Migraine Headache Duration Research Articles

Associations between dietary diversity score and migraine headaches: the results from a cross-sectional study.

There is limited evidence on the link between diet quality and migraine headaches. The present study aimed to evaluate the association between dietary diversity score (DDS), as a good representative of overall diet quality, and clinical features of migraine headaches. In total, 262 subjects (224 females and 34 males), aged 20 to 50 years old were included in the present cross-sectional study. The migraine headache was diagnosed according to the third edition of the International Classification of Headache Disorders (ICHD-3). Clinical features of migraine headaches including frequency, severity, and duration of migraine headaches, headache impact test-6 (HIT-6), and serum levels of nitric oxide (NO) were assessed by standard procedures. The dietary intake of participants has been assessed by a validated 168-item food frequency questionnaire (FFQ) and used to calculate DDS. The association between DDS and clinical variables of migraine headaches was investigated using multiple linear regression analysis, and the beta (β) estimates with 95% confidence intervals (CIs) were reported. A significant inverse association was found between DDS and headache frequency (β = -2.19, 95% CI: -4.25, -0.14) and serum levels of NO (β = -6.60, 95% CI: -12.58, -0.34), when comparing patients in the third tertile of DDS to those in the first tertile. The association remained significant and became stronger after adjustment for confounders for both outcomes of headache frequency (β = -3.36, 95% CI: -5.88, -0.84) and serum levels of NO (β = -9.86, 95% CI: -18.17, -1.55). However, no significant association was found between DDS with HIT-6 score, migraine headache duration, and severity. The present study demonstrates that higher dietary diversity is correlated with lower migraine frequency and serum levels of NO.

The relationship between dietary nutrients patterns and intensity and duration of migraine headaches.

Migraine is a complicated brain disorder which affects approximately 12 % of the population, whilst the presence of migraine headaches is typically higher in women than men. Several nutrients are posited to improve headache severity. The aim of this study was to investigate the relationship between dietary nutrients patterns and intensity and duration of migraine headaches. This cross-sectional study was conducted with 266 women. Physical activity, general characteristics, anthropometric values and dietary intake were collected. Nutrient patterns were derived using principal component analysis with varimax rotation, and based on the correlation matrix, after completing the 147 item semi-quantitative FFQ, we discerned three nutrients patterns. The validated Migraine Disability Assessment (MIDAS) questionnaire and visual analogue scale (VAS) were used for assessing migraine intensity. Duration of headaches were defined as the hours the participants had headache in 1 d in last month. ANOVA, χ2 and linear regression tests were used to interrogate the data. Linear regression showed there was a positive relationship between second pattern rich in vitamin B1, carbohydrate, vitamin B3, vitamin B9, protein, and total fibre and VAS and pain duration. Furthermore, there was an inverse relationship between MIDAS and the first nutrient pattern characterised by dietary Ca, vitamin A, vitamin K, vitamin C, vitamin B6, vitamin B2, and Mg among women. Furthermore, there was a positive significant association between vitamin D and B12 (pattern 3) and headache duration. Dietary nutrients patterns should be monitored closely in individuals suffering with migraine.

Is there a relationship between dietary sodium and potassium intake and clinical findings of a migraine headache?

Few studies have assessed the association between sodium (Na) and potassium (K) and migraine headaches. In this study, we aimed to examine the relationship between 24-hour urine Na and K intakes and clinical findings of migraine in an Iranian sample. In this cross-sectional study, 262 participants, aged 20-50 years, were included with a body mass index (BMI) of 18·5-30 kg/m2and a diagnosis of migraine. One 24-hour urine sample was collected from each subject to estimate the Na and K intakes. The clinical features of migraine, including frequency, duration, severity, Migraine Headache Index Score (MHIS), and Headache Impact Test (HIT) score, were assessed. Besides, a multiple linear regression analysis was performed, and beta estimates and the corresponding 95% confidence intervals (CIs) were reported. Overall, 224 women and 38 men, with a mean age of 36·10 years and BMI of 25·55 kg/m2 comprised our study population. After controlling for potential confounders, the 24-hour urine Na was positively associated with a longer headache duration (β = 0·29; 95% CI: 0·06, 0·53) in the group with the highest urine Na levels as compared to the group with the lowest levels. After adjustments for potential confounders, an increase of 13·05 in the MHIS was observed when the 24-hour urine Na level increased from the first to the third tertile (β = 13·05; 95% CI: 1·70, 24·41). Our findings suggested that a higher 24-hour urine Na level was positively associated with a longer duration of migraine headaches and a higher MHIS.

Peripheral Occipital Nerve Decompression Surgery in Migraine Headache.

Background:Migraine headache in the occipital region is characterized by a recurrent pain of moderate to severe intensity. However, the diagnosis can be difficult because of the multitude of symptoms overlapping with similar disorders and a pathophysiology that is not well-understood. For this reason, the medical management is often complex and ineffective.Methods:A literature search according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was conducted to evaluate the surgical treatment of occipital migraines. Inclusion criteria were: English language, diagnosis of migraine, occipital neuralgia, or tension headache in compliance with the classification of the International Headache Society, follow-up at minimum 3 months, and adult age. The treatment had to consist of peripheral occipital nerve surgery.Results:323 records were identified after duplicates were removed, 30 full text articles were assessed for eligibility, and 9 records were selected for inclusion. A total of 1046 patients were included in the review. General positive response after surgery (>50% reduction in occipital migraine headaches) ranged from 80.0% to 94.9%. However, many differences in the selection of patients, target of decompression surgery, and measurement outcome were described.Conclusion:Despite the decennial proven effectiveness and safeness of surgical therapy for chronic occipital migraine headaches, more significant proof is needed to definitively confirm its use as a standard therapy.

Prophylactic efficacy of levetiracetam on migraine headaches in children aged 4–14-year-old

Background: Migraine is the most common type of episodic headache. Migraine can affect the pediatric patients' life through absence from school and restricting inside-home and social activities. Objective: This study was done with the objective of investigating the prophylactic effect of levetiracetam on pediatric migraine headaches. Materials and Methods: In this before-after clinical trial, 30 children aged 4–14 years with migraine headache were included and followed for 6 months. The required data were gathered through observation, examination, paraclinical studies, and interview. The data were entered into a checklist. Furthermore, the Pediatric Migraine Disability Assessment (PedMIDAS) questionnaire was used to assess disability. Levetiracetam tablet was administered for 6 months. The frequency and duration of migraine headaches as well as migraine-related symptoms and possible side effects were documented. The data were then analyzed by the SPSS software (ver. 20.0, IBM Company). Results: The frequency of headaches, their severity, and duration decreased significantly at the end of the study (P

Tart Cherry Juice Consumption as a Potential Treatment for Migraine Headaches

PURPOSE: Anti-inflammatory and antioxidant effects of tart cherry juice accelerate exercise recovery (Bell 2013). These effects likely yield additional health benefits. The purpose of this study was to examine the effect of regular consumption of tart cherry juice on frequency, intensity and duration of migraine headaches in a single patient with a 4-year history of migraines. The study rationale was threefold: (1) migraineurs have elevated c-reactive protein (CRP) and nitric oxide (NO) (Lippi 2014; van der Kuy & Lohman 2003); (2) cherries can reduce CRP and NO (Kelley 2006); (3) tart cherry anthocyanin bioavailability is high in brain tissue (Kirakosyan 2015). METHODS: The 24 yo female patient had a 4-year history of migraine headache with aura, sensory (pins-and-needles) and visual disturbance (Alice in Wonderland syndrome); and was taking Zolmitriptan (2.5 mg) to treat migraine occurrences. A 3-phase study was completed: Phase 1 - 50 days without cherry juice; Phase 2 - 50 days drinking 8 fl oz tart cherry juice daily (Cheribundi, Geneva NY); Phase 3 - 50 days without cherry juice. Migraine frequency (migraines/week), duration (hours/migraine), intensity (VAS pain 0-10 scale) and medication use (pills/week) were documented. RESULTS: When taking tart cherry juice migraine frequency and duration were reduced by 65% and 78%, respectively. Medication use was reduced by 91%. Migraines occurred during 3 of 4 menstrual cycles when the patient was not taking cherry juice, but during neither menstrual cycle when the patient was taking cherry juice.Table: No title available.CONCLUSIONS: Given the scientific rationale for the potential benefits of cherry juice in preventing migraine headaches, and the positive results of this pilot study, a clinical trial is warranted.

Is Migraine Surgery Ready for Prime Time? The Surgical Team's View.

Based on unsolicited reports by patients that their headaches had ceased or reduced following forehead rejuvenation, our team began stepwise and logical studies to investigate the efficacy of surgery as a potential preventive modality for selected patients with migraine headaches (MH). The purpose of this report is to summarize the pertinent studies demonstrating the efficacy of surgical decompression trigger sites of migraine trigger sites. These studies included a retrospective, a prospective pilot, a prospective randomized study with a control arm, a prospective randomized study with sham surgery, and a 5-year follow-up. There were 3 reputable and respected neurologists who specialize in headaches, an expert biostatistician, 13 residents, and 10 medical students involved in these studies. In our retrospective study, of the 249 patients, 39 confirmed having MH prior to the surgery, and 31 (P < .0001) experienced either complete elimination or significant improvement (at least 50% reduction) of their MH. In our prospective pilot study, 21 of the 22 patients noted a significant improvement (P < .001). In our prospective randomized study, 82 of 89 (92%) observed at least 50% improvement in the frequency, intensity, and duration of MH (P < .00001). Sixty-one of 69 (88%) patients in this study who were followed for 5 years persisted to have significant improvement after 5 years (P < .0001). In our randomized study involving sham surgery, 21 of the 49 (83%) patients benefitted from the real surgery compared to 15 of 26 (56%) patients in the sham surgery group (P = .014). While 28 (57%) patients in the real surgery group observed complete elimination, only 1 patient in the sham surgery group reported elimination (P < .0001). This report discusses the facts surrounding the discovery of this surgery, demonstrates accuracy of our studies and effectiveness of the proposed surgeries and dispels some of the unfounded assertions trying to discredit the research that we have conducted over 14 years.

Intraoperative corticosteroid injections in migraine surgery: efficacy in preventing refractory symptoms.

A subset of patients have been noted to have refractory migraine symptoms in site IV (occipital triggers) following primary surgery. It was postulated that the cause of refractory migraine symptoms is new scar tissue formation causing irritation of the greater occipital nerve. The goal of this study was to determine whether intraoperative corticosteroid injections have the potential to prevent these refractory symptoms. A retrospective review of all patients operated on by the senior author (B.G.) from 2000 to 2010 was undertaken. All patients who had site IV decompression and at least 1 year of follow-up were included. Patients were divided into two groups, those who had corticosteroids injected and those who did not. Data analyzed included demographics and preoperative and postoperative migraine headache symptoms review based on the migraine headache questionnaire. A total of 476 patients were included in the study. There were 282 patients in the corticosteroid group and 194 in the no-corticosteroid group. A significant reduction was found in the frequency of migraine headaches (-9.8 versus -8.0; p = 0.03) and the migraine headache index (-92.9 versus -65.2; p = 0.0065). There was no significant reduction in migraine headache duration (-0.50 versus -0.70; p = 0.10) or severity (-3.50 versus -3.80; p = 0.38). Intraoperative injection of corticosteroids during site IV migraine surgery may reduce migraine frequency and migraine headache index postoperatively. Corticosteroid injection in migraine site IV surgery is an effective adjunctive measure in reducing the migraine headache index. Therapeutic, III.

Impact of Preoperative Narcotic Use on Outcomes in Migraine Surgery

This study focuses on the impact of preoperative narcotic medication use on outcomes of surgical treatment of migraine headaches. A retrospective comparative review was conducted with patients undergoing migraine surgery. Data gathered included demographic information, baseline migraine headache characteristics, migraine surgery sites, postoperative migraine headache characteristics 1 year or more following surgery, and preoperative migraine medication use. Patients were grouped based on preoperative narcotic medication use. The narcotic users were subdivided into low and high narcotic user groups. Preoperative migraine characteristics were comparable between groups and the outcomes of migraine surgery were compared between the groups. Outcomes in 90 narcotic users were compared with those for 112 patients not using narcotic medications preoperatively. Narcotic users showed statistically significantly less reduction in frequency, severity, and duration of migraine headaches after surgery. Narcotic users had clinical improvement in 66.7 percent of patients and elimination in 18.9 percent versus 86.6 and 36.6 percent, respectively, in the nonnarcotic group. The group that consumed narcotics had significantly lower rates of improvement in all migraine indices. Previous studies have discouraged the routine use of narcotic medications in the management of migraine medications. The authors' study demonstrates that narcotic medication use before migraine headache surgery may predispose patients to worse outcomes postoperatively. Because pain cannot be objectively documented, the question remains of whether this failure to improve the pain was indeed a suboptimal response to surgery or the need for narcotic substances. Risk, II.

The effects of cinnarizine versus sodium valproate in migraine prophylaxis

Aim: The aim of this randomized, double-blind, parallel-group study was to compare the efficacy and safety of low-dose cinnarizine and sodium valproate in migraine prophylaxis. Methods: A total of 104 patients were treated during a 12-week treatment period. Cinnarizine dose of 25 mg and 200-mg sodium valproate were administered every 12 hours. During follow-up period, frequency, intensity and duration of migraine attacks, symptoms associated with headache, analgesics use, as well as drugs’ side effects were studied. Participants completed Migraine Disability Assessment (MIDAS) and Headache Impact Test (HIT-6) questionnaires before and after treatment. Results: Frequency, intensity and duration of migraine headaches as well as MIDAS score and administration of symptomatic medications decreased significantly between repeated follow-up visits in both groups. Reduction of 4-week migraine frequencies in patients receiving cinnarizine and valproate was 36.4% and 55%, respectively, and the difference between two groups was statistically significant (p < 0.001). Conclusion: 0ur results showed that administration of 25-mg cinnarizine every 12 hours can significantly decrease headache duration (p ≤ 0.001) and headache frequency (p ≤ 0.001) in patients with migraine. These results suggest that cinnarizine may be an appropriate substitution for first-line migraine prophylaxis such as valproate.

A Comparative Study of the Effects of Low-Dose Topiramate Versus Sodium Valproate in Migraine Prophylaxis

ABSTRACTThe present study was performed to evaluate the efficacy of low-dose topiramate and compare it with sodium valproate that is prevalently prescribed as a migraine prophylaxis. This was a randomized, double-blind, parallel-group clinical trial on 56 patients who completed the course of study. Topiramate and valproate were administered at 50 mg/day and 400 mg/day, respectively, during the follow-up period. Frequency, intensity, duration, associated symptoms with headaches, analgesics use, as well as drugs’ side effects were studied. Participants completed MIDAS and HIT-6 questionnaires before and after treatment. Frequency, intensity, and duration of migraine headaches as well as MIDAS score and symptomatic medications decreased significantly between repeated follow-up visits in both groups. Responder rate for patients treated with topiramate and valproate were 71.6% and 64.3%, respectively, and the difference between the two groups was not statistically significant. The reduction of headache severity in the topiramate group was significantly more than that in the valproate group (p = .027). During the study, no statistically significant reduction in associated symptoms with migraine were observed in both the groups. Topiramate dose of 50 mg/day with fewer side effects in comparison with its higher doses may be an appropriate substitution for first-line migraine prophylaxis such as valproate.

Effect of Pain Intensity and Time to Administration on Responsiveness to Almotriptan: Results from AXERT® 12.5 mg Time Versus Intensity Migraine Study (AIMS)

To determine whether time-based early treatment, independent of pain intensity, is superior to a pain intensity-based treatment, where patients are asked to treat at least moderate intensity headaches, resulting in a reduction of overall migraine headache duration. Retrospective and prospective trials have reported improved outcomes when triptans were used early or to treat mild migraine headache pain. However, tolerability as well as efficacy may be 2 of several key issues that have prevented this new treatment paradigm from becoming universally accepted. In this multicenter, open-label, cluster-randomized study, patients with IHS-defined migraine were instructed to treat 2 sequential migraine headaches with almotriptan 12.5 mg using either Early Treatment (ET, ie, treat at earliest onset of headache pain, within 1 hour) or Standard Treatment (ST, ie, treat when headache pain intensity is moderate or severe). The novel trial design uses total migraine headache pain duration as the primary endpoint. Results are presented for the first headache and include an ITT population of 757 ET and 693 ST patients. Median headache duration (time from onset of headache pain until no pain) was significantly shorter in ET patients compared to ST patients (3.18 vs 5.53 hours, P < .001). An analysis of the ET subgroup treating headache pain within 1 hour of onset revealed pain intensity, ie, treating mild or moderate versus severe pain, was significantly correlated with treatment outcomes defined by total headache duration, 2-hour pain free, sustained pain free, and use of rescue medication. Multivariate analyses comparing ST subgroups that treated within 1 hour versus greater than 1 hour after headache onset, demonstrate that both pain intensity, ie, treating moderate versus severe headache pain, and treating early versus late, were significantly correlated with total headache duration, 2-hour pain free, sustained pain free, and use of rescue medication. The overall incidence of adverse events was low; nausea and dizziness were the only adverse events with an incidence > or =1% in either treatment group (nausea: 2.5% and 1.7% and dizziness 1.1% and 0.7%, in the ET and ST groups, respectively). Total headache duration was significantly shorter in the early treatment group compared to the standard treatment group. Considering time to treatment within a relatively early range of 1 hour or less, efficacy results when treating mild versus moderate pain were similar and both were associated with better outcomes than treatment of severe pain. When considering the prognostic variables of time to treatment and headache pain intensity (limited to moderate vs severe), both were independent predictors, with time to treatment a better predictor of headache duration and rescue medication use, and pain intensity a better predictor of 2-hour pain free and sustained pain free.

Duration of Migraine Headaches in Children

Children referred to the Headache Center at Children’s Hospital Medical Center, Cincinnati, OH, Sept 1996-June 1997, were evaluated for clinical characteristics of the headaches, using criteria of the International Headache Society (IHS), and older criteria by Vahlquist and Prensky and Sommer for comparison.