and MEDLINE, to identify relevant studies published in the past two decades. Inclusion criteria were studies involving adult patients diagnosed with headaches and treated with OMT. Both randomized controlled trials (RCTs) and observational studies were included. The review identified 15 studies meeting the inclusion criteria. Evidence suggests that OMT can be beneficial in reducing the frequency, intensity, and duration of headaches, particularly tension-type headaches (TTHs) and migraines. Techniques such as myofascial release, cranial osteopathy, and muscle energy techniques were commonly employed. Many studies reported significant improvements in patients' quality of life and functional status post-treatment. However, the heterogeneity in study designs, sample sizes, and outcome measures warrants cautious interpretation of the results. Osteopathic manipulation shows promise as a complementary approach for managing headaches, with positive effects on pain relief and functional improvement. Further large-scale, high-quality RCTs are needed to confirm these findings and to establish standardized treatment protocols. Integrating OMT into multidisciplinary headache management strategies could potentially enhance patient outcomes and reduce reliance on pharmacological interventions.

Headache Treatment Options.

Family medicine physicians often see headache as the chief complaint when meeting patients within their practice. The goal is to try different treatment modalities without having to send the patient to a specialist. Headaches affect different individuals during their lifetime. Before any treatment begins, it is best that one rules out possible causes of the headache, for example, drug interactions or structural cerebrum conditions. Nonpharmacological treatment is recommended first before attempting a stepwise approach to cost-effective pharmacological treatment options. Pharmacological treatment options should include preventive and on-demand options. A family physician has all the resources to assist patients with different types of headaches.

An overview of headache treatments during the tenth century

ABSTRACT Although the history of treating headaches spans thousands of years, scientists during the tenth century made unique and significant contributions to understanding, treating, and preventing the development of headaches. In fact, the tenth century saw the ability to differentiate between types of headache and treatments for the first time. This article looks at the contributions of Persian, Anglo-Saxon, and Chinese medicine to the diagnosis and treatment of different types of headaches in the tenth century. It does so with reference to a range of herbal, surgical, and pharmacological methods of treating this ailment. The article also uncovers how tenth-century herbal remedies were effective at explaining the properties of their ingredients in modern terms and concepts including analgesia, anti-inflammation, and antinociception, and explores the way tenth-century treatments relieved painful headaches and prevented their recurrence.

PREVALENCE, PREDICTORS TRIGGERS AND COPING STRATEGIES OF TENSION HEADACHE AMONG MEDICAL STUDENTS AND IN KSAU-HS RIYADH, SAUDI ARABIA

This study aimed to investigate the prevalence of primary headaches, specifically tension-type headaches (TTH), among medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia, and to identify the factors that contribute to the occurrence and relief of headaches. A cross-sectional study was conducted among second to sixth-year medical students at KSAU-HS from October 2022 to February 2023. Participants with chronic headaches who volunteered to participate were included. The International Classification of Headache Disorders, third edition (ICHD-3), was used to classify and differentiate between different types of headaches. Additional questions were included to assess factors that exacerbate or alleviate headaches, headache management strategies, and the impact of headaches on academic performance. Data were collected using electronic self-administered questionnaires and analyzed using SPSS version 21. A total of 303 participants were included in the study, with a mean age of 22 ± 1.7 years. The majority of participants were male (59.4%), and most were in clinical years (61.1%) with a GPA of 4.5 to 5 (57.1%). Nearly all participants reported experiencing at least one episode of headache in the past year, and 60.7% met the criteria for TTH. The most commonly reported headache characteristics were bilateral location (71.3%), frequent occurrence (53.8%), duration of more than one hour (84.5%), and frontal site (61.7%). Lack of sleep (62.4%) was identified as the most common trigger, while taking simple analgesics like Paracetamol (72.3%) and sleep (50.5%) were the most commonly used therapies to manage headaches. The majority of participants (75.9%) reported that their headaches did not significantly affect their academic performance. A significant association was found between gender and tension-type headaches, with male students being at a higher risk (p-value &lt; 0.001). In conclusion, primary headaches, particularly tension-type headaches, are prevalent among medical students at KSAU-HS, potentially impacting their academic performance. Further research is warranted to raise awareness among students regarding effective headache management strategies.

Neck pain repercussions in migraine – The role of physiotherapy

IntroductionMigraine is a neurological and disabling disease whose peripheral manifestations can be addressed with physiotherapy. These manifestations can include pain and hypersensitivity to muscular and articular palpation in the neck and face region, a higher prevalence of myofascial trigger points, limitation in global cervical motion, especially in the upper segment (C1–C2), and forward head posture with worse muscular performance. Furthermore, patients with migraine can present cervical muscle weakness and greater co-activation of antagonists in maximum and submaximal tasks. In addition to musculoskeletal repercussions, these patients can also present balance impairment and a greater risk of falls, especially when chronicity of migraine frequency is present. The physiotherapist is a relevant player in the interdisciplinary team and can help these patients to control and manage their migraine attacks. PurposeThis position paper discusses the most relevant musculoskeletal repercussions of migraine in the craniocervical area under the perspective of sensitization and disease chronification, besides addressing physiotherapy as an important strategy for evaluating and treating these patients. ImplicationsPhysiotherapy as a non-pharmacological treatment option in migraine treatment may potentially reduce musculoskeletal impairments related to neck pain in this population. Disseminating knowledge about the different types of headaches and the diagnostic criteria can support physiotherapists who compose a specialized interdisciplinary team. Furthermore, it is important to acquire competencies in neck pain assessment and treatment approaches according to the current evidence.

Correlation of different types of headaches, their severity with BMI and hyperandrogenism in PCOS patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Headache and epilepsy: prevalence and clinical variants

Headache, which is often present in patients with epilepsy, can occur outside of epileptic seizures as well as have a temporary connection with them – occur immediately before, during or after an attack. Clinical types of headache in epilepsy are considered in the International Classification of Headache, but not in the classification of epileptic seizures and types of epilepsy. Meanwhile, the presence of concomitant headache and its clinical phenotype should be taken into account when choosing treatment tactics in patients with epilepsy. The article presents data on the prevalence of different types of headache in patients with epilepsy and a modern classification of cephalalgia depending on the temporal relationship with an epileptic attack. Diagnostic criteria for four clinical variants of cephalgia are given: interictal, preictal, ictal and postictal. The comorbid relationship between epilepsy and migraine is considered in more detail, including the pathophysiological mechanisms underlying the combination of these paroxysmal conditions.

Головная боль у пациентов с дисплазией соединительной ткани

Headache in patients with connective tissue dysplasia (CTD) is an urgent problem of modern medicine. The article discusses different types of headache in patients with connective tissue dysplasia. The most well studied are differentiated forms of connective tissue dysplasia (Ehlers — Danlos syndrome, Marfan syndrome, etc.) and, accordingly, variants of cephalgia in them are described. A significant problem is the dissection of the carotid and vertebral arteries, which are variants of acute cerebrovascular accident. The interrelation of primary and secondary headaches with CTD syndrome is shown. The variety of clinical manifestations of headaches and connective tissue dysplasia in the same patient makes it difficult to diagnose, which can contribute to the chronicity of cephalalgia, the appointment of inadequate therapy and the development of complications. Further study of headache options in patients with CTD will improve the provision of medical care to this category of patients.

Association between the dietary inflammatory index and chronic daily headache: findings from Dena Persian cohort

PurposeWhile several studies have reported a relationship between chronic daily headache (CDH) and different dietary patterns, no study has investigated the association between CDH and the dietary inflammatory index (DII). This study aims to hypothesize that a higher DII score (proinflammatory diets) is associated with higher odds of CDH.Design/methodology/approachThis cross-sectional study was performed using the baseline data of the Dena PERSIAN cohort study, including demographic information, body mass index, medical history, laboratory tests, sleep duration and blood pressure. The DII was computed based on the data collected by a valid 113-item food frequency questionnaire and a 127-item indigenous food questionnaire. The association between CDH and DII score was analyzed by simple and multiple logistic regression.FindingsOut of 3,626 people included in the study, 23.1% had CDH. The median DII was −0.08 (interquartile range = 0.18). People in the third and fourth quartiles of DII (proinflammatory diet) had a 20% (odds ratio: 0.80; 95% confidence interval: 0.65–1) and a 25% (odds ratio: 0.75; 95% confidence interval: 0.61–0.94) lower chance of having CHD than those in the first quartile, respectively. After adjustment for confounding variables, this association did not remain statistically significant (p > 0.05).Originality/valueAlthough the analysis conducted without adjustment for medical history showed a significant association between proinflammatory diet and reduced CDH, considering the diverse etiology of different types of headaches and the paucity of studies in this area, further studies are needed to investigate the DII score of patients by the type of headache, its severity and duration.

Cerebral perfusion variance in new daily persistent headache and chronic migraine: an arterial spin-labeled MR imaging study.

New daily persistent headache (NDPH) and chronic migraine (CM) are two different types of headaches that might involve vascular dysregulation. There is still a lack of clarity about altered brain perfusion in NDPH and CM. This study aimed to investigate the cerebral perfusion variances of NDPH and CM using multi-delay pseudo-continuous arterial spin-labeled magnetic resonance imaging (pCASL-MRI). Fifteen patients with NDPH, 18 patients with CM, and 15 age- and sex-matched healthy controls (HCs) were included. All participants underwent 3D multi-delay pCASL-MRI to obtain cerebral perfusion data, including arrival-time-corrected cerebral blood flow (CBF) and arterial cerebral blood volume (aCBV). The automated anatomical labeling atlas 3 (AAL3) was used to parcellate 170 brain regions. The CBF and aCBV values in each brain region were compared among the three groups. Correlation analyses between cerebral perfusion parameters and clinical variables were performed. Compared with HC participants, patients with NDPH were found to have decreased CBF and aCBV values in multiple regions in the right hemisphere, including the right posterior orbital gyrus (OFCpost.R), right middle occipital gyrus (MOG.R), and ventral anterior nucleus of right thalamus (tVA.R), while patients with CM showed increased CBF and aCBV values presenting in the ventral lateral nucleus of left thalamus (tVL.L) and right thalamus (tVL.R) compared with HCs (all p < 0.05). In patients with NDPH, after age and sex adjustment, the increased aCBV values of IFGorb. R were positively correlated with GAD-7 scores; and the increased CBF and aCBV values of tVA.R were positively correlated with disease duration. The multi-delay pCASL technique can detect cerebral perfusion variation in patients with NDPH and CM. The cerebral perfusion changes may suggest different variations between NDPH and CM, which might provide hemodynamic evidence of these two types of primary headaches.

A Meta-Analysis of the Genome-Wide Association Studies on Two Genetically Correlated Phenotypes Suggests Four New Risk Loci for Headaches

Headache is one of the commonest complaints that doctors need to address in clinical settings. The genetic mechanisms of different types of headache are not well understood while it has been suggested that self-reported headache and self-reported migraine were genetically correlated. In this study, we performed a meta-analysis of genome-wide association studies (GWAS) on the self-reported headache phenotype from the UK Biobank and the self-reported migraine phenotype from the 23andMe using the Unified Score-based Association Test (metaUSAT) software for genetically correlated phenotypes (N = 397,385). We identified 38 loci for headaches, of which 34 loci have been reported before and four loci were newly suggested. The LDL receptor related protein 1 (LRP1)—Signal Transducer and Activator of Transcription 6 (STAT6)—Short chainDehydrogenase/Reductase family 9C member 7 (SDR9C7) region in chromosome 12 was the most significantly associated locus with a leading p value of 1.24 × 10–62 of rs11172113. The One Cut homeobox 2 (ONECUT2) gene locus in chromosome 18 was the strongest signal among the four new loci with a p value of 1.29 × 10–9 of rs673939. Our study demonstrated that the genetically correlated phenotypes of self-reported headache and self-reported migraine can be meta-analysed together in theory and in practice to boost study power to identify more variants for headaches. This study has paved way for a large GWAS meta-analysis involving cohorts of different while genetically correlated headache phenotypes.

Pregestational neurological disorders among women of childbearing age—Nationwide data from a 13-year period in Hungary

Comprehensive statistics evaluating pregnancies complicated by various medical conditions are desirable for the optimization of prenatal care and for improving maternal and fetal outcomes. The main objective of our study was to assess pregnancies during a 13-year study period with accompanying pregestational neurological disorders in medical history on a nationwide level. In the framework of the NEUROHUN 2004-2017 project utilizing medical reports submitted for reimbursement purposes to the National Health Insurance Fund, we included women with at least one labor during 2004-2016 who had at least one pregestational diagnosis of a neurological disorder received within this time frame prior to their first pregnancy during the studied period. Three-digit codes from the 10th International Classification of Diseases (ICD) were used for the identification and classification of neurological and obstetrical conditions. Specific inclusion and exclusion criteria were employed during the study process. A total of 744 226 women have been identified with at least one delivery during the study period with 98 792 of them (13.3%) having at least one neurological diagnosis received during 2004-2016 before their first gestation in the time frame of the study. The vast majority of diagnosis codes were related to different types of headaches affecting 69 149 (9.3%) individuals. The most prevalent diagnoses following headaches were dizziness and giddiness (15 589 patients [2.1%]; nerve, nerve root and plexus disorders (10 375 patients [1.4%]); epileptic disorders (7028 patients [0.9%]); neurological diseases of vascular origin (6091 patients [0.8%]); other disorders of the nervous system (5358 patients [0.7%]); and demyelinating diseases of the central nervous system (2129 patients [0.3%]). The present findings of our study show high prevalence of pregestational neurological disorders, the dominance of headaches followed by the rather nonspecific diagnosis of dizziness and giddiness, the relevance of nerve, nerve root and plexus disorders and epilepsy, and the importance of cerebrovascular disorders among women of childbearing age. The present research findings can help healthcare professionals, researchers and decision makers in adopting specific health policy measures based on nationwide data and further aid the development of new diagnostic and therapeutic algorithms of various neurological manifestations concerning women of childbearing age.

Оказание фармацевтической помощи посетителям аптек с головной болью: систематизированный обзор зарубежных исследований

The article presents an overview of studies of pharmaceutical care for patients with different types of headache. Various methods were used, including education of pharmacists, questionnaires for patients and specialists, interviews, the use of special protocols and algorithms for providing pharmaceutical care, patient modelling.

TENSION TYPE HEADACHE (TTH)

Cerebrovascular disease is the number one cause of epilepsy in the elderly population. Headaches are relatively common in patients with cerebrovascular disorders. The frequency of stroke-related headaches ranges from 7% to 65% with different types of headaches. The prevalence of persistent post-stroke headaches from 7-23%, with follow-up times ranging from 3 months to 3 years after stroke. Persistent headache in the population was associated with high depression and fatigue scores and significantly impacted returning to work. Most headaches at stroke onset will resolve, persistent headaches are a real entity even years after the stroke. The mechanism that might explain the relationship between headache and hemorrhagic stroke is still unclear, including changes in blood vessel walls supported by endothelial dysfunction in migraine sufferers as well as comorbid vascular risk factors such as arterial hypertension or platelet dysfunction. Headache after stroke intracerebral hemorrhage is believed to be the result of vasoconstriction that causes ischemia of the vessel wall.