26 research outputs found
P300 as an auxiliary method in clinical practice: A review of literature
Cognitive functions can be assessed and followed up over a period of time with cognitive evoked potentials (CEP) P300. In this context, brainstem auditory evoked potentials (BAEP) are most commonly used, but visual evoked potentials (VEP) are utilized as well. The research in this area has demonstrated that these techniques could be used as a supplemental method in diagnostics of numerous diseases such as Alzheimer's disease, mild cognitive impairment, vascular dementia, epilepsy, craniocerebral trauma, Parkinson's disease, multiple sclerosis, and other degenerative diseases. In addition, P300 can also be used as an auxiliary method in the diagnostics of mental disorders conditions such as schizophrenia, panic disorders, narcotic drug addiction, nicotinism, alcoholism, etc. The method assists in monitoring the course of diseases leading to encephalopathy, such as liver and kidney damage and grave anaemia. The advantages of P300 testing are easy application, non-invasiveness, and an unlimited number of potential applications. Moreover, the results obtained with this method are measurable and can be compared
Multipli intrakranijski Å”vanomi: prikaz sluÄaja
Schwannomas are benign encapsulated tumors arising from the sheaths of peripheral nerves. They present as slowly enlarging solitary lumps, which may cause neurological defects. Multiple schwannomas in non-neurofibromatosis type 2 patients are extremely rare. We report a case of a 60-year-old female patient, without any family history of neurofibromatosis or schwannomatosis, presented with trigeminal neuralgia and progressive facial nerve palsy. Magnetic resonance imaging revealed the presence of acoustic schwannoma involving facial nerve and trigeminal schwannoma of the cisternal part of the nerve involving gasserian ganglion (Meckelās cave). After gamma knife radiosurgery, trigeminal neuralgia was relieved completely with improvement of facial nerve palsy.Å vanomi su dobroÄudni inkapsulirani tumori koji potjeÄu iz ovojnica perifernih živaca. NajÄeÅ”Äe se javljaju kao pojedinaÄni sporo rastuÄi tumori koji mogu uzrokovati neuroloÅ”ke deficite. Mnogostruki Å”vanomi su iznimno rijetki u bolesnika koji nemaju neurofibromatozu tip 2. Prikazujemo sluÄaj 60-godiÅ”nje bolesnice s negativnom obiteljskom anamnezom za neurofibromatozu ili Å”vanomatozu, koja se prezentirala s neuralgijom trigeminusa i progresivnom paralizom facijalnog živca. Magnetska rezonanca prikazala je prisutnost akustiÄnog Å”vanoma sa zahvaÄanjem i facijalnog živca te Å”vanoma cisternalnog dijela trigeminalnog živca sa Å”irenjem u podruÄje gangliona istog (Meckelova Å”upljina). Nakon āgamma knifeā radiokirurgije simptomi trigeminalne neuralgije su se u potpunosti povukli uz znaÄajno kliniÄko poboljÅ”anje paralize facijalnog živca
Platelet adhesion onto immobilized fibrinogen under arterial and venous in-vitro flow conditions does not significantly differ between men and women
BACKGROUND: Gender-related differences in incidence of arterial thrombosis have been a focus of interest for years. The platelet integrin Ī±IIbĪ²3 is primarily responsible for the interaction between platelets and fibrinogen and consecutive thrombus growth. In this study, we evaluated platelet adhesion onto immobilized fibrinogen under venous and arterial flow conditions in men and women. METHODS: Platelets in whole anticoagulated blood were labelled with the fluorescence dye Mepacrine and perfused through the rectangular flow chamber over glass cover slips coated with fibrinogen (shear rates of 50 s(-1), 500 s(-1 )and 1500 s(-1)). A fluorescence laser-scan microscope was used for visualisation and quantification of platelet adhesion at 15 seconds, 1 and 5 minutes after the start of perfusion. RESULTS: During perfusion, the platelet adhesion linearly increased in regard to exposition time and shear rate. After five minutes of perfusion the platelet adhesion onto immobilized fibrinogen showed no significant gender related difference, neither at 50 s(-1 )nor at 500 s(-1 )and 1500 s(-1 )(p > 0.05), respectively. No significant difference in platelet adhesion onto immobilized fibrinogen, in regard to the menopausal status, was either observed (p > 0.05). CONCLUSION: In our in vitro experimental system, hormonal differences between men and women did not influence platelet adhesion onto immobilized fibrinogen, neither under venous nor under arterial rheological conditions
Depresija i umor uzrokovani opstrukcijskom apnejom tijekom spavanja u multiploj sklerozi
To our knowledge, there is no study investigating whether fatigue and depression
as the most commonly reported symptoms in multiple sclerosis (MS) and obstructive sleep apnea
(OSA) patients have arisen from primary mechanisms of MS or from secondary associated conditions
such as OSA in MS patients. The aim of our survey study was to determine whether depression and
fatigue in MS patients were associated with clinical features of OSA or with MS. We conducted
a self-administered survey using four validated questionnaires (STOP-BANG, Epworth Sleepiness
Scale, Fatigue Severity Scale and The Center for Epidemiologic Studies Depression Scale-Revised)
in 28 consecutive outpatients with proven MS. The prevalence of MS patients at an increased risk of
OSA was 29% and age was positively correlated with this risk (p=0.019). None of the clinical features
of MS patients (subtype, disability status, disease duration, modifying therapy, other medication) was
correlated with depression and fatigue. On the contrary, excessive daytime sleepiness as a hallmark
of OSA was significantly and positively associated with the level of depressive symptoms (p=0.004)
and level of fatigue (p=0.015). Also, depression was significantly and positively correlated with the
increased risk of OSA (p=0.015) and age of MS patients (p=0.016). Finally, a significant positive
correlation was found between fatigue severity and level of depressive symptoms (p=0.003). OSA is
a common disorder in MS patients. The clinical features and risk factors for OSA in MS patients are
associated with the two most commonly reported symptoms of depression and fatigue, thus supporting
the hypothesis that both symptoms are due to a secondary condition in MS.Sukladno naÅ”im saznanjima nema studije koja je istraživala nastaju li umor i depresija kao najuÄestaliji simptomi kod
bolesnika s multiplom sklerozom (MS) i opstrukcijskom apnejom tijekom spavanja (OSA) primarnim mehanizmima MS ili
iz sekundarnih povezanih stanja kao Ŕto je OSA kod bolesnika s MS. Cilj naŔe anketne studije bio je utvrditi jesu li depresija
i umor u bolesnika s MS povezani s kliniÄkim obilježjima OSA ili MS. Proveli smo anketu pomoÄu Äetiri validirana upitnika
(STOP-BANG, Epworthova ljestvica pospanosti, ljestvica težine umora i revidirana ljestvica depresije Centra za epidemioloŔke
studije) u 28 uzastopnih ambulantnih bolesnika s kliniÄki i parakliniÄki dokazanom MS. UÄestalost bolesnika s MS
s poveÄanim rizikom od nastanka OSA bila je 29%, a dob je bila u pozitivnoj korelaciji s tim rizikom (p=0,019). Nijedna
od kliniÄkih znaÄajka bolesnika s MS (podtip, status invaliditeta, trajanje bolesti, modificirajuÄa terapija, drugi lijekovi) nije
bila u korelaciji s depresijom i umorom. Naprotiv, pretjerana pospanost tijekom dana kao obilježje OSA bila je znaÄajno i
pozitivno povezana s razinom simptoma depresije (p=0,004) i razinom umora (p=0,015). TakoÄer, depresija je znaÄajno i
pozitivno korelirala s poveÄanim rizikom od OSA (p=0,015) i dobi bolesnika s MS (p=0,016). KonaÄno, utvrÄena je znaÄajna
pozitivna korelacija izmeÄu težine umora i simptoma depresije (p=0,003). OSA je Äest poremeÄaj kod bolesnika s MS.
KliniÄke znaÄajke i Äimbenici rizika za OSA u bolesnika s MS povezani su s dva najÄeÅ”Äe prijavljivana simptoma depresije i
umora, podupiruÄi tako hipotezu da su oba simptoma posljedica sekundarnog stanja u MS
PROPHYLAXIS OF MIGRAINE ā A REVIEW OF LITERATURE
Cilj ovog prikaza literature je procijeniti moguÄnosti proļ¬ lakse migrene. Prema preporukama International Headache Society (IHS) proļ¬ laksa migrene provodi se u bolesnika koji imaju ā„4 dana migrensku glavobolju na mjesec bilo da se radi o epizodiÄnoj ili kroniÄnoj migreni. UÄinkovitim lijeÄenjem smatra se smanjenje uÄestalosti migrenskih ataka za ā„50 %. UÄinkovitima su se pokazali Ī²-blokatori, kalcijski antagonisti, antiepileptici kao Å”to su topiramat i valproat kao i gabapentin i pregabalin, te ļ¬ unarizin i antidepresivi. UÄinkovitost levatiracetama, cervikalne miofascijalne anestezije te kožne elektrostimulacije i muskularne stimulacije joÅ” je u ispitivanju. Dvojben je uÄinak botulinum toksina. Istražuje se moguÄa primjena histamina, zatvaranje foramena ovale te primjena akupunkture, supraorbitalne i vagalne nervne stimulacije te transkranijske magnetske stimulacije. Istražuje se utjecaj kateholamina i melatonina te kontraceptiva, riboļ¬ avina, dekstrometorļ¬ na u nastanku migrenskih glavobolja. Potrebna je adekvatna procjena moguÄih uÄinaka u proļ¬ laksi primjenom probiotika, koenzima Q10 i magnezija. KliniÄka istraživanja su pokazala da primjena humanih monoklonskih protutijela erenumaba, fremanezumaba i galkanezumaba pokazuju statistiÄki znaÄajnu uÄinkovitost (ā„50 % uÄinkovitosti) u proļ¬ laksi migrene Å”to je potrebno potvrditi u kliniÄkoj praksi.This literature review is aimed at assessing the possibilities of migraine prophylaxis. The International Headache Society (IHS) recommends performing migraine prophylaxis in patients suffering ā„4 migraine headaches per month, either episodic or chronic. The treatment is deemed successful when the migraine attacks are decreased by ā„50%. Efļ¬ ciency has been demonstrated for Ī²-blockers, calcium antagonists, antiepileptics such as topiramate and valproate, as well as gabapentin, pregabalin, ļ¬ unarizine and antidepressants. The efļ¬ ciency of levetiracetam, cervical myofascial anesthesia, skin electrostimulation and muscular stimulation is still being tested. The effects of botulinum toxin are dubious. There is ongoing research of the possibility of using histamines, closing foramen ovale, acupuncture, supraorbital and vagal nerve stimulation and transcranial magnetic stimulation. Effects of catecholamine, melatonin, contraceptives, riboļ¬ avin, dextromethorphan and melatonin in persisting migraine headaches are being researched as well. Required is an appropriate assessment of the possible effects of probiotics, coenzyme q10 and magnesium in migraine prophylaxis. Clinical researches have shown the use of human monoclonal antibodies erenumab, fremanezumab and galcanezumab to demonstrate a statistically signiļ¬ cant efļ¬ ciency (ā„50%) in migraine prophylaxis, yet requiring further conļ¬ rmation in clinical practice
PROPHYLAXIS OF MIGRAINE ā A REVIEW OF LITERATURE
Cilj ovog prikaza literature je procijeniti moguÄnosti proļ¬ lakse migrene. Prema preporukama International Headache Society (IHS) proļ¬ laksa migrene provodi se u bolesnika koji imaju ā„4 dana migrensku glavobolju na mjesec bilo da se radi o epizodiÄnoj ili kroniÄnoj migreni. UÄinkovitim lijeÄenjem smatra se smanjenje uÄestalosti migrenskih ataka za ā„50 %. UÄinkovitima su se pokazali Ī²-blokatori, kalcijski antagonisti, antiepileptici kao Å”to su topiramat i valproat kao i gabapentin i pregabalin, te ļ¬ unarizin i antidepresivi. UÄinkovitost levatiracetama, cervikalne miofascijalne anestezije te kožne elektrostimulacije i muskularne stimulacije joÅ” je u ispitivanju. Dvojben je uÄinak botulinum toksina. Istražuje se moguÄa primjena histamina, zatvaranje foramena ovale te primjena akupunkture, supraorbitalne i vagalne nervne stimulacije te transkranijske magnetske stimulacije. Istražuje se utjecaj kateholamina i melatonina te kontraceptiva, riboļ¬ avina, dekstrometorļ¬ na u nastanku migrenskih glavobolja. Potrebna je adekvatna procjena moguÄih uÄinaka u proļ¬ laksi primjenom probiotika, koenzima Q10 i magnezija. KliniÄka istraživanja su pokazala da primjena humanih monoklonskih protutijela erenumaba, fremanezumaba i galkanezumaba pokazuju statistiÄki znaÄajnu uÄinkovitost (ā„50 % uÄinkovitosti) u proļ¬ laksi migrene Å”to je potrebno potvrditi u kliniÄkoj praksi.This literature review is aimed at assessing the possibilities of migraine prophylaxis. The International Headache Society (IHS) recommends performing migraine prophylaxis in patients suffering ā„4 migraine headaches per month, either episodic or chronic. The treatment is deemed successful when the migraine attacks are decreased by ā„50%. Efļ¬ ciency has been demonstrated for Ī²-blockers, calcium antagonists, antiepileptics such as topiramate and valproate, as well as gabapentin, pregabalin, ļ¬ unarizine and antidepressants. The efļ¬ ciency of levetiracetam, cervical myofascial anesthesia, skin electrostimulation and muscular stimulation is still being tested. The effects of botulinum toxin are dubious. There is ongoing research of the possibility of using histamines, closing foramen ovale, acupuncture, supraorbital and vagal nerve stimulation and transcranial magnetic stimulation. Effects of catecholamine, melatonin, contraceptives, riboļ¬ avin, dextromethorphan and melatonin in persisting migraine headaches are being researched as well. Required is an appropriate assessment of the possible effects of probiotics, coenzyme q10 and magnesium in migraine prophylaxis. Clinical researches have shown the use of human monoclonal antibodies erenumab, fremanezumab and galcanezumab to demonstrate a statistically signiļ¬ cant efļ¬ ciency (ā„50%) in migraine prophylaxis, yet requiring further conļ¬ rmation in clinical practice
TENSION-TYPE HEADACHE FROM THE ASPECTS OF PUBLIC HEALTH ISSUES AND TREATMENT POSSIBILITIES
Uvod: Tenzijska glavobolja (TTH) spada u skupinu primarnih glavobolja. Nastanak boli nije posve jasan kao ni patofizioloÅ”ki proces nastanka boli. Glavobolja može biti epizodiÄna (trajanje boli do 15 dana) ili kroniÄnog (trajanje boli 15 ili viÅ”e dana) tipa. Cilj: Cilj ovog rada je procjena javnozdravstvenog problema tenzijske glavobolje kao i moguÄnosti adekvatnog lijeÄenja i profilakse tenzijske glavobolje. Metode: Za ovo ispitivanje koristili smo bazu podataka Pub med uzimajuÄi pojmove; tenzijska glavobolja, prevalencija i lijeÄenje (tension type headache, prevalence, therapy). Rezultati: UÄestalost TTH znaÄajno oscilira u ovisnosti o socioekonomskim uvjetima, a moguÄe i o rasnim razlikama. UÄestalost raste sa životnom dobi. ÄeÅ”Äe se javlja kod žena. LijeÄi se analgeticima i nesteroidnim antireumaticima. Profilaksa kroniÄne TTH provodi se primjenom amitriptilina, mirtazapina, venlafaksina. U sluÄaju potrebe ukljuÄuje se druga linija profilakse koja obuhvaÄa klomipramin, maprotilin i mianserin. Uz to koriste se i nemedikamentne moguÄnosti lijeÄenja kao Å”to su akupunktura, biofeedback metode, kognitivno-bihevioralno lijeÄenje, relaksacijski treninzi. Rasprava: Tenzijska glavobolja je relativno Äest javno-zdravstveni problem u suvremenom svijetu Äiji patofizioloÅ”ki mehanizam nije posve rasvijetljen. Smatra se da je ova glavobolja multifaktorski uvjetovana. Osim epizodiÄne glavobolje znaÄajno veÄi problem je kroniÄna tenzijska glavobolja koja zahtijeva kontinuiranu profilaksu. Nemedikamentne metode profilakse TTH su nedovoljno istražene i zahtijevaju kliniÄko-znanstvenu evaluaciju. ZakljuÄak: U suvremenom svijetu tenzijska glavobolja, posebno kroniÄna TTH, je javnozdravstveni problem koji treba zbrinjavati na adekvatan naÄin. Uz Å”iroku lepezu medikamentne terapije nameÄu se i pomoÄne metode lijeÄenja koje treba dodatno evaluirati.Introduction: Tension-type headache (TTH) belongs to the group of primary headaches. The pain origin is not completely clear, nor is the pathophysiological process of its occurrence. The headache may be of episodic (lasting for up to 15 days) or chronic (lasting for 15 or more days) type. Aim: The aim of the study was to assess public health issues of TTH and the possibilities of its appropriate treatment and prophylaxis. Methods: In this research, we used the PubMed database and the words ātension-type headache, prevalence and therapyā. Results: The TTH prevalence signiļ¬ cantly oscillates depending on socioeconomic conditions and, possibly, race differences. The prevalence increases with age. It is more common in women. It is treated with analgesics and nonsteroidal antirheumatic agents. Chronic TTH prophylaxis includes amitriptyline, mitrazapine and venlafaxine. When necessary, second-line prophylaxis that includes clomipramine, maprotiline and mianserin is administered. Besides these, non-medicamentous treatment methods such as acupuncture, biofeedback, cognitive-behavioral treatment and relaxation trainings are also used. Discussion: In the modern world, TTH is a relatively often public-health issue the pathophysiological mechanism of which has not been clariļ¬ ed yet. This headache is deemed to be of multifactorial cause. Besides episodic headaches, a much greater problem is chronic TTH that requires continuous prophylaxis. The non-medicamentous methods of TTH prophylaxis are insufļ¬ ciently researched and require clinical scientiļ¬ c evaluation. Conclusion: In the modern world, TTH, especially chronic TTH, makes a public-health issue that is to be adequately treated. Besides the wide variety of medicamentous therapies, required are also auxiliary treatment methods that need to be additionally evaluated
TENSION-TYPE HEADACHE FROM THE ASPECTS OF PUBLIC HEALTH ISSUES AND TREATMENT POSSIBILITIES
Uvod: Tenzijska glavobolja (TTH) spada u skupinu primarnih glavobolja. Nastanak boli nije posve jasan kao ni patofizioloÅ”ki proces nastanka boli. Glavobolja može biti epizodiÄna (trajanje boli do 15 dana) ili kroniÄnog (trajanje boli 15 ili viÅ”e dana) tipa. Cilj: Cilj ovog rada je procjena javnozdravstvenog problema tenzijske glavobolje kao i moguÄnosti adekvatnog lijeÄenja i profilakse tenzijske glavobolje. Metode: Za ovo ispitivanje koristili smo bazu podataka Pub med uzimajuÄi pojmove; tenzijska glavobolja, prevalencija i lijeÄenje (tension type headache, prevalence, therapy). Rezultati: UÄestalost TTH znaÄajno oscilira u ovisnosti o socioekonomskim uvjetima, a moguÄe i o rasnim razlikama. UÄestalost raste sa životnom dobi. ÄeÅ”Äe se javlja kod žena. LijeÄi se analgeticima i nesteroidnim antireumaticima. Profilaksa kroniÄne TTH provodi se primjenom amitriptilina, mirtazapina, venlafaksina. U sluÄaju potrebe ukljuÄuje se druga linija profilakse koja obuhvaÄa klomipramin, maprotilin i mianserin. Uz to koriste se i nemedikamentne moguÄnosti lijeÄenja kao Å”to su akupunktura, biofeedback metode, kognitivno-bihevioralno lijeÄenje, relaksacijski treninzi. Rasprava: Tenzijska glavobolja je relativno Äest javno-zdravstveni problem u suvremenom svijetu Äiji patofizioloÅ”ki mehanizam nije posve rasvijetljen. Smatra se da je ova glavobolja multifaktorski uvjetovana. Osim epizodiÄne glavobolje znaÄajno veÄi problem je kroniÄna tenzijska glavobolja koja zahtijeva kontinuiranu profilaksu. Nemedikamentne metode profilakse TTH su nedovoljno istražene i zahtijevaju kliniÄko-znanstvenu evaluaciju. ZakljuÄak: U suvremenom svijetu tenzijska glavobolja, posebno kroniÄna TTH, je javnozdravstveni problem koji treba zbrinjavati na adekvatan naÄin. Uz Å”iroku lepezu medikamentne terapije nameÄu se i pomoÄne metode lijeÄenja koje treba dodatno evaluirati.Introduction: Tension-type headache (TTH) belongs to the group of primary headaches. The pain origin is not completely clear, nor is the pathophysiological process of its occurrence. The headache may be of episodic (lasting for up to 15 days) or chronic (lasting for 15 or more days) type. Aim: The aim of the study was to assess public health issues of TTH and the possibilities of its appropriate treatment and prophylaxis. Methods: In this research, we used the PubMed database and the words ātension-type headache, prevalence and therapyā. Results: The TTH prevalence signiļ¬ cantly oscillates depending on socioeconomic conditions and, possibly, race differences. The prevalence increases with age. It is more common in women. It is treated with analgesics and nonsteroidal antirheumatic agents. Chronic TTH prophylaxis includes amitriptyline, mitrazapine and venlafaxine. When necessary, second-line prophylaxis that includes clomipramine, maprotiline and mianserin is administered. Besides these, non-medicamentous treatment methods such as acupuncture, biofeedback, cognitive-behavioral treatment and relaxation trainings are also used. Discussion: In the modern world, TTH is a relatively often public-health issue the pathophysiological mechanism of which has not been clariļ¬ ed yet. This headache is deemed to be of multifactorial cause. Besides episodic headaches, a much greater problem is chronic TTH that requires continuous prophylaxis. The non-medicamentous methods of TTH prophylaxis are insufļ¬ ciently researched and require clinical scientiļ¬ c evaluation. Conclusion: In the modern world, TTH, especially chronic TTH, makes a public-health issue that is to be adequately treated. Besides the wide variety of medicamentous therapies, required are also auxiliary treatment methods that need to be additionally evaluated
NEUROFEEDBACK IN TREATING MIGRAINE HEADACHE ā A PILOT STUDY
Cilj: Cilj ovog istraživanja bio je objektivizirati terapijski uÄinak neurofeedbacka na lijeÄenje migrenske glavobolje u bolesnika s migrenskom glavoboljom. Metode: Kao instrument istraživanja koristio se anonimni anketni upitnik, strukturiran i modificiran za potrebe ovog istraživanja. Na kraju su uporabljena dva standardizirana testa: test za procjenu onesposobljenosti bolesnika s migrenom (MIDAS - Migraine Disability Assessment Test), te upinik o ispitivanju utjecaja glavobolje (HIT6: Headache Impact Test) koji se koristi za mjerenje utjecaja glavobolje na sposobnost obavljanja zadataka na radnom mjestu/ u Å”koli i u socijalnim situacijama. Rezultati: ProsjeÄan broj glavobolja tijekom jednog mjeseca kod veÄine ispitanika je 11 (5 do 6 puta), uz najÄeÅ”Äe trajanje od 4 do 24 sata, kako navodi 16 ispitanika. ProsjeÄni je intenzitet glavobolje za 10 ispitanika srednje jaka bol, a za 15 ispitanika jaka bol. Dob nije statistiÄki znaÄajan faktor onesposobljenosti migrenama izuzev izostanka iz Å”kole/posla. Povezanost je utvrÄena samo za parametar izostanaka s posla/Å”kole zbog glavobolja u zadnja 3 mjeseca (dani) gdje pozitivne vrijednosti koeficijenta korelacije (ro) upuÄuju na zakljuÄak da je veÄi broj izostanaka s posla/ Å”kole u zadnja 3 mjeseca kod pacijenata s viÅ”im stupnjevima obrazovanja. Nakon provedene terapije utvrÄena je statistiÄki znaÄajna razlika samo u parametrima smanjenja produktivnosti na poslu/u Å”koli zbog glavobolja u zadnja 3 mjeseca (dani) (p=0,001). ZakljuÄak: Testiranjem utjecaja terapije neurofeedbackom na onesposobljenost migrenama utvrÄen je statistiÄki znaÄajan pad HIT6 rezultata, kao i pad vrijednosti svih parametara utjecaja migrena na život - MIDAS rezultati.Objective: The aim of the study was to objectify therapeutic effect of neurofeedback and to treat migraine headaches in patients with migraine. Methods: We used anonymous questionnaire, structured and modified for the purpose of this study. In the end, we used two standardized tests, i.e. the test for assessment of disability in patients with migraine (MIDAS, Migraine Disability Assessment Test) and the questionnaire testing the impact of headache (HIT6, Headache Impact Test), used to measure the impact of headaches on the ability to perform tasks at work/school and in social situations. Results: Concerning the average number of headaches per month, the majority of patients (n=11) had headache 5-6 times, usually lasting for 4 to 24 hours, as reported by 16 subjects. The average headache intensity was reported as severe pain by 10 patients and strong pain by 15 patients. Age was not a statistically significant factor for disabling migraines except for school/work absenteeism. The connection was only established for work/school absenteeism due to headaches in the last three months (days), where positive values of the correlation coefficient (ro) suggested that greater work/school absenteeism in the last three months was recorded in patients with a higher level of education. After the treatment, a statistically significant difference was only found in the reduction of work/school productivity because of headaches in the last three months (days) (p=0.001). Testing the impact of neurofeedback therapy on disability due to migraine revealed a statistically significant decrease in HIT6 results, as well as in the value of all segments of the migraine impact on life, i.e. MIDAS results
NEUROFEEDBACK IN TREATING MIGRAINE HEADACHE ā A PILOT STUDY
Cilj: Cilj ovog istraživanja bio je objektivizirati terapijski uÄinak neurofeedbacka na lijeÄenje migrenske glavobolje u bolesnika s migrenskom glavoboljom. Metode: Kao instrument istraživanja koristio se anonimni anketni upitnik, strukturiran i modificiran za potrebe ovog istraživanja. Na kraju su uporabljena dva standardizirana testa: test za procjenu onesposobljenosti bolesnika s migrenom (MIDAS - Migraine Disability Assessment Test), te upinik o ispitivanju utjecaja glavobolje (HIT6: Headache Impact Test) koji se koristi za mjerenje utjecaja glavobolje na sposobnost obavljanja zadataka na radnom mjestu/ u Å”koli i u socijalnim situacijama. Rezultati: ProsjeÄan broj glavobolja tijekom jednog mjeseca kod veÄine ispitanika je 11 (5 do 6 puta), uz najÄeÅ”Äe trajanje od 4 do 24 sata, kako navodi 16 ispitanika. ProsjeÄni je intenzitet glavobolje za 10 ispitanika srednje jaka bol, a za 15 ispitanika jaka bol. Dob nije statistiÄki znaÄajan faktor onesposobljenosti migrenama izuzev izostanka iz Å”kole/posla. Povezanost je utvrÄena samo za parametar izostanaka s posla/Å”kole zbog glavobolja u zadnja 3 mjeseca (dani) gdje pozitivne vrijednosti koeficijenta korelacije (ro) upuÄuju na zakljuÄak da je veÄi broj izostanaka s posla/ Å”kole u zadnja 3 mjeseca kod pacijenata s viÅ”im stupnjevima obrazovanja. Nakon provedene terapije utvrÄena je statistiÄki znaÄajna razlika samo u parametrima smanjenja produktivnosti na poslu/u Å”koli zbog glavobolja u zadnja 3 mjeseca (dani) (p=0,001). ZakljuÄak: Testiranjem utjecaja terapije neurofeedbackom na onesposobljenost migrenama utvrÄen je statistiÄki znaÄajan pad HIT6 rezultata, kao i pad vrijednosti svih parametara utjecaja migrena na život - MIDAS rezultati.Objective: The aim of the study was to objectify therapeutic effect of neurofeedback and to treat migraine headaches in patients with migraine. Methods: We used anonymous questionnaire, structured and modified for the purpose of this study. In the end, we used two standardized tests, i.e. the test for assessment of disability in patients with migraine (MIDAS, Migraine Disability Assessment Test) and the questionnaire testing the impact of headache (HIT6, Headache Impact Test), used to measure the impact of headaches on the ability to perform tasks at work/school and in social situations. Results: Concerning the average number of headaches per month, the majority of patients (n=11) had headache 5-6 times, usually lasting for 4 to 24 hours, as reported by 16 subjects. The average headache intensity was reported as severe pain by 10 patients and strong pain by 15 patients. Age was not a statistically significant factor for disabling migraines except for school/work absenteeism. The connection was only established for work/school absenteeism due to headaches in the last three months (days), where positive values of the correlation coefficient (ro) suggested that greater work/school absenteeism in the last three months was recorded in patients with a higher level of education. After the treatment, a statistically significant difference was only found in the reduction of work/school productivity because of headaches in the last three months (days) (p=0.001). Testing the impact of neurofeedback therapy on disability due to migraine revealed a statistically significant decrease in HIT6 results, as well as in the value of all segments of the migraine impact on life, i.e. MIDAS results