ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed34s1001.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed34s1002.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed34s1006.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISTransformation of episodic migraine to chronic daily headache (so called transformed migraine) ia now a well recognized phenomenon. Although several factors, i.e. analgesic overuse, increasing age, psychiatric disorders are reported to play some roles in this transformation, the precise cascade is still unclear. Further suppression of an already abnormal antinociceptive system with up‐regulation of post‐synaptic receptors is one of the possible explanation. In order to understand the mechanism underlying this condition, 5‐HT2serotonin receptors on platelets were assayed by the radioligand binding technique. Six transformed migraine patients (67.67 ± 1.52 years) and seven healthy controls (72.86 ± 1.82 years) were studied. [3H]‐spiperone and ketanserin were used to determine the specific binding. We found a significant increase (P<0.05) in the maximal receptor numbers (Bmax) on platelet membrane of the migraine patients when compared to the controls (64.31 ± 11.06 end 39.96 ± 5.42 fmol/mg protein, respectively), whereas the dissociation equilibrium constant (K D ) values remained unchanged (3.63 ± 0.78 nM and 2.84 ± 0.48 nM for the migraine patients and controls, respectively). The up‐regulation of serotonin receptors found in this study provided further support to the ”serotonergic hypofunction“ theory of migraine pathogenesis and may explain the unusual loss of episodicity seen in the transforme

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3401008.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed34s1010.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISA short‐lasting over‐distension of the hand‐forearm veins, obtained through a non‐invasive original maneuver (Hand Arm Vein Distension test) induces local pain when applied to mi‐graine sufferers in inter‐critical period. Conversely, subjects with an absolutely negative personal and family history for any type of idiopathic headache do not report any pain or only an uncertain, slight one.The injection of 1 mL of 2% to 8% (i.e. 0.34 mol/L to 1.36 mol/L) hypertonic saline into the antecubital vein during an extemporary short 1 minute) circulatory blockage (ischemia induced to guarantee a strictly local action of the chemical stimulus) provokes moderate, strong or unbearable local (arm vein) pain in migraine sufferers but not in subjects with a personal and family history absolutely free from any type of headache. These results show for the first time that migraineurs show a proneness to visceral pain in viscera (veins) distant from the head (arm‐hand). Such finding is consistent with the theory that migraine pain is due to a central derangement of the visceros

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3401012.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed34s1013.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISDrugs influencing monoaminergic pathways are of potential use in the treatment of pain.A serotonin re‐uptake inhibitor, paroxetine (20‐30 mg daily), and a dopamine antagonist, sulpiride (200‐400 mg daily) were compared in a randomized, double‐blind, response‐conditional cross‐over pilot study in 50 non‐depressed patients with chronic tension‐type headache.Headache was scored daily on a 5‐point verbal scale during 4‐weeks baseline and during 8 weeks of treatment for each drug. A 5‐point ‘Global’ assessment was obtained for each drug, In both treatment groups headache score decreased compared to baseline.Group comparison of 24 patients first treated with paroxetine and 24 patients first treated with sulpiride showed a non‐significant trend in favor of sulpiride by 'Global' evaluation and by evaluation of the available diary records (18 paroxetine‐treated and 19 sulpiride‐treated).Cross‐over analysis of ‘Global’ records from 20 patients treated with paroxetine followed by sulpiride and 17 patients treated in the reverse order showed better relief from sulpiride compared to paroxetine in patients having tested both drugs (P=.03). A similar difference was reflected in available headache scores (13 and 10 patients respectively; P=.03). Predominant side effects were sedation and depression, for paroxetine also nausea and head pain. None of the drugs improved headache more than one score‐point on average. A placebo control

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3401020.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed34s1022.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISFour patients with SUNCT syndrome (Short‐lasting, Unilateral, Neuralgiform headache attacks with Conjunctival injection and Tearing) were investigated with Doppler ultra‐sonography. Blood flow velocity (V) was measured in all intracranial arteries during both normocapnia and voluntary hyperventilation in 4 patients outside attacks (2 during remission; 2 during bout, but outside attacks) and in 8 healthy individuals. Vasomotor reactivity (VMR) was calculated on the basis of the formula of percentage change in V divided by the reduction in end‐tidal PCO2(PETCO2). Under the basal condition, the patients had a slightly, but non‐significantly higher V in the middle cerebral artery (MCA) (P>0.1) and lower V in the basilar artery (P>0.05) than controls. During hyperventilation, a significant reduction in V was observed in the anterior and posterior cerebral arteries, at a level 1.5‐2 SD above that in controls (P<0.05), but a non‐significant difference in VMR in comparison with controls. VMCAwas continuously insonated during spontaneous (n=8) and precipitated (n=4) attacks in one particular patient on different days. Prior to attack, VMCAwas significantly lower on the symptomatic side than on the non‐symptomatic side (P<0.014). V MCA decreased significantly during spontaneous attacks on both sides (P<0.01) in comparison with the pre‐attack stage, and returned to baseline before the cessation of attack. Similar findings were made during precipitated attacks. PETCO2, was rather constant throughout the entire attack study. Our data suggest that abnormal cerebral circulation may be part of the SUNCT syndrome. The vascular changes may have underlying mechanisms differing from th

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3401025.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY