Brain Cortical Thickness Directly Implicated In Feeling Migraine Pain (1)
A new study presented by Mayo Clinic at the AAN’s (American Academy of Neurology) 67th Annual Meeting was highlighted by the Vice Chair of the Academy. The study clearly demonstrated that there was a direct and positive correlation between the cortical thickness in the brain and the thresholds of pain in migraineurs.
As per the Vice Chair of the AAN, Dr. Rost, who is also the director of acute stroke services at the Massachusetts General Hospital and an associate professor at the Harvard Medical School, “The object of study was to evaluate the cortical thickness in the areas that are potentially associated with pain processing.” (2)
Incidentally, other independent studies conducted previously have also indicated that migraineurs are hypersensitive to perceiving their pain partially because they are over-vigilant to certain painful stimuli and are usually not able to distract themselves from the pain or pain stimuli successfully.
The study examined a total of 63 subjects out of which 31 were migraineurs and the remaining were healthy individuals and formed the control group. Using the T1 sequencing technique in MRIs they studied the cortical thickness of each region of their brains and calculated the relation to the person’s pain threshold.
The values arrived at showed a negative correlation in cortical thickness and pain threshold among non-migraineurs. However, the control group had lower cortical thickness in the area of their interest. On the contrary, migraineurs not only had a positive correlation but had less tolerance to specific pain stimuli. The most significant difference in the cortical thickness between the migraineurs and the control group was found to be in the left superior temporal, anterior parietal regions of the brain. Thus this finding, along with some previous studies form a new approach where the doctors should not only use the old techniques to manage migraines but also apply new one where migraineurs are able to inhibit their pain to a significant extent by distracting themselves from it.
According to Dr. Rost, “This is in face the region of the brain that participates in attention to painful stimulus and orientation to that stimulus. It opens an interesting segue into the dynamic interaction of neurons during a migraine. There is a way to retrain the brain and that plasticity, biofeedback and other therapies, play a role in that.”
- Human Brain by Dream Designs via Stock Photo; Freedigitalphotos.net; Web May 2015; http://www.freedigitalphotos.net/images/human-brain-photo-p214120
- A New Way To Think About Migraines: Biosciencetechnlogy.com; Web May 2015; http://www.biosciencetechnology.com/articles/2015/05/new-way-think-about-migraines
- Correlations between Brain Cortical Thickness and Cutaneous Pain Thresholds Are Atypical in Adults with Migraine; PLOSOne.com; Web May 2015; http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099791
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Migraineurs with Aura Double the Risk of Stroke…and more… (1)
A study conducted by the senior neurologists at the Loyola University Medical Center has put forth its findings that:
- People who experience migraines with auras are at roughly double the risk of ischemic strokes.
- The study also arrived at the shocking conclusion that such migraineurs as those who smoke were thrice as likely to have stroke in their lives.
- Migraineurs who smoked and used birth control pills were 7 times more likely to suffer strokes.
- Migraines also pegged a person’s risk of heart attacks and arterial claudication – a condition that causes poor circulation of blood in the legs and limb extremes causing pain.
The conclusion was put out after the results several independent studies were analysed. This meta-analysis has brought out the direct link between migraines and stroke risk. This and similar other studies have been discussed by lead neurologists Dr. Michael Star and Jose Biller M.D at the Loyola Medical Center in the chapter Headache and Migraine Biology and Management.
As per Drs. Star and Biller, “Taking all of these possible explanations into account, the research may point to stroke and migraine sharing a reciprocal causal relationship.” (2) Ischemic strokes or brain attacks cause brain cell death by the limiting or totally stopping the supply of blood to certain brain tissues. Most often an ischemic stroke can be caused by thrombosis or the obstruction of blood vessel by a blood clot forming locally. Almost 85% of all strokes are of ischemic nature (thus making them the most common types of stroke). Some evidence also exists showing a link between migraines and hemorrhagic strokes. Hemorrhagic strokes are caused by rupture of blood vessels of the brain and are considered the more deadly of stroke types.
So far the biology that exists and underlies the relationship between migraines with aura and strokes has been sketchy and poorly defined at best. According to the neurologists, “There is a significant amount of research attempting to further elucidate this multifaceted relationship.” (3)
Through these studies the researchers have proposed several explanations that could explain the linkage between migraines with aura and stroke occurrence:
- Increased risk of cardiovascular diseases in migraineurs
- Low levels of HDL or good cholesterol in migraineurs
- High levels of c-reactive protein
- Presence of specific genes that predispose them to migraines and strokes
- Consumption of certain medications that pegs the migraineurs risk of stroke
- A phase-phenomenon that occurs in migraine attacks called cortical spreading depression during which strokes occur. During this phase there occurs a slowly propagated wave of depolarization, followed by depression of brain activity setting into motion changes in neural and vascular function.
1. Woman Having Headache At Home; Stock Photos; Image by Marin; Web April 2015; http://www.freedigitalphotos.net/images/woman-having-headache-at-home-photo-p173634
2. People who suffer migraine headaches may be at double the risk of stroke; Science Daily News; Web April 2015; http://www.sciencedaily.com/releases/2015/03/150324111326.htm
3. People who suffer migraine headaches may be at double the risk of stroke; Loyola Medicine – Newswire; Web April 2015; http://www.loyolamedicine.org/newswire/news/people-who-suffer-migraine-headaches-may-be-double-risk-stroke
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New Studies Re-assesses Migraine Drug Efficacies (1)
Efficacy of migraine drugs was under another new review from researchers who have examined all of the scientific literature available on the treatment as well as followed up on migraine patients and the scientists have come up with what in their view prove effective in acute cases of migraine. Besides these 2 criteria the study was also based on the depth of the published research done on the medications as well as the quantum of studies on them.
The conclusions of the new study at a glance are:
|DEEMED EFFECTIVE (LEVEL A)||PROBABLY EFFECTIVE (LEVEL B)|
|TRIPTANS – Sumatriptan, Zolmitriptan, Rizatriptan, Frovatriptan, Almotriptan, Naratriptan, Eletriptan, Avitriptan||OPIOID – Codeine+Acetaminophen, Tramadaol+Acetaminophen|
|NSAID – Aspirin, Ibuprofen, Naproxen|
|OPIOID – Butorphanol Nasal Spray|
|Caffeine with NSAIDS|
Findings of the study were published in the January 2015 issue of the medical journal Headache. As per Dr. Stephen Silberstein , professor of neurology and director of the Jefferson Headache Center of Thomas Jefferson University in Philadelphia, “We hope that this assessment of the efficacy of currently available migraine therapies helps patients and their physicians utilize treatments that are the most appropriate for them.” (2)
Based on the study criteria, drugs were thus rated as deemed effective (Level A), probably effective (Level B), possibly effective (Level C). For such medications where the proof was found either inadequate or gave such results which refutes the use of that medicine, was classified as Level U. For a drug to be classified as deemed effective or a Level A drug, the studies done on the drug must be supported by at least well-designed, double-blind, randomized, placebo-controlled clinical trials. (3)
The American Headache Society will soon be translating the research findings that will aid in providing evidence-based guidelines to clinical practice. In any case, doctors treating migraine patients must consider the individuals on a case to case basis keeping in view the drug side-effects, patient history, costs and drug efficacy.
- Image credit: Pills and Capsules – Stock Photo; freedigitalphotos.net; Web February 2015; http://www.freedigitalphotos.net/images/pills-and-capsules-photo-p308698
- Study Rates Migraine Medications; WebMD.com; Web February 2015; http://www.webmd.com/migraines-headaches/news/20150120/study-rates-migraine-medications
- American Headache Society Provides Updated Assessment of Medications to Treat Acute Migraine; Newswise.com; Web February 2015; http://www.newswise.com/articles/american-headache-society-provides-updated-assessment-of-medications-to-treat-acute-migraine
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For Some Migraineurs, Special Head and Neck Massages Help (1)
For all the research being done with electrical stimulation of nerves, surgeries to potent medications and herbs, for some migraineurs the answer to their misery could come from the unassuming massage. But this by no means is a regular spa massage. Conducted by migraine specialists the massage targets certain places and obstructions to relieve pain and reduce attack incidences. In other words, the migraineurs neither puts up with the horrible side-effects of hand-me-down drugs originally aimed at treating other conditions, nor does she have to go on impractical diets.
A Bay Area physical therapist, Sheldon Low has discovered a massage method that is not currently popular as a migraine treatment and management technique among other doctors. He has worked on some chronic migraineurs and those who experienced the migraine trauma since their teens with amazing results.
A therapist for 35 years, Low worked on patient Zoe Soane who had been migraining since she was only 13 and lived life less than optimally because of the recurrent attacks that left her exhausted with pain and dizziness and rattled. Simple things like motion, computer screen glare, sunshine or strong winds worked as triggers for her. Though Soane was referred to for neck issue but Dr. Low found her a massage technique that worked for her!
As per Dr. Low, “It’s my theory, and my experience that taking pressure off the scalp nerves, that’s taking away the impingement and causative agent of the headaches. I’m actually working into that scar tissue trying to break it down. It’s almost like controlled shearing. If you’re peeling an orange and trying to play that game to keep the orange peel together and you’re trying to work it around so you’re not breaking the peel apart.” (2)
The therapist says he look for lumps or bumps in the head and neck areas. If he finds them sensitive then he knows what he has to work on. He goes by common sense and knowledge that any lumps in that area are not normal and neither skull nor any other bone. Some times these lumps have formed as a part of body’s inflammatory response to a fall or injury that happened in childhood which has hardened over a period of time causing trouble and blockages now.
Soane’s migraine episodes have diminished in number and in intensity. This treatment could be transferred to other migraineurs as well or so believes Dr. Marc Lenaerts, a fellow of the American Headache Society who also runs the headache clinic at UC Davis Medical Center, “Freeing inflammatory fluids, and humors and freeing the adhesions between the tissues is a very important point and worthwhile looking into. Probably not enough people practicing and doing it on a regular basis. Conclusion is we need more scientific evidence, but it’s encouraging and worthwhile going further.” (2)
- Image credit: Massage, flower, spa, gels – Photostock; freedigitalphotos.net; Web February 2015; http://www.freedigitalphotos.net/images/Healthy_Living_g284-Massageflowerspa_Gels_p37679.html
- Migraine Cure Could Be A Massage Away; CBS Sacramento; Web February 2015; http://sacramento.cbslocal.com/2015/02/04/migraine-cure-could-be-a-massage-away/
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Migraineurs at Double The Risk Of Developing Facial Paralysis (1)
As per a recent study conducted by a team of scientists working with Taipei Veterans General Hospital in Taiwan and National Yang-Ming University, migraineurs are at almost double the risk than non-migraineurs to develop facial paralysis also known as Bell’s Palsy.
The report of the study was published in the 13th January, 2015 issue of the medical journal Neurology of the American Association of Neurologists. Bell’s Palsy occurs due to the dysfunction of a specific cranial nerve that controls facial muscle movements. Some characteristics involve not being able to blink with the eye on the side the facial nerve is affected. Other signs include development of a facial droop on the affected side. Other things such as smiling, frowning, tear-formation, salivation, flaring nostrils and raising eyebrows may all be affected in Bell’s Palsy.
As per lead researcher and author of the study, Shuu-Jiun Wang, MD, “This is a very new association between migraine and Bell’s palsy. Our study also suggests that these two conditions may share a common underlying link.” (2)
It is assumed that anything between 11 to 40 people in every 100,000 people get Bell’s Palsy due to recurring migraines. In the study two groups of adult population were selected. The total persons under study were 136,704. One group had the migraineurs and the other had the non-migraineurs. The observations of the study continued for a period of 3 years. During that time, 671 people in the migraine group and 365 of the non-migraine group were newly diagnosed with Bell’s palsy. People with migraine were twice as likely to develop Bell’s palsy even after researchers accounted for other factors and medical conditions. (3)
According to Dr. Wang, “Infection, inflammation or heart and vascular problems could be shared causes for these diseases. If a common link is identified and confirmed, more research may lead to better treatments for both conditions.”
- Image Credit: Woman Face With Natural Look by Phasinphoto; freedigitalphotos.net; Web January 2015; http://www.freedigitalphotos.net/images/woman-face-with-natural-look-photo-p247674
- Migraine May Double Risk Of Facial Paralysis; ScienceDaily.com; Web December 2014; http://www.sciencedaily.com/releases/2014/12/141217171315.htm
- Does Migraine Produce Facial Palsy? Neurology; Web January 2015; http://www.neurology.org/content/84/2/108.short
- For a detailed reading of the study, increased risk of Bell’s Palsy in patients with migraine: A nationwide cohort study; NCBI – PubMed.com; Web January 2015; http://www.ncbi.nlm.nih.gov/pubmed/25520313
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