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Migraine Disorders: HELP
Articles from Austria
Based on 92 articles published since 2010

These are the 92 published articles about Migraine Disorders that originated from Austria during 2010-2020.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
51 Article Impact of depression and anxiety on burden and management of episodic and chronic headaches - a cross-sectional multicentre study in eight Austrian headache centres. 2016

Zebenholzer, Karin / Lechner, Anita / Broessner, Gregor / Lampl, Christian / Luthringshausen, Gernot / Wuschitz, Albert / Obmann, Sonja-Maria / Berek, Klaus / Wöber, Christian. ·Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. karin.zebenholzer@meduniwien.ac.at. · Department of Neurology, Medical University of Graz, Graz, Austria. anita.lechner@klinikum-graz.at. · Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria. gregor.broessner@i-med.ac.at. · Headache Centre Seilerstätte, Hospital Sisters of Charity Linz, Linz, Austria. christian.lampl@bhs.at. · University Clinic of Neurology, Christian-Doppler-Klinik Salzburg, Salzburg, Austria. g.luthringshausen@salk.at. · Neurological Office Vienna, Vienna, Austria. albertwuschitz@gmx.de. · Department of Neurology, Klinikum Klagenfurt, Klagenfurt, Austria. sonja-maria.obmann@kabeg.at. · Department of Neurology, aö. BKH Kufstein, Kufstein, Austria. klaus.berek@bkh-kufstein.at. · Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. christian.woeber@meduniwien.ac.at. ·J Headache Pain · Pubmed #26920681.

ABSTRACT: BACKGROUND: Recurrent and especially chronic headaches are associated with psychiatric comorbidities such as depression and anxiety. Only few studies examined the impact of depression and anxiety on episodic (EH) and chronic headache (CH), and data for Austria are missing at all. Therefore, the aim of the present study was to assess the impact of depression and anxiety on burden and management of EH and CH in patients from eight Austrian headache centres. METHODS: We included 392 patients (84.1 % female, mean age 40.4 ± 14.0 years) who completed the Eurolight questionnaire. The treating physician recorded details about ever-before prophylactic medications. We used Hospital Anxiety and Depression Scale to assess depression and anxiety and compared patients with anxiety and/or depression to those without. RESULTS: Depression and anxiety were more common in CH than in EH (64 % vs. 41 %, p < 0.0001). Presence compared to absence of depression and anxiety increased the prevalence of poor or very poor quality of life from 0.7 % to 13.1 % in EH and from 3.6 % to 40.3 % in CH (p = 0.001; p < 0.0001). Depression and anxiety had a statistically significant impact on employment status and on variables related to the burden of headache such as reduced earnings, being less successful in career, or feeling less understood. Neither in EH nor in CH health care use and the ever-before use of prophylactic medication was correlated with anxiety and/or depression. CONCLUSION: Depression and anxiety have a significant impact on quality of life and increase the burden in patients with EH and CH. Improved multidimensional treatment approaches are necessary to decrease disability on the personal, social and occupational level in these patients.

52 Article Interictal burden attributable to episodic headache: findings from the Eurolight project. 2016

Lampl, Christian / Thomas, Hallie / Stovner, Lars Jacob / Tassorelli, Cristina / Katsarava, Zaza / Laínez, Jose Miguel / Lantéri-Minet, Michel / Rastenyte, Daiva / Ruiz de la Torre, Elena / Andrée, Colette / Steiner, Timothy J. ·Headache Medical Center, Linz, Austria. · Department of Neurogeriatric Medicine and Remobilisation, Hospital of the Sisters of Charity, Linz, Austria. · Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. · Norwegian Advisory Unit on Headache, St Olavs University Hospital, Trondheim, Norway. · Headache Science Centre, C Mondino National Neurological Institute, Pavia, Italy. · Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy. · Department of Neurology, University of Duisberg-Essen, Essen, Germany. · Department of Neurology, Evangelical Hospital Unna, Unna, Germany. · Department of Neurology, Hospital Clinico Universitario, University of Valencia, Valencia, Spain. · Departement d'Evaluation et Traitement de la Douleur, Centre Hospitalo-Universitaire de Nice, Nice, France. · INSERM/UdA, U1107, Neuro-Dol, Clermont-Ferrand, France. · Lithuanian University of Health Sciences, Kaunas, Lithuania. · Asociacion Española de Pacientes con Cefalea (AEPAC), Valencia, Spain. · Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland. · Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg. · Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. t.steiner@imperial.ac.uk. · Division of Brain Sciences, Imperial College London, London, UK. t.steiner@imperial.ac.uk. ·J Headache Pain · Pubmed #26879832.

ABSTRACT: BACKGROUND: Most primary headaches are episodic, and most estimates of the heavy disability burden attributed to headache derive from epidemiological data focused on the episodic subtypes of migraine and tension-type headache (TTH). These disorders give rise directly but intermittently to symptom burden. Nevertheless, people with these disorders may not be symptom-free between attacks. We analysed the Eurolight dataset for interictal burden. METHODS: Eurolight was a cross-sectional survey using modified cluster sampling from the adult population (18-65 years) in 10 countries of the European Union. We used data from nine. The questionnaire included headache-diagnostic questions based on ICHD-II and several question sets addressing impact, including interictal and cumulative burdens. RESULTS: There were 6455 participants with headache (male 2444 [37.9 %]). Interictal symptoms were reported by 26.0 % of those with migraine and 18.9 % with TTH: interictal anxiety by 10.6 % with migraine and avoidance (lifestyle compromise) by 14.8 %, both much more common than in TTH (3.1 % [OR 3.8] and 4.7 % [OR 3.5] respectively). Mean time spent in the interictal state was 317 days/year for migraine, 331 days/year for TTH. Those who were "rarely" or "never" in control of their headaches (migraine 15.2 %, TTH 9.6 %) had significantly raised odds of interictal anxiety, avoidance and other interictal symptoms. Among those with migraine, interictal anxiety increased markedly with headache intensity and frequency, avoidance less so but still significantly. Lost productive time was associated with high ORs (up to 5.3) of anxiety and avoidance. A third (32.9 %) with migraine and a quarter (26.7 %) with TTH (difference: p < 0.0001) were reluctant to tell others of their headaches. About 10 % with each disorder felt families and friends did not understand their headaches. Nearly 12 % with migraine reported their employers and colleagues did not. Regarding cumulative burden, 11.8 % reported they had done less well in education because of headache, 5.9 % reported reduced earnings and 7.4 % that their careers had suffered. CONCLUSIONS: Interictal burden in those with episodic headache is common, more so in migraine than TTH. Some elements have the potential to be profoundly consequential. New methodology is needed to measure interictal burden if descriptions of headache burden are to be complete.

53 Article Reliability of assessing lifestyle and trigger factors in patients with migraine--findings from the PAMINA study. 2016

Zebenholzer, K / Frantal, S / Pablik, E / Lieba-Samal, D / Salhofer-Polanyi, S / Wöber-Bingöl, C / Wöber, C. ·Department of Neurology, Medical University of Vienna, Vienna, Austria. · CeMSIIS Section for Medical Statistics, Medical University of Vienna, Vienna, Austria. · Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria. ·Eur J Neurol · Pubmed #26228627.

ABSTRACT: BACKGROUND AND PURPOSE: Numerous lifestyle factors are blamed for triggering migraine attacks. The reliability of assessing these factors retrospectively is unknown. Therefore, retrospective and prospective assessments of lifestyle in general and of migraine triggers in particular were compared in patients with migraine. METHODS: At baseline, the patients filled in two questionnaires covering the previous 90 days. Thereafter they kept a prospective 90-day diary. Questionnaires and diary included the same set of 45 factors. In the first questionnaire the patients assessed their lifestyle, in the second they rated for each factor the likelihood of triggering a migraine attack, and in the diary they recorded the daily presence of these factors irrespective of headache. Five categories were used for comparing frequencies in questionnaire and diary, defining agreement as identical categories in diary and questionnaire, minor disagreement and major disagreement as overestimation or underestimation by one category and two or more categories, respectively. RESULTS: In all, 327 patients (283 women, age 41.9 ± 12.1 years) who recorded 28,325 patient days were included. Calculating for each factor the percentage of patients with major disagreement the mean proportion was larger for trigger factors than for lifestyle (38.7% ± 6.6% vs. 16.9% ± 6.4%, P < 0.001). The proportion of factors showing major disagreement in more than 20% of the patients was 8.8% for lifestyle but 94.1% for trigger factors (P < 0.001). CONCLUSION: Comparing questionnaire and diary assessments of lifestyle and trigger factors in patients with migraine shows that questionnaire assessment of lifestyle is reliable, whereas trigger factors are overestimated and/or underestimated in retrospective questionnaires.

54 Article Transcutaneous Supraorbital Nerve Stimulation (t-SNS) with the Cefaly 2015

Riederer, Franz / Penning, Sophie / Schoenen, Jean. ·Neurological Center Rosenhuegel and Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria. franz.riederer@uzh.ch. · R&D Department, Cefaly Technology, Liege, Belgium. · Headache Research Unit, Department of Neurology and GIGA-Neurosciences, Liège University, Liege, Belgium. ·Pain Ther · Pubmed #26467451.

ABSTRACT: So far, among the different non-invasive neurostimulation methods, only transcutaneous supraorbital nerve stimulation (t-SNS) with the Cefaly

55 Article Neck pain in episodic migraine: premonitory symptom or part of the attack? 2015

Lampl, Christian / Rudolph, Mirjam / Deligianni, Christina I / Mitsikostas, Dimos D. ·Medical Headache Center, Hospital Sisters of Mercy, Seilerstaette Linz, Linz, 4020, Austria, christian.lampl@bhs.at. ·J Headache Pain · Pubmed #26329488.

ABSTRACT: BACKGROUND: Whether neck pain (NP) is a prodromal migraine symptom or belongs to the migraine attack feature remains controversial. METHODS: In order to prospectively record neck pain (NP) and non-headache symptoms and to evaluate the percentage of patients having NP as clear premonitory, non-headache symptom of their migraine, a specific self fulfilled questionnaire was designed to record NP and premonitory symptoms in a migraine cohort. All patients who reported NP anytime during the migraine phase were allocated to 3 groups: A = NP starts with the onset of headache; B = NP starts < 2 h before the onset of headache; C = NP starts 2-48 h before the onset of headache. RESULTS: Data were evaluated from 487 migraineurs with episodic migraine (73.1 % females; 77 % had migraine without aura). 338 patients (69.4 %) reported NP anytime during the migraine phase. 184 patients (group A; 54.4 %) noticed NP with the start of the headache phase; 118 patients (group B; 24.2 %) reported NP within 2 h before the headache phase; 36 patients (group C; 7.4 %) experienced NP 2-48 h before the headache phase. In group B we found a high proportion of typical migraine associated symptoms and NP progressed into the headache phase in 82.2 %. CONCLUSIONS: These data indicate that NP is a very common feature of migraine attacks and is more likely to be part of the migraine attack than a prodromal migraine symptom.

56 Article Oxidative stress: Determination of 4-hydroxy-2-nonenal by gas chromatography/mass spectrometry in human and rat plasma. 2015

Zelzer, S / Mangge, H / Oberreither, R / Bernecker, C / Gruber, H-J / Prüller, F / Fauler, G. ·a Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz , Austria. ·Free Radic Res · Pubmed #26053028.

ABSTRACT: The lipid peroxidation product 4-hydroxynonenal (HNE) is a biomarker of oxidative stress which is essentially involved in the pathophysiology of many diseases. The analysis of HNE is challenging because this aldehyde is extremely reactive and thus unstable. Hence, we adopted a gas chromatography-mass spectrometry (GC-MS) method based on derivatization of HNE with pentafluorobenzyl-hydroxylamine-HCl followed by trimethylsilylation to trimethylsilyl ethers. Ions representative for a negative ion chemical ionization mode were recorded at m/z = 152 for HNE and at m/z = 162 for the deuterated analogon (HNE-d11) as internal standard. This excellent stable and precise GC-MS method was carefully validated for HNE, and showed good linearity (r(2) = 0.998), and high specificity and sensitivity. Within-day precisions were 4.4-6.1% and between-day precisions were 5.2-10.2%. Accuracies were between 99% and 104% for the whole calibration range (2.5-250 nmol/L) of HNE. To examine the versatility of this modified GC-MS method, we analyzed HNE in ethylenediaminetetraacetic acid (EDTA) plasma in a well-defined collective of migraine patients; recently published. The results underline our former observations that women with migraine are afflicted with increased levels of HNE. Patients with thyroidal dysfunction showed no significant HNE alterations. This was confirmed by normal HNE EDTA plasma levels in hyper- und hypothyroid Sprague-Dawley rats. Taken together, the GC-MS method presented herein is of excellent quality to record oxidative stress-related bioactive HNE levels. This is important for a reorientation of oxidative stress analytics in other human diseases first of atherosclerosis and cancer.

57 Article Markers of endothelial function in migraine patients: Results from a bi-center prospective study. 2015

Fischer, Marlene / Gaul, Charly / Shanib, Hind / Holle, Dagny / Loacker, Lorin / Griesmacher, Andrea / Lackner, Peter / Broessner, Gregor. ·Department of Neurology, Headache Outpatient Clinic, Medical University of Innsbruck, Austria. · Department of Neurology, University of Duisburg-Essen, Germany Migräne und Kopfschmerzklinik Königstein, Germany. · Department of Neurology, University of Duisburg-Essen, Germany. · Central Institute of Medicinal and Chemical Laboratory Diagnostics, University Hospital, Austria. · Department of Neurology, Headache Outpatient Clinic, Medical University of Innsbruck, Austria gregor.broessner@i-med.ac.at. ·Cephalalgia · Pubmed #25533714.

ABSTRACT: BACKGROUND: Numerous studies suggest an increased vascular risk in patients with migraine, in particular in those with aura. A possible link between both conditions might be a dysfunction of the vascular endothelium. This observational study analyzed the endothelial markers angiopoietin-1, angiopoietin-2, Tie-2, sFlt-1 and NT-proBNP for the first time in migraineurs, patients with other primary headache disorders and healthy controls. METHODS: Patients with episodic migraine with and without aura, episodic cluster headache, tension-type headache and healthy controls were included. Blood samples were obtained during migraine attacks and headache-free periods in migraineurs, in and out of bout in cluster headache and during headache-free periods in tension-type headache and healthy individuals to analyze markers of endothelial function. RESULTS: No significant difference in endothelial markers between migraine, other headache disorders and healthy controls was detected. There was no significant difference between migraine attacks and headache-free intervals. Additionally, no distinction could be found between migraine with and without aura. DISCUSSION: The endothelial markers analyzed do not display a characteristic pattern in different headache disorders especially migraine compared to healthy controls. The novel findings of our study indicate that factors other than endothelial dysfunction seem to be responsible for the at least statistical association of migraine with vascular disease.

58 Article Rare clinical findings in a patient with sporadic hemiplegic migraine: FDG-PET provides diminished brain metabolism at 10-year follow-up. 2014

Topakian, R / Pischinger, B / Stieglbauer, K / Pichler, R. ·Department of Neurology, Wagner-Jauregg Hospital, Austria. ·Cephalalgia · Pubmed #24270521.

ABSTRACT: BACKGROUND: Sporadic hemiplegic migraine (SHM) is defined as migraine attacks associated with some degree of motor weakness during the aura phase and where no first-degree relative has identical attacks. SHM has a wide inter- and intraindividual clinical spectrum and, in case of prolonged aura symptoms and disturbed consciousness, can mimic several other acute neurological diseases. CASE: In 1996, during his wedding night, a 28-year-old man developed left face, arm and leg weakness, nausea and a throbbing headache. Neurological examination on presentation revealed stupor, fever, meningism and left hemiplegia. There were no abnormalities on emergency magnetic resonance. Lumbar puncture showed mild lymphocytic pleocytosis and slightly elevated protein. He received symptomatic treatment. Subsequent genetic analysis revealed the T666M mutation in the CACNA1A gene of chromosome 19. He was diagnosed with SHM. In 2005, at the end of another episode of hemiplegic migraine (HM), he for the first time developed an episode of paranoid psychosis with anxiety and visual hallucinations. The psychiatric symptoms resolved within a week. DISCUSSION: All perfusion SPECT and transcranial Doppler studies performed in the first days of HM attacks were consistent with hyperemia of the hemisphere contralateral to the neurological signs. FDG-PET/CT in January 2013 revealed a diffusely reduced glucose metabolism of the supratentorial cortex and marked asymmetric hypometabolism of the left cerebellum. The finding of progressive cortical metabolic dysfunction over years appears as a new finding. Glucose hypometabolism may indicate primary neuronal dysfunction as the cause of the prolonged deficits.

59 Article Unrecognized paraganglioma of the urinary bladder as a cause for basilar-type migraine. 2014

Pichler, Renate / Heidegger, Isabel / Klinglmair, Gerald / Kroiss, Alexander / Uprimny, Christian / Gasser, Rudolf Wolfgang / Schäfer, Georg / Steiner, Hannes. ·Department of Urology, Medical University Innsbruck, Innsbruck, Austria. ·Urol Int · Pubmed #23735539.

ABSTRACT: Extra-adrenal paraganglioma with isolated localization in the urinary bladder is a rare neuroendocrine tumor. Although the typical symptoms like headache, nausea, weight loss, flushing, heart palpitation or paroxysmal hypertension during micturition are well established, we present an unusual case of bladder paraganglioma, 'misdiagnosed' with basilar-type migraine due to headache for the past 8 years. As urologists linked the presence of a tumor (by CT) and symptoms connected with micturition, no cystoscopy and no transurethral resection of the bladder was performed prior to detailed diagnostic workup. After diagnosis of an extra-adrenal paraganglioma, the patient was scheduled for open partial cystectomy. In consideration of the fact that bladder paraganglioma is an infrequent genitourinary cancer, this case report clearly points out the importance of an exact anamnesis and clinical examination to minimize the probability of misdiagnosis with possible fatal consequences in any case with clinical suspicion of bladder paraganglioma.

60 Article Prospective analysis of factors related to migraine aura--the PAMINA study. 2012

Salhofer-Polanyi, Sabine / Frantal, Sophie / Brannath, Werner / Seidel, Stefan / Wöber-Bingöl, Çiçek / Wöber, Christian / Anonymous3080728. ·Department of Neurology, Medical University of Vienna, Vienna, Austria. ·Headache · Pubmed #22671771.

ABSTRACT: OBJECTIVES: The aim of this study was to examine factors increasing and decreasing the risk of occurrence of migraine aura and of headache and migraine not associated with aura (HoA, MoA) prospectively by means of a daily diary. METHODS: Of 327 patients with migraine completing a comprehensive diary up to 90 days, we selected all patients who recorded at least 1 episode of migraine aura. To find risk indicators and triggers of aura, HoA, and MoA, we analyzed 56 variables and calculated univariate and multivariate generalized linear mixed models. RESULTS: Fifty-four patients recorded a total of 4562 patient days including 354 days with migraine aura. In the multivariate analysis, the risk of aura was statistically significantly increased by smoking, menstruation, and hunger, and it was decreased by holidays and days off. The risk of HoA and/or MoA was increased during menstruation, by psychic tension, tiredness, and odors, and it was decreased by smoking. CONCLUSION: Menstruation is the most prominent factor increasing the risk of aura as well as that of HoA and MoA. Smoking shows the most striking difference increasing the risk of aura, but decreasing the risk of HoA and MoA.

61 Article Increased RLS prevalence in children and adolescents with migraine: a case-control study. 2012

Seidel, Stefan / Böck, Andreas / Schlegel, Werner / Kilic, Arzu / Wagner, Gudrun / Gelbmann, Gloria / Hübenthal, Almut / Kanbur, Incifer / Natriashvili, Sofia / Karwautz, Andreas / Wöber, Christian / Wöber-Bingöl, Ciçek. ·Headache Unit at the Department of Neurology, Medical University of Vienna, Austria. ·Cephalalgia · Pubmed #22659118.

ABSTRACT: BACKGROUND: Previous studies have reported an increased frequency of restless legs syndrome (RLS) in adult migraine patients. Until now, the frequency of RLS in pediatric patients has not been investigated. We set out to assess the frequency of RLS in children and adolescents with migraine compared to headache-free controls. METHODS: We investigated 111 consecutive patients with a sole diagnosis of migraine with or without aura presenting to the Headache Unit at the Department of Child and Adolescent Psychiatry and 73 headache-free controls for the presence of RLS using a semistructured interview. In addition, we assessed the level of daytime sleepiness by means of the Epworth sleepiness scale (ESS). A second group of headache-free controls was screened for the presence of RLS using an online questionnaire. RESULTS: The frequency of RLS in migraine patients was significantly higher than in controls (22% vs. 5% (p < 0.001) and 8% (p < 0.001)). DISCUSSION: This is the first study suggesting an association between RLS and migraine in the pediatric population. Future studies are needed to determine the extent of sleep disruption in children and adolescents with migraine and comorbid RLS.

62 Article Long-term outcome of cognitive functions, emotional behavior, and quality of life in a family with familial hemiplegic migraine. 2012

Karner, Elfriede / Nachbauer, Wolfgang / Bodner, Thomas / Benke, Thomas / Boesch, Sylvia / Delazer, Margarete. ·Clinical Department of Neurology, Medical University Innsbruck, Austria. elfriede.karner@uki.at ·Cogn Behav Neurol · Pubmed #22596110.

ABSTRACT: OBJECTIVE: To investigate long-term cognitive outcome, mood, and quality of life in a family with genetically proven familial hemiplegic migraine (FHM). BACKGROUND: FHM is a rare autosomal-dominant subtype of migraine with aura, characterized by some degree of hemiparesis during the aura. In a previous study, we showed preserved and impaired cognitive functions in patients with FHM. Until now, the progression of cognitive dysfunctions has not been known. However, the ability to predict progression is important for counseling patients about education, career, and family life. METHODS: Seven years after extensive baseline neuropsychological testing, we retested 6 members of a family with FHM, including questionnaires about mood and quality of life. RESULTS: The follow-up assessment revealed no global cognitive decline. All the patients' linguistic abilities and verbal memory remained intact; however, their figural memory, attention, and some aspects of executive function were impaired. Half the patients had a slight deterioration in their visuoconstructional functions. Half had higher scores on the trait and state anxiety measures. CONCLUSIONS: Cognitive deficits in a family with FHM persisted, but without marked progression. Worsening of visuoconstructional abilities may be related to executive dysfunction, confirming a disturbance of cerebrocerebellar circuits.

63 Article Brain-derived neurotrophic factor in primary headaches. 2012

Fischer, Marlene / Wille, Georg / Klien, Stephanie / Shanib, Hind / Holle, Dagny / Gaul, Charly / Broessner, Gregor. ·Department of Neurology, Headache Outpatient Clinic, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria. marlene.fischer@i-med.ac.at ·J Headache Pain · Pubmed #22584531.

ABSTRACT: Brain derived neurotrophic factor (BDNF) is associated with pain modulation and central sensitization. Recently, a role of BDNF in migraine and cluster headache pathophysiology has been suspected due to its known interaction with calcitonin gene-related peptide. Bi-center prospective study was done enrolling four diagnostic groups: episodic migraine with and without aura, episodic cluster headache, frequent episodic tension-type headache, and healthy individuals. In migraineurs, venous blood samples were collected twice: outside and during migraine attacks prior to pain medication. In cluster headache patients serum samples were collected in and outside cluster bout. Analysis of BDNF was performed using enzyme-linked immunosorbent assay technique. Migraine patients revealed significantly higher BDNF serum levels during migraine attacks (n = 25) compared with headache-free intervals (n = 53, P < 0.01), patients with tension-type headache (n = 6, P < 0.05), and healthy controls (n = 22, P < 0.001). There was no significant difference between patients with migraine with aura compared with those without aura, neither during migraine attacks nor during headache-free periods. Cluster headache patients showed significantly higher BDNF concentrations inside (n = 42) and outside cluster bouts (n = 24) compared with healthy controls (P < 0.01, P < 0.05). BDNF is increased during migraine attacks, and in cluster headache, further supporting the involvement of BDNF in the pathophysiology of these primary headaches.

64 Article Acute-onset migrainous aura mimicking acute stroke: MR perfusion imaging features. 2012

Floery, D / Vosko, M R / Fellner, F A / Fellner, C / Ginthoer, C / Gruber, F / Ransmayr, G / Doerfler, A / Uder, M / Bradley, W G. ·Institute of Radiology, AKH Linz, Linz, Austria. ·AJNR Am J Neuroradiol · Pubmed #22517281.

ABSTRACT: BACKGROUND AND PURPOSE: In a very limited number of cases, acute migrainous aura may mimic acute brain infarction. The aim of this study was to recognize patterns of MR perfusion abnormalities in this presentation. MATERIALS AND METHODS: One thousand eight hundred fifty MR imaging studies performed for the suspicion of acute brain infarction were analyzed retrospectively to detect patients with acute migrainous aura not from stroke. All patients were examined clinically by 2 neurologists and underwent a standard stroke MR imaging protocol, including PWI. Two radiologists reviewed the perfusion maps visually and quantitatively for the presence, distribution, and grade of perfusion abnormalities. RESULTS: Among 1850 MR imaging studies, 20 (1.08%) patients were found to have acute migrainous aura. Hypoperfusion was found in 14/20 patients (70%) with delayed rMTT and TTP, decreased rCBF, and minimal decrease in rCBV. In contrast to the typical pattern in stroke, perfusion abnormalities were not limited to a single vascular territory but extended to >1. Bilateral hypoperfusion was seen in 3/14 cases. In 11/14 cases, hypoperfusion with a posterior predominance was found. TTP and rMTT were the best maps to depict perfusion changes at visual assessment, but also rCBF maps demonstrated significant hypoperfusion in quantitative analysis. In all patients, clinical and imaging follow-up findings were negative for stroke. CONCLUSIONS: Acute migrainous aura is rare but important in the differential diagnosis among patients with the suspicion of acute brain infarction. Atypical stroke perfusion abnormalities can be seen in these patients.

65 Article Reduced urinary glutamate levels are associated with the frequency of migraine attacks in females. 2012

Ragginer, C / Lechner, A / Bernecker, C / Horejsi, R / Möller, R / Wallner-Blazek, M / Weiss, S / Fazekas, F / Schmidt, R / Truschnig-Wilders, M / Gruber, H-J. ·Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria. christine.ragginer@klinikum-graz.at ·Eur J Neurol · Pubmed #22435925.

ABSTRACT: BACKGROUND AND PURPOSE: Recent evidences indicate that glutamatergic homeostasis disorders are implicated in the pathogenesis of migraine. In particular, plasma and cerebrospinal fluid glutamate levels seem to be altered in migraine patients. However, the impacts of glutamate on migraine and especially on aura symptoms, alterations in the frequency of migraine attacks as well as investigations on glutamate on migraine-related metabolic dysfunctions, like hyperinsulinaemia, and an atherogenic lipid profile remain elusive to date. The aim of the present study was to investigate the impact of glutamate on migraine and related metabolic dysfunctions. METHODS: We investigated the urinary glutamate levels of female migraineurs (n = 48) in the interictal phase and healthy controls (n = 48). Parameters of the insulin- and lipid metabolism, inflammatory parameters and anthropometric parameters were additionally determined. RESULTS: Urinary glutamate levels of female migraineurs were significantly decreased with respect to the control group. Logistic regression revealed an odds ratio of 4.04 for migraine. We found a significant correlation with the time-period of patients' last attack and a significant inverse correlation with the annual frequency of migraine attacks. Other parameters of the insulin- and lipid metabolism, anthropometric and inflammatory parameters showed no significant correlation with glutamate levels. CONCLUSION: We show here that female migraineurs exhibit decreased urinary glutamate levels which are associated with a 4.04-fold higher risk for migraine and correlated with patients' frequency of migraine attacks.

66 Article Facial pain, scotomas and hemihypaesthesia as presenting symptoms of type A aortic dissection in a patient with migraine with aura. 2012

Seidel, Stefan / Elwischger, Kirsten / Wöber, Christian. ·Medical University of Vienna, Austria. stefan.seidel@meduniwien.ac.at ·Cephalalgia · Pubmed #22407662.

ABSTRACT: We report the case of a 31-year-old man with a history of migraine with aura who was admitted to our emergency department because of a sudden onset of severe bilateral facial pain radiating bilaterally into the medial cervical region after defecation. The pain was accompanied by scotomas in the right visual field and hypaesthesia in both upper limbs. Imaging of the aorta and supra-aortic vessels revealed a type A aortic dissection. Subsequently, the patient received an aortic valve replacement and an aortic tube graft. After the surgery he experienced recurring visual disturbances with a sudden onset mimicking his migraine aura. Due to a new onset of atrial fibrillation, he was put on oral anticoagulants. At follow-up after 10 months he still reported episodic and mostly isolated visual auras with a gradual onset.

67 Article [Trigger factors in headache and migraine: myths and facts]. 2012

Wöber, Christian. ·Univ.-Klinik für Neurologie, Medizinische Universität Wien. christian.woeber@meduniwien.ac.at ·MMW Fortschr Med · Pubmed #22352256.

ABSTRACT: -- No abstract --

68 Article Dysfunctional coping in headache: avoidance and endurance is not associated with chronic forms of headache. 2012

Wieser, T / Walliser, U / Womastek, I / Kress, H G. ·Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Allgemeines Krankenhaus, Währinger Gürtel 18-20, 1090, Vienna, Austria. thomas.wieser@meduniwien.ac.at ·Eur J Pain · Pubmed #22323379.

ABSTRACT: INTRODUCTION: About 4% of the population suffer from daily or near daily headache, which in most cases evolved from an episodic type of headache. The impact of psychological factors on this process is unknown. It seems reasonable to assume, that besides somatic and social conditions psychological factors like pain-related coping and cognition play an important role, as has been shown for other pain conditions. METHODS: We performed a cross sectional study on pain coping behaviour in 211 patients with migraine and tension type headache. Pain-related cognition and coping was investigated using the Kiel Pain Inventory. Prevalence of depression, medication intake and headache characteristics were analysed in regard to chronicity of headache. RESULTS: Overall pain intensity was high in the patient sample. The level of depression increased with headache frequency. Dysfunctional coping, characterized by fear and avoidance is frequently used by headache patients. As in low back pain, also endurance is highly prevalent. Other features known to be associated with chronic headache, like depression and medication overuse, could be confirmed. DISCUSSION: Dysfunctional coping was seen with high prevalence in the entire patient sample (66%). Against our hypothesis, it was not confined to chronic forms of headache. In respect to our data, we discuss the role of avoidance and endurance coping in headache and its possible role in chronicity.

69 Article Aspirin is first-line treatment for migraine and episodic tension-type headache regardless of headache intensity. 2012

Lampl, Christian / Voelker, Michael / Steiner, Timothy J. ·Department of Neurology, Pain and Headache Center, Konventhospital Barmherzige Brueder, Linz, Austria. christian.lampl@bblinz.at ·Headache · Pubmed #21883198.

ABSTRACT: OBJECTIVES: (1) To establish whether pre-treatment headache intensity in migraine or episodic tension-type headache (ETTH) predicts success or failure of treatment with aspirin; and (2) to reflect, accordingly, on the place of aspirin in the management of these disorders. BACKGROUND: Stepped care in migraine management uses symptomatic treatments as first-line, reserving triptans for those in whom this proves ineffective. Stratified care chooses between symptomatic therapy and triptans as first-line on an individual basis according to perceived illness severity. We questioned the 2 assumptions underpinning stratified care in migraine that greater illness severity: (1) reflects greater need; and (2) is a risk factor for failure of symptomatic treatment but not of triptans. METHODS: With regard to the first assumption, we developed a rhetorical argument that need for treatment is underpinned by expectation of benefit, not by illness severity. To address the second, we reviewed individual patient data from 6 clinical trials of aspirin 1000 mg in migraine (N = 2079; 1165 moderate headache, 914 severe) and one of aspirin 500 and 1000 mg in ETTH (N = 325; 180 moderate, 145 severe), relating outcome to pre-treatment headache intensity. RESULTS: In migraine, for headache relief at 2 hours, a small (4.7%) and non-significant risk difference (RD) in therapeutic gain favored moderate pain; for pain freedom at 2 hours, therapeutic gains were almost identical (RD: -0.2%). In ETTH, for headache relief at 2 hours, RDs for both aspirin 500 mg (-4.2%) and aspirin 1000 mg (-9.7%) favored severe pain, although neither significantly; for pain freedom at 2 hours, RDs (-14.2 and -3.6) again favored severe pain. CONCLUSION: In neither migraine nor ETTH does pre-treatment headache intensity predict success or failure of aspirin. This is not an arguable basis for stratified care in migraine. In both disorders, aspirin is first-line treatment regardless of headache intensity.

70 Article Migraine attack frequency, duration, and pain intensity: disease burden derived from a community-based survey in northern Tanzania. 2011

Dent, Wolfgang / Stelzhammer, Brigitte / Meindl, Michael / Matuja, William B P / Schmutzhard, Erich / Winkler, Andrea S. ·Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria. wolfgang.dent@usz.ch ·Headache · Pubmed #22050317.

ABSTRACT: OBJECTIVE: One goal of the campaign "Lifting the burden: The global campaign against headache" is to highlight existing evidence about headache worldwide. In this context, the aim of our study was to report the migraine-related headache burden in northern Tanzania. METHODS: From December 2003 until June 2004 a community-based door-to-door survey was undertaken in northern Tanzania, using multistage cluster sampling. Based on the criteria of the International Headache Society, 7412 individuals were enrolled in this survey. RESULTS: Migraine patients' average annual attack frequency was 18.4 (n = 308, standard deviation [SD] ± 47.4) with a mean duration of 16.4 hours (SD ± 20.6). The average headache intensity per patient was 2.65 (SD ± 0.59) with a calculated loss of 6.59 (SD ± 26.7) working days per year. Extrapolation of data to the investigated population (n = 7412) resulted in annual migraine burden of 281.0 migraine days per 1000 inhabitants. CONCLUSIONS: To our knowledge, this study reports for the first time the burden that arises from migraine headache in a rural population of sub-Sahara Africa (SSA). As the presented migraine-related burden is considerable, we hope that our data will increase the awareness among local decision makers in allocating resources for treatment and research on headache.

71 Article Clinical features of unilateral headaches beyond migraine and cluster headache and their response to indomethacin. 2011

Seidel, Stefan / Lieba-Samal, Doris / Vigl, Marion / Wöber, Christian. ·Department of Neurology, Medical University of Vienna, Vienna, Austria. stefan.seidel@meduniwien.ac.at ·Wien Klin Wochenschr · Pubmed #21833596.

ABSTRACT: The majority of previous studies on unilateral headaches beyond migraine and cluster headache have focussed on certain disorders such as paroxysmal hemicrania, SUNCT and primary stabbing headache. We assessed headache characteristics, importance of neuroimaging and response to indomethacin in an unselected series of uncommon unilateral headaches. We investigated all consecutive patients presented with unilateral headaches not fulfilling ICHD-II criteria of migraine and cluster headache. Patients underwent cranial magnetic resonance imaging or computed tomography as well as an indo-test, i.e. oral indomethacin 75 mg b.i.d. for 3 days. Among 63 patients we diagnosed primary stabbing headache in 12 patients, (probable) paroxysmal hemicrania in 6 and tension-type headache in 3 patients. One patient each had probable SUNCT, new daily persistent headache and nasociliary neuralgia. Eight patients had a secondary headache and 31 could not be classified according to ICDH-II. Imaging revealed lesions causally related to the headache in 8 patients. Indo-test achieved full remission of headache in 13 of 51 patients. At follow-up 11 ± 3 months after the first visit 29% of the patients were headache-free for ≥3 months. In conclusion, almost half of the patients presented with unilateral headaches beyond migraine and cluster headache cannot be classified according to ICHD-II. Among classifiable headaches primary stabbing headache was the most common. Imaging should be considered to rule out secondary headaches. The course is favourable in one third of the patients.

72 Article Oxidative stress is associated with migraine and migraine-related metabolic risk in females. 2011

Bernecker, C / Ragginer, C / Fauler, G / Horejsi, R / Möller, R / Zelzer, S / Lechner, A / Wallner-Blazek, M / Weiss, S / Fazekas, F / Bahadori, B / Truschnig-Wilders, M / Gruber, H-J. ·Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria. claudia.bernecker@klinikum-graz.at ·Eur J Neurol · Pubmed #21518147.

ABSTRACT: BACKGROUND AND PURPOSE: Oxidative stress is discussed to be implicated in the pathophysiology of migraine. However, data are in part controversial and the possible underlying mechanisms remain elusive to date. The aim of this study was to investigate the oxidative stress status of female patients with migraine and its implications on migraine-related metabolic alterations. METHODS: Oxidative stress markers malondialdehyde (MDA), 4-hydroxy-2-nonenal (HNE), carbonylated proteins, parameters of associated nitric oxide stress, inflammation, lipid- and glucose-metabolism were determined in the interictal phase in female patients with migraine and controls. RESULTS: We found significantly increased HNE levels in female migraineurs compared with controls. Logistic regression analyses of HNE revealed an odds ratio for migraine of 4.55. HNE showed significant correlations with the nitric oxide pathway, the insulin- and the lipid-metabolism. CONCLUSIONS: We show here that increased oxidative stress is associated with migraine and contributes to migraine-related metabolic risk like nitrosative stress, an atherogenic lipid profile and hyperinsulinemia. Our data suggest that oxidative stress may represent a key event in the pathophysiology of migraine and a suitable therapeutic target.

73 Article Headache, menstruation and combined oral contraceptives: a diary study in 184 women with migraine. 2011

Lieba-Samal, Doris / Wöber, Christian / Frantal, Sophie / Brannath, Werner / Schmidt, Karin / Schrolnberger, Claudia / Wöber-Bingöl, Cicek / Anonymous1390689. ·Department of Neurology, Medical University of Vienna, Austria. ·Eur J Pain · Pubmed #21402485.

ABSTRACT: Half of female migraineurs in childbearing age use combined oral contraceptives (COCs), but the influence of COCs on perimenstrual migraine is still unclear. We therefore aimed to analyze the risk of occurrence and persistence (i.e. presence for more than 1 day) of headache and migraine before and during menstruation in women with migraine, comparing users of COCs to non-users. We included 184 women with at least 1 day of menstruation recorded in a 90-day diary. We differentiated between (a) the 2 days before menstruation, (b) the first 3 days of menstruation and (c) the remaining days of menstruation and analyzed subgroups of women with (n=82) and without (n=102) COCs. In both groups, risk of any headache as well as that of migraine was highest during the first 3 days of menstruation with a hazard ratio of 1.9 and 2.1 for non-users and 2.1 and 2.2 for users. Although use of COCs showed no statistically significant overall effect, users were at higher risk for any headache premenstrually and non-users at higher risk for migraine on days 4+ of menstruation. In conclusion, use of COCs exerts only subtle differences on the course of perimenstrual migraine in menstruating women with migraine.

74 Article No association between bipolar disorder risk polymorphisms in ANK3 and CACNA1C and common migraine. 2011

Wöber-Bingöl, Ciçek / Tropeano, Maria / Karwautz, Andreas / Wagner, Gudrun / Campos-de-Sousa, Sara / Zesch, Heidi E / Kienbacher, Christian / Natriashvili, Sofia / Kanbur, Incifer / Ray, Munni / Wöber, Christian / Collier, David A. ·Headache Outpatient Centre, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria. ·Headache · Pubmed #21395576.

ABSTRACT: BACKGROUND: Migraine and bipolar disorder are characterized by a high level of co-morbidity, and a common familial-genetic basis has recently been hypothesized for the 2 disorders. Genome-wide association studies have reported strong evidence of association between the polymorphisms rs10994336[T] in the ANK3 gene and rs1006737[A] in the CACNA1C gene and risk of bipolar disorder. OBJECTIVE: The aim of this study was to evaluate the hypothesis of a genetic linkage between migraine and bipolar disorder by investigating the familial transmission of the 2 bipolar disorder risk polymorphisms, in a sample of family trios with probands with childhood migraine, and unrelated controls. METHODS: Our sample comprised 192 family trios, each with a proband with childhood migraine (137 migraine without aura, 44 migraine with aura) and 228 unrelated controls. The markers rs10994336 and rs1006737 were genotyped using a TaqMan single nucleotide polymorphism Genotyping Assay. The transmission disequilibrium test analysis for the family trios and the case-control analysis were performed using the program UNPHASED. RESULTS: The allelic and genotypic transmission disequilibrium test analysis did not show any evidence of transmission distortion of the 2 markers in both migraine overall (rs10994336: OR = 1.61, P = .11; rs1006737: OR = 1.12, P = .49) and in the migraine without aura and migraine with aura subgroups. Likewise, the case-control analysis of alleles and genotypes frequencies did not show any evidence of association. CONCLUSION: In the present study, we did not find evidence for association between the bipolar disorder risk polymorphisms rs10994336 in the ANK3 gene and rs1006737 in the CACNA1C gene in migraine. However, as these are variants that have a small effect on the risk of bipolar disorder (OR < 1.5), we cannot exclude a similar small effect on migraine susceptibility with the present sample size.

75 Article Migraine in patients with eating disorders: a study using a sister-pair comparison design. 2011

Seidel, Stefan / Karwautz, Andreas / Wagner, Gudrun / Zormann, Arno / Eder, Harald / Huemer, Julia / Nattiashvili, Sofia / Wöber, Chistian / Wöber-Bingöl, Çiçek. ·Headache Unit at the Department of Neurology, Medical University of Vienna, Vienna, Austria. ·Headache · Pubmed #21284607.

ABSTRACT: OBJECTIVE: To evaluate the relationship between migraine and eating disorders by applying a special study design. BACKGROUND: To date, only a few studies have assessed eating disorders and eating behavior in patients with migraine. METHODS: The distinctive feature of this design is the comparison of sister pairs with one sister suffering from an eating disorder according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition and the other being free of such disease. RESULTS: We investigated 120 female patients with a median age of 24 years (interquartile range 20-31) as well as their non-eating-disordered sisters with a median age of 24 (20-31) years. Headache was diagnosed according to the International Classification of Headache Disorders, Second Edition. Thirteen sister pairs were concordant for the presence of migraine, 67 were concordant for the absence of migraine and 40 were discordant. Among the latter, 21 patients and 19 controls had migraine. The prevalence of migraine was virtually identical in patients (28%) and controls (27%). CONCLUSION: This clinic-based controlled study using a sister-pair comparison design showed no evidence of an increased prevalence of migraine among patients with eating disorder.

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