偏头痛慢性化的潜在危险因素

目的 探讨与偏头痛慢性化相关的潜在危险因素.方法 依据ICHD-Ⅱ(2004)及其关于慢性偏头痛最新修订版(2006)的诊断标准,2006年3月至2008年3月上海仁济医院神经内科头痛门诊连续就诊登记偏头痛患者250例,其中慢性偏头痛43例、发作性偏头痛207例,回顾分析两组患者的人口学资料及头痛病史.结果 慢性偏头痛占总偏头痛就诊人数的17.2%.单因素分析结果显示两组中性别构成、教育程度、体力劳动者比例以及存在一级亲属家族史、系统疾病史者的比例相似(P>0.05);头痛严重程度、持续时间、既往发作频率以及存在先兆的比例也无显著差异(P>0.05).慢性偏头痛组中急性期止痛药物的使用率较对照组明显增高(P=0.0005).两组患者偏头痛起病年龄相当,但慢性偏头痛组患者病程明显长于对照组,并于多因素分析中仍显示明显差异.结论 偏头痛慢性化的风险可能随病程延长而增大,但须行进一步的前瞻性队列研究以证实.在临床工作中,对病程长、可能存在止痛药物滥用的患者应加强治疗及随访.     

偏头痛慢性转化的临床危险因素分析

目的比较慢性偏头痛(CM)与发作性偏头痛(EM)的病史特征、临床特点等,探究偏头痛慢性转化的危险因素,为其防治提供依据和策略。方法共纳入在中南大学湘雅医院神经内科就诊的CM患者72例及EM患者109例进行回顾性分析。采集患者基本信息,先进行单因素分析,筛选有统计学意义的指标进行相关分析和非条件性多因素logistic回归分析。结果单因素分析发现两组的BMI(P=0.000)、病程(P=0.000)、基线头痛发作频率(P=0.000)、基线头痛持续时间(P=0.037)、匹兹堡睡眠质量指数量表(PSQI,P=0.000)、焦虑自评量表(SAS,P=0.000)及抑郁自评量表(SDS,P=0.001)差异有统计学意义。logistic回归分析显示BMI(OR=1.468,95%CI:1.148～1.876)、病程(OR=1.102,95%CI:1.022～1.188)、基线头痛发作频率(OR=1.461,95%CI:1.247～1.711)、睡眠质量(OR=1.494,95%CI:1.198～1.864)、焦虑状态(OR=1.201,95%CI:1.048～1.376)是偏头痛慢性转化的危险因素。结论控制体重、减少头痛发作频率、缩短病程、改善心境状态与睡眠质量,有可能延缓偏头痛的慢性进展。     

发作性偏头痛慢性转化的影响因素

目的探讨发作性偏头痛慢性转化的影响因素。方法收集126例发作性偏头痛(EM)和50例慢性偏头痛(CM)患者的临床资料,并进行比较。采用Logistic多元回归方法分析偏头痛慢性转化的独立危险因素。结果 EM组超重、女性比率,年龄及体重指数(BMI)显著低于CM组(均P0.01),受教育年限显著高于CM组(P0.05)。两组间起病年龄、初发持续时间、初发疼痛程度及有先兆的比率差异无统计学意义(均P0.05)。EM组初发频率、病程、急性期止痛药物过度使用比率以及焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数评分均显著低于CM组(P0.05~0.01)。BMI(OR=1.159,95%CI:1.004~1.338)、SAS(OR=3.100,95%CI:1.360~7.069)、SDS(OR=3.390,95%CI:1.117~10.287)及急性期止痛药物过度使用(OR=2.714,95%CI:1.022~7.204)是EM慢性转化的独立危险因素(均P0.05)。结论伴有抑郁/焦虑、止痛药物过度使用和超重是EM慢性转化的独立危险因素。     

女性癫痫患者焦虑、抑郁和失眠发病率及相关因素分析

目的探讨女性癫痫患者焦虑、抑郁和失眠的发病率和相关因素。方法收集428例成人女性癫痫患者的一般资料,并采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数量表(PSQI)进行测评,相关因素用逐步逻辑回归进行分析。结果女性癫痫患者并发焦虑、抑郁和失眠的发病率分别是38.7%,21.4%和28.6%。患病影响夫妻关系、患病影响恋爱关系、担心发作、担心影响生育和哺乳、羞耻感、起病年龄和发作频率均与焦虑相关(均P0.05)。患病影响夫妻关系、患病影响恋爱关系、起病年龄、病程和发作频率均与抑郁相关(均P0.05)。职业、性格、人际关系和雌二醇水平均与失眠相关(均P0.05)。Logistic回归分析显示,患病影响夫妻关系(OR=3.103,95%CI:1.097~4.686,P=0.008)、患病影响恋爱关系(OR=2.164,95%CI:0.873~3.752,P=0.005)和发作频率(OR=1.704,95%CI:0.680~2.586,P=0.015)是影响焦虑的独立影响因素。患病影响夫妻关系(OR=3.245,95%CI:1.536~5.108,P=0.003)、患病影响恋爱关系(OR=3.151,95%CI:2.135~5.018,P=0.006)、病程(OR=1.196,95%CI:0.828~2.654,P=0.035)和发作频率(OR=1.661,95%CI:1.033~4.326,P=0.014)是影响抑郁的独立影响因素。性格(OR=2.543,95%CI:1.237~4.686,P=0.003)和人际关系(OR=1.816,95%CI:0.905~3.593,P=0.017)是影响失眠的独立影响因素。结论成人女性癫痫患者焦虑、抑郁和失眠发病率较高。焦虑和抑郁与家庭因素、生育、哺乳、羞耻感及癫痫发作有关,失眠与性格和人际关系有关。     

偏头痛伴发脑微出血的相关危险因素分析

目的分析偏头痛患者伴发脑微出血(CMBs)的临床特点及影响因素。方法连续收集178例临床确诊的偏头痛患者,根据头颅MRI有无CMBs表现分为两组,收集患者一般资料,头痛特点并进行比较。结果 (1)178例偏头痛患者中CMBs患者56例,偏头痛合并CMBs发生率为31.5%,其中单发病灶17例(30.4%),多发病灶39例(69.6%),单纯脑叶病灶31例(55.4%);(2)与无CMBs的偏头痛患者比较,合并CMBs的偏头痛患者更容易合并高血压(P=0.028),头痛病程长(P=0.002)、头痛发作频率高(P=0.001)且容易伴发先兆(P=0.036);(3)多因素Logistic回归分析显示,在校正年龄、性别及其他危险因素后,头痛病程(OR=1.166,95%CI:1.044~1.303,P=0.007)、头痛发作频率(OR=1.353,95%CI:1.116~1.640,P=0.002)和先兆偏头痛(OR=10.080,95%CI:1.630~62.329,P=0.013)与偏头痛发生CMBs相关。结论偏头痛病程长、发作频率高及伴有先兆是偏头痛发生CMBs的危险因素。     

抽动障碍的家系研究

目的从家系研究的角度分析遗传印迹是否与抽动障碍的垂直传递有关.方法采用Tourette综合征及其相关行为障碍定式检查提纲、美国精神障碍诊断与统计手册第4版诊断标准和美国抽动障碍联合会制定的抽动障碍诊断标准,对171例抽动障碍先证者进行评定和诊断;采用标准化表型评定程序,收集先证者及其一级亲属(342人)、二级亲属(1283人)、三级亲属(2310人)的表型资料;根据父亲或母亲的患病情况,将先证者分为母系传递者和父系传递者.结果母系传递对于先证者复杂运动性抽动症状的影响较为显著(偏回归系数=6.6,P=0.01);父系传递的先证者则更容易表现注意问题(t=2.78,P=0.01);由母系传递先证者的发病年龄[(5.6±0.8)岁]早于父系传递的先证者[(6.1±1.1)岁;t=2.34,P=0.02].结论抽动障碍的垂直传递存在亲源特异性表达,遗传印迹机制可能参与了抽动障碍的发病.     

晚发型偏头痛与青年（早发型）偏头痛临床特点比较

目的：比较晚发型偏头痛和早发型偏头痛临床特点。方法按患者年龄是否≥45岁,将90例偏头痛患者分为晚发型偏头痛组（≥45岁,晚发组）和早发型偏头痛组（＜45岁,早发组）,通过病历资料回顾,从诱发因素、临床分型、头痛性质及部位、头痛程度和持续时间、头痛发作频率和伴随症状等方面比较2组临床特点。结果2组在诱发因素、临床分型、头痛性质（部位）、头痛程度和持续时间、头痛发作频率、伴随症状等临床特点方面差异有统计学意义（ P＜0.05）。结论晚发型偏头痛和早发型偏头痛具有不同的临床特点。在临床治疗方面,要根据不同的临床特点予以针对治疗。     

偏头痛患者运动敏感性的调查

目的评估偏头痛患者的运动敏感性,寻找恐动发生的相关危险因素。方法选择2013年9月~2014年2月在山东省立医院头痛专病门诊就诊的偏头痛患者60例、紧张型头痛患者30例,收集所有患者一般资料,头痛间歇期进行Graybiel晕动程度症状量表、晕动病易感性量表(MSSQ)、视觉眩晕模拟量表(VVAS)问卷调查。结果偏头痛组有恐动症状的29例(48.3%)。偏头痛恐动与无恐动患者在年龄、先兆方面比较差异有统计学意义(均P0.05)。恐动亚组头痛发作次数、持续时间、伴随症状及头痛程度均明显高于无恐动亚组。偏头痛组、紧张型头痛组晕动病发病率分别为71.7%和46.7%(P0.05),Graybiel症状评分分别为(10.07±7.48)和(4.78±6.51)(P0.05)。恐动亚组晕动病发病率(86.2%)明显高于无恐动亚组(60.0%)(P0.05)。结论伴恐动的偏头痛患者头痛发作次数多、持续时间长、头痛程度重、伴随症状多。恐动好发于年轻及有先兆的偏头痛患者。     

偏头痛伴有焦虑/抑郁及功能残疾的临床研究

目的探讨偏头痛伴焦虑/抑郁及功能残疾的相关功能残疾及影响因素。方法临床纳入94例确诊为偏头痛患者,并纳入70例健康人为对照组。分别发放焦虑自评量表(Self-rating anxiety scale,SAS)、抑郁自评量表(Self-rating depression scale,SDS)、匹兹堡睡眠量表(Pittsburgh sleep quality index,PQSI)、偏头痛残疾程度评估量表(Migraine disability assessment scale,MIDAS)、头痛影响测验(Headache impact test-6,HIT-6)调查问卷,对患者的相关进行记录并统计。结果偏头痛组并发焦虑、抑郁、睡眠障碍发生率为47.87%、50.00%、54.26%,对照组为5.71%、8.57%、24.29%,差异有统计学意义(P0.05);多元逐步分析显示:偏头痛伴焦虑/抑郁与患者的头痛程度重、病程长、有头痛家族史、睡眠质量差及生活满意度低有较为密切的联系(P0.05);患者头痛程度、发作频率、持续时间、伴发焦虑/抑郁是造成功能残疾的主要影响因素。结论头痛程度重、病程长、有头痛家族史、睡眠质量差及生活满意度低是偏头痛患者出现焦虑/抑郁等心理情绪发生的主要原因,而患者头痛程度、发作频率、持续时间、伴发焦虑、抑郁是造成患者发生功能残疾的主要原因。     

住院抑郁症患者联合心境稳定剂治疗的影响因素研究

目的对联合心境稳定剂(MS)治疗的住院抑郁症患者的临床特征进行分析,探讨其影响因素,为临床治疗提供参考。方法回顾性分析2013年12月-2016年11月于首都医科大学附属北京安定医院抑郁症治疗中心住院的共472例抑郁症重度发作患者的临床资料,对联合或不联合MS治疗的抑郁症患者人口学资料和疾病特征进行比较。结果联合MS治疗的患者比例为8.3%(39/472)。与未联合MS治疗组相比,联合MS治疗组患者年龄较小(Z=-4.435,P0.01),更多男性(64.1%vs.37.6%,χ~2=10.451,P0.01),更多无配偶(41.0%vs.19.9%,χ~2=9.460,P0.01),更多无业(38.5%vs.21.0%,χ~2=6.253,P0.05),更多18岁前起病(43.6%vs.7.2%,χ~2=51.977,P0.01),更多难治性抑郁(17.9%vs.4.6%,χ~2=11.787,P0.01),较少伴有焦虑特征(23.1%vs.44.7%,χ~2=6.813,P0.01),抗精神病药物使用率更高(76.9%vs.54.5%,χ~2=7.311,P0.01)。多元回归分析显示,患者年轻(OR=0.9,95%CI:0.91~0.98,P0.05),男性(OR=2.4,95%CI:1.1~5.7,P0.05),18岁前起病(OR=0.2,95%CI:0.05~0.4,P0.01),难治性抑郁(OR=4.9,95%CI:1.5~15.9,P0.01),更多使用抗精神病药物(OR=2.4,95%CI:1.1~5.7,P0.05)均是联合MS治疗的影响因素。结论青壮年、起病早、男性、难治性、接受抗精神病药物治疗的抑郁症患者可能更多联合心境稳定剂进行治疗。     

偏头痛患者伴发焦虑/抑郁及功能残疾的临床研究

目的调查偏头痛患者伴发焦虑、抑郁、睡眠障碍、偏头痛相关功能残疾及影响因素分析。方法采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、匹兹堡睡眠量表(Pittsburgh sleep quality index,PQSI)、偏头痛残疾程度评估量表(migraine disability assessment scale,MIDAS)、头痛影响测验(headache impact test-6,HIT-6)调查问卷,分别对94例符合ICHD-II诊断标准的偏头痛患者和60例健康对照者焦虑、抑郁、睡眠障碍、偏头痛情况以及相关危险因素进行对比分析。结果偏头痛患者47.9%伴发焦虑;50.0%伴发抑郁,睡眠障碍发生率58.5%。偏头痛组焦虑、抑郁和睡眠障碍发生率都明显高于健康对照组的8.3%,16.7%,30.0%,(掊2分别为28.728,20.755,10.954,P值均<0.01)。多元逐步回归分析显示:头痛程度重、病程长、头痛家族史、睡眠质量差、生活满意度低是偏头痛并发焦虑/抑郁的主要危险因素。头痛程度、发作频率、持续时间、伴发焦虑/抑郁是导致功能残疾的主要影响因素。结论头痛程度、病程、家族史、睡眠质量、生活满意度是偏头痛并发精神心理症状的主要危险因素。     

No association of C-1019G promoter polymorphism of 5-HT1A receptor gene with migraine

It is well known that migraine has a strong genetic component, although the type and number of genes involved remains unclear. There is evidence to suggest that serotonin-related genes may be involved in the pathogenesis of migraine. To investigate whether the 5-HT1A receptor gene contributes to the risk of migraine we performed an association study of C-1019G promoter polymorphism of the gene in 102 migraineurs and 93 controls. Subjects were of Han Chinese origin. No significant differences in allele (P=0.82) or genotype frequencies (P=0.71) were seen in migraineurs compared with the controls. When migraine with aura, without aura, with family history, without family history were analyzed separately, the frequencies did not vary significantly. Our results suggest that C-1019G in 5-HT1A is not a major genetic risk factor for migraine.     

女性紧张性头痛及经期偏头痛影响因素的比较

目的比较女性紧张性头痛(TTH)及经期偏头痛(MM)的影响因素。方法收集104例女性TTH患者(TTH组)及91例MM患者(MM组)的临床资料。采用视觉模拟评分法(VAS)和头痛影响测评量表-6(HIT-6)对其头痛程度、生活质量进行评估,并采用汉密尔顿焦虑(HAMA)、抑郁量表(HAMD)对患者情绪障碍进行测定。结果 TTH组与经期相关19例,累积发病率18.3%;MM组与经期相关59例,累积发病率64.8%。与TTH组比较,MM组发病年龄显著降低,病程、家族史,焦虑、抑郁、重度疼痛、HIT-6(Ⅳ级)、共病的比率,以及HAMA、HAMD评分均显著升高(P0.05~0.01),而文化程度、吸烟、饮酒、职业差异无统计学意义(均P0.05)。无先兆的月经相关性偏头痛(MRM)、无先兆的单纯月经性偏头痛(PMM)及非月经性无先兆偏头痛患者发病年龄、家族史、VAS及HIT-6评分差异有统计学意义(P0.05~0.01)。结论与女性TTH比较,MM发病年龄更轻、病程更长,也更易合并焦虑、抑郁。在不同类型MM中,PMM发病年龄更早,有家族史的比率更高;而MRM的重度疼痛率及HIT-6评分最高。     

Migraine with aura

Around 15% to one-third of migraineurs experience aura. Aura is a fully reversible focal neurological phenomenon involving visual, sensory, speech, and/or motor symptoms that develops gradually and usually precedes the headache phase. The pivotal role of cortical spreading depression (CSD) as a mechanism underlying aura has been widely supported by a large body of studies. The diagnosis is based on the International Headache Classification Disorders III edition criteria. Aura is characterized by gradual development, duration of each symptom no longer than one hour, a mix of positive and negative features, and complete reversibility. Visual aura is the most common type of aura, occurring in over 90% of patients. When aura symptoms are multiple, they usually follow one another in succession, beginning with visual, then sensory, then aphasic; but the reverse and other orders have been noted. The accepted duration for most aura symptoms is one hour, but motor symptoms, which are rare, are often longer lasting. When a patient experiences for the first time a possible aura phase it's sometimes difficult to know if there was gradual or brutal onset of the symptoms. If the patient has no visual aura symptoms or simultaneous neurological symptoms, or presents neurological symptoms corresponding to a cerebral vascular territory, emergency exploration of a possible transient ischemic attack is necessary. Long duration (greater than one hour) of what may or may not be an aura phase, late onset of aura, or a dramatic increase in aura attacks should also be explored. The relative risk of ischemic stroke is significantly increased in migraine with aura. Combined hormonal contraception with estrogens significantly increases the risk of stroke in women with migraine with aura. It is recommended to start non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin as soon as possible during the aura phase, not to treat the aura, but to avoid or to diminish the headache phase. In case of failure of NSAIDs or aspirin it is recommended to use a triptan when the headache begins. The prophylactic treatments for migraine with aura are those used in migraine without aura based on very few randomized clinical trials specifically dedicated to migraine with aura.     

No effect of eletriptan administration during the aura phase of migraine

Migraine aura is a warning sign readily recognized by patients. From the onset of aura it takes 30-60 min before the headache phase starts. Administration of acute medication during aura should provide sufficient time to achieve therapeutic plasma levels, counteracting the headache. To test this hypothesis we evaluated the efficacy of eletriptan 80 mg taken during aura. Patients met International Headache Society diagnostic criteria for migraine with aura, with an attack frequency of at least one per month and with aura occurring in > 50% of recent attacks. Of 123 patients randomized, 87 (71%) were treated with a double-blind, one attack, during the aura phase before headache, dose of either eletriptan 80 mg (n = 43; 74% female; mean age, 40 years), or placebo (n = 44; 82% female; mean age, 40 years). The primary outcome measure was the proportion of patients not developing moderate-to-severe headache within 6 h post-dose. There was no significant difference in the proportion of patients developing moderate-to-severe headache on eletriptan (61%) versus placebo (46%). Eletriptan was well tolerated and did not prolong the aura phase. Typical transient triptan adverse events were observed; most were mild-to-moderate in intensity. This study confirms the findings of two studies showing that triptans are ineffective but safe when given during the migraine aura phrase.     

Headache,migraine and cardiovascular risk factors: The HUNT study

Background: Migraine with aura (MA) has been found to be a risk factor for cardiovascular disease including ischaemic stroke and myocardial infarction. Studies have also reported a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting as to whether this is restricted to MA or also holds true for migraine without aura (MO). This study aims to examine the relation between headache and cardiovascular risk factors in a large cross‐sectional population‐based study. Methods: A total of 48 713 subjects (age ≥20 years) completed a headache questionnaire and were classified according to the headache status in the Nord‐Trøndelag Health Study in Norway 1995–1997 (HUNT 2). Framingham 10‐year risk for myocardial infarction and coronary death could be calculated for 44 098 (90.5%) of these. Parameters measured were blood pressure, body mass index, serum total and high‐density lipoprotein cholesterol. Results: Compared to controls, Framingham risk score was elevated in non‐migraine headache sufferers (OR 1.17, 95% CI 1.10–1.26), migraineurs without aura (OR 1.17, 95% CI 1.04–1.32) and most pronounced amongst migraineurs with aura (OR 1.54, 95% CI 1.21–1.95). Framingham risk score consistently increased with headache frequency. For non‐migrainous headache and MO, the increased risk was accounted for by the lifestyle factors smoking, high BMI and low physical activity, whilst such factors did not explain the elevated risk associated with MA. Conclusions: Both MA, MO and non‐migrainous headache are associated with an unfavourable cardiovascular risk profile, but different mechanisms seem to underlie the elevated risk in MA than in the other headache types.     

Visual evoked potential changes in migraine. Influence of migraine attack and aura

OBJECTIVE: To assess the visual evoked potential (VEP) changes in migraines with and without aura. STUDY DESIGN: A clinical study in which the VEP results of 45 migraineurs (study group) and 22 healthy volunteers (control group) were compared. Of 45 migraineurs, 29 had migraine with aura (MA) and 16 had migraine without aura (MOA), and they were examined both during and between the migraine attacks. METHODS: The patients and healthy controls underwent VEP assessment. On VEP recording, mono-ocular stimulation was performed by means of the pattern reversal check board. The latencies of N1, P1 and N2, and the N1--P1 amplitude were noted. The following comparisons were made between NI, P1 and N2 latencies and N1--P1 amplitudes of the migraine and control groups; during and between attack the VEP results of the patients with MA and MOA. RESULTS: The VEP results of the migraineurs and healthy controls were similar (P>0.05). The during attack results of MA, during and between attack results of MOA, and the results of the control group were also similar (P>0.05). N2 latency significantly elongated in patients with MA in the attack free period than it was during the attack (P=0.01), and was also longer than it was in the control group (P=0.01). CONCLUSIONS: There is involvement of the visual pathway in MA rather than MOA, and differentiation between these subtypes of the migraine disease may be performed on the basis of VEP findings manifesting by the prolongation of the N2 wave latency. This contention should be confirmed by further studies.     

Glyceryl trinitrate induced headache in migraineurs - relation to attack frequency.

Glyceryl trinitrate, a prodrug of nitric oxide, induces a mild to moderate headache in healthy subjects, whilst migraineurs develop a more severe headache, resembling spontaneous migraine attacks. In order to investigate whether this increased nitric oxide sensitivity depends upon the frequency of spontaneously occurring migraine attacks, intravenous infusion of glyceryl trinitrate (0.5 microg/kg/min) was given to 15 migraine patients with rare attacks (/=12 attacks/year) and 14 healthy subjects served as controls. No significant difference between the migraine groups for any of several parameters was detected, although the trend was always towards more headaches in frequent migraineurs. Both migraineurs with frequent and rare attacks experienced a headache that was significantly more severe, longer lasting, and fulfilled the diagnostic criteria for migraine without aura more often, compared to the healthy subjects (P = 0.0001). Conclusively, supersensitivity to glyceryl trinitrate in migraineurs seems to be related to a basic - probably genetically determined - pathophysiological mechanism involving nitric oxide, and not to the environmental influences, which to a large extent determine the expression of migraine.     

Interrelations between migraine and tension-type headache in the general population.

In a cross-sectional epidemiological survey of a general population, headache disorders were diagnosed according to a structured interview and a neurological examination using the criteria of the International Headache Society. The prevalences and sex distribution of the primary headache disorders were assessed, and characteristics of and interrelationships between different types of headache were analyzed. Severity and frequency of migraine attacks were not correlated, indicating that the migraine attack is an all-or-none phenomenon triggered with an individually variable threshold. Tension-type headache, in contrast, showed increasing severity with increasing frequency, indicating that it is a graded phenomenon. In the previous year, 6% had migraine without aura (previously called "common migraine") and 4% had migraine with aura (previously called "classic migraine"); 63% had episodic tension-type headache and 3% chronic tension-type headache. In women, migraine without aura was twice as prevalent as migraine with aura; in men, an opposite trend emerged. In migraine without aura, pain was more severe than in migraine with aura. Tension-type headache in migraineurs was not significantly more prevalent than in nonmigraineurs and, except for greater frequency and severity, it did not deviate nosographically from pure tension-type headache. Our results support the contention that migraine and tension-type headache are distinct entities, contradict the so-called continuum-severity model, and indicate that the terms combination headache, mixed headache, and interval headache should be avoided.     

Association of the T102C polymorphism of 5-HT2A receptor gene with aura in migraine

OBJECTIVE: To find out the significance of the 5-HT2A receptor gene polymorphism in migraine. Study design: A PCR study in which 61 migraineurs and 44 healthy controls were included. METHODS: The T102C polymorphism of the 5-HT2A receptor gene was studied. The results of the migraineurs and controls were compared. The relationship between the gene polymorphism and aura was also assessed. RESULTS: The representations of the 5-HT2A genotypes were similar in migraineurs and controls (p>0.05) as well as in the male and female migraineurs (p>0.05). The family history of migraine did not associate with 5-HT2A receptor gene polymorphism (p>0.05). There was a significant relationship between the presence of C/C genotype and migraine with aura (p=0.02) while C/T and T/T genotypes were over represented in the patients with migraine without aura (p<0.01). CONCLUSION: The T102C polymorphism of the 5-HT2A receptor gene is not directly related to the increased risk of migraine. The associations between the genotypes of this gene and aura may suggest that 5-HT2A receptor gene polymorphism may be involved in determining the subtypes of or accompanying symptoms in the migraine disease.