Migraines Could Lead To White Matter Damage In Brain: New Study

Migraine photo

Abnormalities are common in the signal-sending white matter of migraineurs with aura (1)

A recent analysis of some 19 medical studies put together on migraineurs point that permanent changes likely occur in the brain of those who suffer from migraines and particularly those among them who experience aura – visual or otherwise, before the onset of an attack.

The analysis which was published online in the latest Journal of Neurology concluded that migraineurs with aura were almost two times as likely to have anamolies/abnormalities in the brain structure as those who do not suffer from migraines.

MRIs clearly show white-matter blips and other tissue changes in the migraineurs brain images but how exactly do these neurological variances translate to significant imagery correlate or give a prognosis of progressive deterioration is yet to be seen.

According to Dr. Richard B. Lipton, a neurologist who heads the Montefiore Headache Center in the Bronx, N.Y. “Part of the message I hope to communicate here is: If you have migraine with aura and you have white-matter lesions, they’re probably not a cause of concern.”  (2) However he noted that migraineurs with aura have twice the risk of getting a stroke than non-aura migraineurs

The 19 medical study analysis said the occurrence of tiny lesions that imitate scars left from strokes in aura migraineurs have left them inconclusive because there was no significant evidence of cognitive decline or other neurological symptoms from such lesions or other white-matter anomalies.

In addition, Dr Lipton said that it was good to follow the ‘you never know’ strategy,  further saying, “If you have migraine with aura, certainly you shouldn’t smoke,. Certainly, if you are going to use oral contraceptives, you should use the lowest possible hormonal dose. If you have other stroke risk factors such as hypertension or diabetes or high cholesterol, it becomes particularly important to manage those risk factors.” (2)

What was found to be more disturbing was the uncertainty that surrounds the direction of the correlations. This especially so because it puts forth the reverse question on the table : Is it that the peculiar white-matter phenomena of aura migraineurs on MRI images is what makes for a migraine-prone brain? That is, are the brains of migraine patients different to begin with?

SOURCE:

  1. Image Credits: Sad Middle Aged Woman Suffering From Headache; StockImages; FreeDigitialPhotos.net; Web August 2103; http://www.freedigitalphotos.net/images/Emotions_g96-Sad_Middle_Aged_Woman_Suffering_From_Headache_p150766.html
  2. Migraine could be associated with brain damage, study warns; Los Angeles Times; Web August 2013; http://www.latimes.com/science/sciencenow/la-sci-sn-migraine-brain-damage-20130828,0,7497521.story

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Peak Bio-availability in 2-3 Minutes: Aegis Awarded 3rd Patent for Intravail(R)

Aegis Therapeutics LLC

Aegis’ Non-Invasive Drug Delivery System For Migraines (1)

Aegis Therapeutics LLC, the developers of drug delivery and drug formulation technologies has announced that it has received it’s 3rd patent for fast acting formulations of triptans, a widely used class of drugs including Sumatriptan, Zolmitriptan, Naratriptan, Rizatriptan, Eletriptan, Almotriptan and Frovatriptan. The total triptan class of drugs has a market of over $3 billion of which Sumatriptan alone accounts for $2 billion.

Trials on humans have demonstrated that the now patented Intravail® formulation of sumatriptan is bioavailable in 2-3 minutes of administration.  This is a 20-30 times faster achievement of therapeutic drug levels than what is currently marketed non-invasive/non-injectable sumatriptan products. (2)

The most common triptan formulations currently available commercially – the oral tablet and the nasal spray reach peak blood level concentration of the drug in 60-120 minutes – many times slower than Intravail® formulation of sumatriptan and thus delaying onset of pain relief.

The new technology – Intravail® formulation of sumatriptan is widely applicable to other small molecule as well as biotherapeutic drugs that step up

The enabling Aegis Intravail formulation technology is broadly applicable to a wide range of small molecule and biotherapeutic drugs to increase noninvasive bioavailability by the oral, nasal, buccal, and sublingual routes especially in those cases where speed is important to the patient. Acute symptoms and A&E cases with severe pain, nausea, emesis, convulsive disorders, spasticity is expected to be greatly helped by the new Intravail® formulation of sumatriptan by Aegis Therapeutic LLC.

SOURCE:

  1. Image credits: Aegis Therapeutics LLC; Web August 2013; http://aegisthera.com/
  2. Aegis Awarded 3rd Patent for Fast Acting Migraine Nasal Spray Treatment; Aegis Therapeutics LLC; Web August 2013; http://aegisthera.com/aegis-awarded-3rd-patent-for-fast-acting-migraine-nasal-spray-treatment/

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Sleep Quality Influences Migraine Frequency And Disability

Sleeping Woman - Migraine Blog

 

Sleep Quality Directly Effects How Often You Get Migraines (1)

Tests conducted by researchers at the University of Mississippi, U.S.A have shown a strong correlation between poor quality of sleep and the frequency of migraine episodes as well as the disabilities that go with the condition.

The Pittsburgh Sleep Quality Index (PSQI) was employed in the study which tested 78 migraineurs and 208 non-migraineurs who formed the control group.

The PSQI is a tool in the form of a scoring but subjective questionnaire developed by the Sleep Medicine Institute of the University of Pittsburgh. It has questions within it’s 7 broad components on which a patient is scored, viz;

  • Subjective Sleep Quality,
  • Sleep Latency,
  • Sleep Duration,
  • Habitual Sleep Efficiency,
  • Sleep Disturbance,
  • Use of Sleep Medicines,
  • Daytime Dysfunction.

Todd Smitherman and his team found that sleep quality was significantly worse for those experiencing episodic migraines than for those in the control group. The migraining group scored an average PSQI of 8.90 as compared to 6.63 in the control group. A PSQI score more than 5 is considered significantly bad.

Factors such as depression, anxiety were adjusted for the regression analysis calculations but still it accounted for 5.3% and 5.8% of unique variance in headache frequency and disability, respectively, which the researchers say is a modest but non-trivial amount. Even when depression and anxiety factors after poor sleep quality were included in the calculations the affective symptoms did not significantly improve these analysis models beyond that of sleep quality alone which made sleep quality almost an independent and very relevant factor in assessing headache frequencies and related disabilities.

As per Smitherman, “As such, sleep quality should be assessed preferentially to other sleep disturbance variables when subjective self-report measures of insomnia are used. In light of the present findings, conclusions from systematic reviews, and practice guidelines, the most potent means of improving sleep quality and insomnia among migraineurs is likely a treatment package that incorporates stimulus control and/or sleep restriction in addition to basic sleep hygiene education and management of comorbid psychiatric symptoms.” (2)

SOURCES:

  1. Image Credits: Freedigitalphotos.net; Tired Woman by Graur Codrin; Web August 2013; http://www.freedigitalphotos.net/images/agree-terms.php?id=10021635
  2. Sleep Quality A Key Contributor To Migraine Severity; MedWireNews.com (Springer Healthcare Limited); Web August 2013; http://www.medwirenews.com/44/104664/General_neurology/Sleep_quality_a_key_contributor_to_migraine_severity_.html
  •  Abstract of the research may be had at:

Sleep Disturbance and Affective Comorbidity Among Episodic Migraineurs; Wiley Online Library; Web August 2013; http://onlinelibrary.wiley.com/doi/10.1111/head.12168/abstract

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