1,721,203 research outputs found
Effects of botulinum toxin a on allodynia in chronic migraine: An observational open-label two-year study
No full textBackground: Onabotulinumtoxin A (OBT-A) is a treatment option for chronic migraine (CM), though the possible effect on central sensitization and allodynia is still unknown. Aims: The present study aimed to evaluate (1) the long-term outcome of allodynia in a group of CM treated with OBT-A (2) if the presence and severity of allodynia could predict the long-term effect of OBT-A (3) if the improvement of allodynia, could contribute to the clinical efficacy of OBT-A. Methods: This was an observational, open-label, cohort study conducted on 99 CM patients treated for 1 year and 44 patients treated for 2 years with periodic OBT-A 155-195 U injections. In basal condition (T0), after 1 year (T1) and 2 years (T2) treatment, allodynia, migraine disability, and headache frequency were the main variables. Anxiety, depression and sleep deprivation were also considered potentially correlated factors to allodynia. Results: Allodynia decreased after 1 year (Student t test p = 0.0001), and decreased further after the second year of treatment (p = 0.015). There was a relationship between allodynia severity at T0 and reduced headache frequency change at T1 (r = 0.22) and T2 (r = 0.37). The effect of OBT-A on allodynia correlated with the reduction of MIDAS score after 1 year (r = 0.4) and 2 years (r = 0. 63) of treatment. Conclusions: OBT-A seems to have an effect on central sensitization, expressed by allodynia. This action could be exerted by modulating nociceptive transmission, and reducing the global burden of migraine. Patients with more severe allodynia display a limited long-term effect on headache frequency. The modulation of central sensitization could reduce migraine disability, in spite of the persistence of frequent headache
Effects of Neuromodulation on Gait
No full textIn the last decades, non-invasive brain stimulation (NIBS) has evolved to become a valuable tool in both basic and clinical neuroscience. Various methods of transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) have been widely used for diagnostic, prognostic and even therapeutic applications in a broad range of neurological and psychiatric disorders. The rationale for using NIBS techniques lies in the possibility to modulate, in a targeted manner, the activity of different cerebral and cerebellar cortical regions, as well as the functional connections between these areas and distant brain regions also including subcortical structures. The neural circuitry involved in the different aspects of gait control is very complex and includes, along with the basal ganglia-cortical loops, the cerebellum and structures of the brainstem and the spinal cord. This is why different approaches of NIBS have been suggested for treatment of gait disorders in a variety of neurological disorders including Parkinson’s disease, stroke, cerebellar ataxia, multiple sclerosis, cerebral palsy and spinal cord injury. This review will collate the available knowledge on the physiology of gait and balance control, focusing on the ways in which the use of NIBS may contribute to the understanding and treatment of gait disorders
Prophylaxis of hemicrania continua: two new cases effectively treated with topiramate.
No full textHemicrania continua (HC) is an uncommon and under-recognized primary headache disorder characterized by a strictly unilateral continuous headache of moderate intensity with possible exacerbations and associated with ipsilateral autonomic features. HC has generally a prompt and enduring response to indomethacin although 25% to 50% of treated patients develop gastrointestinal side effects
From different neurophysiological methods to conflicting pathophysiological views in migraine: a critical review of literature.
No full textAbnormal increased cortical responsivity to various types of stimuli plays a major role in migraine pathogenesis. Neurophysiological studies, however, have provided ambiguous findings of either hypo or hyper cortical excitability. This is why the term "dysexcitability" has been recently proposed to indicate a more general dysregulation of cortical excitability. The aims of this review are: (1) to provide existing knowledge and research advances in migraine pathophysiology; (2) to propose a unitary interpretation of apparently conflicting neurophysiological findings. Data of studies conducted in migraine through various evoked potentials techniques and non-invasive brain stimulation methods are reviewed, and in some cases reinterpreted according to more recent findings on migraine pathophysiology. In particular, we emphasize the concept that various methods of testing brain excitability may induce different degrees of cortical activation depending on the stimulus parameters used (e.g., intensity, frequency, and duration of stimulation), so shedding light on different pathophysiological aspects. Finally, we try to reconcile apparently conflicting neurophysiological data in the light of a unitary pathophysiological model, suggesting that a condition of interictal cortical hyperresponsivity, possibly due to a glutamatergic dysfunction, could represent the primum movens of migraine pathogenesis
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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