RESUMO
This note reflects on my collaborations with Nick Martin and the GenEpi group over the past 20 years. Over the past two decades, our work together has focused on gene mapping and understanding the genetic architecture of a wide range of traits with particular foci on migraine and common baldness. Our migraine research has included latent class and twin analyses cumulating in genome-wide association analyses which had identified 44 (34 new) risk variants for migraine. Leveraging these results through polygenic risk score analyses identified subgroups of patients likely to respond to triptans (an acute migraine drug), providing the first step toward precision medicine in migraine [Kogelman et al. (2019) Neurology Genetics, 5, e364].
Assuntos
Predisposição Genética para Doença , Transtornos de Enxaqueca/genética , Estudo de Associação Genômica Ampla/história , História do Século XX , História do Século XXI , Genética Humana/história , Humanos , Transtornos de Enxaqueca/história , FenótipoAssuntos
Hematologia/história , Distinções e Prêmios , Transtornos Plaquetários/história , Dislexia/história , Educação Médica/história , Eritrócitos Anormais , História do Século XX , História do Século XXI , Ictiose/história , Transtornos de Enxaqueca/história , Medicina Militar/história , Miose/história , Fadiga Muscular , Noruega , Pesquisa/história , Baço/anormalidades , Medicina Veterinária/históriaRESUMO
Understanding the history and evolution of ideas is key to developing an understanding of complex phenomena and is the foundation for surgical innovation. This historical review on migraine surgery takes us back to the beginnings of interventional management for migraine centuries ago, and reflects on present practices to highlight how far we have come. From Al-Zahrawi and Ambroise Paré to Bahman Guyuron, two common themes of the past and present have emerged in the treatment of migraine headache. Extracranial treatment of both nerves and vessels is being performed and analyzed, with no consensus among current practitioners as to which structure is involved. Knowledge of past theories and new insights will help guide our efforts in the future. One thing is clear: Where we are going, there are no roads. At least not yet.
Assuntos
Transtornos de Enxaqueca/cirurgia , Procedimentos Neurocirúrgicos , Procedimentos Cirúrgicos Vasculares , Descompressão Cirúrgica/história , Descompressão Cirúrgica/métodos , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , História Medieval , Humanos , Transtornos de Enxaqueca/história , Procedimentos Neurocirúrgicos/história , Procedimentos Neurocirúrgicos/métodos , Nervos Periféricos/cirurgia , Procedimentos Cirúrgicos Vasculares/história , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
PURPOSE OF REVIEW: The migraine postdrome is the least studied and least understood phase of migraine. This article covers the salient features of the migraine postdrome and provides insight into the history, clinical symptoms, and future implications of this phase of migraine. RECENT FINDINGS: Prospective electronic diary studies have shown that patients are left disabled with various nonheadache symptoms in the migraine postdrome, and 81% of patients report at least one nonheadache symptom in the postdrome. Hence, it is important to understand this phase better and ensure that more effective treatments become available in the future to lessen the morbidity associated with this phase. Functional imaging shows widespread reduction in brain-blood flow in the postdrome, which explains the multitudes of symptoms experienced by patients. SUMMARY: The disability related to migraine is not exclusive to the headache phase but extends into the postdrome phase and is associated with several nonheadache symptoms that prolong the symptoms experienced by patients with migraine. Further research into the postdrome is crucial to improve our overall understanding of migraine mechanisms. This knowledge may also help to treat the concurrent nonheadache symptoms better in the future. Novel neuroimaging techniques provide a valuable noninvasive tool to push the frontiers in the understanding of migraine pathophysiology. These methods may help shed further light onto the possible links between key brain structures and networks that could be implicated in the pathophysiology of the various migraine phases.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Fadiga/etiologia , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/patologia , Náusea/etiologia , Rombencéfalo/patologia , Adulto , Registros Eletrônicos de Saúde , Feminino , História do Século XIX , Humanos , Transtornos de Enxaqueca/históriaRESUMO
Modern literature about the history of migraine treatments often starts with an ancient Egyptian remedy said to be from Papyrus Ebers that involves crocodiles that should be wrapped around the head. A fresh look on this treatment shows the need for revision on many points, including the source of the remedy, its content and meaning, and further implications for the history of Papyrus Ebers.