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 švanomi: prikaz slučaja

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 (Meckel’s cave). After gamma knife radiosurgery, trigeminal neuralgia was relieved completely with improvement of facial nerve palsy.Švanomi su dobroćudni inkapsulirani tumori koji potječu iz ovojnica perifernih živaca. Najčešće se javljaju kao pojedinačni sporo rastući tumori koji mogu uzrokovati neurološke deficite. Mnogostruki švanomi su iznimno rijetki u bolesnika koji nemaju neurofibromatozu tip 2. Prikazujemo slučaj 60-godišnje bolesnice s negativnom obiteljskom anamnezom za neurofibromatozu ili švanomatozu, koja se prezentirala s neuralgijom trigeminusa i progresivnom paralizom facijalnog živca. Magnetska rezonanca prikazala je prisutnost akustičnog švanoma sa zahvaćanjem i facijalnog živca te švanoma cisternalnog dijela trigeminalnog živca sa širenjem u područje gangliona istog (Meckelova šupljina). Nakon “gamma knife” radiokirurgije simptomi trigeminalne neuralgije su se u potpunosti povukli uz značajno kliničko poboljšanje 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 αIIbβ3 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 našim saznanjima nema studije koja je istraživala nastaju li umor i depresija kao najučestaliji simptomi kod bolesnika s multiplom sklerozom (MS) i opstrukcijskom apnejom tijekom spavanja (OSA) primarnim mehanizmima MS ili iz sekundarnih povezanih stanja kao što je OSA kod bolesnika s MS. Cilj naše anketne studije bio je utvrditi jesu li depresija i umor u bolesnika s MS povezani s kliničkim obilježjima OSA ili MS. Proveli smo anketu pomoću četiri validirana upitnika (STOP-BANG, Epworthova ljestvica pospanosti, ljestvica težine umora i revidirana ljestvica depresije Centra za epidemiološke studije) u 28 uzastopnih ambulantnih bolesnika s klinički i paraklinički dokazanom MS. Učestalost bolesnika s MS s povećanim rizikom od nastanka OSA bila je 29%, a dob je bila u pozitivnoj korelaciji s tim rizikom (p=0,019). Nijedna od kliničkih značajka bolesnika s MS (podtip, status invaliditeta, trajanje bolesti, modificirajuća terapija, drugi lijekovi) nije bila u korelaciji s depresijom i umorom. Naprotiv, pretjerana pospanost tijekom dana kao obilježje OSA bila je značajno i pozitivno povezana s razinom simptoma depresije (p=0,004) i razinom umora (p=0,015). Također, depresija je značajno i pozitivno korelirala s povećanim rizikom od OSA (p=0,015) i dobi bolesnika s MS (p=0,016). Konačno, utvrđena je značajna pozitivna korelacija između težine umora i simptoma depresije (p=0,003). OSA je čest poremećaj kod bolesnika s MS. Kliničke značajke i čimbenici rizika za OSA u bolesnika s MS povezani su s dva najčešće prijavljivana simptoma depresije i umora, podupirući tako hipotezu da su oba simptoma posljedica sekundarnog stanja u MS

PROPHYLAXIS OF MIGRAINE – A REVIEW OF LITERATURE

Cilj ovog prikaza literature je procijeniti mogućnosti profi lakse migrene. Prema preporukama International Headache Society (IHS) profi laksa migrene provodi se u bolesnika koji imaju ≥4 dana migrensku glavobolju na mjesec bilo da se radi o epizodičnoj ili kroničnoj migreni. Učinkovitim liječenjem smatra se smanjenje učestalosti migrenskih ataka za ≥50 %. Učinkovitima su se pokazali β-blokatori, kalcijski antagonisti, antiepileptici kao što su topiramat i valproat kao i gabapentin i pregabalin, te fl unarizin i antidepresivi. Učinkovitost levatiracetama, cervikalne miofascijalne anestezije te kožne elektrostimulacije i muskularne stimulacije još je u ispitivanju. Dvojben je učinak botulinum toksina. Istražuje se moguća 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, ribofl avina, dekstrometorfi na u nastanku migrenskih glavobolja. Potrebna je adekvatna procjena mogućih učinaka u profi laksi primjenom probiotika, koenzima Q10 i magnezija. Klinička istraživanja su pokazala da primjena humanih monoklonskih protutijela erenumaba, fremanezumaba i galkanezumaba pokazuju statistički značajnu učinkovitost (≥50 % učinkovitosti) u profi laksi migrene što je potrebno potvrditi u kliničkoj 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 ≥4 migraine headaches per month, either episodic or chronic. The treatment is deemed successful when the migraine attacks are decreased by ≥50%. Effi ciency has been demonstrated for β-blockers, calcium antagonists, antiepileptics such as topiramate and valproate, as well as gabapentin, pregabalin, fl unarizine and antidepressants. The effi 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, ribofl 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 signifi cant effi ciency (≥50%) in migraine prophylaxis, yet requiring further confi rmation in clinical practice

PROPHYLAXIS OF MIGRAINE – A REVIEW OF LITERATURE

Cilj ovog prikaza literature je procijeniti mogućnosti profi lakse migrene. Prema preporukama International Headache Society (IHS) profi laksa migrene provodi se u bolesnika koji imaju ≥4 dana migrensku glavobolju na mjesec bilo da se radi o epizodičnoj ili kroničnoj migreni. Učinkovitim liječenjem smatra se smanjenje učestalosti migrenskih ataka za ≥50 %. Učinkovitima su se pokazali β-blokatori, kalcijski antagonisti, antiepileptici kao što su topiramat i valproat kao i gabapentin i pregabalin, te fl unarizin i antidepresivi. Učinkovitost levatiracetama, cervikalne miofascijalne anestezije te kožne elektrostimulacije i muskularne stimulacije još je u ispitivanju. Dvojben je učinak botulinum toksina. Istražuje se moguća 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, ribofl avina, dekstrometorfi na u nastanku migrenskih glavobolja. Potrebna je adekvatna procjena mogućih učinaka u profi laksi primjenom probiotika, koenzima Q10 i magnezija. Klinička istraživanja su pokazala da primjena humanih monoklonskih protutijela erenumaba, fremanezumaba i galkanezumaba pokazuju statistički značajnu učinkovitost (≥50 % učinkovitosti) u profi laksi migrene što je potrebno potvrditi u kliničkoj 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 ≥4 migraine headaches per month, either episodic or chronic. The treatment is deemed successful when the migraine attacks are decreased by ≥50%. Effi ciency has been demonstrated for β-blockers, calcium antagonists, antiepileptics such as topiramate and valproate, as well as gabapentin, pregabalin, fl unarizine and antidepressants. The effi 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, ribofl 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 signifi cant effi ciency (≥50%) in migraine prophylaxis, yet requiring further confi 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 patofiziološki proces nastanka boli. Glavobolja može biti epizodična (trajanje boli do 15 dana) ili kroničnog (trajanje boli 15 ili više dana) tipa. Cilj: Cilj ovog rada je procjena javnozdravstvenog problema tenzijske glavobolje kao i mogućnosti adekvatnog liječenja i profilakse tenzijske glavobolje. Metode: Za ovo ispitivanje koristili smo bazu podataka Pub med uzimajući pojmove; tenzijska glavobolja, prevalencija i liječenje (tension type headache, prevalence, therapy). Rezultati: Učestalost TTH značajno oscilira u ovisnosti o socioekonomskim uvjetima, a moguće i o rasnim razlikama. Učestalost raste sa životnom dobi. Češće se javlja kod žena. Liječi se analgeticima i nesteroidnim antireumaticima. Profilaksa kronične TTH provodi se primjenom amitriptilina, mirtazapina, venlafaksina. U slučaju potrebe uključuje se druga linija profilakse koja obuhvaća klomipramin, maprotilin i mianserin. Uz to koriste se i nemedikamentne mogućnosti liječenja kao što su akupunktura, biofeedback metode, kognitivno-bihevioralno liječenje, relaksacijski treninzi. Rasprava: Tenzijska glavobolja je relativno čest javno-zdravstveni problem u suvremenom svijetu čiji patofiziološki mehanizam nije posve rasvijetljen. Smatra se da je ova glavobolja multifaktorski uvjetovana. Osim epizodične glavobolje značajno veći problem je kronična tenzijska glavobolja koja zahtijeva kontinuiranu profilaksu. Nemedikamentne metode profilakse TTH su nedovoljno istražene i zahtijevaju kliničko-znanstvenu evaluaciju. Zaključak: U suvremenom svijetu tenzijska glavobolja, posebno kronična TTH, je javnozdravstveni problem koji treba zbrinjavati na adekvatan način. Uz široku lepezu medikamentne terapije nameću se i pomoćne metode liječenja 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 ‘tension-type headache, prevalence and therapy’. Results: The TTH prevalence signifi 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 clarifi 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 insuffi ciently researched and require clinical scientifi 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 patofiziološki proces nastanka boli. Glavobolja može biti epizodična (trajanje boli do 15 dana) ili kroničnog (trajanje boli 15 ili više dana) tipa. Cilj: Cilj ovog rada je procjena javnozdravstvenog problema tenzijske glavobolje kao i mogućnosti adekvatnog liječenja i profilakse tenzijske glavobolje. Metode: Za ovo ispitivanje koristili smo bazu podataka Pub med uzimajući pojmove; tenzijska glavobolja, prevalencija i liječenje (tension type headache, prevalence, therapy). Rezultati: Učestalost TTH značajno oscilira u ovisnosti o socioekonomskim uvjetima, a moguće i o rasnim razlikama. Učestalost raste sa životnom dobi. Češće se javlja kod žena. Liječi se analgeticima i nesteroidnim antireumaticima. Profilaksa kronične TTH provodi se primjenom amitriptilina, mirtazapina, venlafaksina. U slučaju potrebe uključuje se druga linija profilakse koja obuhvaća klomipramin, maprotilin i mianserin. Uz to koriste se i nemedikamentne mogućnosti liječenja kao što su akupunktura, biofeedback metode, kognitivno-bihevioralno liječenje, relaksacijski treninzi. Rasprava: Tenzijska glavobolja je relativno čest javno-zdravstveni problem u suvremenom svijetu čiji patofiziološki mehanizam nije posve rasvijetljen. Smatra se da je ova glavobolja multifaktorski uvjetovana. Osim epizodične glavobolje značajno veći problem je kronična tenzijska glavobolja koja zahtijeva kontinuiranu profilaksu. Nemedikamentne metode profilakse TTH su nedovoljno istražene i zahtijevaju kliničko-znanstvenu evaluaciju. Zaključak: U suvremenom svijetu tenzijska glavobolja, posebno kronična TTH, je javnozdravstveni problem koji treba zbrinjavati na adekvatan način. Uz široku lepezu medikamentne terapije nameću se i pomoćne metode liječenja 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 ‘tension-type headache, prevalence and therapy’. Results: The TTH prevalence signifi 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 clarifi 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 insuffi ciently researched and require clinical scientifi 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 – A PILOT STUDY

Cilj: Cilj ovog istraživanja bio je objektivizirati terapijski učinak neurofeedbacka na liječenje 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 školi i u socijalnim situacijama. Rezultati: Prosječan broj glavobolja tijekom jednog mjeseca kod većine ispitanika je 11 (5 do 6 puta), uz najčešće trajanje od 4 do 24 sata, kako navodi 16 ispitanika. Prosječni je intenzitet glavobolje za 10 ispitanika srednje jaka bol, a za 15 ispitanika jaka bol. Dob nije statistički značajan faktor onesposobljenosti migrenama izuzev izostanka iz škole/posla. Povezanost je utvrđena samo za parametar izostanaka s posla/škole zbog glavobolja u zadnja 3 mjeseca (dani) gdje pozitivne vrijednosti koeficijenta korelacije (ro) upućuju na zaključak da je veći broj izostanaka s posla/ škole u zadnja 3 mjeseca kod pacijenata s višim stupnjevima obrazovanja. Nakon provedene terapije utvrđena je statistički značajna razlika samo u parametrima smanjenja produktivnosti na poslu/u školi zbog glavobolja u zadnja 3 mjeseca (dani) (p=0,001). Zaključak: Testiranjem utjecaja terapije neurofeedbackom na onesposobljenost migrenama utvrđen je statistički značajan 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 – A PILOT STUDY

Cilj: Cilj ovog istraživanja bio je objektivizirati terapijski učinak neurofeedbacka na liječenje 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 školi i u socijalnim situacijama. Rezultati: Prosječan broj glavobolja tijekom jednog mjeseca kod većine ispitanika je 11 (5 do 6 puta), uz najčešće trajanje od 4 do 24 sata, kako navodi 16 ispitanika. Prosječni je intenzitet glavobolje za 10 ispitanika srednje jaka bol, a za 15 ispitanika jaka bol. Dob nije statistički značajan faktor onesposobljenosti migrenama izuzev izostanka iz škole/posla. Povezanost je utvrđena samo za parametar izostanaka s posla/škole zbog glavobolja u zadnja 3 mjeseca (dani) gdje pozitivne vrijednosti koeficijenta korelacije (ro) upućuju na zaključak da je veći broj izostanaka s posla/ škole u zadnja 3 mjeseca kod pacijenata s višim stupnjevima obrazovanja. Nakon provedene terapije utvrđena je statistički značajna razlika samo u parametrima smanjenja produktivnosti na poslu/u školi zbog glavobolja u zadnja 3 mjeseca (dani) (p=0,001). Zaključak: Testiranjem utjecaja terapije neurofeedbackom na onesposobljenost migrenama utvrđen je statistički značajan 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