Higher Incidence Of Migraine Research Articles

Unique Considerations in Episodic Migraine: Underserved Populations.

Episodic migraine is a common and disabling neurological disorder that is underdiagnosed and undertreated. Additional barriers are put in place for those who belong to an underserved population. This could be based on race, ethnicity, gender, sexual orientation, or socioeconomic status. There has been a lot of interest in understanding the extent of these disparities, but studies for many of these groups are lacking. More work is needed to understand the disparities and needs of underserved populations. Most of the literature has been done for Black populations but there are many other underserved communities that need assessment and intervention. The healthcare community needs to take action to improve support for populations with a higher incidence of migraine and disability, yet a lower rate of diagnosis and treatment. Some recommendations include awareness of biases, systemic changes, education, and including diverse populations in research and training.

Prevalence of migraine in systemic lupus erythematosus: A meta-analysis.

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide range of clinical manifestations, including neurological issues in about 25%-75% of cases. Among the neurological involvement cases, most cases show migraine. However, the prevalence of migraine varied worldwide, and in some studies, a higher incidence of migraine in SLE cases was reported compared to healthy controls. In the present study, we adopted a meta-analysis approach to find out the prevalence of migraine in SLE patients worldwide and investigate whether migraine frequency is more prevalent in SLE patients than controls. Various literature databases such as Scopus, PubMed, Science Direct, and Google Scholar were screened for eligible studies. The last search was performed on January 21, 2023. Publication biases were accessed by Egger's regression analysis and funnel plots. Cochrane Q statistics and I2 values explored the presence or absence of heterogeneity. All statistical analysis of meta-analysis was performed in comprehensive meta-analysis software v3. Based on predefined inclusion and exclusion criteria, 17 reports comprising 2901 SLE patients and 575 healthy controls were considered in the present study. The meta-analysis revealed the prevalence of migraine to be 34.8%. Furthermore, migraine was more prevalent in SLE patients than healthy controls (OR: 1.964, p = 0.000, 95% CI = 1.512-2.550). Similar trends were also observed while considering another 10 independent reports those were not disclosed about the migraine diagnosis criteria (number of reports: 27, SLE: 3473, HC: 741, prevalence: 33.5%, SLE vs HC: OR = 2.107, p = 0.000, 95% CI = 1.672-2.655). Subgroup analysis demonstrated that SLE patients from South America had a higher prevalence of migraine (56.2%). About one-third of SLE patients experience migraine worldwide. The prevalence of migraine is more frequent in SLE patients than the healthy controls.

Transient global amnesia - hippocampal lesions in magnetic resonance imaging

BackgroundTransient global amnesia is a benign syndrome characterized by a sudden onset loss of anterograde amnesia with full recovery. Magnetic resonance of the brain including diffusion–weighted imaging of patients with transient global amnesia revealed the presence of punctate hyperintense signal abnormalities in the hippocampus. ObjectiveAnalysis of the presence of hippocampal lesions in brain magnetic resonance imaging in patients with transient global amnesia and the possible influence of additional factors on their appearance. MethodsIn this retrospective, an observational study we assessed brain magnetic resonance imaging in 38 consecutive patients with transient global amnesia. The incidence of brain magnetic resonance imaging lesions was analyzed for the coexisting cardiovascular risk factors and precipitating events. ResultsHippocampal brain magnetic resonance imaging lesions were detected in 47% of patients with transient global amnesia. Of those, 65% had unilateral lesions, 82% were left-sided, and 28% were right-sided. Most lesions were located in the CA1 subfield. The incidence of hypertension in patients with transient global amnesia was higher than in the general population. Stress and exercise preceded the onset of transient global amnesia only in 13% and 16% of patients, respectively. There was no higher incidence of migraine in transient global amnesia patients (13%). ConclusionsWe found that nearly 50% of patients with transient global amnesia had hyperintense hippocampal brain magnetic resonance imaging lesions. In addition to hypertension, individuals with transient global amnesia had similar cardiovascular risk factors as the general population. We did not identify any precipitating events prior to the onset of transient global amnesia.

Attention deficit hyperactivity disorder and risk of migraine: A nationwide longitudinal study.

This study explored the risk of migraine in children, adolescents, and young adults with attention deficit hyperactivity disorder (ADHD) and its association with ADHD medications. The prevalence of migraine peaks between the ages of 35 and 39years. Recent studies have reported a positive association between ADHD and migraine. This longitudinal case-cohort study was conducted using data from the Taiwan National Health Insurance Database. Between 2001 and 2009, we enrolled 81,441 participants with ADHD and a 1:1-matched control cohort for age, sex, and physical and psychiatric comorbidities. All participants had no diagnosis of migraine before enrollment and were followed up to the end of 2011. We examined the risk of newly diagnosed migraine among patients with ADHD and matched controls after adjusting for demographics and physical/psychiatric comorbidities. Patients with ADHD had a higher incidence of migraine than those in the control group (462/81441 [0.6%] vs. 212/81441 [0.3%] patients, p<0.001). After adjusting for potential confounders, the hazard ratio (HR) was 1.92 (95% CI, 1.64-2.34) for migraine in patients with ADHD versus controls. The subgroup analyses stratified by age showed the HRs were 2.01 (95% CI, 1.63-2.49), 1.94 (95% CI, 1.35-2.79), and 1.31 (95% CI, 0.58-2.98) for children (<12years old), adolescents (12-17), and young adults (18-29), respectively, versus controls. When stratified by sex, the HR was 1.97 (95% CI, 1.58-2.46) for men and 1.94 (95% CI, 1.44-2.62) for women versus controls. The cumulative daily dose of ADHD medications was not associated with the risk of migraine. Children and adolescents with ADHD were associated with an increased risk of migraine compared with matched controls. The increased risk was not observed in young adults with ADHD. Further studies are required to examine the mechanisms between migraine and ADHD.

Molecular typing of familial temporal lobe epilepsy.

The pathogenesis of temporal lobe epilepsy (TLE) was originally considered to be acquired. However, some reports showed that TLE was clustered in some families, indicating a genetic etiology. With the popularity of genetic testing technology, eleven different types of familial TLE (FTLE), including ETL1-ETL11, have been reported, of which ETL9-ETL11 had not yet been included in the OMIM database. These types of FTLE were caused by different genes/Loci and had distinct characteristics. ETL1, ETL7 and ETL10 were characterized by auditory, visual and aphasia seizures, leading to the diagnosis of familial lateral TLE. ETL2, ETL3 and ETL6 showed prominent autonomic symptom and automatism with or without hippocampal abnormalities, indicating a mesial temporal origin. Febrile seizures were common in FTLEs such as ETL2, ETL5, ETL6 and ETL11. ETL4 was diagnosed as occipitotemporal lobe epilepsy with a high incidence of migraine and visual aura. Considering the diversity and complexity of the symptoms of TLE, neurologists enquiring about the family history of epilepsy should ask whether the relatives of the proband had experienced unnoticeable seizures and whether there is a family history of other neurological diseases carefully. Most FTLE patients had a good prognosis with or without anti-seizure medication treatment, with the exception of patients with heterozygous mutations of the CPA6 gene. The pathogenic mechanism was diverse among these genes and spans disturbances of neuron development, differentiation and synaptic signaling. In this article, we describe the research progress on eleven different types of FTLE. The precise molecular typing of FTLE would facilitate the diagnosis and treatment of FTLE and genetic counseling for this disorder.

Association between Cervical Spondylosis and Migraine: A Nationwide Retrospective Cohort Study.

Background: Few studies have investigated the longitudinal association between cervical spondylosis (CS) and migraine by using a nationwide population-based database. Methods: We conducted a retrospective cohort study from 2000 to 2011 identifying 27,930 cases of cervical spondylosis and 111,720 control subjects (those without cervical spondylosis) from a single database. The subjects were frequency-matched on the basis of sex, age, and diagnosis date. The non- cervical spondylosis cohort was four times the size of the cervical spondylosis cohort. To quantify the effects of cervical spondylosis on the risk of migraine, univariate and multivariate Cox proportional hazard regression analyses were used to calculate the hazard ratio (HR), and 95% confidence interval (CI). Results: After a 10-year follow-up controlling for potential confounding factors, overall migraine incidence was higher in the cervical spondylosis cohort than in the non-cervical spondylosis cohort (5.16 and 2.09 per 1000 people per year, respectively; crude hazard ratio = 2.48, 95% confidence interval = 2.28–2.69), with an adjusted hazard ratio of 2.03 (95% confidence interval = 1.86–2.22) after accounting for sex, age, comorbidities, and medication. Individuals with myelopathy in the cervical spondylosis cohort had a 2.19 times (95% confidence interval = 1.80–2.66) higher incidence of migraine when compared than did those in the non- cervical spondylosis cohort. Conclusions: Individuals with cervical spondylosis exhibited a higher risk of migraine than those without cervical spondylosis. The migraine incidence rate was even higher among individuals with cervical spondylotic myelopathy.

Benign neonatal sleep myoclonus: our experience of 15 Japanese cases.

Benign neonatal sleep myoclonus is a non-epileptic movement disorder that may mimic neonatal seizures. The aim of this study was to clarify the clinical manifestations and outcomes in Japanese infants with benign neonatal sleep myoclonus. We reviewed the clinical manifestations and outcomes in 15 consecutive patients with benign neonatal sleep myoclonus (males: 10), including three paired familial cases, referred to our center between 1996 and 2011. The diagnosis of benign neonatal sleep myoclonus was based on a neonatal onset, characteristic myoclonic jerks that occurred during sleep, and normal electroencephalogram findings. All were healthy full-term neonates at birth. The age at onset ranged from 1 to 18 days (median: 7 days). Prior to referral to our center (3-8 weeks), two infants had been placed on antiepileptic drugs, without effects. During the clinical course, the myoclonic jerks resolved by 6 months in 14 of the 15 patients. On follow-up (final evaluation, mean: 38 months), all but one patient (speech delay) showed normal development. None developed epilepsy. Of note, migraine occurred after 5 years of age in three children, including one who developed cyclic vomiting syndrome, evolving to migraine. Another boy developed cyclic vomiting syndrome, a precursor of migraine, before 1 year, and was being followed. A high incidence of migraine was observed in five (42%) of 12 parents whose detailed family history was available. Our study suggests that benign neonatal sleep myoclonus is related to migraine. With the high rate of familial cases, further genetic study, including migraine-related gene analysis, is necessary to determine the underlying mechanism responsible for benign neonatal sleep myoclonus.

Stroke in Women

Stroke remains one of the leading causes of morbidity and mortality worldwide. Sexual differences in stroke have been recognized, though the mechanisms remain unclear. Women have a unique risk factor profile, especially so in the reproductively active age group. Exposure to oral contraceptives, hormone replacement therapy and a higher incidence of migraine and vasculitic disorders in women suggest that stroke would be common in women. Yet, the incidence of stroke remains higher in men across all ages, indicating a protective role of sex hormones. The differences in incidence and prevalence of stroke decreases as women age, confirming that hormones play a pivotal role in terms of normal physiology, disease and recovery. Recent evidence also points to sex based differences in response to therapy, in terms of acute management and prevention. Gender based differences in accessibility and provision of health care facilities add to the observed differences in terms of stroke outcome, though here women seem to fare worse than men. This review summarizes the observed sex differences in stroke, possible hormonal mechanisms that may explain the same and outlines recent patents and scope for future research in this field.

Association of progesterone receptor with migraine-associated vertigo

While migraine has been demonstrated to be familial and have genetic contributions, genome-wide linkage analyses and candidate gene studies have highlighted that migraine is genetically complex. Despite substantial efforts, no consistent replication of linkage or association has been reported for common migraine syndromes. Among the candidate genes tested for association with migraine by several groups were female sex hormone genes based on the observation of a much higher incidence of migraine in females. Migraine-associated vertigo (MAV) is a migraine syndrome also much more common in females than males. Because MAV is less common in the general population than migraine or migraine with aura, it may be a better migraine syndrome to detect susceptibility alleles. In this study, we tested the association of two female hormonal genes, progesterone receptor (PGR) and estrogen receptor (ESR1), which were previously reported to be associated with migraine in women. We typed 150 MAV subjects and 145 genomic matched control subjects. One SNP (rs1042838) within PGR, which is in high linkage disequilibrium with the functional PROGINS variant, was significantly associated with MAV (p = 0.0007). Two SNPs (rs2228480 and rs1801132) within ESR1 demonstrated no significant association. No synergistic effect between ESR1 variants and PGR variants was identified.

Optic disc findings in normal tension glaucoma

One hundred thirty stereo photographs of optic discs in patients with normal tension glaucoma (NTG) were reviewed in order to identify characteristics of the three following types of NTG: focal ischemic, senile sclerotic, and generalized cup enlargement. Twenty patients in each group were selected. Focal ischemic patients were more frequently women, had a higher incidence of migraine, a relatively smaller disc size, and localized superior scotoma that often threatened fixation. Senile sclerotic patients were generally elderly, had a higher incidence of surgery under general anethesia, had more ischemic heart disease or systemic hypertension, had a small rim area, and also had extensive peripapillary atrophy as well as combined diffuse and localized visual field defects. Generalized cup enlargement patients were younger, had a relatively larger disc size and a greater incidence of purely diffuse visual field loss. Results of our study suggest that the different characteristics of the groups are related to pathogenic mechanisms specific to each group.

Antidepressant Use in Patients Prescribed β-Blockers

To the Editor.— The article by Avorn et al 1 on increased antidepressant use in patients prescribed β-blockers does not establish β-blockers as a frequent cause of depression. There is a considerably higher incidence of migraine in patients with depression, independent of drug use considerations, yet apparently no effort was made to exclude patients with a diagnosis of migraine. In addition, tricyclic antidepressants (TCAs) as well as β-blockers are used in the treatment of migraine, and if no effort was made to identify or exclude migraine patients, it would seem invalid to suggest that patients being treated with β-blockers and a TCA for headache could not account for the effect observed. The observation that the magnitude of the association between β-blockers and treatment for depression seemed to decline with advancing age could in fact reflect the declining incidence of migraine in this age group. Pharmacokinetic considerations would suggest that if