Discoveries & Stats

21 May 2013

Chronic Tension-Type Headache and Chronic Migraine: Profiles

Profiling is so dangerous, isn’t it? I mean, seriously. As soon as you say something like “most migraineurs are women”, you’re leaving out huge numbers of us who ain’t. Or if you say “migraineurs tend to be fat” you beg all kinds of questions – is it due to the medication they’re taking? The time they spend in bed? Is obesity a migraine trigger? Are we “blaming” people who are overweight? Did I just use the “f-word” in this post??

Sure, profiles are interesting. Maybe they allow us to focus more on women instead of men, since they have more migraine attacks. Wait! I don’t like that idea either. We all need help, and we’re all very different!

But these types of generalities can be useful – as long as we’re careful with them. They can point to tendencies. To possible biological realities of migraine disease. And to possible treatments.

But don’t tell me migraineurs are all depressed, or all women, or all f … frugal… or whatever.

This is actually more of a comparison than a profile. What’s the difference between those with chronic tension-type headache and those with chronic migraine – from The Journal of Headache and Pain.

Chronic TTH	Chronic Migraine
Less common	More common
Less likely to be female	More likely to be female
More likely to drink alcohol	Less likely to drink alcohol
Less likely to smoke	More likely to smoke
Less likely to be obese	More likely to be obese
Less likely to report frequent acute pain drug use	More likely to report frequent acute pain drug use
More likely to be low educated	Less likely to be low educated

This study may be even more useful in understanding chronic tension-type headache. After all, a lot of the right column is pretty well known. This is particularly true for weight issues (a struggle for migraineurs due to medication, and also a very possible factor in developing chronic migraine) and pain drug use (medication overuse is a HUGE factor when it comes to chronic migraine).

Could alcohol use influence chronic tension-type headache? Or lifestyle issues related to a lower education?

But one of the problems with a study like this is that many people seem to have both conditions. And there is increasing evidence that both conditions are related.

Do you suffer from chronic tension-type headache? Have you found a direct link with alcohol consumption in particular? Or, as a migraineur, have you found weight loss to be a help? Or quitting smoking?

For more details: Epidemiological profiles of patients with chronic migraine and chronic tension-type headache.

17 May 2013

Ginger and Sumatriptan: More Information

James Discoveries & Stats, Medications, Treatments 2

I’ve been getting a lot of questions regarding the ginger and sumatriptan study, so we’re going to take the time to talk about a few more details.

Obviously one study is not enough to change treatment practices around the world. However, the researchers were motivated to study ginger because it had already shown great promise as a migraine treatment.

Previous Ginger Studies

First of all, ginger has been regularly used for many related conditions – vertigo, motion sickness, and pain conditions being the most well known. Also, previous studies have shown very little problem with side effects.

Ginger is currently being studied to alleviate dental pain and inflammation. And one study suggested that it works about as well as ibuprofen for menstrual pain.

Products containing ginger, such as Gelstat Migraine, have already helped many people fight migraine symptoms. Gelstat Migraine has been studied in clinical trials, and the results were promising.

An older 1990 report showed that patients taking ginger during and after their attack were able to reduce frequency and severity of migraine.

Ginger Dosage in the Trial

In this trial, patients were given 5 capsules of either 50mg of sumatriptan or 250mg of ginger (these ginger capsules are 350mg). Everyone was to take one capsule when a headache was coming on. They didn’t know which they had (this was a double-blinded randomized controlled clinical trial).

This is actually a very low dose of ginger. As you’ll see below, others have recommended a higher dose, even up to a gram or two a day as a preventative. Ginger supplements are commonly 500mg and higher per capsule.

More on the study results

The patients had been generally diagnosed with migraine many years before, and they typically had several attacks per month.

Ginger and sumatriptan results were similar, with sumatriptan generally performing slightly better for actual headache pain.

250mg of ginger was used in this study, as mentioned above. Previously 500mg had also been recommended, repeated every 4 hours up to 1.5 to 2g per day for 3-4 days. Another report found that a woman found relief using similar amounts of ginger powder (1.5-2g) as a daily supplement.

The bottom line

The researchers of this study concluded that ginger should be preferred to sumatriptan because of the lack of significant side effects. The only reported issue with ginger was indigestion (4% had some issues here – interesting considering that many people take ginger for digestion!). But some patients taking sumatriptan experienced dizziness, vertigo, heartburn, and/or sleepiness (20% with one or more issue). In the end, patients were slightly more satisfied with ginger as a migraine abortive.

Researchers are now calling for more study into what dosage is most effective.

This was also a short term study. Longer term studies will help demonstrate if ginger can continue to fight migraine over the long term in individual patients.

For more on the study read the original post here.

7 May 2013

Another Genetic Link to Migraine?

James Discoveries & Stats, News 0

Researchers at the University of California have discovered a new genetic link to migraine – and a rare sleep disorder – that may get us closer to the cause of migraine than ever before.

First, a note. Last week on Facebook, Damien Higgins posted the following: There was Migraine News today that made many of the international news channels and you havnt even mentioned it!!! this page is not exactly on the ball, is it!!!http://news.sky.com/story/1085914/hope-for-migraine-sufferers-after-genes-find

Well, I have no particular excuse for not mentioning this story sooner, other than to say that this website has not yet reached the level of perfection that I or Damien may want!

That being said, many stories hit “international news” and are really hardly worth mentioning, in my opinion. Honestly, a lot of migraine news is old news, poorly reported, blown out of proportion, or in reality not useful. And sometimes it’s worth taking the extra time to research the news a little more before repeating the same thing here.

Regarding genetics and migraine, we’ve discussed a lot of discoveries here. In fact, back in 2010 we talked about a similar news story – Found: Genetic Link to “Basic” Migraine

We’ve also talked about something critical to understand – Migraine: Why Genetic Studies haven’t Solved all our Problems.

In Damien’s defence, however, this news story is worth mentioning. And I won’t claim that the Sky news report is overblown, although most migraineurs are probably tired of seeing the same old headline – “Hope for Migraine Sufferers…”! 🙂

Study Overview

First, we need to be cautious about claiming that we’ve “finally found the genetic cause of common migraine”. This is not the first time genetic mutations have been linked with common forms of migraine. There are some unique things about this study which we’ll discuss in a moment, but it’s a tricky thing to prove that a genetic mutation is the cause or even related to “most” migraine attacks.

Researchers were actually looking at two conditions: Migraine and Advanced Sleep Phase Syndrome. This sleep syndrome causes you to go to sleep earlier (ie in the evening) and get up earlier (ie between 1 and 5 am).

Researchers found two families in which many members had both conditions (in this case, the sleep disorder would be called familial advanced sleep phase syndrome).

To make a long story short, it was discovered that two related gene mutations were highly associated with both conditions.

Now mice who had one of these mutations (CKIÎ´-T44A) were also researched. These mice had a lower threshold for cortical spreading depression (CSD), a storm that sweeps across the brain that is considered a key part of the migraine chain reaction. In other words, they were more likely to get CSD.

These mice were more sensitive to pain, and astrocytes (certain neurological cells) showed increased calcium signalling, which may relate to parts of the migraine reaction as well.

Now the research on CKIÎ´-T44A and the mice and migraine is not new. Neither is the link between these two mutations and advanced sleep phase syndrome. However, the link with the two mutations and the two conditions – migraine and advanced sleep phase syndrome is.

You might be a little underwhelmed that we’re just talking about two families, and a rare sleep disorder, and just another two mutations after we’ve already linked others with migraine.

However, this is how a lot of good research starts.

These mutations are linked. And the most important finding may not be the mutations themselves, but what they point to.

For one thing, they both influence a special protein known a connexin 43 (Cx43). Even if these particular genetic mutations don’t turn out to be common in migraineurs, there could be other factors that are impacting Cx43, and so that might be the direction that future research takes.

I’ve intentionally avoided getting into all the specific mechanisms of these mutations in order to focus on the practical implications. But if you’re interested in the more technical aspects, you can read the study abstract: Casein Kinase IÎ´ Mutations in Familial Migraine and Advanced Sleep Phase and a discussion of the findings at Gene Mutations Tied to Migraine, Sleep Disorder.

24 April 2013

Migraine in Kids and Teens, Dangerous Herbs, and Migraine Brains (podcast)

James Discoveries & Stats, Medications, News, Podcast, Treatments 0

Podcast: Play in new window | Download

Today’s podcast covers some recent migraine news. Here are some of the links mentioned:

13 March 2013

Migraine in the USA: Just How Big is the Problem?

James Discoveries & Stats 4

How many people are dealing with migraine in the United States? Is it really a big issue, or just something that the media has blown out of proportion?

Researchers at the Department of Psychology at the University of Mississippi used already published studies to estimate just how serious the problem is, based on how many people experience migraine attacks over a three month period.

Among the general population, over 16% had experienced migraine or severe headache over the past 3 months. (This included either migraine and “severe headaches” or else migraine and probable migraine).

Not surprisingly, the group with the most migraine attacks was women between 18 and 44. In this group, the number skyrocketed to 26.1%, or more than 1 in 4 women.
Migraine was significant even in groups we don’t often think about. For example, in men 75 or older, 4.6% had experienced severe headache or migraine over 3 months.

As you might imagine, headache was a major reason for visits to emergency. As we’ve discussed before, although headache usually doesn’t require a visit to emergency, it is often imperative to go right away – in certain cases it can save your life. Head pain turned out to be 5th on the list of reasons why people visit emergency (I’m sure other common reasons include chest and abdominal pain, and things like strains, sprains, and wounds like bruises or cuts). For women, it was #3 on the list.

The researchers also noted that, not only is migraine itself a serious public health problem, you need to figure in common comorbid conditions. These would include things like depression, irritable bowel syndrome, heart conditions, and epilepsy.

So the answer is – no, the media hasn’t overblown the issue. Even in the last three months, chances are that among your 20 best friends, between 3 and 5 have had at least one significant attack in the last 3 months. That doesn’t include other related conditions, and the many other symptoms and “between-migraine-attack” issues that many experience.

Researchers, governments, schools, churches, families, work places, other organizations – they should be talking about migraine and looking for ways to help with the burden so many people bear.

Study abstract: The Prevalence, Impact, and Treatment of Migraine and Severe Headaches in the United States: A Review of Statistics From National Surveillance Studies.
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