A importância da alimentação e nutrição para indivíduos com enxaqueca / La importancia de la alimentación y nutrición para personas con jaqueca / The importance of food and nutrition for people with chronic migraines

Introdução: As cefaleias são consideradas um importante problema de saúde pública e estima-se que são a segunda queixa mais comum de dor, sendo a enxaqueca uma das mais presentes. O tratamento da enxaqueca pode ser sintomático ou profilático, a fim de reduzir os sintomas em períodos de crise e evitar que novas crises se instalem, destacando a importância da adoção de hábitos saudáveis e uma alimentação equilibrada. Objetivo: O objetivo deste estudo foi realizar uma revisão integrativa da literatura, destacando os principais achados sobre a importância da alimentação e nutrição para indivíduos acometidos pela enxaqueca. Metodologia: foi realizado um levantamento de estudos nas bases de dados: Biblioteca Virtual em Saúde (BVS); Medline, LILACS, SciELO e Google Acadêmico, além de ter sido considerada a lista de referências dos trabalhos consultados, utilizando a estratégia PECO, onde P (population) indica a população, a letra E (exposure) exposição, C (comparison) comparação e a letra O (outcome) se refere aos desfechos esperados, assim gerou a pergunta norteadora do estudo: "Qual é a importância da alimentação e nutrição para indivíduos com enxaqueca?". Resultados: Foram selecionados 15 estudos para a produção do presente trabalho e foi realizada uma síntese descritiva dos resultados obtidos da relação e influência de hábitos alimentares com a enxaqueca. Conclusões: Conclui-se que os hábitos alimentares e a nutrição adequada têm grande influência e importância para indivíduos com enxaqueca, pois dessa forma, podem reduzir os sintomas apresentados e crises, já que as substâncias presentes nos alimentos estão relacionadas com o início e intensificação das crises (AU).

Introduction: Headaches are considered an important public health problem and are estimated to be the second most common pain complaint, with migraines being one of the most common. Migraine treatment is symptomatic and prophylactic to reduce symptoms when an attack starts and prevent new ones from forming, highlighting the importance of adopting healthy habits and a balanced diet. Objective: The purpose of this study was to carry out an integrative review of the literature in order to highlight the main findings on the influence of eating habits and the importance of nutrition for migraine patients. Methodology:A survey study was performed in the following databases: Virtual Health Library (VHL); Medline, LILACS, SciELO, and Google Scholar, in addition to considering the reference list of the consulted works. The PECO P (population) E (exposure) C (comparison) O (outcome) strategy was used, which generated the guiding question of the study: 'How important is food and nutrition for people with chronic migraines?'. Results:A total of 15 studies were selected to analyze in this work and a descriptive synthesis of the results was performed on the relationship and influence of eating habits of people with chronic migraines. Conclusions:It was concluded that eating habits and adequate nutrition have great influence and importance for migraine patients, as they are one of the main culprits of triggering and intensifying attacks (AU).

Introducción: Las cefaleas son consideradas un importante problema de salud pública y se estima que son la segunda queja más común de dolor, siendo la jaqueca una de las más frecuentes. El tratamiento de la jaqueca puede ser sintomático o profiláctico, con el fin de reducir los síntomas en periodos de crisis y evitar que nuevas ocurran, destacando la importancia de una adopción de hábitos saludables y una alimentación equilibrada. Objetivo: El objetivo de este estudio fue realizar una revisión integrativa de la literatura, destacando los principales hallazgos sobre la importancia de la alimentación y nutrición en personas afectadas por la jaqueca. Metodología: Fue realizada una investigación de los estudios en las bases de dados: Biblioteca Virtual en Salud (BVS); Medline, LILACS, SciELO y Google Académico, además de considerar la lista de referencias de los trabajos consultados, utilizando la estrategia PECO, donde P (population) indica la población, la letra E (exposure) exposición, C (comparison) comparación y la letra O (outcome) se refiere a los resultados esperados, así fue generada la pregunta guía del estudio: "¿Cuál es la importancia de la alimentación y nutrición para las personas con jaqueca?" Resultados: Fueron seccionados 15 estudios para la producción del presente trabajo y fue realizada una síntesis descriptiva de los resultados obtenidos de la relación e influencia de los hábitos alimentarios con la jaqueca. Conclusiones: Se concluye que los hábitos alimentarios y la nutrición adecuada tienen gran influencia e importancia para las personas conjaqueca, pues de esta forma, pueden reducir los síntomas presentados y crisis, ya que las sustancias presentes en los alimentos están relacionadas con el inicio e intensificación de las crisis (AU).

Bilateral tonic pupil during a migraine attack: a case report / Pupila tônica bilateral durante crise de enxaqueca: relato de caso

INTRODUCTION:Tonic pupil or Adie's pupil occurs due to parasympathetic denervation, and it is characterized by mydriasis with little or no response to light, with pupillary contraction to accommodation. It is caused by eye pathologies, such as infections, trauma, neoplasms, inflammatory diseases, and systemic diseases with autonomic dysfunction. Few cases have been reported of bilateral tonic pupils associated with migraine attacks. CASE REPORT: Our aimed to describe the case of a young female patient with a history of chronic migraine without aura, who presented acutely with bilateral pupillary mydriasis during a migraine attack, characterized as tonic pupil, and to discuss the possible causes of mydriasis during a migraine attack.

INTRODUÇÃO: A pupila tônica ou pupila de Adie ocorre devido à denervação parassimpática e é caracterizada por midríase com pouca ou nenhuma resposta à luz, com contração pupilar à acomodação. É causada por patologias oculares, como infecções, traumas, neoplasias, doenças inflamatórias e doenças sistêmicas com disfunção autonômica. Poucos casos foram relatados de pupilas tônicas bilaterais associadas a crises de enxaqueca. RELATO DE CASO: Nosso objetivo foi descrever o caso de uma paciente jovem, com história de enxaqueca crônica sem aura, que apresentou agudamente midríase pupilar bilateral durante uma crise de enxaqueca, caracterizada como pupila tônica, e discutir as possíveis causas da midríase durante uma crise de enxaqueca. ataque de enxaqueca.

Executive and attentional functions in patients with migraine / Funções executivas e atencionais em pacientes com enxaqueca

INTRODUCTION: Migraine is a disease that affects the overall performance of the patient, especially attention and executive functions (EF), with a direct impact on the person's functionality, highlighting the importance of studies in order to minimize its damage. OBJECTIVE: The objective of this study was to evaluate if there is a link between migraine and executive and attentional functions. METHODOLOGY: Observational study (44 subjects; 29 migraineurs and 15 non-migraineurs) on attentional and executive functioning changes in migraine. Subjects over 18 years of age were included in the study, regardless of gender, recruited for convenience at CAM FAME, FAME and Centro AMA, primary recruitment centers, following the criteria of the International Classification of Headache Disorders (ICHD-3). The participants underwent neuropsychological tests that estimated executive and attentional functioning. For attention, the Psychological Attention the Assessment Battery (AAB) was used, and for EF, the Five-Digit Test (FDT) was used. Student's t test, ANOVA, Mann-Whitney and/or Kruskal-Wallis U test were used, whose analyzes fixed the type I error at 0.05. RESULTS: All AAB subtests pointed to a reduction in the attentional potential in migraineurs when compared to the control group. The FDT showed lowering in the migraineurs group subjects, when compared with the non- migraineurs group. Multivariate analysis identified a relationship between EF, Attention and migraine (p<0.05). CONCLUSION: migraineurs present a decrease in executive functioning and attentional skills and an increase in execution time when compared to non-migraineurs individuals

INTRODUÇÃO: A enxaqueca é uma doença que afeta o desempenho global do paciente, principalmente a atenção e as funções executivas (FE), com impacto direto na funcionalidade da pessoa, destacando a importância de estudos a fim de minimizar seus danos. OBJETIVO: O objetivo deste estudo foi avaliar se existe ligação entre enxaqueca e funções executivas e atencionais. METODOLOGIA: Estudo observacional (44 indivíduos; 29 com enxaqueca e 15 sem enxaqueca) sobre alterações de atenção e funcionamento executivo na enxaqueca. Foram incluídos no estudo indivíduos maiores de 18 anos, independente do sexo, recrutados por conveniência no CAM FAME, FAME e Centro AMA, centros primários de recrutamento, seguindo os critérios da Classificação Internacional de Cefaleias (ICHD-3). Os participantes foram submetidos a testes neuropsicológicos que estimaram o funcionamento executivo e atencional. Para atenção foi utilizada a Bateria de Avaliação da Atenção Psicológica (AAB) e para FE foi utilizado o Teste de Cinco Dígitos (FDT). Foram utilizados teste t de Student, ANOVA, Mann-Whitney e/ou teste U de Kruskal-Wallis, cujas análises fixaram o erro tipo I em 0,05. RESULTADOS: Todos os subtestes da AAB apontaram redução do potencial atencional em enxaquecosos quando comparados ao grupo controle. O FDT apresentou redução nos indivíduos do grupo com enxaqueca, quando comparado com o grupo sem enxaqueca. A análise multivariada identificou relação entre FE, Atenção e enxaqueca (p<0,05). CONCLUSÃO: enxaquecosos apresentam diminuição do funcionamento executivo e das habilidades de atenção e aumento no tempo de execução quando comparados a indivíduos não enxaquecosos

Migraña poscierre percutáneo de defectos septales auriculares / Migraine after percutaneous closure of atrial septal defects / Enxaqueca após fechamento percutâneo de comunicação interatrial

La migraña es una enfermedad que se ha visto asociada a defectos septales auriculares y a su cierre percutáneo, estipulándose en la literatura que sería una rara complicación, pero la evidencia al respecto es escasa. Se realizó una revisión narrativa sobre definiciones, epidemiología, fisiopatología y tratamiento de la migraña y de la entidad migraña poscierre percutáneo de defectos del septum auricular, incluyendo trabajos observacionales (retrospectivos, prospectivos), estudios randomizados, reportes de casos, artículos de revisión y metaanálisis existentes en PubMed y Cochrane, para aportar al conocimiento de esta entidad.

Migraine is a disease that has been associated with atrial septal defects and its percutaneous closure, stipulating in the literature that it would be a rare complication, but evidence is scarce. A narrative review was conducted on definitions, epidemiology, pathophysiology and treatment of migraine and the migraine entity after percutaneous closure of atrial septum defects, including observational studies (retrospective, prospective), randomized studies, case reports, review articles and meta-analyses existing in PubMed and Cochrane, to contribute to the knowledge of this entity.

A enxaqueca é uma doença que tem sido associada a defeitos do septo atrial e seu fechamento percutâneo, estipulando na literatura que seria uma complicação rara, mas as evidências são escassas. Foi realizada uma revisão narrativa sobre definições, epidemiologia, fisiopatologia e tratamento da enxaqueca e da entidade migranosa após fechamento percutâneo de defeitos do septo atrial, incluindo estudos observacionais (retrospectivos, prospectivos), estudos randomizados, relatos de caso, artigos de revisão e metanálises existentes no PubMed e Cochrane, para contribuir com o conhecimento dessa entidade.

Sinais clínicos da migrânea vestibular em adolescentes / Clinical signs of vestibular migraine in adolescents / Signos clínicos de la migraña vestibular em adolescentes

Introdução: A migrânea é um tipo de cefaleia primária incapacitante que, quando associada a crises de vertigem, configura-se migrânea vestibular. Objetivo: Verificar quais as principais manifestações clínicas da migrânea vestibular em adolescentes. Métodos: Trata-se de uma revisão integrativa da literatura, cujas buscas foram executadas nas bases de dados eletrônicas PubMed/Medline, Scientific Electronic Library Online (SciELO), e Portal da Biblioteca Virtual em Saúde (BVS), em junho de 2022. Foram incluídas publicações entre o ano 2012 e o mês de junho de 2022; estudos observacionais e ensaios clínicos envolvendo seres humanos, nos quais o objetivo fosse avaliar indivíduos com idades entre 12 e 19 anos com diagnóstico de migrânea vestibular e verificar suas principais manifestações clínicas nessa população. Resultados: Todos os estudos mencionaram um maior percentual de meninas nas amostras, porém a diferença entre os sexos para os diferentes diagnósticos não foi avaliada em todas as pesquisas. Conclusão: Verificou-se, com a presente revisão, que as manifestações clínicas da migrânea na adolescência são semelhantes às da população adulta. (AU)

Introduction: Migraine is a disabling type of primary headache that, when associated with vertigo attacks, constitutes vestibular migraine. Objective: To investigate the main clinical findings of vestibular migraine in adolescents. Methods: This is an integrative literature review, with searches conducted in the electronic databases PubMed/Medline, Scientific Electronic Library Online (SciELO), and the Virtual Health Library Portal (BVS) in June 2022. Publications from the year 2012 to June 2022 were included; observational studies and clinical trials involving human subjects, in which the objective was to assess individuals aged 12 to 19 years diagnosed with vestibular migraine and investigate their main clinical findings in this population. Results: All studies mentioned a higher percentage of girls in the samples; however, the difference between sexes for different diagnoses was not assessed in all studies. Conclusion: With this review, it was found that the clinical findings of migraine in adolescence are similar to those in the adult population. (AU)

Introducción: La migraña es em tipo de dolor de cabeza adolescente incapacitante que, cuando se dolesc em ataques de vértigo, constituye la migraña vestibular. Objetivo: Investigar las principales manifestaciones clínicas de la migraña vestibular em adolescentes. Métodos: Se trata de em revisión integradora de la literatura, em búsquedas realizadas em las bases de datos electrónicas PubMed/Medline, Scientific Electronic Library Online (SciELO) y el Portal de la Biblioteca Virtual em Salud (BVS) em junio de 2022. Se incluyeron publicaciones desde el año 2012 hasta junio de 2022; dolescê observacionales y ensayos clínicos que involucraran a sujetos humanos, en los cuales el objetivo fuera evaluar adolescentes de 12 a 19 años en diagnóstico de migraña vestibular e investigar sus principales manifestaciones clínicas em esta población. Resultados: Todos los adolescentes mencionaron en mayor porcentaje de niñas en las muestras; sin embargo, la diferencia entre los sexos para diferentes diagnósticos no fue evaluada en todos los adolescentes. Conclusión: En esta revisión, se descobrió que las manifestaciones clínicas de la migraña en la dolescência son similares a las de la población adulta. (AU)

Toxina botulínica para prevenção de migrânea: overview de revisões sistemáticas / Botulinum toxin for the prevention of migraine: overview of systematic reviews

Contextualização: A migrânea, também conhecida por enxaqueca, é um distúrbio sensorial relacionado a fatores genéticos, psicológicos e anatômicos, que afeta cerca de 10% dos adultos, trazendo impacto pessoal, social e econômico. Objetivos: Sumarizar as evidências de revisões sistemáticas, referentes à efetividade da toxina botulínica para prevenção de migrânea. Métodos: Trata-se de overview de revisões sistemáticas. Procedeu-se à busca em três bases eletrônicas de dados: Cochrane - Central de Registros de Ensaios Clínicos ­ CENTRAL (2023), PubMed (1966-2023) e EMBASE (1974-2023), sendo utilizados os descritores MeSH "Migraine disorders" e "Botulinum toxins". Todas as revisões sistemáticas de ensaios clínicos randomizados (ECRs) em humanos foram incluídas. O desfecho primário de análise foi a melhora clínica. Resultados: Foram recuperadas 21 revisões sistemáticas e, diante dos critérios de inclusão, 4 foram incluídas, totalizando 94 ECRs (n = 16.104 participantes). Os estudos sugerem que a toxina botulínica pode ser benéfica na redução do número de crises, intensidade de dor e melhora na qualidade de vida dos pacientes. Entretanto, a evidência é limitada. Discussão: Embora os estudos incluídos tragam benefícios favoráveis à toxina botulínica para prevenção da migrânea, a evidência é de baixa qualidade, diante da heterogeneidade, fragilidades metodológicas e riscos nas análises desses estudos. Sugere-se a comparação da efetividade da toxina botulínica com outras intervenções disponíveis, objetivando melhor elucidação da questão. Conclusão: Parece haver algum benefício da toxina botulínica para prevenção de crises de migrânea, mas a evidência até o momento é limitada, sendo recomendada a comparação com outras terapêuticas utilizadas para prevenção da migrânea.

Hallazgos vestibulares y oculomotores en migraña vestibular: una revisión actualizada / Vestibular and Oculomotor findings in vestibular migraine: an updated review

La migraña vestibular es una de las etiologías más frecuentes del síndrome vestibular episódico a nivel mundial. Presenta varias hipótesis de patofisiología, principalmente a nivel de sistema vestibular central y genético. Su diagnóstico es fundamentalmente clínico, pero se han observado alteraciones a nivel de la función vestibular y de las pruebas oculomotoras. Los hallazgos clínicos no solo están presentes en el momento de la crisis, sino también se han observado en intervalos asintomáticos. La paresia unilateral en la prueba calórica suele ser más frecuente que una ganancia baja del reflejo vestíbulo-ocular del canal lateral en la videonistagmografía, sin embargo, existe una tasa elevada de discordancia entre ambas pruebas. Respecto a la prueba de estudio del movimiento ocular, se han observado alteraciones en el seguimiento pendular, movimiento sacádico, nistagmo optocinético, nistagmo evocado por la mirada, nistagmo espontáneo y nistagmo posicional. Es frecuente observar que el nistagmo provocado por cambios posicionales presenta características centrales durante la crisis de migraña vestibular, pero también se pueden presentar en periodos libres de síntomas en este grupo de pacientes.

Vestibular migraine is one of the most frequent etiologies of episodic vestibular syndrome worldwide. It presents several pathophysiology hypotheses, mainly at the central vestibular system and genetic level. Its diagnosis is fundamentally clinical, but changes in vestibular function and oculomotor tests have been observed. Clinical findings are present not only during the crisis, but also have been seen in the symptom-free interval. Unilateral paresis on caloric testing is usually more common than low gain of the vestibulo-ocular reflex in the lateral canal on videonystagmography, however, there is a high rate of discrepancy between these tests. Regarding the eye movement study test, alterations have been seen in pendulum tracking, saccadic movement, optokinetic nystagmus, gaze-evoked nystagmus, spontaneous nystagmus and positional nystagmus. It is common to observe that nystagmus caused by positional changes has central features during vestibular migraine attacks, but it can also be seen in the symptom-free interval in this group of patients.

Bloodletting at auricular dorsal vein combined with auricular point sticking for menstrual migraine of qi stagnation and blood stasis and its effect on serum levels of E2 and 5-HT / 中国针灸

OBJECTIVE@#To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism.@*METHODS@#A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT4), Neifenmi (CO18), Jiaogan (AH6a), Nie (AT2), Zhen (AT3), Shenmen (TF4) and Yidan (CO11). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E2) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment.@*RESULTS@#Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E2 and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05).@*CONCLUSION@#Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E2 and 5-HT to improve the level of hormone in the body.

Constituent elements and characteristics of ancient acupuncture and moxibustion prescriptions: taking migraine and headache as an example / 中国针灸

The basic constituent elements of ancient acupuncture prescriptions and moxibustion prescriptions for migraine and headache are extracted and summarized. The frequency and proportion of each element are counted and its characteristics are analyzed. The basic constituent elements of ancient acupuncture and moxibustion prescriptions includes five aspects: disease symptoms (main symptoms, concurrent symptoms, etiology and pathogenesis), disease type, acupuncture and moxibustion site (acupoint name, site name, meridian name), manipulation method (acupuncture method, reinforcing and reducing method, blood pricking method, moxibustion method) and curative effect. Acupuncture and moxibustion prescriptions are essential for recording the disease symptoms, while the acupuncture and moxibustion site and manipulation methods are the two core elements of ancient acupuncture and moxibustion prescriptions, which are also the premise to ensure that acupuncture and moxibustion prescriptions have good reference value.

Expert consensus on clinical trials of preventive treatment of adult migraine in China / 中华内科杂志

Migraine is the most common disabling primary headache with a significant socioeconomic burden. At present, some emerging drugs for migraine preventive treatment are under investigation internationally, which significantly promote the progress of migraine treatment. However, only few of this trial for migraine treatment are explored in China. In order to promote and standardize controlled clinical trials of migraine preventive therapy in China, and to provide methodological guidance for the design, implementation and evaluation of clinical trials, the Headache Collaborators of Chinese Society of Neurology formulated this consensus.

Expert consensus on the medical quality evaluation and improvement suggestions of in patients with chronic migraine / 中华内科杂志

Migraine is a highly disabling primary headache disease, accompanied by nausea, emesis, photophobia and phonophobia. Chronic migraine is usually developed from episodic migraine, and usually comorbids with anxiety, depression, and sleep disorders, further aggravating the disease burden. At present, the clinical diagnosis and treatment of migraine in China are not standard, and the migraine medical quality control evaluation system is lacking. In order to achieve standardized diagnosis and treatment of migraine, headache collaborators of Chinese Society of Neurology, based on national and international clinical research on diagnosis and treatment of migraine and combined with the current situation of China's medical system, drafted the expert consensus on the medical quality evaluation of inpatients with chronic migraine.

Effects of moxibustion on serum levels of β-EP, SP and expression of IL-1β and COX-2 protein in brainstem in rats with migraine / 中国针灸

OBJECTIVE@#To observe the effects of moxibustion at "Baihui" (GV 20) and "Dazhui" (GV 14) at different time points on the serum level of β-endorphin (β-EP), substance P (SP) and expression of interleukin-1β (IL-1β) and cyclooxygenase-2 (COX-2) protein in brainstem in rats with migraine, and to explore the effect and mechanism of moxibustion in preventing and treating migraine.@*METHODS@#Forty male SD rats were randomly divided into a blank group, a model group, a prevention+treatment (PT) group and a treatment group, 10 rats in each group. Except the blank group, the rats in the remaining groups were injected with nitroglycerin subcutaneously to prepare migraine model. The rats in the PT group were treated with moxibustion 7 days before modeling (once a day) and 30 min after modeling, while the rats in the treatment group were treated with moxibustion 30 min after modeling. The "Baihui" (GV 20) and "Dazhui" (GV 14) were taken for 30 minutes each time. The behavioral scores in each group were observed before and after modeling. After intervention, ELISA method was used to detect the serum level of β-EP and SP; the immunohistochemistry method was used to detect the number of positive cells of IL-1β in brainstem; the Western blot method was used to detect the expression of COX-2 protein in brainstem.@*RESULTS@#Compared with the blank group, the behavioral scores in the model group were increased 0-30 min, 60-90 min and 90-120 min after modeling (P<0.01); compared with the model group, in the treatment group and the PT group, the behavioral scores were decreased 60-90 min and 90-120 min after modeling (P<0.01). Compared with the blank group, in the model group, the serum level of β-EP was decreased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β in brainstem and the expression of COX-2 protein were increased (P<0.01). Compared with the model group, in the PT group and and the treatment group, the serum level of β-EP was increased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β and the expression of COX-2 protein in brainstem were decreased (P<0.01, P<0.05). Compared with the treatment group, in the PT group, the serum level of β-EP was increased and COX-2 protein expression was decreased (P<0.05).@*CONCLUSION@#Moxibustion could effectively relieve migraine. The mechanism may be related to reduce the serum level of SP, IL-1β and COX-2 protein expression in brainstem, and increase the serum level of β-EP, and the optimal effect is observed in the PT group.

Research on migraine time-series features classification based on small-sample functional magnetic resonance imaging data / 生物医学工程学杂志

The extraction of neuroimaging features of migraine patients and the design of identification models are of great significance for the auxiliary diagnosis of related diseases. Compared with the commonly used image features, this study directly uses time-series signals to characterize the functional state of the brain in migraine patients and healthy controls, which can effectively utilize the temporal information and reduce the computational effort of classification model training. Firstly, Group Independent Component Analysis and Dictionary Learning were used to segment different brain areas for small-sample groups and then the regional average time-series signals were extracted. Next, the extracted time series were divided equally into multiple subseries to expand the model input sample. Finally, the time series were modeled using a bi-directional long-short term memory network to learn the pre-and-post temporal information within each time series to characterize the periodic brain state changes to improve the diagnostic accuracy of migraine. The results showed that the classification accuracy of migraine patients and healthy controls was 96.94%, the area under the curve was 0.98, and the computation time was relatively shorter. The experiments indicate that the method in this paper has strong applicability, and the combination of time-series feature extraction and bi-directional long-short term memory network model can be better used for the classification and diagnosis of migraine. This work provides a new idea for the lightweight diagnostic model based on small-sample neuroimaging data, and contributes to the exploration of the neural discrimination mechanism of related diseases.

Identification of potential influencing factors associated with elimination of migraine headache in patients with PFO after percutaneous closure / 中华心血管病杂志

Objective: To recognize the potential factors that contribute to the eradication of migraine headache in patients with patent foramen ovale (PFO) at one year after percutaneous closure. Methods: A prospective cohort study was conducted, which enrolled patients diagnosed with migraines and PFO at the Department of Structural Heart Disease, First Affiliated Hospital of Xi'an Jiaotong University between May 2016 and May 2018. The patients were segregated into two groups based on their response to treatment, and one group showed elimination of migraines while another did not. Elimination of migraines was defined as a Migraine Disability Assessment Score (MIDAS) score of 0 at one year postoperatively. Least Absolute Shrinkage and Selection Operator (LASSO) regression model was utilized to identify the predictive variables for migraine elimination post-PFO closure. Multiple logistic regression analysis was employed to determine the independent predictive factors. Results: The study enrolled a total of 247 patients, with an average age of (37.5±13.6) years, comprising 81 male individuals (32.8%). One year after closure, 148 patients (59.9%) reported eradication of their migraines. Multivariate logistic regression analysis revealed that migraine with or without aura (OR=0.003 9, 95%CI 0.000 2-0.058 7, P=0.000 18), a history of antiplatelet medication use (OR=0.088 2, 95%CI 0.013 7-0.319 3, P=0.001 48) and resting right-to-left shunt (RLS) (OR=6.883 6, 95%CI 3.769 2-13.548 0, P<0.001) were identified as independent predictive factors for elimination of migraine. Conclusion: Migraine with or without aura, a history of antiplatelet medication use, and resting RLS are the independent prognostic factors associated with elimination of migraine. These results provide important clues for clinicians to choose the optimal treatment plan for PFO patients. However, further studies are needed to confirm these findings.

Episodic syndromes that may be associated with migraine / 中风与神经疾病杂志

Episodic syndromes that may be associated with migraine@#Episodic syndromes that may be associated with migraine are commonly seen in children and are likely to evolve into migraine in the subsequent course of the disease， including several subtypes such as benign paroxysmal torticollis， benign paroxysmal vertigo， and recurrent gastrointestinal disturbance. Understanding the above syndromes has an important clinical significance in the diagnosis of migraine in children.

Application of clinical value assessment of treatment protocols in guideline development: taking the WFAS Clinical Practice Guideline of Acupuncture and Moxibustion for Migraine as an example / 中国针灸

To enhance the clinical applicability of guidelines and provide more effective guidance for clinical practice, a clinical value assessment was conducted during the development of the World Federation of Acupuncture-Moxibustion Societies (WFAS) Clinical Practice Guideline of Acupuncture and Moxibustion for Migraine, which involved the evaluation of 59 acupuncture and moxibustion treatment protocols from randomized controlled trials (RCTs). This article introduced the methodology, content and results of the clinical value assessment of RCT-based acupuncture and moxibustion treatment protocols, which involved the integration of historical and contemporary medical evidence and expert consensus. It served as a methodological reference for the future development of acupuncture and moxibustion clinical practice guidelines.

Discovery of the mechanisms of acupuncture in the treatment of migraine based on functional magnetic resonance imaging and omics / 医学前沿

Migraine is one of the most prevalent and disabling neurological disease, but the current pharmacotherapies show limited efficacy and often accompanied by adverse effects. Acupuncture is a promising complementary therapy, but further clinical evidence is needed. The influence of acupuncture on migraine is not an immediate effect, and its mechanism remains unclear. This study aims to provide further clinical evidence for the anti-migraine effects of acupuncture and explore the mechanism involved. A randomized controlled trial was performed among 10 normal controls and 38 migraineurs. The migraineurs were divided into blank control, sham acupuncture, and acupuncture groups. Patients were subjected to two courses of treatment, and each treatment lasted for 5 days, with an interval of 1 day between the two courses. The effectiveness of treatment was evaluated using pain questionnaire. The functional magnetic resonance imaging (fMRI) data were analyzed for investigating brain changes induced by treatments. Blood plasma was collected for metabolomics and proteomics studies. Correlation and mediation analyses were performed to investigate the interaction between clinical, fMRI and omics changes. Results showed that acupuncture effectively relieved migraine symptoms in a way different from sham acupuncture in terms of curative effect, affected brain regions, and signaling pathways. The anti-migraine mechanism involves a complex network related to the regulation of the response to hypoxic stress, reversal of brain energy imbalance, and regulation of inflammation. The brain regions of migraineurs affected by acupuncture include the lingual gyrus, default mode network, and cerebellum. The effect of acupuncture on patients' metabolites/proteins may precede that of the brain.

The Objective Assessment of Event-Related Potentials: An Influence of Chronic Pain on ERP Parameters / 神经科学通报·英文版

The article presents an original method for the automatic assessment of the quality of event-related potentials (ERPs), based on the calculation of the coefficient ε, which describes the compliance of recorded ERPs with some statistically significant parameters. This method was used to analyze the neuropsychological EEG monitoring of patients suffering from migraines. The frequency of migraine attacks was correlated with the spatial distribution of the coefficients ε, calculated for EEG channels. More than 15 migraine attacks per month was accompanied by an increase in calculated values in the occipital region. Patients with infrequent migraines exhibited maximum quality in the frontal areas. The automatic analysis of spatial maps of the coefficient ε demonstrated a statistically significant difference between the two analyzed groups with different means of migraine attack numbers per month.

Cefalea: una consulta frecuente en oftalmología. Guía práctica para oftalmólogos / Headache: a frequent consultation in ophthalmology. Practical guide for ophthalmologists

La cefalea es un síntoma frecuente de consulta en oftalmología. Cuando el dolor se extiende al globo ocular o a la órbita, el paciente asume que los ojos son la causa del dolor. Esta revisión busca describir las causas de cefalea más comunes para poder realizar un diagnóstico diferencial adecuado y tener claro cuáles son las indicaciones para referir los pacientes a oftalmología.

Headache is a frequent symptom for consultation in ophthalmology. When the pain refers to the eyeball or orbit, the patient assumes the eye is the cause of the pain. This review focuses on describing the most common causes of headache to make a correct differential diagnosis and be clear when to refer patients to ophthalmology.

Why does ingestion of watermelon trigger headache attacks in patients with migraine? / Por que a ingestão de melancia desencadeia crises de dor de cabeça em pacientes com enxaqueca?

Several triggers can trigger a migraine attack, including food. By the way, food only triggers headache in migraine sufferers. The foods that most trigger headache attacks are these: cheese, chocolate, citrus fruits and some sweet fruits, such as watermelon.

Vários gatilhos podem desencadear uma crise de enxaqueca, incluindo alimentos. Aliás, a comida só provoca dor de cabeça em quem sofre de enxaqueca. Os alimentos que mais desencadeiam as crises de dor de cabeça são estes: queijo, chocolate, frutas cítricas e algumas frutas doces, como a melancia.