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Iser C, Arca K. Headache and Autonomic Dysfunction: a Review. Curr Neurol Neurosci Rep 2022; 22:625-634. [PMID: 35994191 DOI: 10.1007/s11910-022-01225-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW We explore the anatomy of the central and peripheral autonomic pathways involved in primary headache as well as the mechanisms for secondary headache associated with disorders of the autonomic nervous system. The prevalence and clinical presentation of cranial and systemic autonomic symptoms in these conditions will be discussed, with a focus on recent studies. RECENT FINDINGS Several small studies have utilized the relationship between headache and the autonomic nervous system to identify potential biomarkers to aid in diagnosis of migraine and cluster headache. Headache in postural orthostatic tachycardia syndrome (POTS) has also been further characterized, particularly in its association with orthostatic headache and spontaneous intracranial hypotension (SIH). This review examines the pathophysiology of primary and secondary headache disorders in the context of the autonomic nervous system. Mechanisms of headache associated with systemic autonomic disorders are also reviewed.
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Affiliation(s)
- Courtney Iser
- Department of Neurology, Mayo Clinic Scottsdale, Scottsdale, AZ, USA
| | - Karissa Arca
- Department of Neurology, Mayo Clinic Scottsdale, Scottsdale, AZ, USA.
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Konishi N, Kumagai H, Sawatari H, Hoshino T, Murase Y, Yamaguchi M, Urabe A, Kiyohara Y, Arita A, Baku M, Sasanabe R, Shiomi T. Efficacy of a Combination Therapy for Difficulties Waking Up in Non-School-Attending Students. J Clin Med 2022; 11:jcm11123271. [PMID: 35743342 PMCID: PMC9225467 DOI: 10.3390/jcm11123271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
School non-attendance due to difficulties waking up is increasing in Japan, and affected students are commonly diagnosed with orthostatic dysregulation (OD); however, OD-associated sleep problems are overlooked. To date, no sleep-medicine-based treatment for wake-up difficulties in non-school-attending students has been established. This study aimed to assess the efficacy of a novel combination therapy for these students. We assessed the combined effect of sleep hygiene guidance, low-dose aripiprazole administration (3 mg/day), and blue-light exposure on wake-up difficulty in 21 non-school-attending teenage patients. The patients were evaluated using sleep studies and questionnaires before and after treatment. The average subjective total sleep time calculated from sleep diaries before treatment in the patients was 10.3 h. The therapy improved wake-up difficulty by 85.7% and further improved school non-attendance by 66.7%. The subjective sleep time significantly decreased by 9.5 h after treatment (p = 0.0004). The self-rating Depression Scale and mental component summary of the 36-item Short-Form Health Survey significantly improved after treatment (p = 0.002 and p = 0.01, respectively). Wake-up difficulties were caused by the addition of a delayed sleep phase to the patients’ long sleep times. The novel combination therapy was effective in improving wake-up difficulty and mental quality of life in non-school-attending teenage students.
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Affiliation(s)
- Noriyuki Konishi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Hajime Kumagai
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Correspondence: ; Tel.: +81-82-257-1922
| | - Hiroyuki Sawatari
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Yoko Murase
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Maiko Yamaguchi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Ayako Urabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Yuka Kiyohara
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Aki Arita
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Masayo Baku
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Toshiaki Shiomi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
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