Lack of habituation of evoked visual potentials in analytic information processing style: evidence in healthy subjects.

Habituation is considered one of the most basic mechanisms of learning. Habituation deficit to several sensory stimulations has been defined as a trait of migraine brain and also observed in other disorders. On the other hand, analytic information processing style is characterized by the habit of continually evaluating stimuli and it has been associated with migraine. We investigated a possible correlation between lack of habituation of evoked visual potentials and analytic cognitive style in healthy subjects. According to Sternberg-Wagner self-assessment inventory, 15 healthy volunteers (HV) with high analytic score and 15 HV with high global score were recruited. Both groups underwent visual evoked potentials recordings after psychological evaluation. We observed significant lack of habituation in analytical individuals compared to global group. In conclusion, a reduced habituation of visual evoked potentials has been observed in analytic subjects. Our results suggest that further research should be undertaken regarding the relationship between analytic cognitive style and lack of habituation in both physiological and pathophysiological conditions.

Pathophysiology of fibromyalgia: a comparison with the tension-type headache, a localized pain syndrome.

Fibromyalgia (FM) is thought to occur because of the combination of interactions among neurotransmitters, such as neuropeptide Y (NPY), stressors, hormones, cytokines, and both the immune and sympathetic nervous systems. The aim of this study was to evaluate serum concentrations of cytokines, antipolymer antibodies (APA), and NPY in 51 patients with FM, 25 with tension-type headache (TTH), and 15 healthy controls. Serum concentrations of eight different cytokines, APA and NPY, were measured. Interleukin (IL)-1RA, IL-6, IL-10, and tumor necrosis factor-alpha were higher in serum of FM patients compared with TTH patients and a significant correlation between IL-10 and Fibromyalgia Impact Questionnaire score was observed. There was a significant difference between FM and TTH versus controls in NPY levels, but not in APA levels. Cytokines and NPY take part in pain modulation and even if they are altered in FM they cannot be considered as measurable biomarkers of disease.

[Comparison of treatment with STRESSEN and arginine glutamate on homocysteine blood levels]. / "STRESSEN" confrontato con glutammato di arginina nell'iperomocisteinemia.

OBJECTIVE: Elevated plasma concentrations of homocysteine may occur because of impaired metabolism of this amino acid as a result of genetic factors or can be attributed to inadeguate blood levels of folate and vitamin B12. Recent studies demonstrated that STRESSEN decreases homocysteinemia more than the above mentioned vitamins do, as reported in literature; this behaviour could be due to the presence in the drug of arginine glutamate, whose specific activity, in comparison with STRESSEN, is here evaluated. MATERIALS AND METHODS: The trial was carried out on 20 patients with hyperhomocysteinemia (> 15 micromol/l) and affected by migraine without aura; 10 subjects have received STRESSEN and 10 arginine glutamate. After 30 days of treatment, homocysteinemia was evaluated. RESULTS: Reduction of blood concentration of this amino acid was 56.3% (P < 0.001) after STRESSEN therapy and 27.0% (P < 0.001) after arginine glutamate. CONCLUSIONS: Obtained results show, for the first time, the efficacy of arginine glutamate on homocysteinemia and strengthen the hypotesis that STRESSEN activity is due to all its components, including arginine glutamate that itself acts on this parameter.

["STRESSEN" in the treatment of psycho-physical stress and hyperhomocysteinemia in patients with migraine without aura]. / "STRESSEN" nel trattamento dello stress psico-fisico e dell'ipe- romocisteinemia in pazienti affetti da emicrania senza aura.

OBJECTIVE: A previous clinical trial evidenced, in patients affected by migraine without aura, that treatment with medicinal product STRESSEN determined a reduction of homocysteinemia and an improved general state of health, also if the protocol had not provided for the latter evaluation. The aim of this study is to confirm, in a similar population, the efficacy of STRESSEN on hyperhomocysteinemia and to control the psycho-physical state of the patients by means of specific parameters. MATERIALS AND METHODS: 20 hyperhomocysteinemic (> 15 micromol/ 1) patients suffering from psycho-physical stress and migraine without aura were enrolled. The efficacy of a 30 days treatment with STRESSEN was evaluated through dosage of this amino acid and through a questionnaire on the general state of health. RESULTS: Homocysteinemia was reduced of 52.1% (P < 0.001) and the score representing the general state of health decreased from 1.63 +/- 0.38 to 0.78 +/- 0.12 (P < 0.001). CONCLUSIONS: This study supported the effectiveness of STRESSEN treatment to restore physiological profile of homocysteinemia and to improve the psycho-physical conditions, usually altered by stress for which the drug is already indicated.

Epidural corticosteroid blockade in cervicogenic headache.

Cervicogenic headache (CGH) is a relatively common form of headache stemming from the neck structures which presents some pathophysiological condition probably linked together with various pain-producing factors. This report presents a series of 9 patients suffering from cervicogenic headache and the results achieved by means of epidural steroid (methylprednisolone 40 mg) injection into the epidural cervical space (C6-C7 or C7-T1) level. The effectiveness of this diagnostic blockade was compared with the results obtained using the same procedure in 6 chronic tension headache (CTH) patients. A sharp decrease in the Numeric Intensity Scale (NIS) and in the Drug Consumption Index (DCI) values were observed after the diagnostic procedure in CGH patients. The short-term (12 hours) and medium-term (4 weeks) marked clinical improvement obtained in CGH patients may increase the number of available diagnostic tools which can be used to identify these underestimated patients population. The long-term effectiveness of this approach in cervicogenic patients is being evaluated over time.

Hyperbaric oxygen in chronic cluster headaches: influence on serotonergic pathways.

A controlled study was done with the aim of assessing the efficacy of hyperbaric oxygen (HBO2) in cluster headache and of studying the possible influence of this therapeutic approach on serotonergic pathways. Fourteen patients, aged between 26 and 56 yr, suffering from the chronic form of cluster headache were treated with HBO2 (n = 10) or environmental air (placebo) ( n = 4) during the 15 sessions of exposure (lasting 30 min each) in the hyperbaric chamber. The influence of this procedure on serotonergic pathways of pain was monitored by means of study of serotonin binding to mononuclear cells before and after the treatment for both subgroups. All of the treated 14 chronic cluster headache patients completed the study. In the subgroup treated with the placebo, no particular modifications on the number of attacks and of analgesic consumption as well as no change in the specific binding curve of serotonin to mononuclear cells were observed, whereas in the subgroup treated with HBO2 the clinical effectiveness and the appearance of plateau in the binding curves indicated that the oxygen therapy could act through serotonergic pathways.

Effect of hyperbaric oxygen on the immunoreactivity to substance P in the nasal mucosa of cluster headache patients.

Exposure to hyperbaric oxygen has been shown to be effective in cluster headache, but the mechanism of the action is still not clear. Primary nociceptive neurons, containing neuropeptides such as substance P and particularly those innervating the nasal mucosa, could be involved in the pathogenesis of cluster headache. The present study evaluated the effect of an exposure to hyperbaric oxygen on the content of substance P in the nasal mucosa of patients affected by cluster headache. The results were compared with those observed in another group of cluster headache patients who underwent a placebo procedure. The samples of nasal mucosa were analyzed by immunocytochemical methods. A qualitative analysis of the slides was carried out by an operator under "blinded conditions". A marked decrease in the content of immunoreactivity for substance P was found in the patients exposed to hyperbaric oxygen. The decrease was statistically significant when compared with the findings of the placebo procedure. The results of the present study indicate that an influence on the content of peripheral neuropeptides could be involved in the mechanism of action of the beneficial effect of hyperbaric oxygen in cluster headache.

[Immunohistochemical profile of the nasal mucosa during the acute phase of cluster headache]. / Profilo immunoistochimico della mucosa nasale durante la fase attiva della cefalea a grappolo.

We studied 20 patients with cluster headache (11 males, 9 females) and 10 subjects free from this disorder. Nasal cavities were endoscopically studied to evaluate the mucociliary transport, pH, IgG, IgA and IgM levels in nasal secretion and in serum, and Na, K and Cl serum levels. We observed in all patients in the study group in comparison with the control group an increase of pH, and of serum IgA and IgM levels (but not of IgG). Na, K, and Cl serum levels in the patients with cluster headache were lower than those in the control subjects.

["Chronic paroxysmal hemicrania" following ophthalmic herpes zoster]. / "Emicrania cronica parossistica" conseguente ad herpes zoster oftalmico.

The authors report the first observation of a 73-year-old woman affected from CPH (Chronic Paroxysmal Hemicrania) which following an ophthalmic herpes-zoster infection. The improvement with a 5-HT 1-like agonist receptors (Sumatriptan) and with Timostimulin is discussed.

Bioelectrical impedance assay (BIA) of total body composition in alcohol-induced migraine patients. Preliminary report.

"Whole body composition" was investigated in 30 people subject to alcohol-induced migraine. The control group was 30 people matched for age, sex, height and weight, who were not subject to migraine and who consumed moderate amounts of alcohol. The following were evaluated: anthropometric data, alcohol intake in grams per day, total body water, fat-free mass, fat mass, and body mass index (kg/m2). Two methods of measurement were used: skin fold thickness evaluation, and bioelectric impedance assay (BIA). BIA is a non-invasive method based on the principle that lean tissues conduct a low frequency alternating current of electricity better than do fatty tissues. Body mass index was increased in the alcohol-induced migraine patients (p less than 0.04), as was fat mass, (p less than 0.03) as evaluated by skin fold measurements. Bioelectric impedance assay demonstrated a slight total body water increase in alcohol-induced migraine patients (p less than 0.07). Possibly, if this total body water increase was reflected at the neuronal level, the bioelectric properties of the migrainous brain may be altered, thus creating a hypothetical link with the phenomenon of spreading depression.

Impairment of 5HT binding to lymphocytes and monocytes from tension-type headache patients.

Serotonin (5HT) binds in a saturable and specific manner to high affinity binding sites present on the surfaces of human lymphocytes and monocytes. We reported that migraine patients have an increase in 5HT binding parallel to the progression of the attack, with the appearance of a subsequent phenomenon of cellular deactivation. The same experiment previously carried out in cluster headache patients revealed a lack of high affinity binding sites, independently of the pain period. Low levels of plasma 5HT were recently described by Anthony in chronic tension-type headache. The implication of 5HT in tension headache was also hypothesized by Shukla with the demonstration of an increased 5HT uptake by platelets. We studied the 5HT binding on surfaces of lymphocytes and monocytes in 26 tension-type headache patients (16 affected by chronic form (CTH) of the disease and 10 by episodic form (ETH]. Fourteen clinically healthy subjects were used as controls. Circulating lymphocytes and monocytes were tested for their ability to specifically bind 5HT, using (3H) labeled 5HT. The "in vitro" 5HT binding curves to lymphocytes and monocytes of tension-type headache patients show a constant trend; during headaches, both CTH and ETH patients present a desensitization phenomenon with a complete loss of high affinity binding sites for 5HT. The 5HT binding curve observed in controls is indistinguishable from that of ETH patients studied outside the attack period. The total amount of 5HT bound appeared to be more markedly raised in CTH patients than in ETH patients when compared to control values.(ABSTRACT TRUNCATED AT 250 WORDS)

Defective expression of IL-2 receptors on peripheral blood lymphocytes from patients with cluster headache.

In a previous study we demonstrated that cluster headache (CH) patients present an increased Natural Cytotoxic response after incubation of their peripheral blood lymphocytes (PBL) with Interleukin-2 (IL-2). This phenomenon led to an investigation of the phenotypic expression of PBL before and after IL-2 incubation, and of the IL-2 lymphocyte receptor. IL-2 receptor is expressed on T-lymphocytes activated with an high-affinity binding site. The analysis of the function of human IL-2 receptor was facilitated by the production of a specific monoclonal antibody (MAb). This MAb identifies the IL-2 receptors by blocking the binding of radiolabelled IL-2 to T-cells. In addition, we studied the expression of Leu-4, specific for T-cells; of Leu-11b, specific for FC receptor on NK cells; and the Transferrin Receptor, specific for lymphoblasts and monocytes. Twenty-three episodic CH patients were selected for this study. Ten sex and age-matched healthy volunteers were used as the control group. We evaluated the PBL phenotypic expression of cells subsets before incubation with IL-2 (1,000 I.U./ml) and after 72 hours. The following Becton Dickinson MAbs have been used: anti-Leu-4 (CD3), anti-IL-2 receptors (CD25), anti-Transferrin receptor (TFR) and anti-Leu-11b (CD16). Indirect fluorescence with a Becton Dickinson FACS-420 flow cytometer was used to analyze the cells.(ABSTRACT TRUNCATED AT 250 WORDS)

[Aspects of organ-specific autoimmunity in cluster headache]. / Aspetti autoimmunitari organo-specifici della cefalea a grappolo.

Fourty-eight cluster headache patients have been studied. Twenty-nine of them were affected also by rhythm cardiac abnormalities, and the other 19 by associated conjunctival hyperaemia. The presence of organ-specific autoantibodies was investigated by immunofluorescence. High titers of antibodies against cardiac antigenic determinants was found. The study of leukocyte subpopulations revealed a parallel increase in blood and in conjunctival mucosa of Leu7+ and LeuM3+ cells. These outcomes confirm the immunopathological theory of cluster headache.

[Cluster headache, Epstein-Barr and Burkitt's lymphoma virus infections]. / Cefalea a grappolo, infezione da virus di Epstein-Barr e linfoma di Burkitt.

Thirteen patients affected by Burkitt's lymphoma were studied. Six out of them had cluster headache associated with Burkitt's lymphoma, and in this group we observed the absence of HLA-B14 antigen. The presence of HLA-B14 antigen in the remaining seven patients, confirm the hypothesis of a protective role of this antigen against cluster headache.