Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,preva...Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,prevalence rate,disability-adjusted life years(DALYs),and age-standardized DALY rates were analyzed by sex,age group,and province for headache disorders and their subtypes(migraine and tension-type headache[TTH])between 1990 and 2021.Percentage changes during this period were also estimated.Results In 2021,approximately 426 million individuals in China were affected by headache disorders,with an age-standardized prevalence rate of 27,582.61/100,000.The age-standardized DALY rate for all headache disorders was 487.15/100,000.Between 1990 and 2021,the number of prevalent cases increased by 37.78%,while the prevalence of all headache disorders,migraine,and TTH increased by 6.92%,7.57%,and 7.86%,respectively.The highest prevalence was observed in the 30-34 age group(39,520.60/100,000).Migraine accounted for a larger proportion of DALYs attributable to headache disorders,whereas TTH has a greater impact on its prevalence.In 2021,the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang(617.85/100,000)and Shanghai(542.86/100,000).Conclusion The prevalence of headache disorders is increasing in China.Effective health education,improve diagnosis and treatment are essential,particularly for middle-aged working populations and women of childbearing age.展开更多
Mild traumatic brain injury(mTBI)-induced post-traumatic headache(PTH)is a pressing public health concern and leading cause of disability worldwide.Although PTH is often accompanied by neurological disorders,the exact...Mild traumatic brain injury(mTBI)-induced post-traumatic headache(PTH)is a pressing public health concern and leading cause of disability worldwide.Although PTH is often accompanied by neurological disorders,the exact underlying mechanism remains largely unknown.Identifying potential biomarkers may prompt the diagnosis and development of effective treatments for mTBI-induced PTH.In this study,a mouse model of mTBI-induced PTH was established to investigate its effects on cerebral structure and function during short-term recovery.Results indicated that mice with mTBI-induced PTH exhibited balance deficits during the early post-injury stage.Metabolic kinetics revealed that variations in neurotransmitters were most prominent in the cerebellum,temporal lobe/cortex,and hippocampal regions during the early stages of PTH.Additionally,variations in brain functional activities and connectivity were further detected in the early stage of PTH,particularly in the cerebellum and temporal cortex,suggesting that these regions play central roles in the mechanism underlying PTH.Moreover,our results suggested that GABA and glutamate may serve as potential diagnostic or prognostic biomarkers for PTH.Future studies should explore the specific neural circuits involved in the regulation of PTH by the cerebellum and temporal cortex,with these two regions potentially utilized as targets for non-invasive stimulation in future clinical treatment.展开更多
OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of acute primary headache and provide clinical practice guidance.METHODS:The guidelines were developed in accordance ...OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of acute primary headache and provide clinical practice guidance.METHODS:The guidelines were developed in accordance with the World Health Organization guideline development manual.After the establishment of steering committee,panel and the registration and protocol formulation,the evidence on TCM for acute primary headache from published guidelines,clinical evidence,and expert experience and consensus were collected.The grading of recommendations assessment,development and evaluation method was used to grade the evidence and make the recommendations.RESULTS:Based on the available evidence,the guidelines recommended three TCM herbal decoctions,six Chinese patent medicines,and two kinds of external application of Chinese herbal medicines.Diagnostic recommendations based on the expert experience and consensus were also included in the guidelines.CONCLUSION:TCM diagnosis and treatment of decoction,Chinese patent medicine and external application for treating acute primary headache were recommended.We hope these guidelines will be helpful in standardize the TCM acute treatment of primary headache.展开更多
Introduction: Tension-type headaches are the most widespread of the primary headache disorders. Due to their high prevalence, tension-type headaches represent a major public health problem with an enormous socio-econo...Introduction: Tension-type headaches are the most widespread of the primary headache disorders. Due to their high prevalence, tension-type headaches represent a major public health problem with an enormous socio-economic burden. Determining their impact remains a challenge. Objective: To assess the impact of occupational tension-type headache in Brazzaville and identify associated factors. Population and Methods: This was an analytical case-control study conducted in public and private companies in the city of Brazzaville over a period of four (04) months. The case population consisted of cephalalgic employees;the control population was drawn from the same companies and was free of tension-type headaches. Study variables were divided into socio-professional, clinical and individual impact variables. Individual impact variables were represented by: the HIT-6 score, which incorporates a very broad conception of disability, covering several domains, namely: severity of pain during attacks and the restrictive and limiting nature of attacks. Results: Individual impact was severe in 18 (62.1%) men and 11 (37.9%) women. Mean age was 36.3 6.14 years for cases with severe impact. The mean duration of headache was 40.3 32.7 months for cases with severe impact. Tension headache evolved in attacks in 22 (75.9%) cases with severe impact, and continuously in seven (24.1%) cases. The average number of attacks per month was 2.52 1.04 for cases with severe impact. Cases with severe impact included 14 (48.3%) with chronic headache and 15 (51.7%) with episodic headache. Pain of severe intensity present in 48.3% of cases was associated with a severe impact of tension-type headache: OR = 151.66 [2.36 - 44245.95] and p-value = 0.037. At least one days absence from work per year was observed in 47.4% of our cases. The number of days off work per year due to tension-type headache had an interquartile range between 0 and 3 days and extremes from 0 to 14 days. It was the consequence of a severe impact on daily and/or professional activities. Conclusion: The high frequency of tension-type headaches in the workplace and its impact on the condition of workers in Brazzaville represent a real public health problem. It was found that the number of days absent from work per year due to tension headaches was the consequence of a severe impact on daily and/or professional activities. An awareness-raising program in this environment seems necessary, as well as an assessment of working conditions.展开更多
Governor vessel-regulating and collaterals-unblocking technique is a specific acupuncture therapy for treatment of headache of ＂GAO＇s acupuncturemoxibustion academic school in Yanzhao land（around Hebei Province are...Governor vessel-regulating and collaterals-unblocking technique is a specific acupuncture therapy for treatment of headache of ＂GAO＇s acupuncturemoxibustion academic school in Yanzhao land（around Hebei Province area）＂.This method is a specific acupuncture therapy for treatment of various types of headache through combining GAO＇s four groups of empirical paired acupoints with governor vessel-regulating needling,z？w？liúzhù acupoint opening needling and meridian sinew needling in Yanzhao land correctly according to the clinical conditions of patients.Immediate effect can be obtained,and the duration of treatment can be shortened through appropriate clinical application,so that good long-term effects can be obtained.In this paper,the specific manipulations and theoretical basis of this needling method will be illustrated,and two cases will be attached for explanation.展开更多
BACKGROUND Cluster headache(CH)is a severe incapacitating headache disorder.By definition,its diagnosis must exclude possible underlying structural conditions.AIM To review available information on CLH caused by struc...BACKGROUND Cluster headache(CH)is a severe incapacitating headache disorder.By definition,its diagnosis must exclude possible underlying structural conditions.AIM To review available information on CLH caused by structural lesions and to provide better guides in the distinguishing process and to ensure that there is not a potentially treatable structural lesion.METHODS We conducted a systematic review of 77 published cases of symptomatic CH and cluster-like headache(CLH)in PubMed and Google Scholar databases.RESULTS Structural pathologies associated with CH were vascular(37.7%),tumoral(32.5%)and inflammatory(27.2%).Brain mass-like lesions(tumoural and inflammatory)were the most common diseases(28.6%),among which 77.3%lesions were at the suprasellar(pituitary)region.Cases of secondary CH related to sinusitis rose dramatically,occupying 19.5%.The third most common disease was internal carotid artery dissection,accounting for 14.3%.Atypical clinical features raise an early suspicion of a secondary cause:Late age at onset and eye and retroorbital pains were common conditions requiring careful evaluation and were present in at least one-third of cases.Abnormal neurological examination was the most significant red flag for impaired cranial nerves.CLH patients may be responsive to typical CH treatments;therefore,the treatment response is not specific.CLH can be triggered by contralateral structural pathologies.CLH associated with sinusitis and cerebral venous thrombosis required more attention.CONCLUSION Since secondary headache could perfectly mimick primary CH,neuroimaging should be conducted in patients in whom primary and secondary headaches are suspected.Cerebral magnetic resonance imaging scans is the diagnostic management of choice,and further examinations include vessel imaging with contrast agents and dedicated scans focusing on specific cerebral areas(sinuses,ocular and sellar regions).Neuroimaging is as necessary at follow-up visits as at the first observation.展开更多
Background and purpose: Vascular and tension-type headache is most commonly encountered, and SI17 therapy has been tested to treat headache with good results. The efficacy of SI17 therapy for vascular and tension-... Background and purpose: Vascular and tension-type headache is most commonly encountered, and SI17 therapy has been tested to treat headache with good results. The efficacy of SI17 therapy for vascular and tension-type headache was compared and the effect of SI17 therapy on pancreatic polypeptide (PP) was studied. Materials and methods: 29 cases of vascular headache (20 cases in acute attack during the trial) and 27 cases of tension-type headache (19 cases in acute attack) were enrolled in the study. Plasma PP level before and 4th day after treatment was measured by radioimmunoassay. Results: SI17 therapy is better for the treatment of vascular headache. Vascular headache with higher PP level and tension-type headache with normal PP level had good therapeutic results. Conclusion: The clinical efficacy is better for vascular headache with the increase of vagus tension and for tension-type headache with normal vagus tension. 展开更多
Objective:This observational cohort pilot study aimed to evaluate the effects of the acupuncture methods,Jiu Cang Zhen(JCZ)and Huang Guan(HG),on changes in headache intensity in an inpatient,multimodal Zurzach Headach...Objective:This observational cohort pilot study aimed to evaluate the effects of the acupuncture methods,Jiu Cang Zhen(JCZ)and Huang Guan(HG),on changes in headache intensity in an inpatient,multimodal Zurzach Headache Programme(ZHP).Methods:Study participants consisted of patients diagnosed with chronic headache disorder(headache ds,30 days per month)or daily persistent headache.All patients received conventional therapies with active and passive approaches.The patient group was treated with JCZ and HG acupuncture methods,receiving a total of six to eight acupuncture sessions of 50 to 60 minutes each,during a 3–4-week multimodal ZHP at the RehaClinic Bad Zurzach.Pain intensity was quantified using a Numerical Rating Scale(NRS)before and after each acupuncture therapy session.Results:Ten patients were recruited,six women and four men,with a mean age of 41.7(standard deviation,[SD]=13.9).A reduction in headache intensity was reported by all patients in each of the sessions.The average NRS for pain was 4.21(SD=1.44)before acupuncture and 1.24(SD=0.93)after acupuncture(means first by number of sessions,then per n=10 patients).This resulted in a mean difference of 2.97(SD=1.04),corresponding to a standardized response mean of 2.85(95%confidence interval:2.11–3.60,one-tailed P<0.001),meaning there was a large effect.Conclusions:This pilot study shows that JCZ and HG are suitable acupuncture methods for reducing headache intensity in the treatment of headaches.A comparison with the conventional classical acupuncture methods from the acupuncture textbook for traditional Chinese medicine students in China,exploration with a larger patient group,and prolonged monitoring of pain behavior could be foci of follow-up investigations.展开更多
Objectives: After reading this article, readers should be able to recognize Post Dural Puncture Headache, understand its mechanism and diagnostic criteria, evaluate the different treatment options available, and be fa...Objectives: After reading this article, readers should be able to recognize Post Dural Puncture Headache, understand its mechanism and diagnostic criteria, evaluate the different treatment options available, and be familiar with a novel treatment option. Background: Post-dural puncture headache is the most common serious complication resulting from lumbar puncture and epidural or spinal anesthetics. The syndrome is characterized by severe headache that occurs within 48 hours following the puncture, located in the frontal and/or occipital region, worsened in the upright position and refractory to routine analgesia. The syndrome incidence was reported to be approximately 1% with typical obstetric anesthesiology practice which reflects more than 20,000 cases per 2014 in the US. Two possible mechanisms are hypothesized as responsible for this syndrome;cerebrospinal fluid leakage and pneumocephalus. Multiple methods of treatment have been applied with wide-ranging results. Design or Methods: Review article with introduction of a novel treatment option. Results: We postulate that Hyperbaric Oxygen Therapy can be used to treat post-dural puncture headache. The rationale for treatment is dual: enhancement of fibroblast proliferation at the site of dural puncture to facilitate faster closure of the tear and compression of air bubbles in case of pneumocephalus according to Boyle’s law. We also claim that hyperbaric oxygen therapy should be considered a prophylactic treatment, if a dural tear is suspected.展开更多
Toutongning capsule is used for the treatment of migraine headaches, and has yielded therapeutically beneficial effects. However, whether Toutongning capsule exerts its effects via endogenous opioid peptides remains p...Toutongning capsule is used for the treatment of migraine headaches, and has yielded therapeutically beneficial effects. However, whether Toutongning capsule exerts its effects via endogenous opioid peptides remains poorly understood. This study investigated the effects of Toutongning capsule on enkephalin expression in the midbrain of rats with nitroglycerin-induced migraine headache at the mRNA and protein levels. Results confirmed that proenkephalin mRNA levels were significantly upregulated following treatment with Toutongning capsule. The numbers methionine-enkephalin and leucine-enkephalin-positive cells were significantly greater in the migraine headache rats following treatment with Toutongning capsule compared with the model group. Taken together, these results show that Toutongning capsule exerts potentially beneficial effects by promoting enkephalin expression in nitroglycerin-induced migraine headache rats.展开更多
Tension-type headache（TTH） is the most prevalent type of primary headache. Many studies have shown that the pathogenesis of primary headache is associated with fine structural or functional changes. However, these s...Tension-type headache（TTH） is the most prevalent type of primary headache. Many studies have shown that the pathogenesis of primary headache is associated with fine structural or functional changes. However, these studies were mainly based on migraine. The present study aimed to investigate whether TTH patients show functional disturbances compared with healthy subjects. We used restingstate functional magnetic resonance imaging（f MRI） and regional homogeneity（Re Ho） analysis to identify changes in the local synchronization of spontaneous activity in patients with TTH. Ten patients with TTH and 10 age-, gender-, and education-matched healthy controls participated in the study. After demographic and clinical characteristics were acquired, a 3.0-T MRI system was used to obtain restingstate f MRIs. Compared with healthy controls, the TTH group exhibited significantly lower Re Ho values in the bilateral caudate nucleus, the precuneus, the putamen, the left middle frontal gyrus, and the superior frontal gyrus. There was no correlation between mean Re Ho values in TTH patients and duration of TTH, number of attacks, duration of daily attacks, Visual Analogue Scale score, or Headache Impact Test-6 score. These results suggest that TTHpatients exhibit reduced synchronization of neuronal activity in multiple regions involved in the integration and processing of pain signals.展开更多
Cervicogenic headache(CEH)has been recognized as a unique category of headache that can be difficult to diagnose and treat.In China,CEH patients are managed by many different specialties,and the treatment plans remain...Cervicogenic headache(CEH)has been recognized as a unique category of headache that can be difficult to diagnose and treat.In China,CEH patients are managed by many different specialties,and the treatment plans remain controversial.Therefore,there is a great need for comprehensive evidence-based Chinese experts’recommendations for the management of CEH.The Chinese Association for the Study of Pain asked an expert panel to develop recommendations for a series of questions that are essential for daily clinical management of patients with CEH.A group of multidisciplinary Chinese Association for the Study of Pain experts identified the clinically relevant topics in CEH.A systematic review of the literature was performed,and evidence supporting the benefits and harms for the management of CEH was summarized.Twenty-four recommendations were finally developed through expert consensus voting for evidence quality and recommendation strength.We hope this guideline provides direction for clinicians and patients making treatment decisions for the management of CEH.展开更多
Objective： To investigate the masseter inhibitory tension-type headache （TTH）. Methods： MIR was studied in 21 sex matched to the study cohort. Median age of patients was reflex （MIR） and its eventual changes in ...Objective： To investigate the masseter inhibitory tension-type headache （TTH）. Methods： MIR was studied in 21 sex matched to the study cohort. Median age of patients was reflex （MIR） and its eventual changes in patients with episodic patients with episodic TTH and 30 healthy subjects, with age and 17.0 years （ranged 16-49 years）, median duration of disease 12 months （1-5 years）, and median frequency of headache 7.5 d per month. Results： The second period of suppression （$2） of MIR was reduced in intensity and duration in 10% of controls and 66.7% （confidence interval （CI） 45.3%-85%; P〈0.05） of patients with episodic TTH （X2=74.9; P〈0.001）. In 3 （14.3%） of patients with episodic TTH, S2 was completely absent. No significant correlation between the duration of disease and headache frequency was found. Conclusion： Our results confirm the link between episodic TTH and reduction or absence of S2. Teenage patients with episodic TTH may exhibit marked pathological changes in S2 in contrast to older individuals.展开更多
OBJECTIVE: To critically appraise the methodological quality of clinical practice guidelines for headache produced over the last two decades, including those covering specific interventions using Traditional Chinese M...OBJECTIVE: To critically appraise the methodological quality of clinical practice guidelines for headache produced over the last two decades, including those covering specific interventions using Traditional Chinese Medicine.METHODS: The guidelines on headache disorders were obtained by searching a number of databases, including Pub Med, EMBASE, Web of Science,Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, and Wanfang database, three guideline-related databases [Guideline-International Network, National Guideline Clearinghouse, and Medlive], and the records of organizations that develop guidelines. The publication date was limited to the period from January 1996 to June 2015. The search terms "headache", "headache disorders", "cephalalgia", "migraine", "tension-type headache", "practice guideline", "consensus ", "statement", "regulation", and "recommendation" were used in the "Me SH" and "Free-text" fields. The guidelines were independently appraised by four researchers using the Appraisal of Guidelines for Research and Evaluation Ⅱ instrument.RESULTS: A total of 23 guidelines published between 1998 and 2014 were reviewed. The overall consistency of the four appraisers was good [interclass correlation coefficient 0.84; 95% confidence interval(CI) 0.82-0.86]. The mean(standard deviation) scores for scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence were 52.1(18.0), 39.5(17.1), 33.4(21.0), 49.8(21.9),23.8(19.3), and 24.2(23.7). Only two guidelines were recommended, 12 were recommended with modification, and nine were not recommended.CONCLUSION: Physical Traditional Chinese Medicine therapies were recommended to treat headache. The overall quality of headache guidelines was low in China, but evidence-based guidelines are gradually becoming mainstream. Guideline developers should carefully consider, in particular,three domains: rigor of development, applicability,and editorial independence.展开更多
Objective To explore the treatment of chronic headaches which are unmanageable to conventional occidental treatments.Methods Traditional Chinese acupuncture on the basis of syndrome differentiation was applied to 253 ...Objective To explore the treatment of chronic headaches which are unmanageable to conventional occidental treatments.Methods Traditional Chinese acupuncture on the basis of syndrome differentiation was applied to 253 patients.The observation and efficacy evaluation criteria were related to the lowering of pain and the diminution in the use of painkillers,antiinflammatories and sedatives.Results For 220(87%) patients,the pain stopped in a permanent way,the remaining 33(13%) patients presented temporary relapses and needed extra treatment or simple pain relievers for their resolution.Conclusion Traditional Chinese Medicine is an efficient method in chronic headaches' treatment.展开更多
OBJECTIVE: To describe the common causes of headache as well as the different methods of Phlebotomy(Fasd) and wet Cupping(Hijamat) based on Persian Medicine.METHODS: In this study, we searched Google Scholar, Science ...OBJECTIVE: To describe the common causes of headache as well as the different methods of Phlebotomy(Fasd) and wet Cupping(Hijamat) based on Persian Medicine.METHODS: In this study, we searched Google Scholar, Science Direct, Pub Med and Scopus to get any in vitro or clinical evidence of the efficacy and possible mechanisms of phlebotomy or wet cupping on different types of headaches. Also different types of headaches, according to PM, under the title of "Sodaa"; extracted from famous Persian medical text books with key words including "Sodaa","Bayze" and "Shaqiqe".RESULTS: According to PM, diseases(dystemperament) are created by abnormal alteration in temperament. Temperament is a monolithic quality yielded by interaction between opposing qualities of four elements that are coldness, hotness, dryness and wetness. Headaches are caused by dystemperament(sue-Mizaj) in brain or in total body that are divided into simple and corporal. Common forms of the latter type are Vaporal and Migrant headache(Bokhari and Rihi). Each of these headaches is treated either through phlebotomy or wet cupping.CONCLUSION: In Persian Medicine, Fasd and Hijamat are easy and economical methods for treatment of headache with reasonable results. By describing the precise areas and indications of phlebotomy and wet cupping, this study provides the first step for future clinical trials in this field.展开更多
Acute myocardial infarction should be diagnosed as early as possible for the appropriate management to salvage ischemic myocardium. Accurate diagnosis is typically based on the typical symptoms of angina. Headache is ...Acute myocardial infarction should be diagnosed as early as possible for the appropriate management to salvage ischemic myocardium. Accurate diagnosis is typically based on the typical symptoms of angina. Headache is an unusual symptom in patients with acute myocardial infraction. We report a patient with ST-segment elevation acute myocardial infarction who presented to the emergency department complaining of severe occipital headache without chest discomfort.展开更多
To compare the acupuncture plus oral administration of Chinese herbal decoction with simple oral administration of Chinese herbal decoction in the treatment of vascular headache. Methods： Sixty two patients were rand...To compare the acupuncture plus oral administration of Chinese herbal decoction with simple oral administration of Chinese herbal decoction in the treatment of vascular headache. Methods： Sixty two patients were randomly divided into a treatment group （32 cases） and a control group （30 cases）. Acupuncture at Baihui （GV 20）, Fengchi （GB 20）, Shuaigu （GB 8）, Xingjian （LR 2）, Neiguan （PC 6）, Sanyinjiao （SP 6） and Ashi points combined with oral administration of Chinese herbal decoction, was applied in the treatment group, and simple oral administration of Chinese herbal decoction was applied in the control group. Results： The total therapeutic effect in the treatment group was better than that in the control group （P〈0.05）. After treatment, the frequency, and duration of the attacks were reduced and shortened, and headache greatly alleviated in both groups （P〈0.01）. The alleviation in the treatment group was more obvious than that in the control group （P〈0.05）. Conclusion： Acupuncture combined with oral administration of Chinese herbal decoction provided remarkable therapeutic effects in treating vascular headache.展开更多
The authors have adopted acupuncture at Jǐngjiājǐ（颈夹脊） combined with nape cluster needling in treatment of 100 patients with cervicogenic headache. Nape cluster needling was： Xiànǎohù（下脑户）（lo...The authors have adopted acupuncture at Jǐngjiājǐ（颈夹脊） combined with nape cluster needling in treatment of 100 patients with cervicogenic headache. Nape cluster needling was： Xiànǎohù（下脑户）（located in the median depression under occipital bone）, Fēngfǔ（风府 GV 16） and Yǎmén（哑门 GV 15） were selected longitudinally; horizontally, the part from GV 16 to Wángǔ（完骨 GB 12） was divided into six equal sections, one section was an acupoint, and there were 12 acupoints in total at the left and right sides. Bilateral Jǐngjiājǐ（颈夹脊） points on the second vertebra to the seventh vertebra were selected. The acupuncture was conducted once a day, five days were considered as one course of treatment, and two days were free from treatment between two courses. Four courses of treatment were needed. All the patients were cured clinically. It can be seen that acupuncture at Jǐngjiājǐ combined with nape cluster needling in treatment of cervicogenic headache has sound effect.展开更多
The gut-brain axis is a bidirectional communication system that exists between the brain and gut. Several studies claimed that some types of headaches are associated with various gastrointestinal(GI) disorders.In Pers...The gut-brain axis is a bidirectional communication system that exists between the brain and gut. Several studies claimed that some types of headaches are associated with various gastrointestinal(GI) disorders.In Persian medicine(PM), physicians believed that gastric disturbances could stimulate headache and introduced some herbs for boosting gastric function as a therapeutic remedy for headache. Here we review the current evidence for the gastroprotective and antiheadache effects of herbs used in PM.Herbs used for their gastrotonic effects in PM were identified from selected Persian medical and pharmaceutical textbooks. Pub Med, Scopus and Google Scholar were used to search for contemporary scientific evidence relating to the gastric and neurologic effects of these plants. A total of 24 plants were recorded from the selected sources included in this review, most of which belonged to the Rosaceae family.Phyllanthus emblica, Zingiber officinale, Boswellias errata, Punica granatum and Hypericum perforatum had the most recent studies related to GI disorder and headache, while current research about quince, rose,apple, hawthorn and pear was limited. Reducing Helicobacter pylori growth, gastritis, erosion of the stomach lining, hemorrhage and perforation, improving gastric mucosal resistance, antisecretary, antiulcer,antipyretic, analgesic, sedative, anxiolytic, anti-inflammatory, anticonvulsant, neuroprotective and antioxidant effects as well as improvement in memory scores were some of the gastrotonic and neuroprotective mechanisms described in the current research. These results confirmed that medicinal plants prescribed in PM may improve headache in patients through the management of GI abnormalities.However, further studies are recommended to investigate the efficacy and safety of the mentioned medicinal plants.展开更多
基金supported by the National Key Research and Development Program of China(2018YFC1315301).
文摘Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,prevalence rate,disability-adjusted life years(DALYs),and age-standardized DALY rates were analyzed by sex,age group,and province for headache disorders and their subtypes(migraine and tension-type headache[TTH])between 1990 and 2021.Percentage changes during this period were also estimated.Results In 2021,approximately 426 million individuals in China were affected by headache disorders,with an age-standardized prevalence rate of 27,582.61/100,000.The age-standardized DALY rate for all headache disorders was 487.15/100,000.Between 1990 and 2021,the number of prevalent cases increased by 37.78%,while the prevalence of all headache disorders,migraine,and TTH increased by 6.92%,7.57%,and 7.86%,respectively.The highest prevalence was observed in the 30-34 age group(39,520.60/100,000).Migraine accounted for a larger proportion of DALYs attributable to headache disorders,whereas TTH has a greater impact on its prevalence.In 2021,the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang(617.85/100,000)and Shanghai(542.86/100,000).Conclusion The prevalence of headache disorders is increasing in China.Effective health education,improve diagnosis and treatment are essential,particularly for middle-aged working populations and women of childbearing age.
基金supported by the Natural Science Foundation of Guangdong Province,China(2021A1515010897)Discipline Construction Fund of Central People’s Hospital of Zhanjiang(2020A01,2020A02)+1 种基金National Natural Science Foundation of China(31970973,21921004,32271148)Biosecurity Research Project(23SWAQ24)。
文摘Mild traumatic brain injury(mTBI)-induced post-traumatic headache(PTH)is a pressing public health concern and leading cause of disability worldwide.Although PTH is often accompanied by neurological disorders,the exact underlying mechanism remains largely unknown.Identifying potential biomarkers may prompt the diagnosis and development of effective treatments for mTBI-induced PTH.In this study,a mouse model of mTBI-induced PTH was established to investigate its effects on cerebral structure and function during short-term recovery.Results indicated that mice with mTBI-induced PTH exhibited balance deficits during the early post-injury stage.Metabolic kinetics revealed that variations in neurotransmitters were most prominent in the cerebellum,temporal lobe/cortex,and hippocampal regions during the early stages of PTH.Additionally,variations in brain functional activities and connectivity were further detected in the early stage of PTH,particularly in the cerebellum and temporal cortex,suggesting that these regions play central roles in the mechanism underlying PTH.Moreover,our results suggested that GABA and glutamate may serve as potential diagnostic or prognostic biomarkers for PTH.Future studies should explore the specific neural circuits involved in the regulation of PTH by the cerebellum and temporal cortex,with these two regions potentially utilized as targets for non-invasive stimulation in future clinical treatment.
基金National Key Research and Development Program of China:Research on the Development and Evaluation of International Standards of Traditional Chinese Medicine(No.2019YFC1712000)。
文摘OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of acute primary headache and provide clinical practice guidance.METHODS:The guidelines were developed in accordance with the World Health Organization guideline development manual.After the establishment of steering committee,panel and the registration and protocol formulation,the evidence on TCM for acute primary headache from published guidelines,clinical evidence,and expert experience and consensus were collected.The grading of recommendations assessment,development and evaluation method was used to grade the evidence and make the recommendations.RESULTS:Based on the available evidence,the guidelines recommended three TCM herbal decoctions,six Chinese patent medicines,and two kinds of external application of Chinese herbal medicines.Diagnostic recommendations based on the expert experience and consensus were also included in the guidelines.CONCLUSION:TCM diagnosis and treatment of decoction,Chinese patent medicine and external application for treating acute primary headache were recommended.We hope these guidelines will be helpful in standardize the TCM acute treatment of primary headache.
文摘Introduction: Tension-type headaches are the most widespread of the primary headache disorders. Due to their high prevalence, tension-type headaches represent a major public health problem with an enormous socio-economic burden. Determining their impact remains a challenge. Objective: To assess the impact of occupational tension-type headache in Brazzaville and identify associated factors. Population and Methods: This was an analytical case-control study conducted in public and private companies in the city of Brazzaville over a period of four (04) months. The case population consisted of cephalalgic employees;the control population was drawn from the same companies and was free of tension-type headaches. Study variables were divided into socio-professional, clinical and individual impact variables. Individual impact variables were represented by: the HIT-6 score, which incorporates a very broad conception of disability, covering several domains, namely: severity of pain during attacks and the restrictive and limiting nature of attacks. Results: Individual impact was severe in 18 (62.1%) men and 11 (37.9%) women. Mean age was 36.3 6.14 years for cases with severe impact. The mean duration of headache was 40.3 32.7 months for cases with severe impact. Tension headache evolved in attacks in 22 (75.9%) cases with severe impact, and continuously in seven (24.1%) cases. The average number of attacks per month was 2.52 1.04 for cases with severe impact. Cases with severe impact included 14 (48.3%) with chronic headache and 15 (51.7%) with episodic headache. Pain of severe intensity present in 48.3% of cases was associated with a severe impact of tension-type headache: OR = 151.66 [2.36 - 44245.95] and p-value = 0.037. At least one days absence from work per year was observed in 47.4% of our cases. The number of days off work per year due to tension-type headache had an interquartile range between 0 and 3 days and extremes from 0 to 14 days. It was the consequence of a severe impact on daily and/or professional activities. Conclusion: The high frequency of tension-type headaches in the workplace and its impact on the condition of workers in Brazzaville represent a real public health problem. It was found that the number of days absent from work per year due to tension headaches was the consequence of a severe impact on daily and/or professional activities. An awareness-raising program in this environment seems necessary, as well as an assessment of working conditions.
文摘Governor vessel-regulating and collaterals-unblocking technique is a specific acupuncture therapy for treatment of headache of ＂GAO＇s acupuncturemoxibustion academic school in Yanzhao land（around Hebei Province area）＂.This method is a specific acupuncture therapy for treatment of various types of headache through combining GAO＇s four groups of empirical paired acupoints with governor vessel-regulating needling,z？w？liúzhù acupoint opening needling and meridian sinew needling in Yanzhao land correctly according to the clinical conditions of patients.Immediate effect can be obtained,and the duration of treatment can be shortened through appropriate clinical application,so that good long-term effects can be obtained.In this paper,the specific manipulations and theoretical basis of this needling method will be illustrated,and two cases will be attached for explanation.
文摘BACKGROUND Cluster headache(CH)is a severe incapacitating headache disorder.By definition,its diagnosis must exclude possible underlying structural conditions.AIM To review available information on CLH caused by structural lesions and to provide better guides in the distinguishing process and to ensure that there is not a potentially treatable structural lesion.METHODS We conducted a systematic review of 77 published cases of symptomatic CH and cluster-like headache(CLH)in PubMed and Google Scholar databases.RESULTS Structural pathologies associated with CH were vascular(37.7%),tumoral(32.5%)and inflammatory(27.2%).Brain mass-like lesions(tumoural and inflammatory)were the most common diseases(28.6%),among which 77.3%lesions were at the suprasellar(pituitary)region.Cases of secondary CH related to sinusitis rose dramatically,occupying 19.5%.The third most common disease was internal carotid artery dissection,accounting for 14.3%.Atypical clinical features raise an early suspicion of a secondary cause:Late age at onset and eye and retroorbital pains were common conditions requiring careful evaluation and were present in at least one-third of cases.Abnormal neurological examination was the most significant red flag for impaired cranial nerves.CLH patients may be responsive to typical CH treatments;therefore,the treatment response is not specific.CLH can be triggered by contralateral structural pathologies.CLH associated with sinusitis and cerebral venous thrombosis required more attention.CONCLUSION Since secondary headache could perfectly mimick primary CH,neuroimaging should be conducted in patients in whom primary and secondary headaches are suspected.Cerebral magnetic resonance imaging scans is the diagnostic management of choice,and further examinations include vessel imaging with contrast agents and dedicated scans focusing on specific cerebral areas(sinuses,ocular and sellar regions).Neuroimaging is as necessary at follow-up visits as at the first observation.
文摘 Background and purpose: Vascular and tension-type headache is most commonly encountered, and SI17 therapy has been tested to treat headache with good results. The efficacy of SI17 therapy for vascular and tension-type headache was compared and the effect of SI17 therapy on pancreatic polypeptide (PP) was studied. Materials and methods: 29 cases of vascular headache (20 cases in acute attack during the trial) and 27 cases of tension-type headache (19 cases in acute attack) were enrolled in the study. Plasma PP level before and 4th day after treatment was measured by radioimmunoassay. Results: SI17 therapy is better for the treatment of vascular headache. Vascular headache with higher PP level and tension-type headache with normal PP level had good therapeutic results. Conclusion: The clinical efficacy is better for vascular headache with the increase of vagus tension and for tension-type headache with normal vagus tension.
基金supported by Zurzach Rehabilitation Foundation SPA and Swiss Traditional Chinese Medicine Academy(STA)。
文摘Objective:This observational cohort pilot study aimed to evaluate the effects of the acupuncture methods,Jiu Cang Zhen(JCZ)and Huang Guan(HG),on changes in headache intensity in an inpatient,multimodal Zurzach Headache Programme(ZHP).Methods:Study participants consisted of patients diagnosed with chronic headache disorder(headache ds,30 days per month)or daily persistent headache.All patients received conventional therapies with active and passive approaches.The patient group was treated with JCZ and HG acupuncture methods,receiving a total of six to eight acupuncture sessions of 50 to 60 minutes each,during a 3–4-week multimodal ZHP at the RehaClinic Bad Zurzach.Pain intensity was quantified using a Numerical Rating Scale(NRS)before and after each acupuncture therapy session.Results:Ten patients were recruited,six women and four men,with a mean age of 41.7(standard deviation,[SD]=13.9).A reduction in headache intensity was reported by all patients in each of the sessions.The average NRS for pain was 4.21(SD=1.44)before acupuncture and 1.24(SD=0.93)after acupuncture(means first by number of sessions,then per n=10 patients).This resulted in a mean difference of 2.97(SD=1.04),corresponding to a standardized response mean of 2.85(95%confidence interval:2.11–3.60,one-tailed P<0.001),meaning there was a large effect.Conclusions:This pilot study shows that JCZ and HG are suitable acupuncture methods for reducing headache intensity in the treatment of headaches.A comparison with the conventional classical acupuncture methods from the acupuncture textbook for traditional Chinese medicine students in China,exploration with a larger patient group,and prolonged monitoring of pain behavior could be foci of follow-up investigations.
文摘Objectives: After reading this article, readers should be able to recognize Post Dural Puncture Headache, understand its mechanism and diagnostic criteria, evaluate the different treatment options available, and be familiar with a novel treatment option. Background: Post-dural puncture headache is the most common serious complication resulting from lumbar puncture and epidural or spinal anesthetics. The syndrome is characterized by severe headache that occurs within 48 hours following the puncture, located in the frontal and/or occipital region, worsened in the upright position and refractory to routine analgesia. The syndrome incidence was reported to be approximately 1% with typical obstetric anesthesiology practice which reflects more than 20,000 cases per 2014 in the US. Two possible mechanisms are hypothesized as responsible for this syndrome;cerebrospinal fluid leakage and pneumocephalus. Multiple methods of treatment have been applied with wide-ranging results. Design or Methods: Review article with introduction of a novel treatment option. Results: We postulate that Hyperbaric Oxygen Therapy can be used to treat post-dural puncture headache. The rationale for treatment is dual: enhancement of fibroblast proliferation at the site of dural puncture to facilitate faster closure of the tear and compression of air bubbles in case of pneumocephalus according to Boyle’s law. We also claim that hyperbaric oxygen therapy should be considered a prophylactic treatment, if a dural tear is suspected.
文摘Toutongning capsule is used for the treatment of migraine headaches, and has yielded therapeutically beneficial effects. However, whether Toutongning capsule exerts its effects via endogenous opioid peptides remains poorly understood. This study investigated the effects of Toutongning capsule on enkephalin expression in the midbrain of rats with nitroglycerin-induced migraine headache at the mRNA and protein levels. Results confirmed that proenkephalin mRNA levels were significantly upregulated following treatment with Toutongning capsule. The numbers methionine-enkephalin and leucine-enkephalin-positive cells were significantly greater in the migraine headache rats following treatment with Toutongning capsule compared with the model group. Taken together, these results show that Toutongning capsule exerts potentially beneficial effects by promoting enkephalin expression in nitroglycerin-induced migraine headache rats.
基金supported by the National Natural Science Foundation of China (81071140)
文摘Tension-type headache（TTH） is the most prevalent type of primary headache. Many studies have shown that the pathogenesis of primary headache is associated with fine structural or functional changes. However, these studies were mainly based on migraine. The present study aimed to investigate whether TTH patients show functional disturbances compared with healthy subjects. We used restingstate functional magnetic resonance imaging（f MRI） and regional homogeneity（Re Ho） analysis to identify changes in the local synchronization of spontaneous activity in patients with TTH. Ten patients with TTH and 10 age-, gender-, and education-matched healthy controls participated in the study. After demographic and clinical characteristics were acquired, a 3.0-T MRI system was used to obtain restingstate f MRIs. Compared with healthy controls, the TTH group exhibited significantly lower Re Ho values in the bilateral caudate nucleus, the precuneus, the putamen, the left middle frontal gyrus, and the superior frontal gyrus. There was no correlation between mean Re Ho values in TTH patients and duration of TTH, number of attacks, duration of daily attacks, Visual Analogue Scale score, or Headache Impact Test-6 score. These results suggest that TTHpatients exhibit reduced synchronization of neuronal activity in multiple regions involved in the integration and processing of pain signals.
文摘Cervicogenic headache(CEH)has been recognized as a unique category of headache that can be difficult to diagnose and treat.In China,CEH patients are managed by many different specialties,and the treatment plans remain controversial.Therefore,there is a great need for comprehensive evidence-based Chinese experts’recommendations for the management of CEH.The Chinese Association for the Study of Pain asked an expert panel to develop recommendations for a series of questions that are essential for daily clinical management of patients with CEH.A group of multidisciplinary Chinese Association for the Study of Pain experts identified the clinically relevant topics in CEH.A systematic review of the literature was performed,and evidence supporting the benefits and harms for the management of CEH was summarized.Twenty-four recommendations were finally developed through expert consensus voting for evidence quality and recommendation strength.We hope this guideline provides direction for clinicians and patients making treatment decisions for the management of CEH.
文摘Objective： To investigate the masseter inhibitory tension-type headache （TTH）. Methods： MIR was studied in 21 sex matched to the study cohort. Median age of patients was reflex （MIR） and its eventual changes in patients with episodic patients with episodic TTH and 30 healthy subjects, with age and 17.0 years （ranged 16-49 years）, median duration of disease 12 months （1-5 years）, and median frequency of headache 7.5 d per month. Results： The second period of suppression （$2） of MIR was reduced in intensity and duration in 10% of controls and 66.7% （confidence interval （CI） 45.3%-85%; P〈0.05） of patients with episodic TTH （X2=74.9; P〈0.001）. In 3 （14.3%） of patients with episodic TTH, S2 was completely absent. No significant correlation between the duration of disease and headache frequency was found. Conclusion： Our results confirm the link between episodic TTH and reduction or absence of S2. Teenage patients with episodic TTH may exhibit marked pathological changes in S2 in contrast to older individuals.
基金Supported by the Special Research Project of Traditional Chinese Medicine of Guangdong Hospital of Chinese Medicine(No.YN2015MS22)the Science planning project of Guangzhou(No.2014Y2-00040)
文摘OBJECTIVE: To critically appraise the methodological quality of clinical practice guidelines for headache produced over the last two decades, including those covering specific interventions using Traditional Chinese Medicine.METHODS: The guidelines on headache disorders were obtained by searching a number of databases, including Pub Med, EMBASE, Web of Science,Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, and Wanfang database, three guideline-related databases [Guideline-International Network, National Guideline Clearinghouse, and Medlive], and the records of organizations that develop guidelines. The publication date was limited to the period from January 1996 to June 2015. The search terms "headache", "headache disorders", "cephalalgia", "migraine", "tension-type headache", "practice guideline", "consensus ", "statement", "regulation", and "recommendation" were used in the "Me SH" and "Free-text" fields. The guidelines were independently appraised by four researchers using the Appraisal of Guidelines for Research and Evaluation Ⅱ instrument.RESULTS: A total of 23 guidelines published between 1998 and 2014 were reviewed. The overall consistency of the four appraisers was good [interclass correlation coefficient 0.84; 95% confidence interval(CI) 0.82-0.86]. The mean(standard deviation) scores for scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence were 52.1(18.0), 39.5(17.1), 33.4(21.0), 49.8(21.9),23.8(19.3), and 24.2(23.7). Only two guidelines were recommended, 12 were recommended with modification, and nine were not recommended.CONCLUSION: Physical Traditional Chinese Medicine therapies were recommended to treat headache. The overall quality of headache guidelines was low in China, but evidence-based guidelines are gradually becoming mainstream. Guideline developers should carefully consider, in particular,three domains: rigor of development, applicability,and editorial independence.
基金Supported by"Hispanic American Acupuncture Association Beijing'84"
文摘Objective To explore the treatment of chronic headaches which are unmanageable to conventional occidental treatments.Methods Traditional Chinese acupuncture on the basis of syndrome differentiation was applied to 253 patients.The observation and efficacy evaluation criteria were related to the lowering of pain and the diminution in the use of painkillers,antiinflammatories and sedatives.Results For 220(87%) patients,the pain stopped in a permanent way,the remaining 33(13%) patients presented temporary relapses and needed extra treatment or simple pain relievers for their resolution.Conclusion Traditional Chinese Medicine is an efficient method in chronic headaches' treatment.
文摘OBJECTIVE: To describe the common causes of headache as well as the different methods of Phlebotomy(Fasd) and wet Cupping(Hijamat) based on Persian Medicine.METHODS: In this study, we searched Google Scholar, Science Direct, Pub Med and Scopus to get any in vitro or clinical evidence of the efficacy and possible mechanisms of phlebotomy or wet cupping on different types of headaches. Also different types of headaches, according to PM, under the title of "Sodaa"; extracted from famous Persian medical text books with key words including "Sodaa","Bayze" and "Shaqiqe".RESULTS: According to PM, diseases(dystemperament) are created by abnormal alteration in temperament. Temperament is a monolithic quality yielded by interaction between opposing qualities of four elements that are coldness, hotness, dryness and wetness. Headaches are caused by dystemperament(sue-Mizaj) in brain or in total body that are divided into simple and corporal. Common forms of the latter type are Vaporal and Migrant headache(Bokhari and Rihi). Each of these headaches is treated either through phlebotomy or wet cupping.CONCLUSION: In Persian Medicine, Fasd and Hijamat are easy and economical methods for treatment of headache with reasonable results. By describing the precise areas and indications of phlebotomy and wet cupping, this study provides the first step for future clinical trials in this field.
文摘Acute myocardial infarction should be diagnosed as early as possible for the appropriate management to salvage ischemic myocardium. Accurate diagnosis is typically based on the typical symptoms of angina. Headache is an unusual symptom in patients with acute myocardial infraction. We report a patient with ST-segment elevation acute myocardial infarction who presented to the emergency department complaining of severe occipital headache without chest discomfort.
文摘To compare the acupuncture plus oral administration of Chinese herbal decoction with simple oral administration of Chinese herbal decoction in the treatment of vascular headache. Methods： Sixty two patients were randomly divided into a treatment group （32 cases） and a control group （30 cases）. Acupuncture at Baihui （GV 20）, Fengchi （GB 20）, Shuaigu （GB 8）, Xingjian （LR 2）, Neiguan （PC 6）, Sanyinjiao （SP 6） and Ashi points combined with oral administration of Chinese herbal decoction, was applied in the treatment group, and simple oral administration of Chinese herbal decoction was applied in the control group. Results： The total therapeutic effect in the treatment group was better than that in the control group （P〈0.05）. After treatment, the frequency, and duration of the attacks were reduced and shortened, and headache greatly alleviated in both groups （P〈0.01）. The alleviation in the treatment group was more obvious than that in the control group （P〈0.05）. Conclusion： Acupuncture combined with oral administration of Chinese herbal decoction provided remarkable therapeutic effects in treating vascular headache.
文摘The authors have adopted acupuncture at Jǐngjiājǐ（颈夹脊） combined with nape cluster needling in treatment of 100 patients with cervicogenic headache. Nape cluster needling was： Xiànǎohù（下脑户）（located in the median depression under occipital bone）, Fēngfǔ（风府 GV 16） and Yǎmén（哑门 GV 15） were selected longitudinally; horizontally, the part from GV 16 to Wángǔ（完骨 GB 12） was divided into six equal sections, one section was an acupoint, and there were 12 acupoints in total at the left and right sides. Bilateral Jǐngjiājǐ（颈夹脊） points on the second vertebra to the seventh vertebra were selected. The acupuncture was conducted once a day, five days were considered as one course of treatment, and two days were free from treatment between two courses. Four courses of treatment were needed. All the patients were cured clinically. It can be seen that acupuncture at Jǐngjiājǐ combined with nape cluster needling in treatment of cervicogenic headache has sound effect.
文摘The gut-brain axis is a bidirectional communication system that exists between the brain and gut. Several studies claimed that some types of headaches are associated with various gastrointestinal(GI) disorders.In Persian medicine(PM), physicians believed that gastric disturbances could stimulate headache and introduced some herbs for boosting gastric function as a therapeutic remedy for headache. Here we review the current evidence for the gastroprotective and antiheadache effects of herbs used in PM.Herbs used for their gastrotonic effects in PM were identified from selected Persian medical and pharmaceutical textbooks. Pub Med, Scopus and Google Scholar were used to search for contemporary scientific evidence relating to the gastric and neurologic effects of these plants. A total of 24 plants were recorded from the selected sources included in this review, most of which belonged to the Rosaceae family.Phyllanthus emblica, Zingiber officinale, Boswellias errata, Punica granatum and Hypericum perforatum had the most recent studies related to GI disorder and headache, while current research about quince, rose,apple, hawthorn and pear was limited. Reducing Helicobacter pylori growth, gastritis, erosion of the stomach lining, hemorrhage and perforation, improving gastric mucosal resistance, antisecretary, antiulcer,antipyretic, analgesic, sedative, anxiolytic, anti-inflammatory, anticonvulsant, neuroprotective and antioxidant effects as well as improvement in memory scores were some of the gastrotonic and neuroprotective mechanisms described in the current research. These results confirmed that medicinal plants prescribed in PM may improve headache in patients through the management of GI abnormalities.However, further studies are recommended to investigate the efficacy and safety of the mentioned medicinal plants.
