Migraineurs’ Likelihood Of Getting Stroke Graded

Migraine Blog Stroke

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:

  1.  Increased risk of cardiovascular diseases in migraineurs
  2. Low levels of HDL or good cholesterol in migraineurs
  3. High levels of c-reactive protein
  4. Presence of specific genes that predispose them to migraines and strokes
  5. Consumption of certain medications that pegs the migraineurs risk of stroke
  6. 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.

SOURCES

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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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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Danger Of Ischemic Stroke In Older Migraineurs

stroke_isc_web Older Migraineurs Have Higher Chances Of Suffering Silent Brain Injuries – (1)

A new study published in the May 15th issue of American Heart and Stroke Association’s medical journal Stroke, suggests that older migraineurs have an double the risk of suffering from silent brain injuries and ischemic stroke than those who do not experience migraines.

Silent strokes can be asymptomatic i.e they do not show symptoms but increase the risk of future strokes. Silent stroke or a silent brain infarction is caused by a blood clot getting into the brain artery and thus interrupting the supply of blood, oxygen and nutrients to brain tissue surrounding the clot thus killing it.

As per Teshamae Monteith, M.D., lead author of the study, “I do not believe migraine sufferers should worry, as the risk of ischemic stroke in people with migraine is considered small. However, those with migraine and vascular risk factors may want to pay even greater attention to lifestyle changes that can reduce stroke risk, such as exercising and eating a low-fat diet with plenty of fruits and vegetables.” (2)

He raised caution that if an older migraineurs had other coexisting conditions like a high blood pressure (hypertension) or a sedentary lifestyle, it would add to the risk factor for suffering silent strokes and brain damage. He thus advised them to take medication to address hypertension and to bring it under control.

The study was a research on diverse ethnic groups including people of Hispanic and African origin. It was a collaborative investigation conducted by University of Miami and Columbia University.

Some of the highlights of the study were as follows: (3)

  • Approximate 40% of the population studied comprised of men.
  • The average age of the population was around 71 years old.
  • 65% of the population under study was of Hispanic origin.
  • Of the 546 studied, 104 had a history of migraines.

Some conclusions arrived at were as:

  • Risk of silent brain infarctions in those with migraine double even after adjusting other stroke risk factors.
  • Migraines with aura were not a deciding factor in measuring risk of silent strokes.
  • No real increase in the volume of white matter/ Small blood vessel anamolies was associated with migraines.
  • Some lesions came across in radiographic images as having ischemic origins but more research was required to confirm this.

According to Monteith, “We still don’t know if treatment for migraines will have an impact on stroke risk reduction, but it may be a good idea to seek treatment from a migraine specialist if your headaches are out of control. (4)

Previous studies indicated migraine could be an important stroke risk factor for younger people.

SOURCES:

  1. Image Credit: Ischemic stroke; Heart & Stroke Foundation – Canada; Web May 2014; http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3484151/k.7916/Stroke__Ischemic_stroke.htm
  2. Older migraine sufferers may have more silent brain injury; Science Daily News; Web May 2014; http://www.sciencedaily.com/releases/2014/05/140515163826.htm
  3. Abstract of the study can be accessed at: http://stroke.ahajournals.org/content/early/2014/05/15/STROKEAHA.114.005447.abstract
  4. Older people with migraines ‘more likely to have silent brain injury’; Medical News Today; Web May 2014; http://www.medicalnewstoday.com/articles/276842.php

Details of the study published in AHA journal, Stroke: http://stroke.ahajournals.org/content/early/2014/05/15/STROKEAHA.114.005447.full.pdf+html

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Finally A Stroke Guideline For Women!

Brain-Haemorrage

Hemorrhagic Stroke Risk In Women Addressed By AHA/ASA For The First Time (1)

Recent research has shown that migraineurs and especially those who experience aura are at an increased risk of a stroke (brain hemorrhage) or a heart attack during a migraine episode. My post of June 20th, 2013 speaks of this research (on high risk of stroke among the migraining population): http://bit.ly/1iON349

A stroke may be either ischemic or hemorrhagic in nature. A hemorrhagic stroke is the rupturing of an artery in the brain which results in bleeding in the tissues surrounding the rupture and killing the brain cells there which are devoid of blood, oxygen and nutrition. An ischemic stroke occurs when there is an obstruction like cholesterol or clot in the arteries in the brain. These account for almost 90% of all strokes and are less likely to result in fatality if given immediate attention. However, migraineurs are more susceptible to the deadlier hemorrhagic strokes. (2)

[Read WebMD research on how women with migraine with aura may be at increased risk for an additional type of stroke called hemorrhagic stroke here: http://bit.ly/1cmHW6Y ]

Given that women are more susceptible to migraines with aura, the higher risk of getting a stroke is inherent yet there have been no guidelines to date to address stroke issues in women. Finally a guideline has been issued by The American Heart Association/American Stroke Association for health professionals to prevent strokes in women. Here are a few of the important recommendation highlights you should know:

1. FOR MIGRAINEURS

“Women are four times more likely to have migraines than men, and they often coincide with hormone swings. Migraines alone don’t raise the risk of stroke, but ones with aura do. Using oral contraceptives and smoking raise this risk even more, so the guidelines urge stopping smoking.” (3)

2. FOR ELDERLY WOMEN

Women over 75 years of age should be screened for atrial fibrillation as it is an increased stroke risk factor.

3. FOR WOMEN WITH HYPERTENSION/ HIGH BLOOD PRESSURE

Low dose aspirin or calcium supplement therapy is recommended to cut of stroke risk

4. WOMEN WITH PRE-ECLAMPSIA

Preeclampsia is a condition where a pregnant woman experiences both high blood pressure and a significant increase in protein in her urine. Women with preeclampsia are twice as likely to get a stroke and four times as likely to suffer from high blood pressure later in life. In addition, they are to be treated for weight and cholesterol issues as well as smoking.

5. PREGNANT WOMEN:

Such women who are pregnant and suffer from high blood pressure (>=160/110 mmHg) should be given medication for high blood pressure. Those who are expectant are to be treated for readings in the range of 150-159 mmHg/100-109 mmHg. (4)

SOURCES

  1. Image Credit: Brain Hemorrhage; Sanitarian.net; Web February 2014; http://www.sanitarian.net/wp-content/uploads/2010/11/Brain-Haemorrage.jpg
  2. Study Shows Increased Risk of Heart Disease and Stroke for Migraines With Aura; WebMD.com; Web February 2014; http://www.webmd.com/stroke/news/20100824/migraines-with-aura-may-raise-stroke-risk
  3. Guidelines For Stroke Prevention In Women Issued; Forbes.com; Web February 2014; http://www.forbes.com/sites/robertglatter/2014/02/09/guidelines-for-stroke-prevention-in-women-issued/2/
  4. Stroke prevention in women: guidelines set for the first time; Medical News Today; Web February 2014; http://www.medicalnewstoday.com/articles/272351.php

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Cerena TMS Okayed For Sale On Prescription By FDA

fajb_magnet_for_headaches_01_dec2013

 

eNeura Therapeutics’ Transcranial Magnetic Stimulator (TMS) Now Available To Migraineurs With Aura (1)

US Food and Drug Administration (FDA) has allowed the marketing and sale on prescription eNeura Therapeutics device for the treatment and management of migraines. It has proved to be beneficial in pain mitigation for those whose migraine episodes are preceded by aura. Prior to awarding of approval, the FDA studied both at pre-market data as well as results of clinical trials of the device on migraineurs with aura. (2)

The device is essentially a transcranial magnetic stimulator (TMS). The Cerena TMS is to be held against the back of the migraineur’s head and turned on by the push of a button. The device releases short pulses of magnetic waves to stimulate the occipital cortex of the migraineur’s brain which in turns either ceases pain or reduces the intensity of pain. The device does not relive any other symptom associated with migraines such as photo or sound sensitivity, nausea etc. (3)

Though classified as a low-moderate risk device, it is not to be used by those suffering from epilepsy and not more than once every 24 hours even by those who are prescribed the use of the TMS. The transcranial magnetic stimulator is not recommended for those patients who have any type of implants especially magnetic metals in the head, neck or upper body, pacemakers, deep brain stimulators etc.

Randomized controlled trials on some 201 patients showed that approximately 38% of those using the TMS device were free of any pain in two hours after administration compared to 17% of controls.

SOURCE

  1. Image Credit: The Transcranial Magnetic Stimulator by eNeura Therapeutics ; Electronicproducts.com; Web December 2013; http://www.electronicproducts.com/Passive_Components/Magnetics_Inductors_Transformers/FDA_approves_pulsating_magnetic_device_to_help_ease_headaches.aspx
  2. First device to treat migraine wins FDA approval; MedicalNewsToday.com; Web December 2013; http://www.medicalnewstoday.com/articles/270233.php
  3. FDA approves pulsating magnetic device to help ease headaches; Hearst Electronic Prodcuts; Web December 2013; http://www.electronicproducts.com/Passive_Components/Magnetics_Inductors_Transformers/FDA_approves_pulsating_magnetic_device_to_help_ease_headaches.aspx

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Launch of Migraine Patch Zecuity Delayed: NuPathe Inc.

nupathe-patch

 

NuPathe Delays The Launch Of Zecuity To Early 2014 (1)

The innovative neuroscience solutions company NuPathe Inc. has announced a delay in the launch of it’s product – a migraine patch that is worn directly on the skin of the upper arm, called Zecuity. The product that was expected to hit the market near the end of this year has now been shifted to early 2014. NuPathe had obtained FDA approval for the marketing of Zecuity earlier this year.

Zecuity is basically a drug delivery system. To be precise it is a sumatriptan iontophoretic trans-dermal system, i.e. it delivers sumatriptan via the skin route using the process of iontophoresis. Iontophoresis involves the delivering of a drug through the skin using low electrical current and so the Zecuity skin patch is embedded with two coin cell lithium batteries which regulate the quantity of current applied and sumatriptan delivered (2). So far, sumatriptan has been known to be delivered through the oral route as pills, injections or as spray via the nasal route. Zecuity is safe for the treatment of acute migraines on patients with or without aura.

Without going into details, the NuPathe CEO Armando Anido, “NuPathe has made substantial progress [toward] securing a partner to maximize the commercial potential of Zecuity. We believe that puts us in a good position to secure a commercial partner and while we have made progress on the partnership and manufacturing fronts, in order to extend our cash runway, we are limiting and delaying certain sales and marketing activities” (3)

However caution is to be exercised with the use of Zecuity if the migraine patient is already on Selective Serotonin Re-uptake Inhibitors (SSRIs), Selective Norepinephrine Inhibitors (SNRIs) or has previously existing conditions such as epilepsy, cardiovascular diseases (heart disease and stroke), diabetes or high cholesterol levels, pregnant or undergoing menopause. (4)

SOURCES

  1. Image Credits: ZECUITY Electronic Drug Patch for Acute Migraines Approved in U.S.Medgadget.com; November 2013; http://www.medgadget.com/2013/01/zecuity-electronic-drug-patch-for-acute-migraines-approved-in-u-s.html
  2. Zecuity; RxList.com; Web November 2013; http://www.rxlist.com/zecuity-drug.htm
  3. NuPathe delays launch of migraine patch; Healthcare Inc. Philadelphia – BizJournal.com; Web November 2013; http://www.bizjournals.com/philadelphia/blog/health-care/2013/11/nupathe-delays-launch-of-migraine-patch.html
  4. Zecuity; zecuity.com; Web November 2013; http://www.zecuity.com/

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Migraining Women Likely To Develop Dementia: Study

Dementia Risk For Migraineurs

 

Migraineurs With Aura Are 48% More Likely To Develop Dementia In Later Life (1)

As if the sustained pounding, debilitating pain, the flurry of traumatic symptoms and ineffective medicines were not enough for migraineurs, studies are now showing that persons who suffer migraines with visual and other aura are 48% more likely to develop dementia as they begin to age than their healthier counterparts! (2)

In part this could be explained by the presence of white matter lesions that the brains of migraineurs are often seemed to have when scanned using an MRI (Magnetic Resonance Imaging).

We know that white matter of the brain consists of nerve fibres (axons) and are surrounded by fat called myelin (3). The main function of the white matter is to transmit signals from one region of the cerebrum to another and between the cerebrum and lower brain centres. Lesions in the white matter interfere with signal transmissions. Damage to this white matter is a common significant factor observed in all those suffering from dementia.

Earlier control tests and those conducted at the Changhua Christian Hospital, Taiwan has already shown that migraineurs are at an exponential risk of diabetes and of developing hypertension, depression and cardiovascular diseases.

However, other studies have shown that the mental status of women with a history of migraine was no different from other women’s, so more research is needed.

SOURCES

  1. Image Credits: Dementia Disease And A Loss Of Brain Function And Memories As Al by David Castillo Dominici: FreeDigitalPhotos.net; Web November 2013; http://www.freedigitalphotos.net/images/dementia-disease-and-a-loss-of-brain-function-and-memories-as-al-photo-p173821
  2. Migraine may be linked to dementia; IOL Lifestyle; Web November 2013; http://www.iol.co.za/lifestyle/migraine-may-be-linked-to-dementia-1.1608597#.UoowF9JmiSo
  3. White matter of the brain; MedlinePlus; Web November 2013; http://www.nlm.nih.gov/medlineplus/ency/article/002344.htm

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