9 research outputs found
Short-term cortical plasticity induced by conditioning pain modulation
No full textTo investigate the effects of homotopic and heterotopic conditioning pain modulation (CPM) on short-term cortical plasticity. Glutamate (tonic pain) or isotonic saline (sham) was injected in the upper trapezius (homotopic) and in the thenar (heterotopic) muscles. Intramuscular electrical stimulation was applied to the trapezius at pain threshold intensities, and somatosensory evoked potentials were recorded with 128 channel EEG. Pain ratings were obtained during glutamate and sham pain injection. Short-term cortical plasticity to electrical stimulation was investigated before, during, and after homotopic and heterotopic CPM versus control. Peak latencies at N100, P200, and P300 were extracted and the location/strength of corresponding dipole current sources and multiple dipoles were estimated. Homotopic CPM caused hypoalgesia (P = 0.032, 30.6% compared to baseline) to electrical stimulation. No cortical changes were found for homotopic CPM. A positive correlation at P200 between electrical pain threshold after tonic pain and the z coordinate after tonic pain (P = 0.032) was found for homotopic CPM. For heterotopic CPM, no significant hypoalgesia was found and a dipole shift of the P300 z coordinate (P = 0.001) was found between glutamate versus sham pain (P = 0.009). This generator was located in the cingulate. A positive correlation at P300 between pain ratings to glutamate injection and the x coordinate during tonic pain (P = 0.016) was found for heterotopic CPM. Heterotopic CPM caused short-term cortical plasticity within the cingulate that was correlated to subjective pain ratings. The degree of long-term depressive effect to homotopic CPM was correlated to the change in location of the P200 dipole
Differences in cortical reorganisation in patients with exploding and imploding migraine
No full textAbnormal brain processing of pain in migraine without aura:a high-density EEG brain mapping study
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Management and Outcome of Pregnancy in Patients With Idiopathic Intracranial Hypertension:A Prospective Case Series Study
No full textBACKGROUND AND OBJECTIVES: Idiopathic intracranial hypertension (IIH) is a syndrome of increased intracranial pressure without an identifiable cause that mostly affects obese persons of childbearing age. In this prospective case series, we have evaluated the overall outcome of pregnancy and birth in participants with IIH and their newborn children. We also provide a proposal for the management of pregnant persons with IIH.METHODS: In this observational study, neuro-ophthalmological findings, the course of IIH-related symptoms, disease management, and pregnancy outcomes were evaluated. The participants were divided into 3 groups according to the course of the disease during pregnancy: stable, worsened, and new diagnosed. Furthermore, the type of delivery and outcome of newborn children such as gestational age, weight at birth, and the presence of asphyxia were compared between the groups.RESULTS: We observed 47 pregnancies in 42 participants; 2 had spontaneous abortions. There were 19 (47%) participants in the stable, 18 (45%) in the worsened, and 3 (8%) in the new diagnosed groups, respectively. A relapse of IIH occurred in 2 (5%). Worsening of IIH-related symptoms was experienced by 18/37 (49%) participants: headache by 17/18 (94%), tinnitus by 11/18 (61%), and vision by 7/18 (39%) (mostly in the first and second trimester). In 8/18 (44%), the symptoms were transient or alleviated in the second and third trimester. Body mass index before and after pregnancy did not significantly differ among the groups. A total of 8 participants were treated with acetazolamide. The frequency of cesarean section was 17/40 (43%). Preterm delivery occurred in 22%. No increased risk of asphyxia was observed, and all infants, but one, were healthy.DISCUSSION: Worsening of headache, tinnitus, and/or vision were experienced by half of pregnant participants with IIH, mostly transient in the first and second trimester, rarely required specific treatment, and were not identified as a relapse of IIH. There was no difference in gestational age and weight at birth in children among the groups, and no perinatal asphyxia was noted. Weight gain in the participants was not identified as a risk factor for relapse of IIH in pregnancy. The rate of cesarean and preterm delivery was higher than in the non-IIH population. A proposal for the management of IIH in pregnancy is provided.</p
Neuroplasticity and modulation of pain is impaired in chronic tension-type headache:a brain mapping study
No full textAbnormal brain processing of pain in migraine without aura: a high-density EEG brain mapping study
No full textUdgivelsesdato: 2009-Jul-10In the present study we used high-density EEG brain mapping to investigate spatio-temporal aspects of brain activity in response to experimentally induced muscle pain in 17 patients with migraine without aura and 15 healthy controls. Painful electrical stimuli were applied to the trapezius muscle and somatosensory-evoked potentials were recorded with 128-channel EEG with and without concurrent induced tonic neck/shoulder muscle pain. At baseline, the calculated P300 dipole for single stimuli was localized in the cingulate cortex. In patients, but not in controls, the dipole changed position from baseline to the tonic muscle pain condition (z = 29 mm vs. z =¿-13 mm, P <0.001) and from baseline to the post-tonic muscle pain condition (z = 29 mm vs. z =¿-9 mm, P <0.001). This may be the first evidence that the supraspinal processing of muscle pain is abnormal in patients with migraine without aura
Use of antimigraine medication before pregnancy and in the first trimester:A cross-sectional study
No full textObjectives/Background: Migraine is common among women, particularly during their reproductive years. There is limited research on the use of antimigraine medication before and during pregnancy. This study was undertaken to describe the use of antimigraine medication 3 months before pregnancy and in the first trimester among women with migraine and to evaluate maternal characteristics associated with continued use in the first trimester. Methods: In this cross-sectional study, we used patient-reported data from the Copenhagen Pregnancy Cohort from October 2013 to May 2019 and included all women with migraine before pregnancy. The use of antimigraine medication before pregnancy and during the first trimester was assessed descriptively. Results: Among women with migraine (N = 1586), 1241 of 1586 (78.2%) reported use of any antimigraine medication before pregnancy, and 347 of 1586 (21.8%) in the first trimester. Before pregnancy, paracetamol was the most used medication (793/1586, 50.0%), followed by ibuprofen (417/1586, 26.3%) and sumatriptan (191/1586, 12.0%). In the first trimester, paracetamol remained the most common medication (271/1586, 17.1%), followed by sumatriptan (49/1586, 3.1%), whereas the use of ibuprofen declined to 11 of 1586 (0.7%). A total of 278 of 1586 (17.5%) reported frequent use (daily or 1–2 times/week) of antimigraine medication before pregnancy, but only 79 of 1586 (5.0%) in the first trimester. Having a short length of education of 1–2 years, other chronic somatic diseases, or mental illness were, after adjustment for maternal age and parity, associated with frequent use of antimigraine medication in the first trimester compared to women with higher education, without other chronic somatic diseases, or without mental illness, respectively (adjusted odds ratio [aOR] = 3.09, 95% confidence interval [CI] = 1.93–4.95; aOR = 1.92, 95% CI = 1.14–3.23; and aOR = 2.14, 95% CI = 1.05–4.38). Conclusion: Most women with migraine used antimigraine medication before pregnancy, whereas usage decreased markedly in the first trimester. Only a few women had frequent use in the first trimester. Women with a short length of education of 1–2 years, additional chronic somatic diseases, or mental illness were more likely to report use of antimigraine medication. By offering an overview of patient-reported use of antimigraine medication before and during early pregnancy in a hospital-based setting, this study contributes to existing knowledge in the field and provides valuable insights for clinicians working with pregnant women affected by migraine.</p
