1,721,496 research outputs found
Energy Metabolism Impairment in Migraine
No full textMigraine is a common disabling neurological disorder which is characterised by recurring headache associated with a variety of sensory and autonomic symptoms. The pathophysiology of migraine remains not entirely understood, although many mechanisms involving the central and peripheral nervous system are now becoming clear. In particular, it is widely accepted that migraine is associated with energy metabolic impairment of the brain. The purpose of this review is to present an update overview of the energy metabolism involvement in the migraine pathophysiology. Several biochemical, morphological and magnetic resonance spectroscopy studies have confirmed the presence of energy production deficiency together with an increment of energy consumption in migraine patients. An increment of energy demand over a certain threshold create metabolic and biochemical preconditions for the onset of the migraine attack. The defect of oxidative energy metabolism in migraine is generalized. It remains to be determined if the mitochondrial deficit in migraine is primary or secondary. Riboflavin and Co-Enzyme Q10, both physiologically implicated in mitochondrial respiratory chain functioning, are effective in migraine prophylaxis, supporting the hypothesis that improving brain energy metabolism may reduce the susceptibility to migraine
Situazioni cliniche particolari: sincope ipotensiva ed ipertensione.
No full textIl capitolo descrive come definire e gestire situazioni cliniche particolari, come l'associazione tra ipertensione arteriosa e ipotensione ortostatica
From Autonomic Nervous System Evaluation to a Novel Paradigm for Scientific Research, Clinical Practice and Economic Development
No full text[No abstract available
Motor-related sleep disorders in Huntington disease. A comment on: Neute et al.: "Nocturnal agitation in Huntington disease is caused by arousal-related abnormal movements rather than by rapid eye movement sleep behavior disorder" by Neutel et al
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Sensitization and Interoception as Key Neurological Concepts in Osteopathy and Other Manual Medicines
Full text linkHistorically, approaches used in manual medicine to explain patient reported symptoms have been focused on the so-called exteroceptive paradigm. Arguably, this mindset lacks an appropriate "reading system" able to interpret musculoskeletal disorders from a different perspective, where the properties of the nervous system are embraced into a more holistic and functional-related context. Interestingly, if the underpinning mechanisms of a given treatment scenario/effect are taking into account, the majority of research outcomes focuses on a proprioceptive/exteroceptive explanation, leaving ting aside the additional or even central role of interoception. Currently, to date, the application of theoretical knowledge acquired on the relatively recent neuroscientific concepts and evidence concerning of interoception, sensitization, touch, autonomic functions, inflammation, and pain into a clinical/research manual medicine scenario is lacking, even if theoretically, the impact on the possible etiological mechanisms and treatment effects seems to be important. Here, we propose the conceptual foundations for a new way of interpreting and reading patients' clinical reported outcomes scenario based on interoception and sensitization. We argue that this will provide a foundation to create the ground for future research focusing on the hypotheses that manual therapies, specifically osteopathy, can intercede with sensitization states, at all levels, using interoceptive pathways
Choosing Wisely: five recommendations related to tests, treatments, and procedures at risk of inappropriateness in the cure of Parkinson’s disease (LIMPE-DISMOV Academy)
Full text linkBiofeedback in the prophylactic treatment of medication overuse headache: a pilot randomized controlled trial
Full text linkAbstract Background: Medication overuse headache (MOH) is a major clinical concern and a common health risk. Recent literature stressed the need to manage chronic headache by using integrated biobehavioral approaches. Few studies evaluated how biofeedback can be useful in MOH. The aim of the study is to evaluate in a randomized, controlled, single-blind trial the effects of biofeedback associated with traditional pharmacological therapy in the prophylactic treatment of MOH. Method: Twenty-seven subjects were randomized to frontal electromyographic (EMG) biofeedback associated with prophylactic pharmacological therapy (Bfb Group) or to pharmacological treatment alone (Control Group). The primary outcome was to evaluate the number of patients that return episodic after treatment. Secondly we evaluate the effects of frontal EMG BFB on frequency of headache and analgesic intake. Changes in coping strategies and in EMG frontalis tension were also evaluated. ANOVA was performed on all the variables of interest. Results: Our results indicate that at the end of treatment the number of patients that returned episodic in the Bfb group was significantly higher than in the Control group. Patients in the Bfb group differed from the Control group in headache frequency, amount of drug intake and active coping with pain. These outcomes were confirmed also after 4 months of follow-up. No significant effects were observed in EMG recordings. Conclusions: Biofeedback added to traditional pharmacological therapy in the treatment of MOH is a promising approach for reducing headache frequency and analgesic intake. Modification of coping cognitions in the Bfb group, as an adjunct mechanism of self-regulation, needs more evaluations to understand the role of biofeedback in changing maladaptive psychophysiological responses
Comment to the article titled: sympathetic dysfunction as an early indicator of autonomic involvement in Parkinson's disease
No full textThe association between restless legs syndrome, cardiovascular and metabolic diseases: hypotheses and evidence from the literature
No full textThe association between RLS and both CVRFs, such as hypertension and diabetes, and CVDs still remains elusive. Although several shared physiopathological causes could explain these possible relationships, the emerging body of literature focusing on these disorders remains controversial. The reasons for these inconsistent findings are mainly due to the different methodologies applied. First, considering that RLS, CVRFs and CVDs are influenced by age and sex, many clinical and population-based studies performed a selection bias by restricting the sample collection to these covariates. Second, assessments of covariates are often incomparable and the methods applied for diseases assessment are often affected by low sensitivity and specificity. Only few population-based studies collected data by means of face-to-face interview or physical examination in order to limit the false positive rate compared to questionnaires administered by mail or telephone. The assessment of RLS was not always performed according to IRLSSG criteria and anyway the four diagnostic criteria did not allow the exclusion of other disorders that may act as mimics (Hening et al., 2009; Allen et al., 2014). Disease assessment ranged from a self-reported diagnosis, information on the use of specific medications, or a direct measurement of BP and blood glucose levels. Moreover, some antihypertensive medications, such as beta-blockers and certain calcium channel blockers, could both ameliorate and aggravate RLS symptoms (Innes et al., 2012) and therefore it would be important to consider medications as confounding factors. In addition, the co-occurrence of several CVRFs is frequent and they may influence each other. Therefore, the cross-sectional nature of most studies cannot assess the causal relationship between them and the variables of interest (i.e., RLS and/ or CVDs). Finally, only few studies adjusted their analyses for other cardiovascular risk factors, such as diabetes mellitus, history of myocardial infarction, BMI, dyslipidemia, and smoking status, that might act as confounders or mediators. In summary, longitudinal population-based studies and meta-analyses will be necessary in order to build a sufficiently robust body of evidence on this topic
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