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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Sex Migraine Is For Real: Loyola Neurologist

Migraine Sex

Migraines & Headaches After Sex (HAS) More Common Than Reported (1)

‘Not tonight honey, I have a headache’ may not be an excuse in avoidance after all,  because for some, especially men, migraines and headaches develop after sexual intercourse, making them avoid it. It is estimated that only as many as 1% of migraning adults actually report experiencing migraines or severe headaches after they have had sex. (2) The real percentage is considered much higher but generally goes under-reported since there is a feeling of discomfort talking about it on the part of the patients who suffer this type of a migraine and doctors who should be asking if the patients suffer this type of an ordeal.

According to Dr. Jose Biller who is the chair of Loyola’s Department of Neurology, and is certified in Headache Medicine by the United Council for Neurologic Subspecialties, “Many people who experience headaches during sexual activity are too embarrassed to tell their physicians, and doctors often don’t ask. Headaches associated with sexual activity can be extremely painful and scary. They also can be very frustrating, both to the individual suffering the headache and to the partner.” (3)

Though a fair percentage of headaches associated with sex (HAS) are considered benign and not life-threatening, others need running neurological diagnostics to look at and rule out dangerous causes such as brain aneurysm, stroke, cervical artery dissection or subdural hematoma etc. It is confirmed that HAS are 3-4 times more likely to occur in men than women.

Basically, the study has identified 3 types of HAS:

Type

Area Intensity Timing

1

Head and Neck Dull

Before Orgasm

2

Back of the head Intense Pain lasting hours

During Orgasm

3

Half Head, Any side Mild To Extreme Pain

After Sex

The cause for the third type of HAS has been identified as internal leaking of spinal fluid extending from lower portions of the skull to lower spine. The pain worsens when a person stands as the brain sags down. Relief is felt when the person lies down.

The different types of HAS require different types of treatment and management. However, the best bet still is on exercising regularly, keeping weight under control, not consuming too much alcohol and reducing exposure to known migraine triggers.

SOURCES

  1. Image Credit: Couple Lying In Bed Back-to-Back Stock Photo; Image by Ambro; Free Digital Photos; Web June 2014; http://www.freedigitalphotos.net/images/CouplesPartners_g216-Couple_Lying_In_Bed_BacktoBack_p76440.html
  2. Headaches during sex likely more common than reported; Science Daily News; Web June 2014; http://www.sciencedaily.com/releases/2014/06/140610100303.htm
  3. Sex headaches: More common than you’d think; Loyola Medicine Publication; Web June 2014; http://loyolamedicine.org/newswire/news/sex-headaches-more-common-youd-think

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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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New Drugs Targeting CGRP Offer Hope: American Academy of Neurology

S1462399411002067_fig3t

Role Of CGRP and Antagonists In Migraine Attack (1)

CGRP is critically implicated in the occurrence and unfolding or progress of a migraine attack. CGRP or Calcitonin gene-related peptide is a powerful protein/peptide containing a short chain of amino acid monomers. It plays a critical role in transmitting pain signals through the body in events such as migraines. It is also involved in the vasodilation, inflammation, immune-modulatory responses among others during migraine attack apart from increasing heart beat and altering sensory transmission.

CGRP is produced by the peripheral and central neurons of our central nervous system specifically around the spinal cord and the trigeminal ganglion. Prior to and during migraine episodes, the central and peripheral neurons release more CGRP. This is then mediated through CGRP receptors (CALCRL and RAMP1) found throughout the body. One way to prevent pain from occurring is to block the receptors that receive the CGRP protein using a chemical/drug. Such drugs are called CGRP antagonists or CGRP blockers.

In a post of March 28th, 2012 I had written (‘CGRP Blockers & SRAs – The New Faces In Research For Migraine Management’) on work being done on drugs that targeted CGRP receptors but were abandoned after Phase III trials due to adverse reaction found in some of the trial population. (2).

Currently, two studies showing work with calcitonin receptor blockers have moved into Phase II trials. This means that though positive outcomes have been had from these researches involving smaller populations, larger studies are required to clear the drug for sale or prescription.

Research 1:

This involves a prospective drug that aims to prevent migraine from starting rather than trying to stop attack from progressing once it has begun. The drug involves monoclonal antibodies or antibodies that are identical immune cells – clones of their unique parent cell. Such monoclonal antibodies are being directed at the CGRP to target the protein.

This research examined 163 migraineurs for a period of six months, who had migraine attacks ranging anything from 5 -14 days every month. In this time, they gave the population either a placebo or the drug under study called ALD403 without the migraineurs knowing what they were taking. Those who took the drug reported a 66% reduction in number of migraine days and in 12 weeks time reported to be migraine-free.

As per lead author Peter Goadsby, MD, PhD, of the UC San Francisco and a member of the American Academy of Neurology, “These results may potentially represent a new era in preventive therapy for migraine. Migraine remains poorly treated, and there are few effective and well tolerated treatments approved that prevent attacks from occurring.” (3)

Research 2:

This potential drug in injectable form too is a preventative rather than a mitigator of migraine condition and is based on monoclonal antibodies targeting CGRPs. In Phase II trials as well, the research studied 217 migraineurs who experienced anything from 4-17 days of migraine days every month.

The population being observed was also administered either a placebo or the drug under study called LY2951742 via the subcutaneous injection route, without being told which was which for a period of three months. Those who were receiving the real drug reported more than 4 days less of migraine days in a month. However, they also experienced more side-effects such as abdominal pain and upper respiratory tract infections.

As per Dr. David Dodick, MD, of Mayo Clinic Arizona in Phoenix and a member of the American Academy of Neurology, “We’re cautiously optimistic that a new era of mechanism-based migraine prevention is beginning. There is a huge treatment need for migraine — the third most common and seventh most disabling medical disorder in the world” (4)

SOURCES:

  1.  Image Credit: The Role of CGRP and its Antagonists in Migraine- Peripheral Actions of CGRP: Neurogenic Inflammation;  Flipper.diff.org; Web April 2014; http://bit.ly/PsCR7O
  2. CGRP Blockers & SRAs – The New Faces In Research For Migraine Management; Web April 2014; https://migrainingjenny.wordpress.com/2012/03/28/cgrp-blockers-sras-the-new-faces-in-research-for-migraine-management/
  3. New drugs offer hope for migraine prevention; ScienceDaily News; Web April 2014; http://www.sciencedaily.com/releases/2014/04/140422162048.htm
  4. Stopping Migraines Before They Start; DailyRx.com; Web April 2014; http://www.dailyrx.com/migraine-patients-had-fewer-attacks-monoclonal-antibody-treatment

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