Migraine Sufferers Research Articles

The treatment of migraine patients within chiropractic: analysis of a nationally representative survey of 1869 chiropractors

BackgroundWhile the clinical role of manual therapies in migraine management is unclear, the use of chiropractors for this condition is considerable. The aim of this study is to evaluate the prevalence and characteristics of chiropractors who frequently manage patients with migraine.MethodsA national cross-sectional survey of chiropractors collected information on practitioner characteristics, clinical management characteristics and practice settings. A secondary analysis was conducted on 1869 respondents who reported on their migraine caseload to determine the predictors associated with the frequent management of patients with migraine.ResultsA large proportion of chiropractors report having a high migraine caseload (HMC) (n = 990; 53.0%). The strongest factors predicting a chiropractor having a HMC include the frequent treatment of patients with axial neck pain (OR = 2.89; 95%CI: 1.18, 7.07), thoracic pain (referred/radicular) (OR = 2.52; 95%CI: 1.58, 3.21) and non-musculoskeletal disorders (OR = 3.06; 95%CI: 2.13, 4.39).ConclusionsSeveral practice-setting and clinical management characteristics are associated with chiropractors managing a HMC. These findings raise key questions about the therapeutic approach to chiropractic migraine management that deserves further examination. There is a need for more primary research to assess the approach to headache and migraine management provided by chiropractors and to understand the prevalence, burden and comorbidities associated with migraine found within chiropractic patient populations. This information is vital in helping to inform safe, effective and coordinated care for migraine sufferers within the wider health system.

Relationship between MIDAS, depression, anxiety and alexithymia in migraine patients.

The co-existence of psychiatric comorbidities with migraine is well known; however, the relationship between alexithymia and migraine has not been persuasively shown yet. The aim of the study was to assess the relationships between migraine-related disability, depression, anxiety and alexithymia. One hundred and forty-five migraine patients (33.18±8.6; 111 females, 34 males), and 50 control subjects (29.06±7.6; 34 females, 16 males) were prospectively enrolled for the study. The participants completed a demographic data form and Migraine Disability Assessment Scale, Beck Depression Inventory, Beck Anxiety Inventory and Toronto Alexithymia Score-20 (TAS-20). All migraine patients were more depressive (p=0.01) and anxious (p=0.001) than the healthy subjects. TAS-20 scores of the migraine sufferers and the control group did not indicate alexithymia. The migraine-related disability of all migraine patients was severe (27.84±29.22). Depression and anxiety scores in the migraine patients were highly correlated with each other and TAS-20 (r=0.485, p=0.001) and all its subscales in turn: difficulty in identifying (r=0.435, p<0.001) and describing feelings (r=0.451, p=0.001) and externally oriented thinking (r=0.302, p=0.001). Moreover, logistic regression analysis revealed that depression and anxiety predicted alexithymia. Our findings showed a complex relationship between migraine, depression, anxiety and alexithymia. On the other hand, alexithymia apparently was not directly connected to migraine, but its presence could be predicted in migraine patients because of co-morbid depression and anxiety.

Influences on headache trigger beliefs and perceptions.

Background Previous headache trigger studies have primarily utilized checklists to measure beliefs about triggers. While this work has defined the diversity of beliefs across headache sufferers, the strength of association and the frequency at which these triggers are encountered remain unexplored. Objective To measure the strength of association, frequency of encounter, and influences on trigger beliefs and perceptions using a laboratory assessment task. Methods This cross-sectional observational study, part of the HACOGS project, included adult current migraine, tension-type, or cluster headache sufferers. Participants rated the chances they would experience a headache if they were to encounter a specific trigger and the number of days per month they experience that trigger for 33 common triggers. Results All 300 participants contributed data on all triggers, with little missing data (1.2%). All triggers exhibited a high degree of inter-individual variability on the strength of association and encounter perceptions. Many triggers were perceived to be encountered daily (e.g., caffeine, air conditioning), and a full range of perceptions were observed for each trigger. Stress (75% chance of headache), missing a meal (60%), and dehydration (60%) were the triggers with the greatest potency beliefs. Only 8-15% of these beliefs were related to individual differences and 26-27% to the triggers themselves. Conclusions Participants expressed diverse beliefs and perceptions about the strength of many common headache triggers. Variation in these beliefs was not associated with individual differences or the triggers themselves. This finding supports the importance of measuring more than just the presence-absence of trigger beliefs.

Comorbidity of gastrointestinal disorders, migraine, and tension-type headache: a cross-sectional study in Iran

Migraine can be accompanied by some gastrointestinal (GI) disorders. In this study, we aimed to investigate the relationship between migraine and tension-type headache (TTH) and different lower and upper GI disorders as well as non-alcoholic fatty liver (NAFLD) and cholelithiasis. This cross-sectional study included 1574 overweight and obese participants who were referred to the Obesity Research Center of Sina Hospital, Tehran, Iran. The diagnosis of migraine and TTH was made by an expert neurologist based on the international classification of headache disorders-III β (ICHD III β). GI disorders, including irritable bowel syndrome (IBS), constipation, heartburn, dyspepsia, non-alcoholic fatty liver (NAFLD), and cholelithiasis, were diagnosed by a gastroenterology specialist. The overall mean age of participants was 37.44±12.62. A total of 181 (11.5%) migraine sufferers (with and without aura) and 78 (5%) TTH subjects were diagnosed. After adjusting for potential confounders by multivariable regression models, migraine had significant association with IBS (OR=5.16, 95% CI=2.07-12.85, P=0.000), constipation (OR=3.96, 95% CI=2.25-6.99, P=0.000), dyspepsia (OR=4.12, 95% CI=2.63-6.45, P=0.000), and heartburn (OR=5.03, 95% CI 2.45-10.33, P=0.000), while the association between migraine and NAFLD was marginally significant (OR=2.03, 95% CI=0.98-4.21, P=0.055). Furthermore, the prevalence of NAFLD (OR=2.93, 95% CI 1.29-6.65, P=0.010) and dyspepsia (OR=4.06, 95% CI=2.24-7.34, P=0.000) was significantly higher in TTH patients than the headache-free group. These findings show an association between GI disorders and primary headaches especially migraine and are, therefore, of value to the management of migraine and TTH. Further studies should investigate the etiology of the relationship between all subtypes of primary headaches and GI disorders.

Herbal Medicine and Migraine

Abstract Many herbs and herbal formulas are effective for migraine sufferers, both as acute treatment and for prevention, particularly when coupled with the identification and elimination of migrai...

Hair Transplantation in Migraine Headache Patients.

Background:Migraine headache is a primary neurologic disease affecting millions of people worldwide. As a consequence, quality of life is diminished, productivity suffers (through loss of work force), and treatment costs are substantial. The occurrence rate in the general population is quite high, with women accounting for 3 of every 4 cases.Methods:Between January 2011 and May 2012, a total of 221 patients received hair transplants. Another 590 patients underwent hair transplantation between June 2012 and December 2016. Initially (first interval), patients were not questioned on migraine headaches in preoperative visits, but questioning was regularly done thereafter. Overall, 150 patients given transplants in the first period were surveyed by phone regarding preoperative migraine headaches. Aside from the 1 incidental discovery, no other instances of migraine emerged. Headache origins were occipital-frontal in 2 patients, occipital-temporal in 2 patients, and occipital-temporal-frontal in the 2 others. Donor/receiver areas in hair transplantation and migraine trigger zones shared locations. Headache frequencies ranged from 4 to 8 days per month (average, 6 days), and pain scores were 5–8 (10 being highest). Duration of pain was 3–5 hours (average, 4 hours). All six patients had used various medications, such as triptans, ergot, and nonsteroidal anti-inflammatory drugs, before hair transplantation. The 1 female patient was a 32-year-old seeking treatment for alopecia, with a 6-year history of migraine headaches. The male patients presenting with androgenetic alopecia (grade 4–5 by Norwood classification) had 6- to 20-year migrainous histories.Results:After hair transplantation, each migraine sufferer was checked once in the first month and then once every 3 months. Those who could not appear in person after the first year were evaluated by phone every 3 months. Migraine headaches had ceased in all 6 patients, none of whom used medical treatments for migraines thereafter. The postoperative improvement each patient experienced was dramatic (P < 0.001). Overall, the mean intensity of headaches declined from 6.6 ± 1.47 to 0, on an analog scale of 1–10 (P < 0.001); and mean headache frequency was reduced from 5.83 ± 1.03/month to 0/month (P < 0.001). Likewise, the migraine pain index fell from a mean of 149.33 ± 19.21/month to mean of 0/month (P < 0.001).Conclusions:This report details 6 patients who experienced abatement of migraine headache symptoms following hair transplantation. The positive effects of hair transplantation on migraine headache and potential mechanisms of action are also discussed.

The KATP channel in migraine pathophysiology: a novel therapeutic target for migraine

BackgroundTo review the distribution and function of KATP channels, describe the use of KATP channels openers in clinical trials and make the case that these channels may play a role in headache and migraine.DiscussionKATP channels are widely present in the trigeminovascular system and play an important role in the regulation of tone in cerebral and meningeal arteries. Clinical trials using synthetic KATP channel openers report headache as a prevalent-side effect in non-migraine sufferers, indicating that KATP channel opening may cause headache, possibly due to vascular mechanisms. Whether KATP channel openers can provoke migraine in migraine sufferers is not known.ConclusionWe suggest that KATP channels may play an important role in migraine pathogenesis and could be a potential novel therapeutic anti-migraine target.

Characteristics of headaches in Japanese elementary and junior high school students: A school-based questionnaire survey

PurposeFew studies have investigated pediatric headaches in Japan. Thus, we examined the lifetime prevalence and characteristics of headaches among elementary and junior high school students in Japan. MethodsIn this school-based study, children aged 6–15years completed a questionnaire based on the diagnostic criteria of the International Classification of Headache Disorders-3β to assess headache characteristics and related disability. ResultsOf the 3285 respondents, 1623 (49.4%) experienced headaches. Migraine and tension-type headaches (TTH) were reported by 3.5% and 5.4% of elementary school students, respectively, and by 5.0% and 11.2% of junior high school students. Primary headaches increased with age. Compared with TTH sufferers, the dominant triggers in migraine sufferers were hunger (odds ratio=4.7), sunny weather (3.3), and katakori (neck and shoulder pain) (2.5). Compared with TTH, migraine caused higher headache-related frustration (P=0.010) as well as difficulty concentrating (P=0.017). Migraine-related disability was greater among junior high school students (feeling fed up or irritated, P=0.028; difficulty concentrating, P=0.016). TTH-related disability was also greater among junior high school students (feeling fed up or irritated, P=0.035). Approximately half of the students who complained of headache-related disability were not receiving medical treatment. ConclusionThis is the first detailed study of headaches in Japanese children to include elementary school students. Nearly 50% of the school children reported headaches and the disruption of daily activities caused by migraine was higher among junior high students than elementary school students.

Tear osmolarity and subjective dry eye symptoms in migraine sufferers

ObjectivePrevious studies have suggested an association between dry eye and migraine. In a busy ophthalmologist clinic, quick identification of dry eye in migraine sufferers may improve their quality of life. Tear osmolarity is an objective and reliable tool for diagnosing dry eye. It has not been investigated in any population with migraine. Using tear osmolarity and questionnaires, we aimed to explore the relationship between dry eye and clinical symptoms in patients with migraine. DesignProspective cross-sectional study. ParticipantsThirty-four adults with migraine sequentially recruited from a single neurologist’s practice. MethodsPatients were assessed for subjective and objective signs of migraine and dry eye by using the Migraine Disability Assessment Score, the Ocular Surface Disease Index, and tear osmolarity (TearLab). Headache characteristics were compared by using χ2, Fisher’s exact, and Mann-Whitney U tests. Osmolarity scores were compared with scores for headache features. ResultsMedian age of patients was 38 years, and 76.5% were females. Severe migraine disability was reported in 75.6%, and 34.5% reported moderate to severe dry eye symptoms. Objectively, 49.5% had evidence of dry eye, significantly higher than the 20% recognized in the general population (p < 0.0001). Aura was found to occur more frequently with dry eye (43.8% vs 5.9%; p = 0.02). Those with daily headaches were also more likely to have higher tear osmolarity with marginal significance (median osmolarity 310 mOsm/L vs 299 mOsm/L; p = 0.08). ConclusionsPatients with migraine, especially those with aura, appear more likely to have dry eye, as indicated by tear osmolarity. Tear osmolarity may also be greater in those who suffer from daily headaches.

The incidence of fibromyalgia in migraine sufferers — a prospective study from South Kerala

Background and Objectives: Migraine is commonly associated various painful syndromes. The Objective of Study is to determine the incidence of fibromyalgia in association with migraine. The clinical profiles of patients with migraine associated with other painful symptoms were studied. Secondary headache syndromes and other causes of generalized body aches were excluded using appropriate investigations. Cases were selected on outpatient basis over a period of 5 years. Materials and Method: 278 Patients with migraine were enrolled in this study based on ICHD II (First revision). The incidence of fibromyalgia was detected on the basis of ACR criteria 2010. The data collected was analyzed systematically. Results and Interpretations: Out of 278 patients, 68 had features of fibromyalgia. This constitute about 24.46 % of total subjects was studied. Conclusions: The present study revealed that 24.46% of patients with migraine having associated symptoms and signs suggestive of fibromyalgia. Keywords: Migraine, Fibromyalgia, secondary headache syndrome

Migraines in Women: Current Evidence for Management of Episodic and Chronic Migraines.

Migraine headache is a disabling brain disorder that affects millions of women in the United States. Many migraine sufferers are undertreated. Both inadequate treatment and overuse of abortive migraine medication can contribute to progression from episodic to chronic migraine disorders. A significant number of migraine headaches or severity of episodic migraine headaches warrants treatment with prophylactic medications for prevention. This clinical update reviews the pathophysiology and diagnosis of migraine headaches in women, discusses the efficacy of abortive and chronic pharmacologic treatment, and examines strategies to prevent progression from episodic migraine to chronic migraine. A discussion of treatment during pregnancy and lactation is included.

Neurobiology of chronicization.

In the past few years, research on chronicization of headache has focussed primarily on migraine, even though there are other types of primary headache that over time can turn into chronic forms. Only a minority of migraine sufferers will develop a chronic condition, with attacks that are likely to vary in their clinical features. As a result, in chronic migraine the specific diagnostic criteria for this headache type do not always exhibit the typical features of migraine. Among the factors that play a major role in favouring chronicization are a high frequency of migraine attacks since the beginning, overuse of symptomatic medication and onset of depression or arterial hypertension. Several neurophysiology, biochemistry and functional neuroimaging studies suggest that chronic migraine may be associated with structural, functional and metabolic changes in the brain, especially involving the brainstem.

Microplate Analysis of 31 carbon sources for people effected/uneffected by migraines.

The objective of the study was to observe any micro bacterial differences in the mouth between people who were chronic sufferers of migraines and people who said they did not suffer from migraines. Differences were observed with an Ecolog plate that contained 3 replicates of 31 carbon sources that the bacteria could use to grow. The participants of the study started by filling out a short questionnaire for basic quantitative data. Mouth swabs were then taken of volunteering participants and placed into centrifuge tubes filled with 8 mL of 1% PBS buffer and then vortexed. The sample was emptied into a pipette tray and had 50 microliters pipetted into each of the 96 wells of the Ecolog Plate. The plates were incubated at 37 degrees Celsius for 3 days, and were read at 590 nanometers using a Biotek Microplate Reader. The analyzed data of the microplates showed that migraine sufferers had higher absorbance values of γ-Hydroxybutyric Acid growing bacteria at 0.189667 ± 0.173711. Compared to people unaffected by migraines the values were 0.059863 ± 0.07651. It was also observed that people who suffer from migraines had low absorbance values of D-Galacturonic Acid growing bacteria at 0.003933 ± 0.006643. This was considered low when compared to the values of 0.056392 ± 0.180113 for the people unaffected by migraines. It was concluded that migraine sufferers have a different mouth micro bacteria make up that makes them more susceptible to migraine headaches.

Changes of intertemporal choice in migraine sufferers

Objective To investigate whether there are changes in the ability of intertemporal choices in migraine sufferers. Method Thirty migraine sufferers and thirty healthy controls were investigated by Delay-discount Test. Results (1)The ratio of later-large (LL) choice in migraine suffers((18.15±17.53)%) was significantly lower than that in the healthy controls((35.37±20.70)%), and the difference was statistically significant(t=3.31, P<0.05). Under the immediate option for now selection conditions and no immediate option for not-now selection conditions, the ratio of later-large (LL) choice in migraine suffers((18.33±21.00)% , (17.96±18.09)%) was also significantly lower than that in the healthy controls((35.56±21.52)%, (35.19±22.05)%), and the difference was statistically significant(t=3.31, P<0.05; t=3.14, P<0.05). (2) Pearson correlation analysis showed that the Stroop Test of migraineurs was positively correlated with LL selection ratio under now conditions (r=0.49, P=0.006) and total LL selection (r=0.42, P=0.021) . Conclusion The ability of intertemporal choices in migraine sufferers has been impaired, which is correlated with executive function. Key words: Migraine; Intertemporal-choice; Self-control; Decision-making

Use of pressure dynamometer in the assessment of the pressure pain threshold in trigger points in the craniocervical muscles in women with unilateral migraine and tension-type headache: An observational study

BackgroundTension type headache (TTH) and migraine are the most prevalent types of primary headaches with central sensitization and myofascial dysfunction linked to their chronicity. Osteopathic manipulative treatment (OMT) is used in the care of headache sufferers; however, there is a scarcity of high-quality evidence to determine the effectiveness of this intervention, and its underpinning biological correlates. ObjectiveThe objectives of this observational study were four-fold. Firstly, to estimate the PPT in diagnosed trigger points in craniocervical muscles in women with unilateral migraine or tension-type headache compared to asymptomatic women. Secondly, to assess between-group differences in PPT and pain intensity. Thirdly, to assess the impact of headache on quality of life (QoL) using the Headache Impact Test 6 (HIT-6) questionnaire on unilateral migraine and tension-type headache sufferers. Finally, to assess links between QoL, PPT, VAS and the score in the temporomandibular disorder screening questionnaire (TMDSQ). MethodA sample of 60 women comprising of 20 patients with unilateral migraine, 20 patients with TTH and 20 asymptomatic were assessed using a portable digital dynamometer for PPT of trigger points found in the Temporalis (4 points), Sternocleidomastoid (6 points), Suboccipital (2 points), and Upper Trapezius (1 point) muscles. VAS was applied when pain was referred on a TP. All participants completed the TMDSQ questionnaire, and the migraine and TTH groups completed the HIT-6 questionnaire. ResultsMigraine and TTH groups presented lower PPT levels in all trigger points studied compared to the Control group (p < 0.01), except for the ECM clavicular TP2L trigger point (p = 0.27). No statistically significant difference between migraine and TTH groups in PPT was found. Migraine and TTH groups showed higher pain intensity in all trigger points compared to Control group (p < 0.01). In the Migraine group, there was a positive association (r = 0.47, p < 0.05) between TMDSQ and HIT-6 scores. ConclusionDespite a greater impact on the QoL of women with unilateral migraine, there was no statistical difference in the PPT values for both unilateral migraine and TTH groups. In future studies, PPT might be used to monitor the effectiveness of OMT or other therapies in women suffering from unilateral migraine and TTH.

Humanistic and economic burden of nausea and vomiting among migraine sufferers.

BackgroundWhile studies have demonstrated the economic burden of migraines in terms of quality of life, health care resource use (HRU), and costs, there exists a notable paucity of data comparing such outcomes among migraineurs with nausea and vomiting (N/V) and those without. The current study aimed to address this gap.MethodsThis was a retrospective study using data from the 2013 US National Health and Wellness Survey, a cross-sectional, internet-based survey. Respondents self-reported their migraine with or without N/V along with demographics and outcomes including depression (Patient Health Questionnaire total score; PHQ-9), sleep problems (11-item total score of sleep problems), HRU (number of physician visits, emergency room [ER] visits, and hospitalizations) and Work Productivity and Activity Impairment-General Health Scale (WPAI-GH), and associated mean annual costs. Generalized linear models, adjusting for covariates, assessed the burden of N/V on all outcomes.ResultsAmong all migraineurs (N=7,855), 73.4% were female, mean age was 41.82 years old, and 57.6% reported experiencing N/V. Adjusting for covariates, migraineurs with N/V vs without N/V had higher mean PHQ-9 scores (7.91 vs 7.02, p<0.001) and mean sleep problems (3.29 vs 2.64, p<0.001). Mean ER visits were more frequent among migraineurs with N/V than those without N/V (0.48 vs 0.38, p=0.001). This difference translated into a 26.3% increase in estimated mean ER costs (N/V=US$1,499 vs without N/V=US$1,187, p=0.002). Mean percentage activity impairment was higher in migraineurs with N/V than in those without N/V (37.73% vs 35.12%, p=0.002) and migraineurs with N/V had higher work productivity loss costs (N/V=US$10,344 vs without N/V=US$9,218, p=0.016).ConclusionMigraine patients with N/V reported worse depression, sleep problems, and activity impairment, and higher ER visits than those without N/V. Migraine with N/V was also associated with an increase in mean annual ER visit costs and work productivity loss costs. Study findings suggest unmet needs with current treatment options for migraine patients with N/V.

Power transmission and workload balancing policies in eHealth mobile cloud computing scenarios

The Internet of Things (IoT) holds big promises for healthcare, especially in proactive personal eHealth. Prediction of symptomatic crises in chronic diseases in the IoT scenario leads to the deployment of ambulatory monitoring systems. These systems place a major concern in the amount of data to be processed and the intelligent management of the energy consumption. The huge amount of data generated for these systems require high computing capabilities only available in Data Centers. This paper presents a real case of prediction in the eHealth scenario, devoted to neurological disorders. The presented case study focuses on the migraine headache, a disease that affects around 15% of the European population. This paper extrapolates results from real data and simulations in a study where migraine patients are monitored using an unobtrusive Wireless Body Sensor Network. Low-power techniques are applied in monitorization nodes. Techniques such us: on-node signal processing and radio policies to make node’s autonomy longer and save energy, have been applied. Workload balancing policies are carried out in the coordinator nodes and Data Centers to reduce the computational burden in these facilities and minimize its energy consumption. Our results draw average savings of € 288 million in this eHealth scenario applied only to 2% of European migraine sufferers; in addition to savings of € 1272 million due to the benefits of the migraine prediction.

Migraine and REM Sleep Behaviour Disorder: A Common Pathogenesis?

Background: REM sleep behaviour disorder (RBD) and migraine are two different disorders that originate from the brainstem. Aim: To examine the relationship between the two diseases. Settings and Design: Patients attending the neurology clinics of Istanbul Medipol University, Medipol Kosuyolu Hospital and Karabuk University. Materials and Methods: The study was conducted in two parts: in the first part, migraine patients were assessed for RBD with a screening questionnaire (RBDSQ). Patients with a score of 5 or higher, meaning they were diagnosed with ‘dream-enacting behaviour’, were called on the phone and recommended to undergo a polysomnography (PSG). In the second part of the study, the patients who agreed to participate were taken a one-night PSG to assess RBD. Results: Of the 230 people who answered the RBDSQ, 51 (22.2%) scored 5 or higher. One hundred ninety-one (83%) were women and 39 (17%) were men. Eleven patients agreed to take PSG. Six (54.5%) were diagnosed with RBD. Statistical analysis: The data were evaluated with SPSS 16.0. Student’s t tests and Mann-Whitney U tests were used to compare the two independent groups and chi-square test was used to compare categorical variables. Conclusions: Among migraine sufferers, which are common in society, the prevalence of RBD is high. The problem of misdiagnosis may be due to the mild clinical symptoms of RBD in females, who are predominant among those with migraine.

Blue and Red Light-Evoked Pupil Responses in Photophobic Subjects with TBI.

Photophobia is a common symptom in individuals suffering from traumatic brain injury (TBI). Recent evidence has implicated blue light-sensitive intrinsically photosensitive retinal ganglion cells (ipRGCs) in contributing to the neural circuitry mediating photophobia in migraine sufferers. The goal of this work is to test the hypothesis that ipRGC function is altered in TBI patients with photophobia by assessing pupillary responses to blue and red light. Twenty-four case participants (mean age 43.3; 58% female), with mild TBI and self-reported photophobia, and 12 control participants (mean age 42.6; 58% female) were in this study. After 10 minutes of dark adaptation, blue (470 nm, 1 × 10 phots/s/cm) and red (625 nm, 7 × 10 phots/s/cm) flashing (0.1 Hz) light stimuli were delivered for 30 seconds to the dilated left eye while the right pupil was recorded. The amplitude of normalized pupil fluctuation (constriction and dilation) was quantified using Fourier fast transforms. In both case and control participants, the amplitude of pupil fluctuation was significantly less for the blue light stimuli as compared to the red light stimuli, consistent with a contribution of ipRGCs to these pupil responses. There was no significant difference in the mean pupil fluctuation amplitudes between the two participant groups, but case participants displayed greater variability in their pupil responses to the blue stimulus. Case and control participants showed robust ipRGC-mediated components in their pupil responses to blue light. The results did not support the hypothesis that ipRGCs are "hypersensitive" to light in TBI participants with photophobia. However, greater pupil response variability in the case subjects suggests that ipRGC function may be more heterogeneous in this group.

Quasi-experimental Effectiveness of Cognitive-behavioral Therapy on Reliving Migraine Headaches in Migraine Sufferers.

This study aimed to investigate the effectiveness of cognitive-behavioral therapy on relieving migraine headaches in migraine sufferers. In this quasi-experimental study with pre-test and post-test method, the samples were outpatients of public hospitals in Ilam City, southwestern Iran since May-Jul 2010. They were selected based on inclusion and exclusion criteria, and divided into experimental and control groups. The data were analyzed using SPSS ver. 16 and via multivariate covariance method. Cognitive-behavioral therapy affected on reducing the duration of symptoms of migraine in sufferers (P<0.05). Cognitive behavioral therapy effects on reducing the time duration of symptoms of migraine headaches. Thistherapeutic method increases the level of individual, familial, social and occupational activities by reducing the time duration of symptoms and this method helps the individuals to resume their activities and regain their previous control instead of founding themselves incapable and helpless due to the pain they suffer from.