Concepts leading to the definition of the term cervicogenic headache:a historical overview.

The idea that headache may originate from a problem at the neck or cervical spine level has fascinated and stimulated researchers for centuries. Contributions and reports seeking to clarify this issue have multiplied in the past 80 or 90 years. Bärtschi-Rochaix reported what seems to have been the first clinical description of cervicogenic headache, but it was not until 1983 that Sjaastad and his school defined diagnostic criteria for this syndrome. The current, revised International Headache Society Classification (ICHD-II) includes the term cervicogenic headache, but the diagnostic criteria it gives differ from those of the International Association for the Study of Pain (IASP), and also from the most recent Cervicogenic Headache International Study Group (CHISG) definition (1998)

Genetic variations within KRIT1/CCM1, MGC4607/CCM2 and PDCD10/CCM3 in a large italian family harbouring a krit1/CCM1 mutation

Cerebral cavernous malformations (CCMs) are congenital vascular anomalies of the central nervous system that can result in seizures, haemorrhage, recurrent headaches and focal neurologic deficit. CCMs can occur as an autosomal dominant trait with incomplete penetrance and a wide phenotypic variability. The genes responsible for this disease are KRIT1/CCM1 on chromosome 7q21.2, MGC4607/CCM2 on chromosome 7p15-p13 and PDCD10/CCM3 on chromosome 3q25.2-q27. Mutations in KRIT1/CCM1 account for more than 40% of CCMs. We previously reported a CCM family harbouring the KRIT1/CCM1 1204delAACAA mutation. In order to search for possible explanation of the clinical variability observed, we looked for genetic variation within exons and exon/intron regions in the three genes KRIT1, MGC4607 and PDCD10 associated to the disease within this large family, 23 subjects have been analysed. Identified genetic variations in the three genes are here presented. We believe that genetic variations could interfere with the proper CCM1/CCM2/CCM3 protein complex thus explaining the observed clinical variability

Human skin mast cells express photoreceptors, and blue light inhibits their degranulation

Background: Allergic skin reactions are driven by dermal mast cells (MCs) and exhibit circadian differences. In human skin, circadian rhythms may be regulated by cryptochromes (CRYs) and opsins (OPNs), photoreceptors (PRs), which were recently identified to be expressed in a number of human cutaneous cell types. Whether human skin MCs express these receptors is currently unknown Method: We obtained MCs from human skin (breast, foreskin, eyelids) and used also cultured CD34‐positive peripheral blood stem cell‐derived MCs (PSCMCs) and LAD2‐MCs. MCs were analyzed for the expression of CRY1 and OPN 1‐3 by qRT‐PCR and Western Blot as well as for the effects of irradiation with blue light on activation via IgE/anti‐IgE or cortistatin, a MRGPRX2 agonist. Results: We found expression of the blue light sensitive CRY1, OPN1 MW (medium‐wave‐length), OPN2 and OPN3 in LAD2‐MCs, cultured MCs from breast skin and foreskin as well as freshly isolated MCs from breast skin and eyelids, with the exception of OPN2 in eyelid MCs. CRY1 expression was the highest overall, and its presence was confirmed at protein level in cultured as well as freshly isolated MCs from breast skin and foreskin. PSCMCs, however, did not show expression of any of the investigated PRs. Importantly, fresh and cultured skin MCs were sensitive to blue light irradiation (at 453 nm) showing a dose‐dependent reduction in their degranulation after exposure to 2 or 30 J/cm2 blue light as measured by β‐hexosaminidase release. Conclusion: Our results demonstrate, for the first time, that human skin MCs express photoreceptors, i.e. CRY1 and OPN1‐3, and blue light, which activates these receptors, inhibits MC degranulation. These findings may explain, at least in part, circadian differences in allergic skin reactions and may be relevant for the development of photoreceptor‐targeted treatments for patients with MC‐driven skin diseases such as chronic spontaneous or inducible urticaria

Anaerobic and aerobic bioremediation of chlorinated solvents and hydrocarbons plumes from an old landfill in the Venice lagoon environment

An old industrial waste landfill with a surface of 16 ha in the surroundings of the Venice lagoon has produced heavy hydrocarbons and chlorinated compounds groundwater contamination. Microbiological and chemical results of a two field tests have confirmed the feasibility of bioremediation and have allowed the facilities design. An organic substrate, able to increase the reductive dehalogenation, was injected and recycled in anaerobic barrier near the landfill; air sparging was performed and nutrients injected in order to increase hydrocarbons degradation in aerobic barrier downgradient. Hydrogeological investigation and microbiological analysis were carried out to verify the effectiveness of the reclamation in anaerobic environment, having achieved chlorinated compounds degradation values of almost 24 kg/day. Further studies are underway to improve the aerobic barrier

Facilitated temporal summation of pain at spinal level in Parkinson's disease

BACKGROUND: Pain is one of the major nonmotor symptoms of Parkinson's disease. We hypothesized that Parkinson's disease patients could show an early diffuse abnormal processing of the nociceptive inputs also in the absence of clinical pain syndrome and that this could represent the physiopathological substrate to explain the high incidence of diffuse pain symptoms. MATERIALS AND METHODS: We used the temporal summation threshold of the nociceptive withdrawal reflex and the related pain sensation to evaluate the facilitation in pain processing at spinal level. Fifteen (7 Women; 8 Men; mean age 63.0 ± 9.1) Parkinson's disease patients without clinical pain and 12 (6 Women, 6 Men; mean age 61.2 ± 4.2) healthy subjects were recruited. Parkinson's disease group has been subdivided into two subgroups, 7 early-stage Parkinson's disease patients with unilateral signs (Hoehn and Yahr stage 1) and 8 patients in a more advanced stage of the disease showing bilateral parkinsonian signs (Hoehn and Yahr stages 2 and 2.5), both "on" and "off" treatments with levodopa. RESULTS: A significant facilitation in temporal summation of pain (reduced temporal summation threshold and increased painful sensation) was found in Parkinson's disease patients when compared with controls. This facilitation is more evident in Parkinson's disease with bilateral signs and on the side more affected in Parkinson's disease with unilateral signs. Levodopa administration failed to significantly modify the neurophysiological abnormalities; however, a slight improvement has been detected. CONCLUSIONS: The increased gain in pain processing at spinal level in Parkinson's disease patients could be a consequence of the degenerative phenomena involving supraspinal projections implicated in the modulation of pain processing and could make Parkinson's disease patients more predisposed to develop a pain condition

Pisa syndrome in Parkinson's disease: clinical, electromyographic, and radiological characterization.

Abnormal postures of the trunk are a typical feature of Parkinson's disease (PD). These include Pisa syndrome (PS), a tonic lateral flexion of the trunk associated with slight rotation along the sagittal plane. In this study we describe clinical, electromyographic (EMG), and radiological features of PS in a group of 20 PD patients. All patients with trunk deviation underwent EMG and radiological (RX and CT scan) investigation. Clinical characteristics of patients with PS were compared with a control group of PD patients without trunk deviation. PD patients with PS showed a significantly higher score of disease asymmetry compared with the control group. In the majority of patients with PS, trunk bending was contralateral to the side of symptom onset. EMG showed abnormal tonic hyperactivity on the side of the deviation in the paravertebral thoracic muscles and in the abdominal oblique muscles. CT of the lumbar paraspinal muscles showed muscular atrophy more marked on the side of the deviation, with a craniocaudal gradient. PS may represent a complication of advanced PD in a subgroup of patients who show more marked asymmetry of disease and who have detectable hyperactivity of the dorsal paravertebral muscles on the less affected side. This postural abnormality deserves attention and proper early treatment to prevent comorbidities and pain

Facilitated temporal summation of pain at spinal level in Parkinson's disease.

BACKGROUND:: Pain is one of the major nonmotor symptoms of Parkinson's disease. We hypothesized that Parkinson's disease patients could show an early diffuse abnormal processing of the nociceptive inputs also in the absence of clinical pain syndrome and that this could represent the physiopathological substrate to explain the high incidence of diffuse pain symptoms. MATERIALS AND METHODS:: We used the temporal summation threshold of the nociceptive withdrawal reflex and the related pain sensation to evaluate the facilitation in pain processing at spinal level. Fifteen (7 Women; 8 Men; mean age 63.0 \ub1 9.1) Parkinson's disease patients without clinical pain and 12 (6 Women, 6 Men; mean age 61.2 \ub1 4.2) healthy subjects were recruited. Parkinson's disease group has been subdivided into two subgroups, 7 early-stage Parkinson's disease patients with unilateral signs (Hoehn and Yahr stage 1) and 8 patients in a more advanced stage of the disease showing bilateral parkinsonian signs (Hoehn and Yahr stages 2 and 2.5), both "on" and "off" treatments with levodopa. RESULTS:: A significant facilitation in temporal summation of pain (reduced temporal summation threshold and increased painful sensation) was found in Parkinson's disease patients when compared with controls. This facilitation is more evident in Parkinson's disease with bilateral signs and on the side more affected in Parkinson's disease with unilateral signs. Levodopa administration failed to significantly modify the neurophysiological abnormalities; however, a slight improvement has been detected. CONCLUSIONS:: The increased gain in pain processing at spinal level in Parkinson's disease patients could be a consequence of the degenerative phenomena involving supraspinal projections implicated in the modulation of pain processing and could make Parkinson's disease patients more predisposed to develop a pain condition. \ua9 2010 Movement Disorder Society