News

25 November 2008

Measuring Pre-Migraine Stress Levels

A new study out of Japan is raising questions about the connection between stress levels and migraine attacks.

Stress and Migraine - what is the connection?

A little background here. Headaches have traditionally been connected to stress. It’s natural that migraine, with the common symptom of headache, has also been connected to stress levels in people’s minds.

But in recent years, the connection between migraine, and even tension type headaches, and stress, has been increasingly questioned. Part of the reason is that new technology is allowing us to see some of the complex changes taking place in the body during attacks. We’re even seeing that there are fundamental physiological differences in people with migraine disease.

Research also has failed to show a direct cause and effect between migraine, types of headache, and stress.

However, there is a relationship of some kind.

The Japanese study

This September a small study out of the Toho University in Tokyo set out to find new ways to measure psychological factors and actual stressful events in relation to migraine attacks.

The interesting thing about this study was that they went more in depth with various factors that might relate to migraine. My greatest hope from a study like this is that it will get researchers thinking about new and better ways to study the relationship between psychology and life events and migraine attacks. This is not a simple relationship, as many people once thought (ie more stress = more migraine attacks).

The study followed 16 people, studying the 3 days before an attack. Recorded were: stressful events, daily hassles, domestic stress, non-domestic stress, anxiety, depressive tendency and irritability.

The researchers actually didn’t find a large increase in stressful events in the days before an attack. There was no significant increase in stressful events. There was an increase in "daily hassles". Naturally, there was an increase in stress and some types of life-stresses during a migraine attack.

The researchers concluded that the increase in life stresses in the days before the attack were not as high as had been reported in some earlier studies.

Other studies

I’m not going to do a review of all the studies on migraine and stress, but I was browsing some of the other studies from the 1990s. One (from the USA) focused more on phsychological factors and suggested that there was increased tension before attacks, and tried to measure when tensions would result in an attack. The other (from the Netherlands) showed increased daily hassles in the 24 hours before an attack, fatigue and decreased sleep before an attack.

Surprised by the results?

I’m a little surprised that the studies so far have not found more of a correlation between psychological factors and the hours before an attack. That’s not because I think that stress brings on migraine attacks.

There’s another factor at work here – the premonitory, prodrome or aura phase of the migraine. It’s hard to tell exactly when the attack starts, because the headache (if there is one) generally comes late in the migraine chain of events. Mood changes are very often an early phase of the attack, and can start many hours before the headache itself. So, if we’re talking about how irritable someone is, or how difficult they find daily tasks, one would expect that there would be an increase for many people before the headache phase.

That being said, there are two things to note about this study. First, I’m glad researchers are getting more specific – types of stress, types of mood changes, etc. The studies coming out in the 90s were much more basic. However, it could be a long time before we unravel the connection between life events, stress, and migraine attacks.

Second, this study further weakens the case for a direct and constant relationship between stress and migraine attacks. It confirms the decision of the International Headache Society to remove stress from the list of migraine triggers to the list of exacerbating factors.

If you want to study the results more closely, read Stress and psychological factors before a migraine attack: A time-based analysis

18 November 2008

Headache and Migraine: Too many not seeing a doctor

James News, Tips 6

… at least that’s the impression I get from our latest poll. I shouldn’t be surprised – but I was.

Let’s look at the results from the recent poll we ran here at Headache and Migraine News. An incredible 67% of visitors confessed that it was several years after their first attack before they saw a doctor! Now, perhaps some of those people had very few attacks, but still, that is incredible.

13% said it was several months, and 10% said it was several weeks. 10% said they had had 5 or fewer attacks before seeing a doctor.

Why do we wait so long? This isn’t a matter of waiting before trying a new treatment (that’s another story), this is a matter of not even seeing a doctor or specialist once.

In my case, one reason I waited so long was because I didn’t realize what was going on. I was young and thought the symptoms I was experiencing were a normal part of life.

I would like to suggest that one of the biggest reasons people aren’t getting to a doctor or specialist is because our society tells us that headaches are normal. Everyone gets them, and so we should just deal with them.

There is one type of headache that is very common – tension type headache. TTH feels like a band of pressure around the head. It is a steady pain, rarely throbbing.

However, a headache can be a sign of something very serious. And if you’ve never seen a doctor qualified in headache treatment, how can you be sure what kind of headache you have?

Headaches are not normal, in the sense that you should just ignore them. Ignoring a headache could mean permanent damage. Ignoring a headache could mean it will be harder to treat down the road.

And remember – often, very often, those over-the-counter painkillers are not the best way to go.

So if you have any kind of head pain, let’s get it out of our heads that it’s just "normal" and you should just "put up with it". Don’t let your friends get away with saying "oh, don’t worry about me – it’s just a headache".

Go see a doctor – at least once – if you have a headache for the first time, or have new symptoms, or a worst-ever headache. You could be saving yourself a lot of pain in the future by acting now!

13 November 2008

Migraine patients more sensitive to Topamax?

James Medications, News 56

Topamax – things "tasting funny"
a common side effect for migraineurs

Topamax (topiramate) has been a help to many patients with migraine and epilepsy. Unfortunately, many migraine patients also experience Topamax side effects, and these side effects make them more likely to stop topiramate treatment.

Researchers at the University of California in the United States and the University Medical Center in the Netherlands decided to ask the question – why so many problems? Are migraineurs actually more likely to have side effects from Topamax?

The researchers compared patients with epilepsy and patients with migraine who were taking topiramate alone as a treatment. The data showed that migraineurs were indeed more likely to stop taking the drug because of adverse reactions.

Epilepsy patients were more likely to suffer behaviour reactions and headache. Migraine patients were more likely to find that things "taste different", or have cognitive problems (such as language problems). Migraineurs were also more likely to drop out of topiramate treatment because of adverse reactions.

Technical data for the study can be found here: Are Migraineurs at Increased Risk of Adverse Drug Responses?

30 October 2008

Probiotics for IBS – study review

James News, Tips, Treatments 12

We’ve been talking lately about the use of a probiotics supplement for migraine. A probiotics supplement is especially attractive to those who are trying to avoid yogurt, which triggers migraine attacks in some.

One unwelcome visitor that often comes along with migraine is irritable bowel syndrome (IBS). So a recent review of studies done of patients with IBS taking probiotics supplements caught my eye, because it has implications for both groups (more on the link between IBS and migraine).

In a nutshell, the studies were presented at the American College of Gastroenterology’s 73rd Annual Scientific Meeting. Researchers suggested the following:

Probiotics are safe
Probiotics help lessen symptoms of IBS
Multistrain probiotics are effective
Probiotics were also effective for teenagers and children

Why does this matter to migraine sufferers? Most obviously, because many are also suffering from IBS. But there’s another reason – the evidence is mounting that multistrain probiotics actually do help.

That may seem obvious, but some have argued that by the time the supplement gets into your system (especially into your intestines), you’re lucky if there are any probiotics that are actually still there to help you. There’s no doubt this is true for some brands (more on that in a moment). But a quality probiotic is actually improving your body’s functioning, and that is major news.

Previously I recommended Natureâ€™s Way Primadophilus Optima. I chose this particular brand because
(1) It’s a multistrain probiotic (14 strains, including bifidobacterium infantis)
(2) It seems to be among the best when it comes to getting the maximum amount of probiotic benefit into your body. Many brands of probiotics fall far short of the label’s claims about the amounts of each strain, once you actually go to take the supplement. Buying the wrong brand (this goes for yogurt too, by the way) may mean you’re taking something with very little benefit.

To maximize the benefits, be sure to refrigerate the bottle as soon as it arrives. And don’t buy 243 bottles in advance – stick to 2 or 3.

You can find Primadophilus Optima at Vitacost (above link). Primadophilus Optima is also available on amazon.com.

There is growing evidence that taking care of your "gut" (intestines) can be a powerful way to fight migraine. Finding ways to do this that are safe and effective will continue to help migraineurs make smart decisions.

Read more about the studies at Science Daily: How Effective Are Probiotics In Irritable Bowel Syndrome?

27 October 2008

Calling People with Cluster Headaches from the USA!

James News 0

If you’re a US resident, and you’ve been diagnosed with cluster headaches by a neurologist, listen up. The Organization for Understanding Cluster Headaches (O.U.C.H.) is asking you to participate in a groundbreaking online survey.

As many of you know, there is a lack of information, and a lot of misinformation, about cluster and cluster headache treatments. Though a often considered rare, it probably strikes more than 1 in 1000 people, meaning that millions around the world suffer from what have been called "suicide headaches" (see this estimate, and this one).

The results of the study will be submitted to a medical journal by a neurologist specializing in cluster treatment. The goal is to better understand cluster patients, and raise awareness among doctors, specialists, insurance companies, and the general public.

The survey will not request your name or other personal identifying information. And remember, this is only for US residents who have been diagnosed with cluster headache by a board certified neurologist You can start right now by visiting the online Cluster Headache Survey.