Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factor...Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factors. Recent studies have suggested that the pathogenesis of vestibular migraine may be associated with variations in the CACNA1A gene, which is an important gene target for controlling calcium ion channels. Such variations may further affect the functions of the vestibular nervous system, thereby causing a series of vestibular nervous system-related symptoms. This article will summarize the genetic association studies of vestibular migraine, vestibular function studies, and research on how to establish relevant animal models to illustrate the possible association between CACNA1A variations and the pathogenesis of VM, providing new ideas for clarifying the pathogenesis of VM.展开更多
BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch a...BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.展开更多
OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target informa...OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target information of Baihui(GV20)and Fengchi(GB20)was retrieved,and after intersection with migraine,Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome,and Uni Prot Keywords were used for functional enrichment.After selecting the main pathway,rats were selected and nitroglycerin was used for modeling,and the behavioral scores,inflammatory factors,heme oxygenase 1(HMOX1),protein kinase B(AKT1),signal transducer and activator of transcription 3(STAT3),phosphorylated extracellular signal-regulated kinase 1/2(P-ERK1/ERK2)and other states of the rats in the acupuncture,twisting,and electroacupuncture groups were compared.RESULTS:A total of 135 Baihui(GV20)targets and 27 Fengchi(GB20)targets were collected.A total of 73 target information were obtained after the intersection of these targets in migraine.These 73 targets have three main pathways:hypoxia-inducible factor 1(HIF-1)signaling pathway,signaling by interleukins and inflammatory response.The main targets in the pathway were verified and found that interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)and HMOX1,AKT1,STAT3,P-ERK1/ERK2 can be regulated by Baihui(GV20)and Fengchi(GB20).CONCLUSION:Baihui(GV20)and Fengchi(GB20)can regulate migraine by regulating inflammatory factors and HMOX1,AKT1,STAT3,P-ERK1/ERK2 and other changes in HIF-1 signaling pathway,Signaling by Interleukins and Inflammatory response pathways.Based on systems biology and network pharmacology,and with the model of"acupoint-target-disease",explore the research methods of systematic acupuncture and moxibustion.We believe this is a usable research direction for exploring the mechanism of acupuncture stimulation.展开更多
Objective:To analyze and validate how Jiawei Sanpian decoction treats migraines by integrating network pharmacology,molecular docking technology,and experimental studies.Method:Using network pharmacology,the chemical ...Objective:To analyze and validate how Jiawei Sanpian decoction treats migraines by integrating network pharmacology,molecular docking technology,and experimental studies.Method:Using network pharmacology,the chemical components and core target proteins of the Jiawei Sanpian decoction were analyzed.Key chemical components were docked with core targets using mo-lecular docking,and the results were visualized.Nitroglycerin was injected into the dorsal cervical region to establish a rat migraine model.Finally,experiments were conducted to verify the effects of Jiawei Sanpian on related pathways and targets.Results:Four notable chemical components were identified,namely,b-sitosterol,quercetin,mairin,and kaempferol.Five representative targets were identified,namely,insulin-like growth factor 1(IGF-1),matrix metallopeptidase 2(MMP-2),interleukin-2(IL-2),superoxide dismutase 2(SOD2),and inducible nitric oxide synthase(NOS2).Molecular docking results revealed that the minimum binding energies between the four chemical components and the five targets were below5 kcal/mol,indicating favor-able binding activity.Enzyme linked immunosorbent assay(ELISA)results demonstrated the efficacy of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).Real-time quantitative polymerase chain reaction(RT-qPCR)results demonstrated the effectiveness of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).After using erastin,the therapeutic effect of Jiawei Sanpian decoction declined.Conclusion:This study provides initial insights into the complex and multilayered therapeutic mecha-nisms of Jiawei Sanpian decoction in treating migraine,primarily through its diverse components,tar-gets,and pathways.These findings indicate that Jiawei Sanpian decoction may exert its effects mainly through processes linked to the mitochondrial inflammatory pathway,thereby providing therapeutic benefits for migraine.展开更多
Background:The active components of Horcha-6 were identified using liquid chromatography with tandem mass spectrometry.Also,we investigated the potential mechanisms that explain why Horcha-6 may be effective in treati...Background:The active components of Horcha-6 were identified using liquid chromatography with tandem mass spectrometry.Also,we investigated the potential mechanisms that explain why Horcha-6 may be effective in treating migraines through the use of network pharmacology and a rat migraine model.Methods:After identifying the active components of Horcha-6,the corresponding genes of the active components’target were obtained from the Universal Protein database,and a“compound-target-disease”network was constructed using Cytoscape 3.9.0 software.For the in vivo experiments,nitroglycerin was injected intraperitoneally into rats to create a migraine model.Pre-treatment with Horcha-6 was administered orally for 14 days,and rats were subjected to migraine-related behavior tests.RNA sequencing was performed to identify the gene expression regulated by Horcha-6 in the trigeminal nerve.Results:A total of 903 chemical components of Horcha-6 have been collected in the liquid chromatography with tandem mass spectrometry.We discovered 55 of the Horcha-6 bio-active components that were evaluated based on their Percent Human Oral Absorption(≥30%)and DL values(≥0.185)on the traditional Chinese medicine systems pharmacology database.The“compound-target-disease”network contained 163 intersection targets with the migraine state.Gene Ontology analysis indicated that these components significantly regulated the immune response,vascular function,oxidative stress,etc.When Kyoto Encyclopedia of Genes and Genomes enrichment analysis was performed,we observed that most of the target genes were significantly enriched in the inflammation and neuro-related signaling pathway,toll-like receptor signaling pathway,neuroactive ligand-receptor interaction,etc.These predictions were further demonstrated via in vivo animal model experiments.The RNA sequencing results showed that 41 genes were down-regulated(P<0.05)and 86 genes were up-regulated(P<0.05)in the Horcha-6 treated group compared with the untreated group.Those genes were mainly involved in neuromodulation,vascular function,and hormone metabolism.Conclusion:The 55 bio-active components in Horcha-6 regulate inflammation,hormone metabolism,and neurotransmitters and have potential as a therapy to treat migraines.展开更多
Objective:To better understand the clinical phenotype of Méenière’s disease(MD),we examined family history,thyroid disorder,migraine,and associated disorders in complaints of people living with MD.Method:We...Objective:To better understand the clinical phenotype of Méenière’s disease(MD),we examined family history,thyroid disorder,migraine,and associated disorders in complaints of people living with MD.Method:We designed the study as a retrospective and examined data gathered from 912 participants with MD.Their data were originally collected by the Finnish M′eni`ere Federation(FMF).The survey data included individual case histories for environmental factors,comorbidities,disease-specific complaints,impact-related questions,cognitive complaints,health-related quality of life(HRQoL),and sense of coherence(SOC).Results:We observed significant differences between those with and without sporadic occurrence,family history,thyroid disorder,and migraine-associated complaints.Family history explained 20%of variability in patient complaints.Patients with a family history of MD whose disease started at younger age experienced balance problems,more severe vertigo spells,more severe vestibular drop attacks(VDA),and less nausea,although they had good SOC.Thyroid disorder explained 14%of variability in patient complaints.MD patients with a thyroid disorder comorbidity suffered more often from constant dizziness,balance problems,greater impact of hearing problems,cognitive complaints,and poor HRQoL.Migraine explained 12%of variability in patients’complaints and was associated with poor SOC and cognitive balance problems.MD patients with both thyroid disorder and migraine used antidepressants more often than other groups.Logistic regression analysis showed comorbidities of ischemic brain disorder(among 7.1%),kidney insufficiency(among 1.2%),and diabetes(among 7.3%)had statistically significant but restricted association with balance and gait problems,VDA,and reduced HRQoL.Conclusions:Family history of MD and thyroid disorder or migraine comorbidities in MD influence the complaint pattern and partially explain complex symptom profiles,including symptoms of cognitive problems.Confounders play a minimal role in complaint profile and impact of MD whereas comorbidities influence the complaint structure and partly explain the complex symptom profile in MD.展开更多
Background:White matter lesion(WML)is common in aging brain and is associated with cognitive impairment and dementia.However,recent studies reported an association between patent foramen ovale(PFO)and WML in migraineu...Background:White matter lesion(WML)is common in aging brain and is associated with cognitive impairment and dementia.However,recent studies reported an association between patent foramen ovale(PFO)and WML in migraineurs,especially in young,middle-aged migraineurs.Our retrospective,case-control study aims to describe the clinical characteristics of WML in this population and to explore potential risk factors.Methods:226 patients with migraine and PFO were consecutively initially screened.Relevant factors were selected by the least absolute shrinkage and selection operator(LASSO)regression and multivariable logistic regression model.A Nomogram was employed to visualize the prediction model conveniently.The discrimination and calibration abilities were evaluated using the Receiver Operating Characteristic(ROC)curve,the Hosmer-Lemeshow test,and calibration curves.Results:One hundred and nineteen participants were ultimately enrolled in our study,with a median age of 36.9±12.7 years and 80.7%of females.Brain magnetic resonance imaging MRI showed 67(56.3%)patients had WML,whereas 52(43.7%)patients were categorized into the non-WML group.LASSO regression screened out potential variables and subsequent multivariate analysisfinally identified age,mean platelet volume,andfibri-nogen(FIB)as independent predictive factors of WML.The area under the ROC curve(AUC)was 0.807.Hos-mer-Lemeshow test and calibration curve verified a consistency between the predicted and actual probability.Conclusion:The predictive nomogram established and validated in our study may assist clinicians in screening WML among young middle-aged migraineurs with PFO and developing individualized preventive and treatment strategies.展开更多
BACKGROUND Yangxue Qingnao Granules(YXQN)is a Chinese patent medicine that has been commonly used in the clinical treatment of migraine.AIM To assess the efficacy and safety of YXQN alone for the treatment of migraine...BACKGROUND Yangxue Qingnao Granules(YXQN)is a Chinese patent medicine that has been commonly used in the clinical treatment of migraine.AIM To assess the efficacy and safety of YXQN alone for the treatment of migraine.METHODS We searched 10 databases to identify relevant randomized controlled trials(RCTs)published before September 2022.Two review authors independently searched and screened the literature,extracted the data,and assessed the methodological quality of the studies using criteria from ROB 2.0,and analyzed the data using Review Manager 5.4 software.RESULTS A total of 12 RCTs including 767 participants with migraine met the selection criteria.We divided these studies into comparisons of YXQN with placebo,routine treatment drugs,and other Chinese patent medicines.The meta-analysis showed the following:(1)Efficacy:The YXQN group outperformed the placebo group[relative risk(RR)=0.29,95%confidence interval(95%CI):0.15–0.43,P<0.00001],routine treatment group(RR=0.18,95%CI:0.09–0.27,P<0.0001),and Chinese patent medicine group(RR=0.27,95%CI:0.13–0.41,P<0.001);(2)frequency of headache:There was a significant difference between YXQN vs placebo[mean difference(MD)=-1.25,95%CI:-1.60 to-0.90,P<0.00001],routine treatment drugs(MD=-0.85,95%CI:-1.15 to-0.56,P<0.00001),and Chinese patent medicine(MD=-0.91,95%CI:-1.35 to-0.46,P<0.0001);(3)headache duration:We found great heterogeneity between studies,with no differences between YXQN and placebo(MD=-0.61,95%CI:-1.53 to-0.31,P=0.19)and routine treatment drugs(MD=-0.22,95%CI:-0.89 to 0.46,P<0.53).YXQN was more effective than other Chinese patent medicines in reducing headache duration(MD=-1.24,95%CI:-1.70 to-0.77,P<0.00001);and(4)headache severity:There was no significant difference between YXQN vs placebo(MD=-1.67,95%CI:-3.52 to 0.19,P=0.08),routine treatment drugs(MD=-0.53,95%CI:-2.02 to 0.96,P=0.68),and other Chinese patent medicines(MD=-0.49,95%CI:-2.83 to 1.85,P=0.68).Mild gastrointestinal adverse reactions were reported in three cases.CONCLUSION This study revealed that YXQN is effective and safe for treatment of migraine.展开更多
Introduction: Migraine is the most common primary headache, and can cause significant disability. There are two types, migraine without aura and migraine with aura. The diagnosis of migraine is essentially clinical. W...Introduction: Migraine is the most common primary headache, and can cause significant disability. There are two types, migraine without aura and migraine with aura. The diagnosis of migraine is essentially clinical. Worldwide prevalence was estimated at 11.6% in 2009. In Africa, it is estimated at 10.4%. Objective: To describe the clinical and therapeutic aspects of migraine in Brazzaville. Patients and Methods: This was a door-to-door cross-sectional study conducted from 1<sup>st</sup> May to 1<sup> st</sup> July 2018 in the city of Brazzaville. Subjects over 18 with clearly expressed consent were included. The questionnaire covered demographic characteristics, diagnostic criteria for migraine according to the IHS, treatments taken. The degree of disability was determined using the Migraine Disability Assessment Scale (MIDAS). Statistical analysis was performed using SPSS 22.0 for MAC. Results: Of the 1017 subjects interviewed in this study, 115 (39.9%) had migraine, including 73 women (63.47%) and 42 men (36.52%). In the group of migraine sufferers, the number of cases of definite migraine was 61 (53.04%) and that of probable migraine 54 (46.95%). For 81 migraine sufferers (70.43%), stress was the triggering factor. The frequency of attacks was weekly and monthly for 30 (26.1%) and 19 (16.5%) sufferers respectively. The location of the migraine was unilateral in 38% of cases and tilted in 24.3%. The intensity of the attack was described as moderate and severe in 41.7% and 57.4% of subjects respectively. Phonophobia/photophobia accompanied the migraine in 65.2% of cases. One hundred and eight subjects were treated. Of these, 106 (98.1%) were on medication. Eleven (10.37%) had received a medical prescription, and ninety-seven (89.8%) were self-medicating. Five and three subjects were under the care of a general practitioner and a neurologist respectively. Conclusion: Migraine is a frequent pathology in Brazzaville. Its preponderance among young people and women calls for the implementation of effective prevention strategies for these already vulnerable social groups. The form without aura was the most common type. Visual aura was the most common type. Headache-related symptoms were dominated by phonophotophobia, followed by nausea and vomiting. Almost all migraine sufferers were self-medicating, and very few were under the care of a doctor. First-line analgesics and NSAIDs were the mainstay of treatment.展开更多
Background:To explore the potential mechanism of action of the active ingredients of Smilacis Glabrae Rhizoma(SGR)in the treatment of migraine using network pharmacology and in vivo experiments.Methods:Through the sea...Background:To explore the potential mechanism of action of the active ingredients of Smilacis Glabrae Rhizoma(SGR)in the treatment of migraine using network pharmacology and in vivo experiments.Methods:Through the search of Traditional Chinese Medicines Systems Pharmacology Database and Analysis Platform,Genecards,Drugbank and other databases,we obtained active ingredients,targets of SGR and related disease targets of migraine,and took the intersection for protein-protein interactions analysis.After constructing the network diagram,network topology analysis was performed to derive the core targets and key active ingredients,and Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed.Finally,molecular docking was performed and validated by in vivo experiments.In vivo experiments,18 male BALB/c mice were selected,and the SGR group was fed with SGR drinking tablet concentrate,and nitroglycerin injection was used to construct a mouse model of migraine.Enzyme-linked immunosorbent assay test was used to detect the levels of TNF-α,IL-1β,IL-6,and AKT1 in plasma.Results:The results showed that the core targets of SGR for the treatment of migraine were TNF-α,IL-1β,IL-6,and AKT1.These core targets and key active ingredients had better binding ability.Compared with the blank group,the number of head scratching in the model group increased.Compared with the model group,there was a significant reduction of the number of head scratching in the SGR group.In comparison with the blank group,the protein level in the plasma in the model group was markedly higher.Compared with the model group,the protein level in the SGR group was significantly lower.Conclusion:SGR has the characteristics of improving migraine based on multi-targets,multi-components and multi-pathways,and the mechanism of action may be related to the inhibition of the release of inflammatory factors,neuron protection,and interference with apoptosis and other processes.展开更多
Objective: This systematic review examines the impact of lifestyle factors on migraine frequency and severity through a comprehensive analysis of lifestyle factors such as diet, physical activity, sleep patterns, stre...Objective: This systematic review examines the impact of lifestyle factors on migraine frequency and severity through a comprehensive analysis of lifestyle factors such as diet, physical activity, sleep patterns, stress, mental health, and environmental influences. Methods: We thoroughly searched Google Scholar, PUBMED, Scopus, and Web of Science databases using keywords related to migraines and lifestyle factors. Keywords incorporated the Boolean operator “and” to narrow search results. Following the PRISMA guidelines, we identified, screened, and evaluated studies for inclusion, resulting in nine studies meeting the eligibility criteria. Results: A total of 4917 records were initially identified from Scopus (2786), PubMed (854), and Web of Science (1277). Following deduplication, 3657 records underwent title screening, with 382 additionally screened by abstract. Ultimately, 88 full-text articles were assessed, resulting in 9 studies meeting eligibility for qualitative synthesis: 7 prospective and 2 retrospective studies. Our findings highlight the multifaceted role of lifestyle factors in migraine pathophysiology and management. Dietary habits, such as high-calorie, high-fat, and gluten-containing diets were linked to migraine triggers. Moderate physical activity showed beneficial effects on migraine management, while intense exercise could exacerbate symptoms. Poor sleep hygiene and insomnia were strongly associated with increased migraine frequency and severity. Chronic stress and poor mental health significantly contributed to migraine exacerbation, with stress management techniques proving beneficial. Environmental factors, including light, sound, weather changes, and allergens, were also identified as significant migraine triggers. Conclusions: Personalized lifestyle modifications, tailored to individual patient profiles, are crucial in managing migraines. Evidence-based recommendations include balanced diets, moderate physical activity, improved sleep hygiene, stress management techniques, and environmental adaptations.展开更多
Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of the...Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of these models can well-explain the transmission of the disease. We hypothesied that migraine is a sex-conditioned inherited disorder （autosomal dominant in females and autosomal recessive in males）. This hypothesis is supported by the evidence such as the locations of genes associated with familial hemiplegic migraine, possibly ＂typical＂ migraine as well （dominantly on chromosome 19p, lq, and 2q）, male：female ratio of prevalence （1：2-1：4）, the mostly youth-onset, the provocation by the contraceptives, the induction by menstruation, and the self-limitation after menopause. Female sex-hormones appear to be the key contributor to a higher prevalence of migraine in female. Socio-environmental factors may also play an important role.展开更多
Clinical studies have suggested that internal and/or external aversive cues may produce a negative affective-motivational component whereby maladaptive responses(plasticity)of dural afferent neurons are initiated cont...Clinical studies have suggested that internal and/or external aversive cues may produce a negative affective-motivational component whereby maladaptive responses(plasticity)of dural afferent neurons are initiated contributing to migraine chronification.However,pathophysiological processes and neural circuitry involved in aversion(unpleasantness)-producing migraine chronification are still evolving.An interdisciplinary team conducted this narrative review aimed at reviewing neuronal plasticity for developing migraine chronicity and its relevant neurocircuits and providing the most cutting-edge information on neuronal mechanisms involved in the processing of affective aspects of pain and the role of unpleasantness evoked by internal and/or external cues in facilitating the chronification process of migraine headache.Thus,information presented in this review promotes the understanding of the pathophysiology of chronic migraine and contribution of unpleasantness(aversion)to migraine chronification.We hope that it will bring clinicians’attention to how the maladaptive neuroplasticity of the emotion brain in the aversive environment produces a significant impact on the chronification of migraine headache,which will in turn lead to new therapeutic strategies for this type of pain.展开更多
AIM To report the effects of greater occipital nerve(GON) blocks on refractory chronic migraine headache.METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment wi...AIM To report the effects of greater occipital nerve(GON) blocks on refractory chronic migraine headache.METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month(for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up.RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change(not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.展开更多
Objective To observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients. Methods Atotal of 60...Objective To observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients. Methods Atotal of 60 migraine patients with the symptom of hyperactivity of liver yang who met the inclusive criteria were randomly divided into a opposing needling group （group A） and a routine acupuncture group （group B） by using SPSS 15.0 software according to the registration order with 30 patients in each group. Patients in group A were treated with opposing needling. Taich6ng （太冲 LR 3）, Zhongzhu （中渚 TE 3）, ZOlfnqi （足临泣 GB 41） and QiOxu （丘墟 GB 40） in the uninjured side were selected. After deqi, reducing method was used. Then Taixi （太溪 KI 3） in the uninjured side was selected. After deqi, rein forcing method was used. Needles were retained for 30 rain. Patients in group B were treated with routine acupuncture. Local Ash point, Sishncong （ 四神聪EX-HN1）, Yifeng （翳风 TE 17）, Fengchi （风池 GB 20）, Sizhukong （丝竹空 TE 23）, Shuaigu （率谷GB 8）, Hegu （合谷 LI 4） and LiEque （列缺 LU 7） were selected. After puncturing, reducing method was used routinely and needles were retained for 30 rain. After 2 weeks treatment, migraine specific quality of life questionnaire （MSQ）, visual analogue scale （VAS） and nitric oxide （NO） level in plasma of patients in two groups were observed. Results After treatment, the MSQ, VAS and NO of two groups were significantly improved compared with those before treatment. After treatment, score of MSQ functional limitation was 73.41±10.22 in group A and 60.95 ± 10.15 in group B; the score of MSQ dysfunction was 86.11 ±8.22 in group A and 75.45±8.34 in group B; score of MSQ emotion was 80.51±10.16 in group A and 75.01± 10.20 in group B. The improvements of group A were superior to those of group B, and the differences were all statistically significant （all P〈0.05）. After treatment, the VAS score was 0.93 ± 1.25 in group A and 2.17± 1.70 in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. After treatment, blood plasma NO level was （42.15 ± 16.15） μmol/L in group A and （62.76±15.17） μmol/L in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. Overall response rate was 86.7% （26/30） in group A and 53.3% （16/30） in group B, and the difference between two groups was statistically significant （P〈0.05）. Conclusion Opposing needling is an effective method for the treatment of migraine with the symptom of hyperactivity of liver yong. Its mechanism is to regulate the generation of NO in migraine patients, and improve the relaxation and contraction of cerebral vascular smooth muscle, so as to adjust the cerebral circulation.展开更多
Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified ca...Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified cases were randomly divided into treatment group （146 cases according to the design） and control group （140 cases）, which were respectively treated with electro-acupuncture and drugs （Compound Aminopyrine Phenacetin Tablets, Ergotamine Caffeine Tablets, Diazepam Tablets）, and observed the overall effect and scores of headache, accompanying symptoms, psychological and social adaptability scores, life quality scores, TCM symptoms scores and follow-up results before and after the treatment. Results In treatment group, the successful rate of attack control was 47.3 %, the improvement rate was 73.3 %, and the total effectiveness was 90.4 %, the clinical control rate and improvement were much superior to control group （the clinical control rate 35.7 %, improvement 61.4 %, the total effectiveness 85. 7 % ）, P〈0. 01, the difference in effect was mainly reflected in patients with moderate severity; the total scores of TCM syndrome after the treatment was obviously significant or very obviously significant（ P〈0. 05, P〈0. 01 ）, but the headache scores between two groups was not obviously significant（P〉0.05）, the difference in accompanying symptoms was significant（ P〈0. 01 ） ;the long term attack control action in two groups was not satisfactory, the recurrence was similar （P〉0. 05） ,the severity of headache in recurrence cases of treatment group was alleviated and superior to control group（ P 〈 0. 01 ）, the occurrence of headache after the treatment is much less than that before the treatment and the situation after 2 months was superior to control group （P〈0. 01 ）. Sleepiness and redness of face in some patients which were seen in control group weren＇t seen in treatment group. Conclusion Electro-acupuncture on Tàiyáng （太阳 EX-HN5） can control the attack of migraine due to hyperactivity of liver yang, and it has advantages in improving the accompanying symptoms and reducing the toxic and side effects of western drugs.展开更多
The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures i...The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine.Sixteen episodic migraine patients,16 chronic migraine patients,and 24 normal controls were recruited and underwent 3.0 T MRI scanning.The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables.Results demonstrated that the volumes of specific regions in the frontal and occipital lobes,and the right putamen,were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls.The volumes of the left basal forebrain,optic chiasm,and,the fourth ventricle were decreased in the chronic migraine patients,while the occipital cortex and the right putamen were larger.Compared to episodic migraine patiants,chronic migraine patients displayed larger left thalamus and smaller frontal regions.Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole,right lateral orbital gyrus,and medial frontal lobes and positively correlated with the volume of the left thalamus.The sleep disturbance score was negatively correlated with the volume of the left basal forebrain.This suggests that migraine patients have structural changes in regions associated with pain processing and modulation,affective and cognitive processing,and visual perception.The remodeling of selective intracranial structures may be involved in migraine attacks.This study was approved by the Ethics Committee of Chinese PLA General Hospital(approval No.S2018-027-02)on May 31,2018.展开更多
We present a 29-year-old woman with a long history of attacks of migraine with and without visual aura.She was a heavy smoker(20 cigarettes/d) and was currently taking oral contraceptives. During a typical migraine at...We present a 29-year-old woman with a long history of attacks of migraine with and without visual aura.She was a heavy smoker(20 cigarettes/d) and was currently taking oral contraceptives. During a typical migraine attack with aura, she developed dysarthria,left brachial hemiparesis and hemihypoesthesia and brief and autolimited left clonic facial movements. Four hours after onset, vascular headache and focal sensorimotor neurological deficit were the only persisting symptoms and, on seventh day, she was completely recovered. Brain magnetic resonance imaging on day 20 after onset showed a subacute ischemic lesion in the right temporo-parietal cortex compatible with cortical laminar necrosis(CLN). Extensive neurological work-up done to rule out other known causes of cerebral infarct with CLN was unrevealing. Only ten of 3.808 consecutive stroke patients included in our stroke registry over a 19-year period fulfilled the strictly defined International Headache Society criteria for migrainous stroke. The present case is the unique one in our stroke registry that presents CLN related to migrainous cerebral infarction. Migrainous infarction can result in CLN.展开更多
Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center ...Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.展开更多
Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their uti...Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.展开更多
文摘Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factors. Recent studies have suggested that the pathogenesis of vestibular migraine may be associated with variations in the CACNA1A gene, which is an important gene target for controlling calcium ion channels. Such variations may further affect the functions of the vestibular nervous system, thereby causing a series of vestibular nervous system-related symptoms. This article will summarize the genetic association studies of vestibular migraine, vestibular function studies, and research on how to establish relevant animal models to illustrate the possible association between CACNA1A variations and the pathogenesis of VM, providing new ideas for clarifying the pathogenesis of VM.
文摘BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.
基金the Study on the Mechanism of Action of Dutong and Tiaoshen Acupuncture in Improving Upper Limb Motor Function After Ischemic Stroke based on Functional Near-infrared Spectroscopy Technology(Science and Technology Program of Panyu,2022-Z04-107)。
文摘OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target information of Baihui(GV20)and Fengchi(GB20)was retrieved,and after intersection with migraine,Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome,and Uni Prot Keywords were used for functional enrichment.After selecting the main pathway,rats were selected and nitroglycerin was used for modeling,and the behavioral scores,inflammatory factors,heme oxygenase 1(HMOX1),protein kinase B(AKT1),signal transducer and activator of transcription 3(STAT3),phosphorylated extracellular signal-regulated kinase 1/2(P-ERK1/ERK2)and other states of the rats in the acupuncture,twisting,and electroacupuncture groups were compared.RESULTS:A total of 135 Baihui(GV20)targets and 27 Fengchi(GB20)targets were collected.A total of 73 target information were obtained after the intersection of these targets in migraine.These 73 targets have three main pathways:hypoxia-inducible factor 1(HIF-1)signaling pathway,signaling by interleukins and inflammatory response.The main targets in the pathway were verified and found that interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)and HMOX1,AKT1,STAT3,P-ERK1/ERK2 can be regulated by Baihui(GV20)and Fengchi(GB20).CONCLUSION:Baihui(GV20)and Fengchi(GB20)can regulate migraine by regulating inflammatory factors and HMOX1,AKT1,STAT3,P-ERK1/ERK2 and other changes in HIF-1 signaling pathway,Signaling by Interleukins and Inflammatory response pathways.Based on systems biology and network pharmacology,and with the model of"acupoint-target-disease",explore the research methods of systematic acupuncture and moxibustion.We believe this is a usable research direction for exploring the mechanism of acupuncture stimulation.
基金funded by the National Natural Science Foundation of China(81873256)Natural Science Foundation of Xiamen(3502Z202371045).
文摘Objective:To analyze and validate how Jiawei Sanpian decoction treats migraines by integrating network pharmacology,molecular docking technology,and experimental studies.Method:Using network pharmacology,the chemical components and core target proteins of the Jiawei Sanpian decoction were analyzed.Key chemical components were docked with core targets using mo-lecular docking,and the results were visualized.Nitroglycerin was injected into the dorsal cervical region to establish a rat migraine model.Finally,experiments were conducted to verify the effects of Jiawei Sanpian on related pathways and targets.Results:Four notable chemical components were identified,namely,b-sitosterol,quercetin,mairin,and kaempferol.Five representative targets were identified,namely,insulin-like growth factor 1(IGF-1),matrix metallopeptidase 2(MMP-2),interleukin-2(IL-2),superoxide dismutase 2(SOD2),and inducible nitric oxide synthase(NOS2).Molecular docking results revealed that the minimum binding energies between the four chemical components and the five targets were below5 kcal/mol,indicating favor-able binding activity.Enzyme linked immunosorbent assay(ELISA)results demonstrated the efficacy of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).Real-time quantitative polymerase chain reaction(RT-qPCR)results demonstrated the effectiveness of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).After using erastin,the therapeutic effect of Jiawei Sanpian decoction declined.Conclusion:This study provides initial insights into the complex and multilayered therapeutic mecha-nisms of Jiawei Sanpian decoction in treating migraine,primarily through its diverse components,tar-gets,and pathways.These findings indicate that Jiawei Sanpian decoction may exert its effects mainly through processes linked to the mitochondrial inflammatory pathway,thereby providing therapeutic benefits for migraine.
基金supported by grants The Natural Science Foundation of Inner Mongolia(2019MS08104)The Natural Science Foundation of Inner Mongolia(2022ZD09)The Central Government Guiding Special Funds for Development of Local Science and Technology(2020ZY0020).
文摘Background:The active components of Horcha-6 were identified using liquid chromatography with tandem mass spectrometry.Also,we investigated the potential mechanisms that explain why Horcha-6 may be effective in treating migraines through the use of network pharmacology and a rat migraine model.Methods:After identifying the active components of Horcha-6,the corresponding genes of the active components’target were obtained from the Universal Protein database,and a“compound-target-disease”network was constructed using Cytoscape 3.9.0 software.For the in vivo experiments,nitroglycerin was injected intraperitoneally into rats to create a migraine model.Pre-treatment with Horcha-6 was administered orally for 14 days,and rats were subjected to migraine-related behavior tests.RNA sequencing was performed to identify the gene expression regulated by Horcha-6 in the trigeminal nerve.Results:A total of 903 chemical components of Horcha-6 have been collected in the liquid chromatography with tandem mass spectrometry.We discovered 55 of the Horcha-6 bio-active components that were evaluated based on their Percent Human Oral Absorption(≥30%)and DL values(≥0.185)on the traditional Chinese medicine systems pharmacology database.The“compound-target-disease”network contained 163 intersection targets with the migraine state.Gene Ontology analysis indicated that these components significantly regulated the immune response,vascular function,oxidative stress,etc.When Kyoto Encyclopedia of Genes and Genomes enrichment analysis was performed,we observed that most of the target genes were significantly enriched in the inflammation and neuro-related signaling pathway,toll-like receptor signaling pathway,neuroactive ligand-receptor interaction,etc.These predictions were further demonstrated via in vivo animal model experiments.The RNA sequencing results showed that 41 genes were down-regulated(P<0.05)and 86 genes were up-regulated(P<0.05)in the Horcha-6 treated group compared with the untreated group.Those genes were mainly involved in neuromodulation,vascular function,and hormone metabolism.Conclusion:The 55 bio-active components in Horcha-6 regulate inflammation,hormone metabolism,and neurotransmitters and have potential as a therapy to treat migraines.
文摘Objective:To better understand the clinical phenotype of Méenière’s disease(MD),we examined family history,thyroid disorder,migraine,and associated disorders in complaints of people living with MD.Method:We designed the study as a retrospective and examined data gathered from 912 participants with MD.Their data were originally collected by the Finnish M′eni`ere Federation(FMF).The survey data included individual case histories for environmental factors,comorbidities,disease-specific complaints,impact-related questions,cognitive complaints,health-related quality of life(HRQoL),and sense of coherence(SOC).Results:We observed significant differences between those with and without sporadic occurrence,family history,thyroid disorder,and migraine-associated complaints.Family history explained 20%of variability in patient complaints.Patients with a family history of MD whose disease started at younger age experienced balance problems,more severe vertigo spells,more severe vestibular drop attacks(VDA),and less nausea,although they had good SOC.Thyroid disorder explained 14%of variability in patient complaints.MD patients with a thyroid disorder comorbidity suffered more often from constant dizziness,balance problems,greater impact of hearing problems,cognitive complaints,and poor HRQoL.Migraine explained 12%of variability in patients’complaints and was associated with poor SOC and cognitive balance problems.MD patients with both thyroid disorder and migraine used antidepressants more often than other groups.Logistic regression analysis showed comorbidities of ischemic brain disorder(among 7.1%),kidney insufficiency(among 1.2%),and diabetes(among 7.3%)had statistically significant but restricted association with balance and gait problems,VDA,and reduced HRQoL.Conclusions:Family history of MD and thyroid disorder or migraine comorbidities in MD influence the complaint pattern and partially explain complex symptom profiles,including symptoms of cognitive problems.Confounders play a minimal role in complaint profile and impact of MD whereas comorbidities influence the complaint structure and partly explain the complex symptom profile in MD.
文摘Background:White matter lesion(WML)is common in aging brain and is associated with cognitive impairment and dementia.However,recent studies reported an association between patent foramen ovale(PFO)and WML in migraineurs,especially in young,middle-aged migraineurs.Our retrospective,case-control study aims to describe the clinical characteristics of WML in this population and to explore potential risk factors.Methods:226 patients with migraine and PFO were consecutively initially screened.Relevant factors were selected by the least absolute shrinkage and selection operator(LASSO)regression and multivariable logistic regression model.A Nomogram was employed to visualize the prediction model conveniently.The discrimination and calibration abilities were evaluated using the Receiver Operating Characteristic(ROC)curve,the Hosmer-Lemeshow test,and calibration curves.Results:One hundred and nineteen participants were ultimately enrolled in our study,with a median age of 36.9±12.7 years and 80.7%of females.Brain magnetic resonance imaging MRI showed 67(56.3%)patients had WML,whereas 52(43.7%)patients were categorized into the non-WML group.LASSO regression screened out potential variables and subsequent multivariate analysisfinally identified age,mean platelet volume,andfibri-nogen(FIB)as independent predictive factors of WML.The area under the ROC curve(AUC)was 0.807.Hos-mer-Lemeshow test and calibration curve verified a consistency between the predicted and actual probability.Conclusion:The predictive nomogram established and validated in our study may assist clinicians in screening WML among young middle-aged migraineurs with PFO and developing individualized preventive and treatment strategies.
文摘BACKGROUND Yangxue Qingnao Granules(YXQN)is a Chinese patent medicine that has been commonly used in the clinical treatment of migraine.AIM To assess the efficacy and safety of YXQN alone for the treatment of migraine.METHODS We searched 10 databases to identify relevant randomized controlled trials(RCTs)published before September 2022.Two review authors independently searched and screened the literature,extracted the data,and assessed the methodological quality of the studies using criteria from ROB 2.0,and analyzed the data using Review Manager 5.4 software.RESULTS A total of 12 RCTs including 767 participants with migraine met the selection criteria.We divided these studies into comparisons of YXQN with placebo,routine treatment drugs,and other Chinese patent medicines.The meta-analysis showed the following:(1)Efficacy:The YXQN group outperformed the placebo group[relative risk(RR)=0.29,95%confidence interval(95%CI):0.15–0.43,P<0.00001],routine treatment group(RR=0.18,95%CI:0.09–0.27,P<0.0001),and Chinese patent medicine group(RR=0.27,95%CI:0.13–0.41,P<0.001);(2)frequency of headache:There was a significant difference between YXQN vs placebo[mean difference(MD)=-1.25,95%CI:-1.60 to-0.90,P<0.00001],routine treatment drugs(MD=-0.85,95%CI:-1.15 to-0.56,P<0.00001),and Chinese patent medicine(MD=-0.91,95%CI:-1.35 to-0.46,P<0.0001);(3)headache duration:We found great heterogeneity between studies,with no differences between YXQN and placebo(MD=-0.61,95%CI:-1.53 to-0.31,P=0.19)and routine treatment drugs(MD=-0.22,95%CI:-0.89 to 0.46,P<0.53).YXQN was more effective than other Chinese patent medicines in reducing headache duration(MD=-1.24,95%CI:-1.70 to-0.77,P<0.00001);and(4)headache severity:There was no significant difference between YXQN vs placebo(MD=-1.67,95%CI:-3.52 to 0.19,P=0.08),routine treatment drugs(MD=-0.53,95%CI:-2.02 to 0.96,P=0.68),and other Chinese patent medicines(MD=-0.49,95%CI:-2.83 to 1.85,P=0.68).Mild gastrointestinal adverse reactions were reported in three cases.CONCLUSION This study revealed that YXQN is effective and safe for treatment of migraine.
文摘Introduction: Migraine is the most common primary headache, and can cause significant disability. There are two types, migraine without aura and migraine with aura. The diagnosis of migraine is essentially clinical. Worldwide prevalence was estimated at 11.6% in 2009. In Africa, it is estimated at 10.4%. Objective: To describe the clinical and therapeutic aspects of migraine in Brazzaville. Patients and Methods: This was a door-to-door cross-sectional study conducted from 1<sup>st</sup> May to 1<sup> st</sup> July 2018 in the city of Brazzaville. Subjects over 18 with clearly expressed consent were included. The questionnaire covered demographic characteristics, diagnostic criteria for migraine according to the IHS, treatments taken. The degree of disability was determined using the Migraine Disability Assessment Scale (MIDAS). Statistical analysis was performed using SPSS 22.0 for MAC. Results: Of the 1017 subjects interviewed in this study, 115 (39.9%) had migraine, including 73 women (63.47%) and 42 men (36.52%). In the group of migraine sufferers, the number of cases of definite migraine was 61 (53.04%) and that of probable migraine 54 (46.95%). For 81 migraine sufferers (70.43%), stress was the triggering factor. The frequency of attacks was weekly and monthly for 30 (26.1%) and 19 (16.5%) sufferers respectively. The location of the migraine was unilateral in 38% of cases and tilted in 24.3%. The intensity of the attack was described as moderate and severe in 41.7% and 57.4% of subjects respectively. Phonophobia/photophobia accompanied the migraine in 65.2% of cases. One hundred and eight subjects were treated. Of these, 106 (98.1%) were on medication. Eleven (10.37%) had received a medical prescription, and ninety-seven (89.8%) were self-medicating. Five and three subjects were under the care of a general practitioner and a neurologist respectively. Conclusion: Migraine is a frequent pathology in Brazzaville. Its preponderance among young people and women calls for the implementation of effective prevention strategies for these already vulnerable social groups. The form without aura was the most common type. Visual aura was the most common type. Headache-related symptoms were dominated by phonophotophobia, followed by nausea and vomiting. Almost all migraine sufferers were self-medicating, and very few were under the care of a doctor. First-line analgesics and NSAIDs were the mainstay of treatment.
基金supported by Open Fund Project of Key Laboratory of Xin’an Medicine Ministry of Education(2020xayx09)Scientific Research Program of Chinese Society of Ethnomedicine(2020Z1066-410113).
文摘Background:To explore the potential mechanism of action of the active ingredients of Smilacis Glabrae Rhizoma(SGR)in the treatment of migraine using network pharmacology and in vivo experiments.Methods:Through the search of Traditional Chinese Medicines Systems Pharmacology Database and Analysis Platform,Genecards,Drugbank and other databases,we obtained active ingredients,targets of SGR and related disease targets of migraine,and took the intersection for protein-protein interactions analysis.After constructing the network diagram,network topology analysis was performed to derive the core targets and key active ingredients,and Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed.Finally,molecular docking was performed and validated by in vivo experiments.In vivo experiments,18 male BALB/c mice were selected,and the SGR group was fed with SGR drinking tablet concentrate,and nitroglycerin injection was used to construct a mouse model of migraine.Enzyme-linked immunosorbent assay test was used to detect the levels of TNF-α,IL-1β,IL-6,and AKT1 in plasma.Results:The results showed that the core targets of SGR for the treatment of migraine were TNF-α,IL-1β,IL-6,and AKT1.These core targets and key active ingredients had better binding ability.Compared with the blank group,the number of head scratching in the model group increased.Compared with the model group,there was a significant reduction of the number of head scratching in the SGR group.In comparison with the blank group,the protein level in the plasma in the model group was markedly higher.Compared with the model group,the protein level in the SGR group was significantly lower.Conclusion:SGR has the characteristics of improving migraine based on multi-targets,multi-components and multi-pathways,and the mechanism of action may be related to the inhibition of the release of inflammatory factors,neuron protection,and interference with apoptosis and other processes.
文摘Objective: This systematic review examines the impact of lifestyle factors on migraine frequency and severity through a comprehensive analysis of lifestyle factors such as diet, physical activity, sleep patterns, stress, mental health, and environmental influences. Methods: We thoroughly searched Google Scholar, PUBMED, Scopus, and Web of Science databases using keywords related to migraines and lifestyle factors. Keywords incorporated the Boolean operator “and” to narrow search results. Following the PRISMA guidelines, we identified, screened, and evaluated studies for inclusion, resulting in nine studies meeting the eligibility criteria. Results: A total of 4917 records were initially identified from Scopus (2786), PubMed (854), and Web of Science (1277). Following deduplication, 3657 records underwent title screening, with 382 additionally screened by abstract. Ultimately, 88 full-text articles were assessed, resulting in 9 studies meeting eligibility for qualitative synthesis: 7 prospective and 2 retrospective studies. Our findings highlight the multifaceted role of lifestyle factors in migraine pathophysiology and management. Dietary habits, such as high-calorie, high-fat, and gluten-containing diets were linked to migraine triggers. Moderate physical activity showed beneficial effects on migraine management, while intense exercise could exacerbate symptoms. Poor sleep hygiene and insomnia were strongly associated with increased migraine frequency and severity. Chronic stress and poor mental health significantly contributed to migraine exacerbation, with stress management techniques proving beneficial. Environmental factors, including light, sound, weather changes, and allergens, were also identified as significant migraine triggers. Conclusions: Personalized lifestyle modifications, tailored to individual patient profiles, are crucial in managing migraines. Evidence-based recommendations include balanced diets, moderate physical activity, improved sleep hygiene, stress management techniques, and environmental adaptations.
文摘Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of these models can well-explain the transmission of the disease. We hypothesied that migraine is a sex-conditioned inherited disorder （autosomal dominant in females and autosomal recessive in males）. This hypothesis is supported by the evidence such as the locations of genes associated with familial hemiplegic migraine, possibly ＂typical＂ migraine as well （dominantly on chromosome 19p, lq, and 2q）, male：female ratio of prevalence （1：2-1：4）, the mostly youth-onset, the provocation by the contraceptives, the induction by menstruation, and the self-limitation after menopause. Female sex-hormones appear to be the key contributor to a higher prevalence of migraine in female. Socio-environmental factors may also play an important role.
基金Supported by The Science and Technology Department of Yibin,No.2016YZY004.
文摘Clinical studies have suggested that internal and/or external aversive cues may produce a negative affective-motivational component whereby maladaptive responses(plasticity)of dural afferent neurons are initiated contributing to migraine chronification.However,pathophysiological processes and neural circuitry involved in aversion(unpleasantness)-producing migraine chronification are still evolving.An interdisciplinary team conducted this narrative review aimed at reviewing neuronal plasticity for developing migraine chronicity and its relevant neurocircuits and providing the most cutting-edge information on neuronal mechanisms involved in the processing of affective aspects of pain and the role of unpleasantness evoked by internal and/or external cues in facilitating the chronification process of migraine headache.Thus,information presented in this review promotes the understanding of the pathophysiology of chronic migraine and contribution of unpleasantness(aversion)to migraine chronification.We hope that it will bring clinicians’attention to how the maladaptive neuroplasticity of the emotion brain in the aversive environment produces a significant impact on the chronification of migraine headache,which will in turn lead to new therapeutic strategies for this type of pain.
文摘AIM To report the effects of greater occipital nerve(GON) blocks on refractory chronic migraine headache.METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month(for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up.RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change(not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.
基金Supported by Traditional Chinese Medicine Bureau of Guangdong Province,project number:20141240
文摘Objective To observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients. Methods Atotal of 60 migraine patients with the symptom of hyperactivity of liver yang who met the inclusive criteria were randomly divided into a opposing needling group （group A） and a routine acupuncture group （group B） by using SPSS 15.0 software according to the registration order with 30 patients in each group. Patients in group A were treated with opposing needling. Taich6ng （太冲 LR 3）, Zhongzhu （中渚 TE 3）, ZOlfnqi （足临泣 GB 41） and QiOxu （丘墟 GB 40） in the uninjured side were selected. After deqi, reducing method was used. Then Taixi （太溪 KI 3） in the uninjured side was selected. After deqi, rein forcing method was used. Needles were retained for 30 rain. Patients in group B were treated with routine acupuncture. Local Ash point, Sishncong （ 四神聪EX-HN1）, Yifeng （翳风 TE 17）, Fengchi （风池 GB 20）, Sizhukong （丝竹空 TE 23）, Shuaigu （率谷GB 8）, Hegu （合谷 LI 4） and LiEque （列缺 LU 7） were selected. After puncturing, reducing method was used routinely and needles were retained for 30 rain. After 2 weeks treatment, migraine specific quality of life questionnaire （MSQ）, visual analogue scale （VAS） and nitric oxide （NO） level in plasma of patients in two groups were observed. Results After treatment, the MSQ, VAS and NO of two groups were significantly improved compared with those before treatment. After treatment, score of MSQ functional limitation was 73.41±10.22 in group A and 60.95 ± 10.15 in group B; the score of MSQ dysfunction was 86.11 ±8.22 in group A and 75.45±8.34 in group B; score of MSQ emotion was 80.51±10.16 in group A and 75.01± 10.20 in group B. The improvements of group A were superior to those of group B, and the differences were all statistically significant （all P〈0.05）. After treatment, the VAS score was 0.93 ± 1.25 in group A and 2.17± 1.70 in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. After treatment, blood plasma NO level was （42.15 ± 16.15） μmol/L in group A and （62.76±15.17） μmol/L in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. Overall response rate was 86.7% （26/30） in group A and 53.3% （16/30） in group B, and the difference between two groups was statistically significant （P〈0.05）. Conclusion Opposing needling is an effective method for the treatment of migraine with the symptom of hyperactivity of liver yong. Its mechanism is to regulate the generation of NO in migraine patients, and improve the relaxation and contraction of cerebral vascular smooth muscle, so as to adjust the cerebral circulation.
文摘Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified cases were randomly divided into treatment group （146 cases according to the design） and control group （140 cases）, which were respectively treated with electro-acupuncture and drugs （Compound Aminopyrine Phenacetin Tablets, Ergotamine Caffeine Tablets, Diazepam Tablets）, and observed the overall effect and scores of headache, accompanying symptoms, psychological and social adaptability scores, life quality scores, TCM symptoms scores and follow-up results before and after the treatment. Results In treatment group, the successful rate of attack control was 47.3 %, the improvement rate was 73.3 %, and the total effectiveness was 90.4 %, the clinical control rate and improvement were much superior to control group （the clinical control rate 35.7 %, improvement 61.4 %, the total effectiveness 85. 7 % ）, P〈0. 01, the difference in effect was mainly reflected in patients with moderate severity; the total scores of TCM syndrome after the treatment was obviously significant or very obviously significant（ P〈0. 05, P〈0. 01 ）, but the headache scores between two groups was not obviously significant（P〉0.05）, the difference in accompanying symptoms was significant（ P〈0. 01 ） ;the long term attack control action in two groups was not satisfactory, the recurrence was similar （P〉0. 05） ,the severity of headache in recurrence cases of treatment group was alleviated and superior to control group（ P 〈 0. 01 ）, the occurrence of headache after the treatment is much less than that before the treatment and the situation after 2 months was superior to control group （P〈0. 01 ）. Sleepiness and redness of face in some patients which were seen in control group weren＇t seen in treatment group. Conclusion Electro-acupuncture on Tàiyáng （太阳 EX-HN5） can control the attack of migraine due to hyperactivity of liver yang, and it has advantages in improving the accompanying symptoms and reducing the toxic and side effects of western drugs.
基金supported by the Natural Science Foundation of Hainan Province of China,No.818MS153(to ZYC)the National Natural Science Foundation of China,No.81771200(to ZD)+2 种基金the National Key Research and Development Projects of Beijing Science and Technology Plan of China,No.Z161100002616013(to SYY)the Special Financial Grant from the China Postdoctoral Science Foundation,No.2014T70960(to ZYC)the Nursery Technology Innovation Fund of Chinese PLA General Hospital,No.12KMM39(to XYC)
文摘The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine.Sixteen episodic migraine patients,16 chronic migraine patients,and 24 normal controls were recruited and underwent 3.0 T MRI scanning.The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables.Results demonstrated that the volumes of specific regions in the frontal and occipital lobes,and the right putamen,were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls.The volumes of the left basal forebrain,optic chiasm,and,the fourth ventricle were decreased in the chronic migraine patients,while the occipital cortex and the right putamen were larger.Compared to episodic migraine patiants,chronic migraine patients displayed larger left thalamus and smaller frontal regions.Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole,right lateral orbital gyrus,and medial frontal lobes and positively correlated with the volume of the left thalamus.The sleep disturbance score was negatively correlated with the volume of the left basal forebrain.This suggests that migraine patients have structural changes in regions associated with pain processing and modulation,affective and cognitive processing,and visual perception.The remodeling of selective intracranial structures may be involved in migraine attacks.This study was approved by the Ethics Committee of Chinese PLA General Hospital(approval No.S2018-027-02)on May 31,2018.
文摘We present a 29-year-old woman with a long history of attacks of migraine with and without visual aura.She was a heavy smoker(20 cigarettes/d) and was currently taking oral contraceptives. During a typical migraine attack with aura, she developed dysarthria,left brachial hemiparesis and hemihypoesthesia and brief and autolimited left clonic facial movements. Four hours after onset, vascular headache and focal sensorimotor neurological deficit were the only persisting symptoms and, on seventh day, she was completely recovered. Brain magnetic resonance imaging on day 20 after onset showed a subacute ischemic lesion in the right temporo-parietal cortex compatible with cortical laminar necrosis(CLN). Extensive neurological work-up done to rule out other known causes of cerebral infarct with CLN was unrevealing. Only ten of 3.808 consecutive stroke patients included in our stroke registry over a 19-year period fulfilled the strictly defined International Headache Society criteria for migrainous stroke. The present case is the unique one in our stroke registry that presents CLN related to migrainous cerebral infarction. Migrainous infarction can result in CLN.
文摘Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.
文摘Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.
