Defective Nerve Insulation In Migraineurs: Study

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Myelin Sheath & Cellular Elements Over Axons of Nerve Cells Are Patchy Or Missing In Migraineurs (1)

A study conducted by a team of researchers from three different departments at Case Western School of Medicine, clearly exhibits that certain changes at the cellular-level of the nerve structure of migraineurs leads to migraines in many patients. This in turn brings about functional changes of the nerves and further contributes to painful migraine episodes.

The findings of the study were published in the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons. You can read the report by clicking on the link below (2)

Myelin is an electricity insulating material that forms a layer/sheath which surrounds the axon of a nerve cell/neuron. The detailed study of miniscule specimens of the trigeminal nerves of migraineurs showed that there were abnormalities in the myelin sheath that served as insulation around nerve fibres in the trigeminal nerves.

Another group of patients that had been evaluated and found eligible and thus had opted for plastic surgery as a route to treat their migraine was also studied. They had all undergone the forehead lift procedure, which involved removal of some muscle and vessel tissue surrounding the cranial nerves.

The nerve fiber samples of all these patients were studied and compared for proteomic analysis. Electron microscopy techniques were used for the process of evaluating the presence and functioning of different proteins in the nerve fiber obtained from the patient’s trigeminal nerves. It was found that migraining patients without the surgery had missing or defective myelin sheaths over their nerve cells compared to those that had opted for the surgery.

As per surgeon Bahman Guyuron, MD, of Case Western Reserve University, “If the insulation becomes cracked or damaged by conditions in the environment, that’s going to affect the cable’s ability to perform its normal function. In a similar way, damage to the myelin sheath may make the nerves more prone to irritation by the dynamic structure surrounding them, such as muscle and blood vessels, potentially triggering migraine attacks.” (3)

Another key observation made was that the placement and organization of cellular elements in the nerve fibers was tight and uniform for the group that undergone surgery to treat migraines whereas the migraining group was found to have a discontinuous and patchy distribution of the cellular elements in their nerve fibers.

This brings to light the criticality of the peripheral nerves in triggering complex events in a migraine attack that eventually involves our central nervous system. Co-authors of this study add, “These findings may also lead to other opportunities to treat patients with migraine headaches non-invasively, or with less invasive procedures that repair the defective myelin around nerves, lending additional protection for the nerves.”

SOURCES

  1. Image Credit: Neurons by Dreams Design; Freedigitialphotos.net; Web November 2014; http://www.freedigitalphotos.net/images/Human_body_g281-Neuron_p122308.html
  2. Excerpt of the study may be read at: Electron Microscopic and Proteomic Comparison of Terminal Branches of the Trigeminal Nerve in Patients with and without Migraine Headaches; Journal of The American Society of Plastic Surgeons; Web November 2014; http://journals.lww.com/plasreconsurg/pages/articleviewer.aspx?year=2014&issue=11000&article=00036&type=abstract
  3. Migraine Linked To Defective ‘Insulation’ Around Nerve Fibers, Suggests Study; Sciencedaily.com; Web November 2014; http://www.sciencedaily.com/releases/2014/11/141103113557.htm

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Happy Deepawali 2014!!

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Wishing All Our Readers A Very Happy, Auspicious, Festive & Prosperous Deepawali!

May You Be Rich Of Friends and Family, Good Health, Ample Time and Life’s Joys:)

Image Credit: Red Candles by think4photop; freedigitalphotos.net; Web October 2014; http://www.freedigitalphotos.net/images/Lighting_g192-Red_Candles_p54566.html

Middle Age Migraineurs At Risk Of Parkinson’s Later

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Studies Show Some Middle-Age Migraineurs Go On To Develop Parkinson’s At Old Age (1)

A recent study conducted at the Uniformed Services University in Bethesda, and published in the medical journal Neurology (of the American Academy of Neurology) , showed that there was a link between migraines and the development of Parkinson’s Disease.

Though severe migraine attacks are considered as disabling as serious illnesses such as dementia, active psychosis or even quadriplegia, it is still the most under-funded and less researched of all neurological diseases in the world.

As per lead author of the study, Ann I. Scher, M.D migraines are the most common brain disorder among both the sexes linked to both cerebrovascular and heart disease. However, the study exhibited that the link between middle-age migraining and Parkinson’s is stronger for women who suffer migraines with aura. She says, “This new possible association is one more reason research is needed to understand, prevent and treat the condition.” (2)

The research involved 5620 persons from Iceland for a period of 25 years. Their ages were between 33 and 65 years at the time when the study began. Of the 5620 persons studied, 1028 had headaches without migraine symptoms, 238 had migraines without aura and 430 experienced migraines with aura. Here are the result highlights:  (3)

  • Migraineurs with aura twice as likely to develop Parkinson’s later than Migraineurs without aura
  • 1% of the persons without headaches developed Parkinson’s later when compared to 2.4% who developed it and had migraines with aura.
  • People with migraine with aura were also around 3.6 times more likely to report at least four of the six symptoms of Parkinson’s, and people with migraine without aura were 2.3 times more likely.
  • Overall rates in absolute terms were as:
        • In people with migraine with aura: 19.7%
        • In people with migraine without aura: 12.6%
        • In people with no headaches at all: 7.5%.

According to Scher, “A dysfunction in the brain messenger dopamine is common to both Parkinson’s and Restless Leg Syndrome (RLS), and has been hypothesized as a possible cause of migraine for many years. Symptoms of migraine such as excessive yawning, nausea and vomiting are thought to be related to dopamine receptor stimulation.  More research should focus on exploring this possible link through genetic studies”

SOURCES

  1. Image Credit: Frustrated Caucasian Woman by Stock Images; Freedigitalphotos.net; Web October 2014; http://www.freedigitalphotos.net/images/Emotions_g96-Frustrated_Caucasian_Woman_p81435.html
  2. Link Found Between Migraine And Parkinson’s; Medical News Today; Web October 2014; http://www.medicalnewstoday.com/articles/282678.php
  3. Migraines In Middle Age, Parkinson’s Risk Later? WebMD.com; Web October 2014; http://www.webmd.com/migraines-headaches/news/20140917/are-migraines-in-middle-age-tied-to-raised-parkinsons-risk-later

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Mindfulness Meditation Reduces Suffering In Chronic Migraineurs: Study

Migraine Meditation

Studies Show Meditation Helps Migraineurs (1)

A study conducted by researchers at Wake Forest Baptist Medical Center, Winston-Salem, NC, and Harvard Medical School in Boston, MA, examined 19 adults suffering from chronic migraines in order to find the effects of mindfulness meditation on those experiencing chronic headaches and to test the safety and feasibility of such a practice.

The findings of this study were published online in journal Headache.  Such a test was conducted mainly keeping in mind the hypothesis that stress-trigger in migraines could be addressed mindfulness meditation. As per lead author of the study, Rebecca Erwin Wells, assistant professor of neurology at Wake Forest Baptist, “Stress is a well-known trigger for headaches and research supports the general benefits of mind/body interventions for migraines, but there hasn’t been much research to evaluate specific standardized meditation interventions”. (2)

The study however demonstrated that mindfulness meditation did indeed help alleviate migraine pains and that they were a safe way to reduce the intensity and frequency of the migraines.

Mindfulness-based Stress Reduction or MBSR used yoga, mindfulness meditation and body awareness in a standardized 8-week program on the migraining volunteers. The migraineurs were divided into any of the 2 groups. They were then evaluated on disability, self-efficacy and mindfulness. After this was done, one group received conventional or mainstream migraine management care while the other group took part in the 8-week MBSR program. The MBSR program required the candidates to practice their mindfulness techniques for 45 minutes every day for at least 5 days a week. They were exposed to 1 instruction class every week as well. During this 8-week program all the participants noted how frequent their migraine episodes were, how long they lasted, how intense they were.

The researchers found that the patients who completed the MBSR program tended to have 1.4 fewer headaches per month that were less severe. Not only this, the episodes lasted less longer, were less disabling, the migraineurs felt a better sense of control over the events. Besides this, the program with its techniques proved safe as no adverse side effects were observed during the trial.

However, larger sample sizes and population with varied ethnicity, age groups, gender and socio-economic strata need to be studied for MBSR to be integrated into the mainstream and conventional treatment package for migraineurs.

According to Prof. Wells, “For the approximate 36 million Americans who suffer from migraines, there is a big need for non-pharmaceutical treatment strategies, and doctors and patients should know that MBSR is a safe intervention that could potentially decrease the impact of migraines.” (3)

SOURCES

  1. Image Credit: Woman Doing Yoga On Rock Stock Photo by Adamr; Free Digital Photos; Web September 2014; http://www.freedigitalphotos.net/images/Healthy_Living_g284-Woman_Doing_Yoga_On_Rock_p100414.html
  2. Migraine sufferers may find meditation helps; Medical News Today: Web September 2014; http://www.medicalnewstoday.com/articles/282441.php
  3. Meditation May Mitigate Migraine Misery;Wake Forest Baptist Medical Center – News & Media Resources; Web September 2014; http://www.wakehealth.edu/News-Releases/2014/Meditation_May_Mitigate_Migraine_Misery.htm

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Tackling Migraines Quickly With Beta-Blocker Eye Drops

Eye Drops For Migraines

Eye Drops With Beta Blockers Contain Migraine Pain (1)

In the latest edition of the journal Missouri Medicine, ophthalmologists Carl V. Migliazzo and John C. Hagan have have outlined how administering just 1-2 drops per eye of eye drops containing beta blockers stub migraine pain and in some cases almost cure migraineurs of attacks.

The eye doctors conducted their study on a population that comprised of women only migraineurs who were suffering for many years, even decades with migraine attacks.

Dr. Migliazzo seemed to have struck upon this treatment entirely by coincidence when he had been routinely managing his glaucoma patients with these eye drops. As per him, “People would report to me spontaneously saying: ‘You know, doctor, my headaches started getting better after I started on this medication.’” (2) And since then he has recommended it to his patients who also experience migraines. He does accept that there may be a placebo affect at work for some patients who said it worked for them. To obtain more data on his study, Dr. Migliazzo wants to examine more patients and have a control group as well to check on the eye drops placebo effect.

However, there may be a good scientific rationale behind why eye drops containing beta blockers work for migraine patients. Beta blockers are primary drugs in the current scenario to manage hypertension, certain heart conditions and are also prescribed as prophylaxis for migraines. Besides, they are very cheap and safe with really low side effects. In addition to this, beta blockers reach the blood stream relatively faster and in time to save a migraine attack.

During a study of one beta blocker, a patient told researchers that he not only had fewer chest pains, but fewer migraines as well. His migraines returned only after he was switched to a placebo.

According to Dr. Mittal who is working with Dr. Hagan, “Eye drops containing beta quickly drain into the nose, where they’re rapidly absorbed into the bloodstream through the mucus membrane. If you can get something in their system as soon as possible, you have a better chance” to stop migraine attacks.” (3)

So it sounds like a case that certainly requires further testing and research. Dr. Hagan hopes that someone will pursue this research to be sure if this certainly works or if there is a large placebo effect at work. Earlier studies from the 1980s have shown some migraineurs benefiting from the use of such eye drops but no further testing had been pursued on the matter.

SOURCES

  1. Image Credit: Putting Drops In Eye Stock Photo by Marin; Freedigitalphotos.net; Web September 2014; http://www.freedigitalphotos.net/images/Healthcare_g355-Putting_Drops_In_Eye_p112466.html
  2. Eye drops may hold quick relief for migraine sufferers; Kansas City News; Web September 2012; http://www.kansascity.com/news/local/article1379677.html
  3. Eye drops may hold quick relief for migraine sufferers; Life Extension Foundation; web September 2014; http://www.lef.org/news/LefDailyNews.htm?NewsID=22812&Section=Disease

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More Frequent Migraines During Peri-menopause: Study

Menopause and Migraines

Study Shows Increase In Attacks During Menopause Transition (1)

A first of it’s kind study conducted by researchers at the University of Cincinnati Headache and Facial Pain Program shows conclusive proof that there is a recordable increase in the number of migraine episodes in women undergoing peri-menopause.

Peri-menopause is a phase of transitioning menopause. It could begin several months to years before actual menopause and is characterized by the woman experiencing some or all of symptoms such as irregular periods, fatigue, hot flashes, memory lapses, dry vagina, loss of libido, thinning of bones, incontinence, mood swings and breast tenderness etc. (2) All this is caused primarily due to the drop in the levels of female reproductive hormones such as estrogen and progesterone.

It was seen that headache instances rose during both peri-menopause and menopause when compared to pre-menopause. Pre-menopause was characterized by regular periods. As per Vincent T. Martin, M.D who is a professor of Medicine in the Department of Internal Medicine, University of Cincinnati, “Ours is the first study to demonstrate that the frequency of migraine attacks increases during the menopausal transition. The results of our study validate the belief by many women that their headaches worsen during the transition into menopause” (3)

Summary of the research study is as follows:

Particulars Numbers Comments
Total Women studied 3,603
Age range (women) 35 -65 years
Group classification
  1. High Frequency >10 episodes a month
  2. Low-Mod frequency < 10 attacks a month
Analysis classification
  1. 34% – premenopausal
  2. 35% – perimenopausal
  3. 30% – menopausal
  4. High Freq was 50-60% more common in perimenpausal and menopausal women

 

According to Richard B. Lipton, M.D., professor of Neurology and director of the Montefiore Headache Center at the Albert Einstein College of Medicine, “Given that migraines tend to worsen during menstruation, it may seem paradoxical that when periods become irregular during the peri-menopause or absent during menopause that headache become more frequent. We believe that both declining estrogen levels that occur at the time of menstruation as well as low estrogen levels that are encountered during the menopause are triggers of migraine in some women.” (3)

SOURCES

  1. Young Woman Suffering From Headache By Stock Images; FreeDigitalPhotos; Web August 2014; http://www.freedigitalphotos.net/images/young-woman-suffering-from-headache-photo-p171720
  2. Menopause Health Center – Perimenopause; Web MD; Web August 2014; http://www.webmd.com/menopause/guide/guide-perimenopause
  3. Women with Migraines Experience More Headaches During The Menopausal Transition; Science Daily News; Web August 2014; sciencedaily.com/releases/2014/06/140624215851.htm

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Cosmetic Eyelid Surgery Offers Significant Relief To Some Migraineurs: Study

Migraine Blog Eyelid

Eyelid Nerve Decompression Surgery Benefits Some Migraineurs (1)

What some migraineurs are willing to risk to shut off that pain. Turns out that getting under a knife that works on your eyelid is a risk well worth taking for them. This is not a procedure recommended for every migraineur. To be eligible for this eyelid cosmetic surgery, you need to meet certain criteria and thus screened to check if you should do this. The surgery essentially decompresses the nerves in the eyelid that trigger migraine episodes in many.

Dr. Oren Tessler, Assistant Professor of Clinical Surgery at LSU Health Sciences Center New Orleans School of Medicine, have seen that more than 90% of the patients who underwent this surgery experienced relief and also got a bonus cosmetic eyelid surgery. The study and it’s findings have been published in the medical journal Plastic and Reconstructive Surgery.

The study examined 35 patients all of whom suffered from chronic nerve decompression triggering migrainous episodes. All of them had used some sort of nerve blocking treatment earlier or Botox at some point of time trying to tackle the pain.

As per Dr. Oren, “Surgery is a valid treatment for migraines in certain patients. We believe that these patients should have ready access to migraine trigger site decompression surgery. Although larger studies are needed, we have shown that we can restore these patients to full and productive lives.” (2)

The eyelid nerve decompression surgery is an alternative to the much done endoscopic approach where sensors are passed under scalp skin. However, this latter method makes it unsuitable for many depending on their anatomy. Also endoscopes are not available with every team and neither is it safe to assume endoscopy expertise in ever surgeon. However, in the eyelid cosmetic surgery for the screened and selected patients simply involved making a minor slit in their upper eyelid resulting in release of the decompressed nerve and subsequent deactivation of the nerve involved in the migraine episodes. (3)

The team involved in the study also included surgeons from Massachusetts General Hospital and Harvard Medical School.

Some statistics on the surgery:

  • An overall positive response of 90.7%
  • Complete elimination of migraines in 51% of the patients.
  • 33% of the patients had between 50 and 80% of their symptoms resolved.

SOURCES

  1.  Caucasian Girl’s Blue Eye; Image Credit – Serge Bertasius Photography; Free Digital Photos; Web August 2014; http://www.freedigitalphotos.net/images/Younger_Women_g57-Caucasian_Girls_Blue_Eye_p154783.html
  2. Surgeons report significant migraine relief from cosmetic eyelid surgery technique; Eureka Alert; Web August 2014; http://www.eurekalert.org/pub_releases/2014-07/lsuh-srs073114.php
  3. Cosmetic eyelid surgery technique can help cure migraine: Study; Business Standard; Web August 2014; http://www.business-standard.com/article/news-ani/cosmetic-eyelid-surgery-technique-can-help-cure-migraine-study-114080101045_1.html

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