375 research outputs found

    A hypothalamic mechanism regulates the duration of a migraine attack. Insights from microstructural and temporal complexity of cortical functional networks analysis

    No full text
    The role of the hypothalamus and the limbic system at the onset of a migraine attack has recently received significant interest. We analyzed diffusion tensor imaging (DTI) parameters of the entire hypothalamus and its subregions in 15 patients during a spontaneous migraine attack and in 20 control subjects. We also estimated the non-linear measure resting-state functional MRI BOLD signal’s complexity using Higuchi fractal dimension (FD) and correlated DTI/fMRI findings with patients’ clinical characteristics. In comparison with healthy controls, patients had significantly altered diffusivity metrics within the hypothalamus, mainly in posterior ROIs, and higher FD values in the salience network (SN). We observed a positive correlation of the hypothalamic axial diffusivity with migraine severity and FD of SN. DTI metrics of bilateral anterior hypothalamus positively correlated with the mean attack duration. Our results show plastic structural changes in the hypothalamus related to the attacks severity and the functional connectivity of the SN involved in the multidimensional neurocognitive processing of pain. Plastic changes to the hypothalamus may play a role in modulating the duration of the attack

    Problematic donation procedures vs. futuristic research and treatment applications: a dichotomous social representation of stem cells in Italy

    No full text
    Introduction: Currently, stem cells (SC) are one of the most studied issues of medical research as well as a widespread, complex, socially and ethically relevant issue. Objective: The general aim of the present study is to explore how social representations (SR) of SC is different for people more or less willing to donate SC, also comparing bone marrow SC (BMSC) donation and umbilical cord blood SC (UCBSC) donation. Method: A paper-and-pencil survey was administrated to 78 Italian respondents. A structural analysis of SC-SRs (prototypical and co-occurrence analysis) was conducted comparing people with a high/low intention to donate UCBSC/BMSC. Results: Similarly to other bioethically relevant issues, SR of SC seems to be ambivalent and dichotomously organized, with the donation procedure been a barrier. Conclusion: These results are in line with studies finding two sets of dichotomies: on the one hand, a gift-of-life/replacement-of-body-parts dichotomy coexisting within people's SR of organ donation; on the other hand, a help/pain and needle dichotomy within blood donation's SR. Directions for future research are suggested

    Genetics influences drug consumption in medication overuse headache, not in migraine. Evidence from Wolframin His611Arg polymorphism analysis

    Get PDF
    Background: The Wolframin His611Arg polymorphism can influence drug consumption in psychiatric patients with impulsive addictive behavior. This cross-sectional study aims to assess the prevalence of the Wolframin His611Arg polymorphism in MOH, a secondary headache belonging to the spectrum of addictive disorders, episodic migraine (EM), and healthy subjects (HS), and its influence on drug consumption. Methods: One-hundred and seventy-two EM, 107 MOH, and 83 HS were enrolled and genotyped for the Wolframin His611Arg polymorphism. Subjects were classified as homozygous for allele His (H/H subjects), homozygous for allele Arg (R/R subjects), and heterozygous (H/R subjects), regrouped as R/R and carriers of allele H (non-R/R), and matched for clinical data. Results: There were no differences in allelic distributions between the three groups (p = 0.19). Drug consumption and other clinical characteristics were not influenced by the Wolframin His611Arg polymorphism (p = 0.42; ő≤ = 0.04) in the EM group. Among the MOH population, R/R subjects consumed more analgesics (p < 0.0001; ő≤ = ‚ąí0.38), particularly combination drugs (p = 0.0001; d = 2.32). Discussion: The Wolframin His611Arg polymorphism has a similar prevalence between the MOH, EM, and HS groups. The presence of the R/R genotype does not influence symptomatic drug consumption in EM, whereas it determines an increased use of symptomatic drugs in the MOH group, in particular combination drugs (i.e., drugs containing psychoactive compounds). Conclusions: Our findings are consistent with the hypothesis that the Wolframin His611Arg polymorphism plays its effect only in the MOH population, influencing the impulsivity control underlying addictive behavior

    Pain control and functional improvement in patients treated by autologous conditioned serum after failure of platelet rich plasma treatments in knee osteoarthritis

    No full text
    Objective: To assess the efficacy of autologous conditioned serum (ACS) for the treatment of patients with knee osteoarthritis after failure of medical treatments and platelet rich plasma (PRP) injections. Background: Knee osteoarthritis is the most common form of arthritis. Prior to prosthetic surgery these patients might benefit from medical treatments, physiotherapy, and in case of their ineffectiveness, from autologous blood component injections. Methodology: We have treated 30 patients with Kellgren-Lawrence I-III knee osteoarthritis with ACS after failure of standard medical treatments/physiotherapy and platelet rich plasma (PRP) injections for a full cycle, within the previous year from enrollment. Results: ACS administration was performed in all patients with mild side effects and produced prompt (1 month) improvements of VAS and Lequesne scales in 67% of patients and this result persisted at 6 and 12 months. No relationship between the rate of response and Kellgren-Lawrence scale at enrollment was observed whilst responders had a significantly higher amount of interleukin-1 receptor antagonist (IL1-RA) in ACS as compared to nonresponders. Conclusion: The present study confirms the efficacy of ACS in pain control and functional recovery of patients with knee osteoarthritis resistant to medical and PRP treatment. These results were obtained in a well-defined cohort of resistant patients and seem to be related with IL1-RA content in injected ACS. ¬© 2021 British Blood Transfusion Society

    Genetics influences drug consumption in medication overuse headache, not in migraine: evidence from Wolframin His611Arg polymorphism analysis

    No full text
    Background: The Wolframin His611Arg polymorphism can influence drug consumption in psychiatric patients with impulsive addictive behavior. This cross-sectional study aims to assess the prevalence of the Wolframin His611Arg polymorphism in MOH, a secondary headache belonging to the spectrum of addictive disorders, episodic migraine (EM), and healthy subjects (HS), and its influence on drug consumption.Methods: One-hundred and seventy-two EM, 107 MOH, and 83 HS were enrolled and genotyped for the Wolframin His611Arg polymorphism. Subjects were classified as homozygous for allele His (H/H subjects), homozygous for allele Arg (R/R subjects), and heterozygous (H/R subjects), regrouped as R/R and carriers of allele H (non-R/R), and matched for clinical data.Results: There were no differences in allelic distributions between the three groups (p = 0.19). Drug consumption and other clinical characteristics were not influenced by the Wolframin His611Arg polymorphism (p = 0.42; beta = 0.04) in the EM group. Among the MOH population, R/R subjects consumed more analgesics (p < 0.0001; beta = -0.38), particularly combination drugs (p = 0.0001; d = 2.32).Discussion: The Wolframin His611Arg polymorphism has a similar prevalence between the MOH, EM, and HS groups. The presence of the R/R genotype does not influence symptomatic drug consumption in EM, whereas it determines an increased use of symptomatic drugs in the MOH group, in particular combination drugs (i.e., drugs containing psychoactive compounds).Conclusions: Our findings are consistent with the hypothesis that the Wolframin His611Arg polymorphism plays its effect only in the MOH population, influencing the impulsivity control underlying addictive behavior

    Neurophysiology of migraine with aura

    No full text
    In this chapter, we review the findings obtained by neurophysiological studies in migraine with aura (MA). Spontaneous electroencephalography activity in MA is characterized by abnormalities in alpha rhythm power and symmetry, and the presence of slowing, and increased, information flow in a wide range of frequency bands. Evoked potential (EP) studies indicate the occurrence of increased grand-average cortical response amplitudes, interhemispheric response asymmetry, as well as deficient habituation to any kind of repetitive sensory stimulation, in MA patients. Transcranial magnetic stimulation (TMS) methods applied in MA confirm abnormalities in cortical responsivity, such as greater motor evoked potential (MEP) amplitude, lower threshold for phosphene production, and paradoxical effects induced by depressing or enhancing repetitive TMS. Brainstem reflex studies indicate a deficit of blink reflex habituation in MA. Mild abnormalities of neuromuscular transmission shown by single-fibre electromyography were more pronounced in migraineurs with aura, and positively correlated to the complexity of their aura. The few studies performed in patients during the aura described suppression of evoked potentials, desynchronization in extrastriate areas and the temporal lobe, and large variations in direct current potentials using magnetoelectroencephalography. In contrast, patients affected by familial hemiplegic migraine had opposite neurophysiological patterns in comparison with patients suffering from the common forms of migraine

    Brain oscillations and migraine

    No full text
    The rhythmic oscillations embedded in the spontaneous or evoked electroencephalographic (EEG) activity are closely related to the subtle cognitive processes of the brain. This review is aimed to provide a comprehensive overview of the studies investigating brain oscillations across various frequency ranges in migraine, using EEG and evoked potentials. The analysis of quantitative EEG in migraine provided inconclusive results, especially the amplitude of alpha waves. Alpha phase hyper-synchronization during flash visual stimulation has been consistently reported and helps in the neurophysiological discrimination between migraine with and without aura. The strength of functional connectivity between the alpha rhythmic activity from the cuneus to the temporal pole and the anterior cingulate cortex fluctuates depending on the distance from the last attack. The analysis of the high- (beta/gamma bands) and very high-frequency (around 600 Hz) oscillations (HFOs) underlying the common visual and somatosensory evoked potentials discloses a reduced thalamocortical activity during the pain-free phase of migraine. The amplitude of these HFOs may contribute to the determination of migraine clinical features. Overall, the analysis of the oscillatory neural activity in the migraineur brain provided evidence in favor of a thalamocortical dysrhythmia, probably due to a thalamic deafferentation from the brainstem monoaminergic tonic activity. Supplementary studies of HFOs are needed to compare the recordings with other primary headaches, such as tension-type or cluster headache, in order to verify the specificity of these findings for migraine

    Direct anterior approach for total hip arthroplasty: Hip biomechanics and muscle activation during three walking tasks

    No full text
    Background: Total hip replacement with minimally invasive direct anterior approach using the ‚ÄúSmith Petersen‚ÄĚ interval is an alternative technique to conventional surgery aimed at preserving the integrity of the muscles around the hip joint. This study aimed to observe hip biomechanics, gait variables, hip muscle activation and locomotor performance during three locomotor tasks (forward, lateral, and backward walking), in subjects who undergo total hip arthroplasty with direct anterior approach. Methods: Fourteen patients with primary osteoarthritis who underwent direct anterior approach were included in the study. The optoelectronic 3-D motion analysis system integrated with an electromyography surface device was used to acquire the biomechanics of patients before surgery and at 3 and 6 months post-surgery. Spatio-temporal, dynamic, and hip muscle electromyographic parameters were analyzed and compared whit those of healthy controls. Findings: Almost all gait parameters improved after surgery. The majority of gait variables neared to the control group at 6 months, while the hip joint range of motion did not. The abnormally increased activation of the muscles around the hip joint was reduced at 6 months post-surgery during all three locomotor tasks. Conversely, the altered gait phase-related electromyographic pattern did not change after the surgery. Interpretation: Our results indicate that hip and gait function during several locomotor tasks improved after surgery, while simultaneously either preserve or restore the muscle activation around the hip joint. A full biomechanical evaluation of the hip function during locomotion may aid physicians and surgeons in optimizing the management of patients before and after hip replacement surgery

    Neuromodulation for evaluating the pathophysiology of migraine

    No full text
    The two most frequently used techniques for the non-invasive modulation of brain activity are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). These techniques have repeatedly been used to modulate the activity of a given area within a neuronal network to study pathophysiological changes in migraine. The most freqeuntly stimulated areas are visual and sensorimotor areas. We discuss here what kinds of paradoxical effects have been described in response to inhibitory and excitatory modulation in patients with episodic and chronic migraine and how neuromodulation can help distinguish patients with chronic migraine from those with medication overuse headache. Furthermore, we elaborate how these methods can normalize the habituation deficit in response to visual and somatosensory stimuli, frequently detected between migraine attacks. From the studies reviewed in this chapter, it emerges that the brain of the migraine patient is characterized by alterations of synaptic activity-dependent plasticity, i.e., the phenomena of long-term potentiation and depression

    Migraine during covid-19: Data from second wave pandemic in an Italian cohort

    No full text
    Objectives: The study aims to assess the impact of the second COVID-19 pandemic wave on migraine characteristics. Methods: This is an observational cross-sectional study conducted on migraine patients previously interviewed during the first Italian pandemic outbreak. A second structured telephone interview was conducted between 20 November 2020 and 18 January 2021. We compared migraine characteristics among T0 (before pandemic), T1 (during the first pandemic phase), and T2 (during the second pandemic phase). Results: Among the 433 patients interviewed during the first pandemic phase, 304 cases were finally considered. One hundred forty-eight patients had a control visit between March 2020 and December 2020, 120 had an in-person visit, 14 by phone, the remainder used telemedicine software provided by the hospital. Frequency of headache, number of symptomatic drugs and headache intensity worsened during T2, compared to T0 and T1, especially in episodic migraine. Headache intensity increased relating to the negative emotional impact of the pandemic. Migraine management during the pandemic did not influence the clinical outcome. Conclusion: The prolongation of the pandemic seems to have a negative impact on migraine evolution. The arousal and negative psychological behavior toward the COVID-19 outbreak seem to worsen migraine
    • ‚Ķ
    corecore