New Research From AAN: Your Pain Threshold Directly Links To Cortical Thickness

Brain Cortical Thickess

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.”

SOURCE

  1. Human Brain by Dream Designs via Stock Photo; Freedigitalphotos.net; Web May 2015; http://www.freedigitalphotos.net/images/human-brain-photo-p214120
  2. A New Way To Think About Migraines: Biosciencetechnlogy.com; Web May 2015; http://www.biosciencetechnology.com/articles/2015/05/new-way-think-about-migraines
  3. 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’ 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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What Should Work, What Might: Migraine Meds Reassessed

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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
Dihydroergotamins
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.

SOURCES

  1. Image credit: Pills and Capsules – Stock Photo; freedigitalphotos.net; Web February 2015; http://www.freedigitalphotos.net/images/pills-and-capsules-photo-p308698
  2. Study Rates Migraine Medications; WebMD.com; Web February 2015; http://www.webmd.com/migraines-headaches/news/20150120/study-rates-migraine-medications
  3. 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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Massage For Your Migraines?

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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)

SOURCES

  1. Image credit: Massage, flower, spa, gels – Photostock; freedigitalphotos.net; Web February 2015; http://www.freedigitalphotos.net/images/Healthy_Living_g284-Massageflowerspa_Gels_p37679.html
  2. 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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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

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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