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Saliba M, Wilton A, Hagen K, Romanowicz M. A complex case of young child with ADHD, developmental delay who developed seronegative autoimmune encephalitis exacerbated by stimulants. Brain Behav Immun Health 2023; 34:100692. [PMID: 37842135 PMCID: PMC10569956 DOI: 10.1016/j.bbih.2023.100692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/07/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023] Open
Abstract
Autoimmune encephalitis (AE) is a group of disorders characterized by a wide clinical spectrum ranging from the typical limbic encephalitis to more complex neuropsychiatric symptoms including abnormal movements, psychosis, deficits in memory and cognition, dysautonomia, seizures, or coma. Psychiatric symptoms can occur early in the disease progress or manifest during its course. These symptoms are challenging and often slow down the diagnosis of AE. This is a crucial aspect considering that early diagnosis and management of AE are critical for a good outcome. However, there is a lack in studies outlining the exact symptomatology and specific appropriate care that would allow clinicians to achieve an early diagnosis and management. Additionally, AE in children mostly presents with neuropsychiatric symptoms and diagnosis is especially challenging in kids because of their limited capacity in describing their symptoms, the normal childhood behavioral changes and the possibility of a comorbid psychiatric diagnosis. We present a complex case of seronegative AE with comorbid ADHD (Attention Deficit Hyperactivity Disorder) and anxiety in a young six-year-old girl.
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Affiliation(s)
- M. Saliba
- Dept. of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - A. Wilton
- Dept. of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - K. Hagen
- Dept. of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - M. Romanowicz
- Dept. of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Leiva RA, Bergersen BM, Finbråten AK, Sandvei PK, Simonsen Ø, Rosseland CM, Hagen K, Young L, Roberts RS, Mikkelsen Y, Singh R, Lagging M, Dalgard O. High real-world effectiveness of 12-week elbasvir/grazoprevir without resistance testing in the treatment of patients with HCV genotype 1a infection in Norway. Scand J Gastroenterol 2023; 58:264-268. [PMID: 36063075 DOI: 10.1080/00365521.2022.2118555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS The recommended treatment duration of hepatitis C virus (HCV) genotype 1a (GT1a) infection with elbasvir/grazoprevir (EBR/GZR) in the presence of a high baseline viral load and resistance associated substitutions (RAS) is 16 weeks with ribavirin added. The objective of this study was to evaluate the real-world effectiveness of 12 weeks of EBR/GZR without ribavirin and regardless of baseline viral load and RAS testing. METHOD This retrospective, observational cohort study was performed at five Norwegian hospitals that did not systematically utilize RAS testing. All adult patients with chronic HCV GT1a and compensated liver disease who had received 12 weeks of EBR/GZR without ribavirin and baseline RAS testing, were included. The primary endpoint was sustained virologic response at week 12 (SVR12), or if not available, at week 4 (SVR4). RESULTS We included 433 patients and attained SVR data on 388. The mean age was 45.7 years (22-73 years). 67.2% were male. HIV co-infection was present in 3.8% (16/424) and cirrhosis in 4% (17/424). The viral load was >800 000 IU/mL in 55.0% (235/427) of patients. Overall SVR was achieved in 97.2% (377/388). SVR was achieved in 98.3% (169/172) of those with viral load ≤800 000 IU/mL and in 96.2% (202/210) of those with viral load >800 000 IU/mL. CONCLUSION We observed high SVR rates among patients with HCV GT1a infection treated with EBR/GZR for 12 weeks without ribavirin, with no regard to baseline viral load and no RAS testing.
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Affiliation(s)
- Rafael A Leiva
- Department of Infectious Diseases, Haukeland University Hospital, Bergen, Norway
| | - Bente M Bergersen
- Department of Infectious Diseases, Oslo University Hospital, Ullevål, Norway
| | - Ane-Kristine Finbråten
- Department of Infectious Diseases, Oslo University Hospital, Ullevål, Norway.,Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | | | - Øystein Simonsen
- Department of Infectious Diseases, Østfold Hospital, Kalnes, Norway
| | | | | | | | | | | | | | - Martin Lagging
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olav Dalgard
- Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway.,Institute for Clinical Medicine, University of Oslo, Oslo, Norway
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Daza JF, Cuthbertson BH, Myles PS, Shulman MA, Wijeysundera DN, Wijeysundera DN, Pearse RM, Myles PS, Abbott TEF, Shulman MA, Torres E, Ambosta A, Melo M, Mamdani M, Thorpe KE, Wallace S, Farrington C, Croal BL, Granton JT, Oh P, Thompson B, Hillis G, Beattie WS, Wijeysundera HC, Ellis M, Borg B, Kerridge RK, Douglas J, Brannan J, Pretto J, Godsall MG, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Kirabiyik Y, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter TW, Macklin S, Elliott A, Carrera AM, Terblanche NCS, Pitt S, Samuels J, Wilde C, Leslie K, MacCormick A, Bramley D, Southcott AM, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney CJL, Choi S, Somascanthan P, Flores K, Karkouti K, Clarke HA, Jerath A, McCluskey SA, Wasowicz M, Day L, Pazmino-Canizares J, Belliard R, Lee L, Dobson K, Stanbrook M, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, McAllister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G. Measurement properties of the WHO Disability Assessment Schedule 2.0 for evaluating functional status after inpatient surgery. Br J Surg 2022; 109:968-976. [PMID: 35929065 DOI: 10.1093/bjs/znac263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/17/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Expert recommendations propose the WHO Disability Assessment Schedule (WHODAS) 2.0 as a core outcome measure in surgical studies, yet data on its long-term measurement properties remain limited. These were evaluated in a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) prospective cohort. METHODS Participants were adults (40 years of age or older) who underwent inpatient non-cardiac surgery. The 12-item WHODAS and EQ-5DTM-3L questionnaires were administered preoperatively (in person) and 1 year postoperatively (by telephone). Responsiveness was characterized using standardized response means (SRMs) and correlation coefficients between change scores. Construct validity was evaluated using correlation coefficients between 1-year scores and comparisons of WHODAS scores across clinically relevant subgroups. RESULTS The analysis included 546 patients. There was moderate correlation between changes in WHODAS and various EQ-5DTM subscales. The strongest correlation was between changes in WHODAS and changes in the functional domains of the EQ-5D-3L-for example, mobility (Spearman's rho 0.40, 95 per cent confidence interval [c.i.] 0.32 to 0.48) and usual activities (rho 0.45, 95 per cent c.i. 0.30 to 0.52). When compared across quartiles of EQ-5D index change, median WHODAS scores followed expected patterns of change. In subgroups with expected functional status changes, the WHODAS SRMs ranged from 'small' to 'large' in the expected directions of change. At 1 year, the WHODAS demonstrated convergence with the EQ-5D-3L functional domains, and good discrimination between patients with expected differences in functional status. CONCLUSION The WHODAS questionnaire has construct validity and responsiveness as a measure of functional status at 1 year after major surgery.
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Affiliation(s)
- Julian F Daza
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Brian H Cuthbertson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Mark A Shulman
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Duminda N Wijeysundera
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada
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Arnheim-Dahlström L, Zarabi N, Hagen K, Bencina G. Parental acceptance and knowledge of varicella vaccination in relation to socioeconomics in Sweden: A cross-sectional study. PLoS One 2021; 16:e0256642. [PMID: 34673809 PMCID: PMC8530319 DOI: 10.1371/journal.pone.0256642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/11/2021] [Indexed: 11/18/2022] Open
Abstract
Varicella infection is a highly contagious disease which, whilst mild in most cases, can cause severe complications. Varicella vaccination is available privately in Sweden and is currently being reviewed for inclusion in the Swedish Public Health Agency's national immunisation program (NIP). A cross-sectional study of parents of Swedish children aged 1-8 years (n = 2212) was conducted to understand parental acceptance, beliefs and knowledge around varicella infection and vaccination. Respondents generally viewed varicella infection as a mild disease, with only a small proportion aware of potential severe complications. While 65% of respondents were aware of the vaccine, only 15% had started the course of vaccination as of February 2019. Further, 43% of parents did not intend to vaccinate, most commonly due to lack of inclusion in the NIP, but also due to perception of mild disease. Nevertheless, if offered within the NIP, 85% of parents would be highly likely to vaccinate their child. A number of statistically significant differences in awareness and behaviours were observed between sociodemographic subgroups. In general, women were more aware of vaccination (72%) compared to men (58%). Among unemployed or respondents with elementary school education, awareness was below 43%, and among respondents with high income the awareness was above 75%. Similarly, among unemployed or respondents with a low income the vaccination rate was as low as 30% compared with at least 57% among respondents with a high income. Respondents from metropolitan areas, those with university degrees and respondents with a higher income were more likely to be aware of the varicella vaccine and to have vaccinated their child. Whilst inclusion in the NIP is clearly the main driver for uptake, these identified knowledge gaps should inform educational efforts to ensure that all parents are informed of the availability and benefits of the varicella vaccine independent of socioeconomic status.
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Asselah T, Pol S, Hezode C, Loustaud-Ratti V, Leroy V, Ahmed SNS, Ozenne V, Bronowicki JP, Larrey D, Tran A, Alric L, Nguyen-Khac E, Robertson MN, Hanna GJ, Brown D, Asante-Appiah E, Su FH, Hwang P, Hall JD, Guidoum A, Hagen K, Haber BA, Talwani R, Serfaty L. Efficacy and safety of elbasvir/grazoprevir for 8 or 12 weeks for hepatitis C virus genotype 4 infection: A randomized study. Liver Int 2020; 40:1042-1051. [PMID: 31765046 DOI: 10.1111/liv.14313] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/11/2019] [Accepted: 11/18/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Hepatitis C virus (HCV) genotype (GT) 4 infection is prevalent in sub-Saharan Africa and the Middle East, particularly in Egypt. This study evaluated the safety and efficacy of elbasvir/grazoprevir administered for 8 and 12 weeks in participants with HCV GT4 infection. METHODS In this partially randomized, open-label multicentre study conducted in France (NCT03111108; Protocol MK5172-096), treatment-naive participants with GT4 infection and F0-F2 fibrosis were randomized 2:1 to elbasvir (50 mg)/grazoprevir (100 mg) for 8 or 12 weeks. Treatment-naive participants with F3-F4 fibrosis and all treatment-experienced participants (F0-F4) were assigned to elbasvir/grazoprevir for 12 weeks. The primary endpoint was sustained virologic response (SVR) 12 weeks after the end of therapy. RESULTS One hundred and seventeen participants were enrolled. Among treatment-naive participants with F0-F2 fibrosis, SVR was achieved by 94% (50/53) and 96% (26/27) of those receiving elbasvir/grazoprevir for 8 or 12 weeks, respectively, and four participants relapsed. In the 12-week arm, 95% (35/37) achieved SVR and two participants relapsed. NS5A resistance-associated substitutions were present at baseline and virologic failure in five of the participants with relapse. Drug-related adverse events occurred in 42% (n = 22) and 50% (n = 32) of participants receiving 8 and 12 weeks of treatment, respectively. No participant discontinued treatment owing to an adverse event. CONCLUSION These data confirm the efficacy of elbasvir/grazoprevir administered for 12 weeks in treatment-experienced individuals with HCV GT4 infection and those with advanced fibrosis. Treatment-naive individuals with mild fibrosis can be treated effectively with an 8-week regimen.
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Affiliation(s)
- Tarik Asselah
- Department of Hepatology and Gastroenterology, University Paris Diderot, Sorbonne Paris Cité, CRI, UMR 1149 INSERM, Paris, France.,Department of Hepatology, AP-HP Hôpital Beaujon, Clichy, France
| | - Stanislas Pol
- Department of Hepatology, APHP Hôpital Cochin/Université Paris Descartes/INSERM U1223, Institut Pasteur, Paris, France
| | - Christophe Hezode
- Department of Hepatology, Henri Mondor Hospital, APHP, University of Paris-Est, INSERM U955, Créteil, France
| | - Veronique Loustaud-Ratti
- Department of Hepatology and Gastroenterology, CHU de Limoges, U850 INSERM, Université Limoges, Limoges, France
| | | | - Si Nafa Si Ahmed
- Department of Hepatology and Gastroenterology, Pȏle de Recherche Clinique, Hôpital Saint Joseph, Marseille, France
| | - Violaine Ozenne
- Department of Hepatology and Gastroenterology, Hôpital Saint Antoine, Paris, France
| | | | - Dominique Larrey
- Department of Hepatology, Hôpital Saint Eloi, Ecole de Médecine de Montpellier, Montpellier, France
| | - Albert Tran
- Department of Gastroenterology, Université Côte d'Azur, Nice, France.,Centre Digestif, CHU de Nice, Nice, France.,INSERM, U1065, C3M, Team 8, Nice, France
| | - Laurent Alric
- Department of Internal Medicine/Gastroenterology, CHU de Toulouse, Toulouse, France
| | - Eric Nguyen-Khac
- Department of Hepatology and Gastroenterology, CHU de Amiens, Amiens, France
| | | | - George J Hanna
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Deborah Brown
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | | | - Feng-Hsiu Su
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Peggy Hwang
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | | | - Amir Guidoum
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Karin Hagen
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Barbara A Haber
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Rohit Talwani
- Department of Infectious Diseases, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Lawrence Serfaty
- Department of Hepatology, Hôpital de Hautepierre, Universitaires de Strasbourg, Strasbourg, France
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Hagen K, Hammer S, Frei S, Ortmann S, Głogowski R, Kreuzer M, Clauss M. Digestive physiology, resting metabolism and methane production of captive Indian crested porcupine ( Hystrix indica). J Anim Feed Sci 2019. [DOI: 10.22358/jafs/102741/2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Uhlig B, Hagen K, Engstrøm M, Stjern M, Gravdahl G, Sand T. The relationship between obstructive sleep apnea and insomnia: a population-based cross-sectional polysomnographic study. Sleep Med 2019; 54:126-133. [DOI: 10.1016/j.sleep.2018.10.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/21/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
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Shulman M, Cuthbertson B, Wijeysundera D, Pearse R, Thompson B, Torres E, Ambosta A, Wallace S, Farrington C, Myles P, Wallace S, Thompson B, Ellis M, Borg B, Kerridge R, Douglas J, Brannan J, Pretto J, Godsall M, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter T, Macklin S, Elliott A, Carrera A, Terblanche N, Pitt S, Samuels J, Wilde C, MacCormick A, Leslie K, Bramley D, Southcott A, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney C, Choi S, Somascanthan P, Flores K, Beattie W, Karkouti K, Clarke H, Jerath A, McCluskey S, Wasowicz M, Granton J, Day L, Pazmino-Canizares J, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, Mcallister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G, Melo M, Mamdani M, Hillis G, Wijeysundera H. Using the 6-minute walk test to predict disability-free survival after major surgery. Br J Anaesth 2019; 122:111-119. [DOI: 10.1016/j.bja.2018.08.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/13/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022] Open
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Zwerenz R, Becker J, Knickenberg RJ, Siepmann M, Hagen K, Beutel ME. Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach. Psychother Psychosom 2018; 86:341-350. [PMID: 29131090 DOI: 10.1159/000481177] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/30/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. METHODS A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online information on depression) in addition to inpatient psychodynamic psychotherapy. Both groups had access to their respective experimental intervention for 12 weeks, regardless of inpatient treatment duration. Reduction of depressive symptoms, as measured with the Beck Depression Inventory-II, was the primary outcome at the end of the intervention (T2). RESULTS Depressive symptoms were statistically significantly lower in the IG compared to the active CG at T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d = 0.38) at discharge from inpatient treatment (T1). No statistically significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. CONCLUSIONS This is the first evidence for blended treatment combining online self-help with inpatient psychotherapy. The study opens new and promising avenues for increasing the efficacy of inpatient psychotherapy. Future studies should determine how integration of online self-help into the therapeutic process can be developed further.
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Affiliation(s)
- Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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Johnsen MB, Winsvold BS, Børte S, Vie GÅ, Pedersen LM, Storheim K, Skorpen F, Hagen K, Bjørngaard JH, Åsvold BO, Zwart JA. The causal role of smoking on the risk of headache. A Mendelian randomization analysis in the HUNT study. Eur J Neurol 2018; 25:1148-e102. [PMID: 29747220 DOI: 10.1111/ene.13675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Headache has been associated with various lifestyle and psychosocial factors, one of which is smoking. The aim of the present study was to investigate whether the association between smoking intensity and headache is likely to be causal. METHOD A total of 58 316 participants from the Nord-Trøndelag Health (HUNT) study with information on headache status were genotyped for the rs1051730 C>T single-nucleotide polymorphism (SNP). The SNP was used as an instrument for smoking intensity in a Mendelian randomization analysis. The association between rs1051730 T alleles and headache was estimated by odds ratios with 95% confidence intervals. Additionally, the association between the SNP and migraine or non-migrainous headache versus no headache was investigated. All analyses were adjusted for age and sex. RESULTS There was no strong evidence that the rs1051730 T allele was associated with headache in ever smokers (odds ratio 0.99, 95% confidence interval 0.95-1.02). Similarly, there was no association between the rs1051730 T allele and migraine or non-migrainous headache versus no headache. CONCLUSION The findings from this study do not support that there is a strong causal relationship between smoking intensity and any type of headache. Larger Mendelian randomization studies are required to examine whether higher smoking quantity can lead to a moderate increase in the risk of headache subtypes.
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Affiliation(s)
- M B Johnsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - B S Winsvold
- Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - S Børte
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
| | - G Å Vie
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - L M Pedersen
- Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
| | - K Storheim
- Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
| | - F Skorpen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - K Hagen
- Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian Advisory Unit on Headaches, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - J H Bjørngaard
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Forensic Department and Research Centre Brøset, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - B O Åsvold
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - J A Zwart
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
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Uhlig BL, Sand T, Nilsen TI, Mork PJ, Hagen K. Insomnia and risk of chronic musculoskeletal complaints: longitudinal data from the HUNT study, Norway. BMC Musculoskelet Disord 2018; 19:128. [PMID: 29699540 PMCID: PMC5921548 DOI: 10.1186/s12891-018-2035-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 04/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the prospective association between insomnia and risk of chronic musculoskeletal complaints (CMSC) and chronic widespread musculoskeletal complaints (CWMSC). A second aim was to evaluate the association between insomnia and number of body regions with CMSC at follow-up. METHODS We used data from the second (HUNT2, 1995-1997) and third (HUNT3, 2006-2008) wave of the Nord-Trøndelag Health Study (the HUNT Study). The population-at-risk included 13,429 people aged 20-70 years who reported no CMSC at baseline in HUNT2 and who answered the questionnaires on insomnia in HUNT2 and CMSC in HUNT3. Insomnia was defined according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) with minor modification, whereas CMSC was assessed for nine different body regions. CWMSC was defined according to the 1990 criteria by the American College of Rheumatology. We used Poisson regression to estimate adjusted risk ratios (RRs) for CMSC and CWMSC at 11 years follow-up. Precision of the estimates was assessed by a 95% confidence interval (CIs). RESULTS Insomnia at baseline was associated with increased risk of any CMSC (RR 1.16, 95% CI 1.03-1.32) and CWMSC (RR 1.58, 95% CI 1.26-1.98) at follow-up. RR for CMSC for specific body regions ranged from 1.34 (95% CI 1.05-1.73) for the knees and 1.34 (1.10-1.63) for the neck to 1.60 (95% CI 1.19-2.14) for the ankles/ft. Further, insomnia was associated with increased risk of CMSC in 3-4 regions (RR 1.36, 95% CI 1.05-1.77), and 5 or more regions (RR 1.93, 95% CI 1.40-2.66), but not 1-2 regions (RR 0.99, 95% CI 0.80-1.24). CONCLUSIONS Insomnia is associated with increased risk of CMSC, CWMSC, and CMSC located in 3 or more body regions.
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Affiliation(s)
- B L Uhlig
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), PB 8905, MTFS, N-7489, Trondheim, Norway.
| | - T Sand
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), PB 8905, MTFS, N-7489, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, N-7006, Trondheim, Norway
| | - T I Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, N-7006, Trondheim, Norway
| | - P J Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway
| | - K Hagen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), PB 8905, MTFS, N-7489, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, N-7006, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St. Olavs Hospital, N-7006, Trondheim, Norway
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12
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Abstract
The aim of this large, cross-sectional, population-based study was to examine the association between sick leave and headache. Between 1995 and 1997, all 92 566 adults in Nord-Tr⊘ndelag County in Norway were invited to participate in a health survey. Out of 73 327 invited individuals <67 years old, a total of 38 192 (52±) responded to questions about headache, work situation and sick leave during the past year. Associations between sick leave, headache and migraine included were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95± confidence intervals (CIs). There was an increasing prevalence of sick leave with increasing frequency of migraine and non-migrainous headache. The prevalence of sick leave >8 weeks during the past year was more than three times higher among individuals with headache >14 days per month (20±) compared with those without headache (6±). The results may indicate that better treatment of individuals with chronic headache may have beneficial economic implications.
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Affiliation(s)
- I Fiane
- Department of Clinical Neuroscience, Section of Neurology, Norwegian University of Science and Technology, Trondheim, Norway
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13
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Abstract
The number of epidemiological headache studies is rapidly increasing, and has accentuated the need to improve the quality of the way studies are performed and how results are interpreted. The aims of this review were to summarize the main findings from the Head-HUNT study, to describe strengths and limitations of the Head-HUNT approach and to discuss the significance of some of our findings. Head-HUNT included a large sample size of 51 383 participants that gave the opportunity to make analyses also of relatively rare conditions. The wide range of health-related information made it possible to adjust for many potential confounding variables. Blood samples for future genetic headache studies are available for a non-selected large group of individuals. The data show that among several factors that have been evaluated, age and gender were the two most clearly related to migraine, whereas analgesic overuse and the presence of some comorbid conditions were most strongly associated with the prevalence of chronic headache. Interesting relationships to blood pressure and thyroidstimulating hormone levels were also found. Methodological problems in headache epidemiological studies are discussed and, in particular, problems with causal inferences. Despite the limitations of the head-HUNT study, we believe that the results so far have provided clues to causes and preventive factors of headache that should be explored in other populations and in prospective studies.
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Affiliation(s)
- K Hagen
- Department of Clinical Neuroscience, Faculty of medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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14
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Abstract
As clinic-based studies show an association between headache and both high and low levels of haemoglobin, we analysed this relationship in a population-based cross-sectional study (the HUNT Study). A total of 2385 women aged 20-55 years responded to a headache questionnaire and gave blood samples for measuring haemoglobin and ferritin. In the multivariate analyses, adjusting for age and education, there was a linear trend of decreasing prevalence of headache ( P = 0.02) and migraine ( P = 0.01) with decreasing haemoglobin. In particular, migraine was less likely among women with low haemoglobin (values < 11.5 g/dl) (odds ratio 0.4, confidence interval 0.2, 0.9). There was no correlation between headache prevalence and ferritin. The present findings may be relevant for the headache reported in polycythaemia and chronic altitude sickness.
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Affiliation(s)
- A H Aamodt
- Norwegian National Headache Centre, Trondheim University Hospital, Trondheim, Norway.
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15
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Uglem M, Omland P, Engstrøm M, Gravdahl G, Linde M, Hagen K, Sand T. Non-invasive cortical modulation of experimental pain in migraine. Clin Neurophysiol 2016; 127:2362-9. [DOI: 10.1016/j.clinph.2016.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/10/2016] [Accepted: 03/12/2016] [Indexed: 11/29/2022]
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16
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Metzger F, Hagen K, Kroczek A, Polak T, Ehlis AC, Fallgatter A. V43. Vagus somatosensory evoked potentials in elderly: A potential risk marker for neurodegeneration and its relation to Subjective Memory Impairment. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Kvalheim S, Sandvik L, Winsvold B, Hagen K, Zwart JA. Early menarche and chronic widespread musculoskeletal complaints--Results from the HUNT study. Eur J Pain 2015; 20:458-64. [PMID: 26132558 DOI: 10.1002/ejp.747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a predominance of chronic widespread musculoskeletal complaints (WMSC) among women. Previous studies suggest an association between hormonal factors and pain. However, it is not known whether earlier age at menarche is associated with higher prevalence of chronic WMSC. The aim of this study was to investigate the association between age at menarche and chronic WMSC. METHODS Data from a cross-sectional study of inhabitants ≥20 years in Nord-Trøndelag County (Helseundersøkelsen i Nord-Trøndelag -HUNT), conducted in 1995-1997 (HUNT 2) were used. The study population comprised 32,673 women with valid information of age at menarche (exposure) and chronic WMSC (outcome data). RESULTS In total, 8986 (27.5%) women reported WMSC. The overall prevalence of WMSC was 29.7% among those with menarche ≤12 years and 26.7% among those with menarche >12 years. The prevalence of chronic WMSC was consistently higher for those with early age at menarche in all age groups. The crude odds ratio for chronic WMSC, when comparing women with age at menarche ≤12 years to women with age at menarche >12 years, was 1.16 (95% CI: 1.10-1.22). The corresponding odds ratio was 1.26 (95% CI: 1.19-1.34) when adjusted for age, education, body mass index (BMI), smoking, alcohol consumption, depression, systolic blood pressure (SBP) and parity. CONCLUSION In this cross-sectional study, there was an association between early age at menarche and chronic WMSC later in life, but the difference in absolute risk was low (3%).
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Affiliation(s)
- S Kvalheim
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
| | - L Sandvik
- Department of Biostatistics, Oslo University Hospital, Oslo, Norway
| | - B Winsvold
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
| | - K Hagen
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian National Headache Centre, Section of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - J-A Zwart
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
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Zwerenz R, Becker J, Knickenberg RJ, Hagen K, Dreier M, Wölfling K, Beutel ME. Enhancing inpatient psychotherapeutic treatment with online self-help: study protocol for a randomized controlled trial. Trials 2015; 16:98. [PMID: 25872505 PMCID: PMC4376072 DOI: 10.1186/s13063-015-0620-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is one of the most debilitating and costly mental disorders. There is increasing evidence for the efficacy of online self-help in alleviating depression. Knowledge regarding the options of combining online self-help with inpatient psychotherapy is still limited. Therefore, we plan to evaluate an evidence-based self-help program (deprexis®; Gaia AG, Hamburg, Germany) to improve the efficacy of inpatient psychotherapy and to maintain treatment effects in the aftercare period. METHODS/DESIGN Depressed patients (n = 240) with private internet access aged between 18 and 65 are recruited during psychosomatic inpatient treatment. Participants are randomized to an intervention or control group at the beginning of inpatient treatment. The intervention group (n = 120) is offered an online self-help program with 12 weekly tasks, beginning during the inpatient treatment. The control group (n = 120) obtains access to an online platform with weekly updated information on depression for the same duration. Assessments are conducted at the beginning (T0) and the end of inpatient treatment (T1), at the end of intervention (T2) and 6 months after randomization (T3). The primary outcome is the depression score measured by the Beck Depression Inventory-II at T2. Secondary outcome measures include anxiety, self-esteem, quality of life, dysfunctional cognitions and work ability. DISCUSSION We expect the intervention group to benefit from additional online self-help during inpatient psychotherapy and to maintain the benefits during follow-up. This could be an important approach to develop future concepts of inpatient psychotherapy. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02196896 (registered on 16 July 2014).
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Affiliation(s)
- Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Jan Becker
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Rudolf J Knickenberg
- Clinic for Psychosomatic Rehabilitation, Rhön-Klinikum AG, Salzburger Leite 1, 97616 Bad, Neustadt/Saale, Germany.
| | - Karin Hagen
- Clinic for Psychosomatic Rehabilitation, Rhön-Klinikum AG, Salzburger Leite 1, 97616 Bad, Neustadt/Saale, Germany.
| | - Michael Dreier
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Klaus Wölfling
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
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19
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Husøy AK, Honningsvåg LM, Håberg AK, Hagen K, Linde M, Gårseth M, Stovner LJ. EHMTI-0148. Perivascular spaces and headache: a population-based imaging study (MRI HUNT). J Headache Pain 2014. [PMCID: PMC4182254 DOI: 10.1186/1129-2377-15-s1-f12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Fagernaes CF, Heuch I, Zwart JA, Winsvold BS, Linde M, Hagen K. Blood pressure as a risk factor for headache and migraine: a prospective population-based study. Eur J Neurol 2014; 22:156-62, e10-1. [DOI: 10.1111/ene.12547] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/02/2014] [Indexed: 01/15/2023]
Affiliation(s)
- C. F. Fagernaes
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
| | - I. Heuch
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
| | - J.-A. Zwart
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - B. S. Winsvold
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - M. Linde
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St Olavs University Hospital; Trondheim Norway
| | - K. Hagen
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St Olavs University Hospital; Trondheim Norway
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21
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Engstrøm M, Hagen K, Bjørk MH, Stovner LJ, Sand T. Sleep quality and arousal in migraine and tension-type headache: the headache-sleep study. Acta Neurol Scand 2014:47-54. [PMID: 24588507 DOI: 10.1111/ane.12237] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2013] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The present paper summarizes and compares data from our studies on subjective and objective sleep quality and pain thresholds in tension-type headache (TTH), migraine, and controls. MATERIAL AND METHODS In a blinded controlled explorative study, we recorded polysomnography (PSG) and pressure, heat, and cold pain thresholds in 34 controls, 20 TTH, and 53 migraine patients. Sleep quality was assessed by questionnaires, sleep diaries, and PSG. Migraineurs who had their recordings more than 2 days from an attack were classified as interictal while the rest were classified as either preictal or postictal. Interictal migraineurs (n=33) were also divided into two groups if their headache onsets mainly were during sleep and awakening (sleep migraine, SM), or during daytime and no regular onset pattern (non-sleep migraine, NSM). TTH patients were divided into a chronic or episodic group according to headache days per month. RESULTS Compared to controls, all headache groups reported more anxiety and sleep-related symptoms. TTH and NSM patients reported more daytime tiredness and tended to have lower pain thresholds. Despite normal sleep times in diary, TTH and NSM had increased slow-wave sleep as seen after sleep deprivation. Migraineurs in the preictal phase had shorter latency to sleep onset than controls. Except for a slight but significantly increased awakening index SM, patients differed little from controls in objective measurements. CONCLUSIONS We hypothesize that TTH and NSM patients on the average need more sleep than healthy controls. SM patients seem more susceptible to sleep disturbances. Inadequate rest might be an attack-precipitating- and hyperalgesia-inducing factor.
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Affiliation(s)
- M. Engstrøm
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Department of Neurology and Clinical Neurophysiology; St. Olavs Hospital; Trondheim Norway
| | - K. Hagen
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St. Olavs Hospital; Trondheim Norway
| | - M. H. Bjørk
- Department of Neurology; Haukeland University Hospital; Bergen Norway
- Department of Clinical Medicine; University of Bergen; Bergen Norway
| | - L. J. Stovner
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St. Olavs Hospital; Trondheim Norway
| | - T. Sand
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Department of Neurology and Clinical Neurophysiology; St. Olavs Hospital; Trondheim Norway
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22
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Hagen K, Clauss M, Hatt JM. Drinking preferences in chinchillas (Chinchilla laniger
), degus (Octodon degu
) and guinea pigs (Cavia porcellus
). J Anim Physiol Anim Nutr (Berl) 2014; 98:942-7. [DOI: 10.1111/jpn.12164] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 12/09/2013] [Indexed: 12/28/2022]
Affiliation(s)
- K. Hagen
- Clinic for Zoo Animals; Exotic Pets and Wildlife; Vetsuisse Faculty; University of Zurich; Winterthurerstr Zurich Switzerland
| | - M. Clauss
- Clinic for Zoo Animals; Exotic Pets and Wildlife; Vetsuisse Faculty; University of Zurich; Winterthurerstr Zurich Switzerland
| | - J.-M. Hatt
- Clinic for Zoo Animals; Exotic Pets and Wildlife; Vetsuisse Faculty; University of Zurich; Winterthurerstr Zurich Switzerland
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23
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Engstrøm M, Hagen K, Bjørk M, Stovner LJ, Stjern M, Sand T. Sleep quality, arousal and pain thresholds in tension-type headache: a blinded controlled polysomnographic study. Cephalalgia 2013; 34:455-63. [PMID: 24366979 DOI: 10.1177/0333102413515339] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION We aimed to compare subjective and objective sleep quality in tension-type headache (TTH) patients and to evaluate the relationship between sleep quality and pain thresholds (PT) in controls and TTH patients. METHODS A blinded cross-sectional study where polysomnography (PSG) and PT (to pressure, heat and cold) measurements were done in 20 patients with TTH (eight episodic (ETTH) and twelve chronic (CTTH) TTH) and 29 healthy controls. Sleep diaries and questionnaires were applied. RESULTS TTH patients had more anxiety ( P = 0.001), insomnia ( P < 0.0005), daytime tiredness ( P < 0.0005) and reduced subjective sleep quality ( P < 0.0005) compared to healthy controls. Sleep diaries revealed more long awakenings in TTH ( P = 0.01) but no total sleep-time differences. TTH patients had more slow-wave sleep ( P = 0.002) and less fast arousals ( P = 0.004) in their PSGs. CTTH subjects had lower pressure PT ( P = 0.048) and more daytime sleepiness than the controls ( P = 0.039). Among TTH lower cold PT (CPT) correlated inversely with light sleep (N1) ( R = -0.49, P = 0.003) while slow arousals correlated inversely with headache-frequency ( R = -0.64, P = 0.003). CONCLUSIONS We hypothesize that TTH patients need more sleep than healthy controls and might be relatively sleep deprived. Inadequate sleep may also contribute to increased pain sensitivity and headache frequency in TTH.
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Affiliation(s)
- M Engstrøm
- Department of Neuroscience; Norwegian University of Science and Technology, Norway
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24
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Nilsson H, Blomqvist L, Douglas L, Nordell A, Jacobsson H, Hagen K, Bergquist A, Jonas E. Dynamic gadoxetate-enhanced MRI for the assessment of total and segmental liver function and volume in primary sclerosing cholangitis. J Magn Reson Imaging 2013; 39:879-86. [PMID: 24123427 DOI: 10.1002/jmri.24250] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 05/09/2013] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To evaluate dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) for the assessment of global and segmental liver volume and function in patients with primary sclerosing cholangitis (PSC), and to explore the heterogeneous distribution of liver function in this patient group. MATERIALS AND METHODS Twelve patients with primary sclerosing cholangitis (PSC) and 20 healthy volunteers were examined using DHCE-MRI with Gd-EOB-DTPA. Segmental and total liver volume were calculated, and functional parameters (hepatic extraction fraction [HEF], input relative blood-flow [irBF], and mean transit time [MTT]) were calculated in each liver voxel using deconvolutional analysis. In each study subject, and incongruence score (IS) was constructed to describe the mismatch between segmental function and volume. Among patients, the liver function parameters were correlated to bile duct obstruction and to established scoring models for liver disease. RESULTS Liver function was significantly more heterogeneously distributed in the patient group (IS 1.0 versus 0.4). There were significant correlations between biliary obstruction and segmental functional parameters (HEF rho -0.24; irBF rho -0.45), and the Mayo risk score correlated significantly with the total liver extraction capacity of Gd-EOB-DTPA (rho -0.85). CONCLUSION The study demonstrates a new method to quantify total and segmental liver function using DHCE-MRI in patients with PSC.
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Affiliation(s)
- Henrik Nilsson
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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25
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Heuch I, Heuch I, Hagen K, Zwart J. Does high blood pressure reduce the risk of chronic low back pain? The Nord-Trøndelag Health Study. Eur J Pain 2013; 18:590-8. [DOI: 10.1002/j.1532-2149.2013.00398.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2013] [Indexed: 01/02/2023]
Affiliation(s)
- I. Heuch
- Department of Neurology and FORMI; Oslo University Hospital; Norway
| | - I. Heuch
- Department of Mathematics; University of Bergen; Norway
| | - K. Hagen
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; Department of Neurology; St. Olavs Hospital; Trondheim Norway
| | - J.A. Zwart
- Department of Neurology and FORMI; Oslo University Hospital; Norway
- Faculty of Medicine; University of Oslo; Norway
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Hagen K, Linde M, Steiner TJ, Zwart JA, Stovner LJ. Risk factors for MOH and chronic daily headache: an 11-year follow-up study. The Nord-Trøndelag Health Studies (HUNT). J Headache Pain 2013. [PMCID: PMC3620052 DOI: 10.1186/1129-2377-14-s1-p13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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27
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Stovner LJ, Hagen K, Linde M, Steiner TJ, Zwart JA. The relationship between headache and chronic musculoskeletal complaints: an 11-year follow-up in the The Nord-Trøndelag Health Study (HUNT). J Headache Pain 2013. [PMCID: PMC3620002 DOI: 10.1186/1129-2377-14-s1-p12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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28
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Linde M, Langnes HA, Hagen K, Bergh K, Stovner LJ. No increase in headache after previous intracranial infections: a historical cohort study (The Nord-Trøndelag Health Survey). J Headache Pain 2013. [PMCID: PMC3620365 DOI: 10.1186/1129-2377-14-s1-p148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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29
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Linde M, Langnes HA, Hagen K, Bergh K, Stovner LJ. No increase in headache after previous intracranial infections: a historical cohort study (The Nord-Trøndelag Health Survey). J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-p148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kjeken I, Bø I, Rønningen A, Spada C, Mowinckel P, Hagen K, Dagfinrud H. A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: Randomized controlled trial. J Rehabil Med 2013; 45:260-7. [DOI: 10.2340/16501977-1078] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Stovner LJ, Hagen K, Linde M, Steiner TJ, Zwart JA. The relationship between headache and chronic musculoskeletal complaints: an 11-year follow-up in the The Nord-Trøndelag Health Study (HUNT). J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-p12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hagen K, Linde M, Steiner TJ, Zwart JA, Stovner LJ. The bidirectional relationship between headache and chronic musculoskeletal complaints: an 11-year follow-up in the Nord-Trøndelag Health Study (HUNT). Eur J Neurol 2012; 19:1447-54. [PMID: 22519547 DOI: 10.1111/j.1468-1331.2012.03725.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 03/13/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Chronic daily headache (CDH) and chronic musculoskeletal complaints (CMSCs) are associated disorders, but whether there is a causal relationship between them is unclear. OBJECTIVE To determine whether CMSCs are associated with the subsequent development of CDH and vice versa. METHODS This longitudinal population-based cohort study used data from two consecutive surveys in the Nord-Trøndelag Health Study (HUNT 2 and 3) performed in 1995-1997 and 2006-2008. Amongst the 51 383 participants aged ≥ 20 years at baseline, 41 766 were eligible approximately 11 years later. Of these, 26 197 (63%) completed the questions regarding headache and CMSCs in HUNT 3. RESULTS A bidirectional relationship was found between headache and CMSCs. In the multivariate analyses adjusting for known potential confounders, a nearly two fold risk (OR 1.8; 95% CI 1.5-2.3) for developing CDH was found for those with CMSCs at baseline. Vice versa, a similarly elevated risk of CMSCs (OR 1.8; 95% CI 1.2-2.6), and even higher risk of chronic widespread MSCs (OR 2.7; 95% CI 1.6-4.7), was found at follow-up amongst those with CDH at baseline. CONCLUSION CMSCs predispose to CDH and CDH predisposes to CMSCs 11 years later. This may have relevance to understanding the pathophysiology of these disorders. CMSCs should be treated not only to relieve them but also to prevent the development of CDH, and vice versa.
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Affiliation(s)
- K Hagen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
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Abstract
BACKGROUND Recent scientific data support an effect of botulinum neurotoxin (BoNT) on pain and headache. OBJECTIVE We sought to conduct a systematic review of BoNT in the secondary headaches and cranial neuralgias. METHODS MEDLINE, EMBASE, Cochrane, ClinicalTrials.gov and reference lists were searched up to December 2010 to identify all relevant publications. RESULTS Only two papers were rated as highest evidence (Level 1). The absolute majority (30/38, 79%) of identified publications yield only low evidence (Level 4). DISCUSSION No treatment recommendations of Grade A or Grade B can be made based on available research. Grade C treatment recommendations in support of BoNT can be made for chronic headache attributed to whiplash injury, cephalalgic alopecia areata, headache and facial pain in blepharospasm, trigeminal neuralgia, occipital neuralgia and nummular headache. As a result of studies being troublingly inconsistent or inconclusive, only the weakest rank of recommendations (Grade D) can be made for using BoNT in medication overuse headache, cervicogenic headache, headache attributed to craniocervical dystonia, pain in masticatory hyperactivity and headache or facial pain attributed to temporomandibular disorder. CONCLUSION At present, BoNT cannot be firmly recommended as an evidence-based treatment in secondary headaches or cranial neuralgias.
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Affiliation(s)
- M Linde
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
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Mann E, Hagen K, Gerber B. Die vaginale Entbindungsrate und das fetale Outcome in Abhängigkeit von der Länge der Austreibungsperiode (AP). Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Linde M, Langnes HA, Hagen K, Bergh K, Stovner LJ. No increase in headache after previous intracranial infections: a historical cohort study (HUNT). Eur J Neurol 2011; 19:324-31. [PMID: 21951375 DOI: 10.1111/j.1468-1331.2011.03525.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Despite the absence of robust scientific evidence, it is today generally accepted that the acute headache typical for intracranial infections can develop into permanent headache complaints. This widespread concept was explored in the first, large, longitudinal, population-based study. METHODS Data on confirmed exposure to intracranial infections amongst all adult inhabitants in a geographical area during a 20-year period were assembled from hospital records. Surviving individuals were later invited to the third Nord-Trøndelag Health Survey (HUNT 3), where 39,690 (42%) of 94,194 invited inhabitants aged ≥20 years responded to a validated headache questionnaire. Using logistic regression, the 1-year prevalence of headache and its subtypes according to the diagnostic criteria of the International Headache Society was assessed and compared between those with and without previous confirmed intracranial infection. Age and sex were used as covariates. RESULTS Overall, 43 participants were identified with earlier intracranial infection, whereof three had more than one infection: bacterial meningitis (n=19), lymphocytic meningitis (n=18), encephalitis (n=9), and brain abscess (n=1).The mean interval from infection to participation in HUNT 3 was 11.2 (range 1.5-19.7) years. There was no significant increase in the prevalence of headache (OR 1.10, 95% CI 0.58-2.07), its subtypes (migraine, or tension-type headache), or chronic daily headache (OR 1.85, 95% CI 0.45-7.68) amongst participants with previous intracranial infection compared with the surrounding population. CONCLUSIONS This study challenges the existence of chronic post-bacterial meningitis headache and does not indicate the presence of other long-term headaches induced by intracranial infection.
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Affiliation(s)
- M Linde
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
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Bjørk M, Stovner LJ, Hagen K, Sand T. What initiates a migraine attack? Conclusions from four longitudinal studies of quantitative EEG and steady-state visual-evoked potentials in migraineurs. Acta Neurol Scand 2011:56-63. [PMID: 21711258 DOI: 10.1111/j.1600-0404.2011.01545.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Quantitative electroencephalograpic (QEEG) frequency spectra and steady-state visual-evoked potentials (SSVEP) are indicators of corticothalamic excitability (e.g., arousal). Increased interictal excitability is suggested to be an important element in the migraine pathophysiology. In this paper, we summarize our results from four studies of QEEG and SSVEP recordings in migraineurs interictally and in the days before an attack with the intention to shed light on attack-initiating mechanisms. MATERIAL AND METHODS Thirty-two healthy controls, 33 migraineurs without and eight with aura each had three EEGs with photic stimulation on different days. Using the patient headache diaries, we classified the recordings as interictal, preictal, ictal, or post-ictal retrospectively. Interictal recordings were compared pairwise with attack-related EEGs from the same patient as well as with control EEGs. We also correlated clinical variables with the QEEG and SSVEP data. RESULTS Between attacks, we found increased relative theta activity and attenuated medium-frequency photic responses in migraineurs without aura compared with those in controls. Within 36 h before the attack, slow and asymmetric EEG activity developed. Increased trigger sensitivity and photophobia correlated with higher theta power and depressed photic responses. Attack duration, migraine history duration, and pain intensity were associated with EEG slowing. CONCLUSIONS A general tendency toward EEG slowing and depression of photic responses characterized the migraine group. This pattern was also related to increased severity of symptoms. A change in cortical activity occurred within 36 h before attacks. Our results indicate that thalamocortical hypoexcitability is associated with attack initiation and sensory hypersensitivity in migraine.
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Affiliation(s)
- M Bjørk
- Department of Neuroscience, Norwegian University of Science and Technology, Olav Kyrresgate 9, Trondheim, Norway.
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Abstract
BACKGROUND Different opinions exist regarding the optimal treatment of patients with medication-overuse headache (MOH). Few studies have evaluated the long-term prognosis among these patients, and there are no standard measures of outcome in such studies. AIM To summarize the 1- and 4-year outcome of patients with MOH previously included in a randomized follow-up study. MATERIAL AND METHODS Sixty-one patients with MOH were randomly assigned to receive either preventive treatment from day 1 without detoxification, a standard out patient detoxification program without preventive treatment from day 1, or no specific treatment. Sixty patients still alive were invited to a 4-year follow-up, whereof 50 (83%) participated. RESULTS Early introduction of preventive treatment effectively reduced headache days and in particular headache suffering both during the first months and at 12-month follow-up. At 4-year follow-up, 16 persons (32%) were considered as responders (i.e. ≥50% reduction in headache frequency from baseline), whereas 17 persons (34%) met the criteria for MOH. None of the baseline characteristics consistently influenced all five outcome measures. DISCUSSION Early introduction of prophylactic medication was an effective way to reduce headache days during the first 3 months, and the notion that patients with MOH need withdrawal of analgesics to respond to preventive medication seems to be incorrect. The long-term prognosis during the 4-year follow-up was relatively favorable as there was a steady decline in headache, one-third of the patients with MOH having ≥50% reduction in headache frequency from baseline and two-thirds being without medication overuse.
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Affiliation(s)
- K Hagen
- Department of Neuroscience; Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Laurell K, Artto V, Bendtsen L, Hagen K, Kallela M, Meyer EL, Putaala J, Tronvik E, Zwart JA, Linde M. Migrainous infarction: a Nordic multicenter study. Eur J Neurol 2011; 18:1220-6. [PMID: 21414105 DOI: 10.1111/j.1468-1331.2011.03364.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Migrainous infarction (MI), i.e., an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included <10 cases which make conclusions less valid. This study aimed to describe characteristics and outcome of MI in a larger sample. METHODS We analyzed demographic data, risk factors, migraine medication, stroke localization, symptoms, and outcome in a sample of 33 patients with MI according to second edition of the ICHD criteria collected from seven Nordic headache clinics. RESULTS Amongst 33 patients with MI, there were 20 (61%) women and 13 (39%) men with the median age for stroke of 39 (range 19-76) years. Traditional risk factors for stroke were rare compared with Scandinavian young ischemic stroke populations. During the acute phase, 12 (36%) patients used ergotamines or triptans. Stroke was located in the posterior circulation in 27 (82%) patients and cerebellum was involved in 7 (21%). Except in two patients with brainstem infarctions, the outcome was favorable with total recovery or limited residual symptoms. CONCLUSIONS The prevalence of traditional risk factors was low and the infarctions were predominantly located in posterior circulation territory, supporting theories of migraine specific mechanisms. The outcome was in general favorable.
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Affiliation(s)
- K Laurell
- Department of Neuroscience, Neurology, Uppsala University Hospital, Uppsala, Sweden. mail:
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Abstract
Vitamin B12 is stored in hepatocytes and inhibits hepatitis C virus (HCV) RNA translation. The implication of B12 in the setting of antiviral treatment is unknown. This study aims to retrospectively evaluate the discriminative efficacy of pretreatment B12 serum levels (s-B12) on end-of-treatment response (ETR) in patients with chronic HCV. Ninety-nine treatment naïve HCV patients, treated with interferon and ribavirin were studied. Serum B12 (s-B12) was analysed in samples collected before treatment start. Pretreatment s-B12 levels were correlated to ETR using univariate analysis. S-B12 and clinical data were evaluated in a multivariate logistic regression model. Mean pretreatment s-B12 was 331 pm in ETR and 260 pm in nonresponders (NR) (P = 0.012). In patients with s-B12 levels ≤ 360 pm, 23 (31.5%) were NR and 50 (68.5%) had ETR. In patients with s-B12 > 360 pm, one (3.8%) was NR and 25 (96.2%) had ETR (P = 0.0034). The results of the multivariate analysis were as follows: Pretreatment s-B12 > 360 vs ≤ 360 pm: OR 28.6 CI 2.31-354, P = 0.008. Fibrosis stage 3-4 vs 0-2: OR 0.29 CI 0.074-1.12, P = 0.068. Genotype 2/3 vs 1/4/5: OR 15.5 CI 2.87-83.9, P = 0.0012. Dose reduction vs no dose reduction: OR 0.21, CI 0.048-0.91 P = 0.034. Standard interferon vs pegylated-interferon: OR 0.079, CI 0.0091-0.68 P = 0.019. Age and gender were not correlated to ETR. S-B12 > 360 pm is independently correlated to ETR in HCV patients treated with interferon and ribavirin. This suggests that B12 is involved in suppression of viral replication during anti-HCV treatment.
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Affiliation(s)
- P Rosenberg
- Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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Aegidius KL, Zwart J, Hagen K, Dyb G, Holmen TL, Stovner LJ. Increased headache prevalence in female adolescents and adult women with early menarche. The Head‐HUNT Studies. Eur J Neurol 2011; 18:321-328. [DOI: 10.1111/j.1468-1331.2010.03143.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- K. L. Aegidius
- Norwegian National Headache Centre, St. Olav’s University Hospital, Trondheim, and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J.‐A. Zwart
- Norwegian National Headache Centre, St. Olav’s University Hospital, Trondheim, and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo
| | - K. Hagen
- Norwegian National Headache Centre, St. Olav’s University Hospital, Trondheim, and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - G. Dyb
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- National Centre of Violence and Traumatic Stress and University of Oslo
| | - T. L. Holmen
- HUNT research centre, Institute of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - L. J. Stovner
- Norwegian National Headache Centre, St. Olav’s University Hospital, Trondheim, and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Bjørk M, Hagen K, Stovner L, Sand T. Photic EEG-driving responses related to ictal phases and trigger sensitivity in migraine: a longitudinal, controlled study. Cephalalgia 2010; 31:444-55. [PMID: 21098109 DOI: 10.1177/0333102410385582] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Photic driving is believed to be increased in migraineurs and has been interpreted as a sign of cortical hyperexcitability. However, most previous studies have included patients in various phases of the migraine cycle. The results are, therefore, difficult to interpret as neurophysiological abnormalities tend to accumulate close to the attack in migraineurs. SUBJECTS AND METHODS We recorded steady state visual evoked EEG-responses (SSVEPs) for 6, 12, 18 and 24 Hz flash stimuli from 33 migraineurs without aura, eight migraineurs with aura and 32 healthy controls. Interictal recordings were compared pair-wise with recordings before, during and after attack, as well as with EEGs from healthy controls. Driving power was also correlated with sensory hypersensitivity and severity of migraine. RESULTS Between attacks, driving responses to 18 Hz and 24 Hz were attenuated in migraineurs without aura. Driving power of 12 Hz increased before the attack. Attack trigger sensitivity, photophobia, pain intensity and a family history of migraine were related to decreased and/or symmetric photic driving. CONCLUSIONS Earlier results may have overestimated the driving response in migraine due to inclusion of recordings during the preictal interval and/or habituation among controls. Abnormal photic driving may be related to the pathophysiology of clinical sensory hypersensitivity.
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Affiliation(s)
- M Bjørk
- Norwegian University of Science and Technology, Norway.
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Winsvold BS, Hagen K, Aamodt AH, Stovner LJ, Holmen J, Zwart JA. Headache, migraine and cardiovascular risk factors: The HUNT study. Eur J Neurol 2010; 18:504-11. [DOI: 10.1111/j.1468-1331.2010.03199.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Robberstad L, Dyb G, Hagen K, Stovner LJ, Holmen TL, Zwart JA. An unfavorable lifestyle and recurrent headaches among adolescents: the HUNT study. Neurology 2010; 75:712-7. [PMID: 20720191 DOI: 10.1212/wnl.0b013e3181eee244] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine the relationship between recurrent headache disorders (i.e., migraine and tension-type headache) and lifestyle factors (overweight, low physical activity, and smoking) in an unselected population study among adolescents. METHODS In this cross-sectional study from Norway, a total of 5,847 students were interviewed about headache complaints and completed a comprehensive questionnaire including items concerning physical activity and smoking. In addition, they underwent a clinical examination with height and weight measurements. Adolescents with high physical activity who were not current smokers and not overweight were classified as having a good lifestyle status. These students were compared to those with 1 or more of the negative lifestyle factors present in regard to headache diagnosis and headache frequency. RESULTS In adjusted multivariate analyses, recurrent headache was associated with overweight (odds ratio [OR] = 1.4, 95% confidence interval [CI] 1.2-1.6, p < 0.0001), low physical activity (OR = 1.2, 95% CI 1.1-1.4, p = 0.002), and smoking (OR = 1.5, 95% CI 1.3-1.7, p < 0.0001). The prevalence of OR increased with more than 1 negative lifestyle factor present, evident for headache diagnoses and frequency. CONCLUSION The results from the present study show that overweight, smoking, or low physical activity are independently and in combination associated with recurrent headache among adolescents. The associations observed and the additive effect of these negative lifestyle factors on the prevalence of recurrent headache indicates possible targets for preventive measures.
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Tuntland H, Kjeken I, Nordheim L, Falzon L, Jamtvedt G, Hagen K. The Cochrane review of assistive technology for rheumatoid arthritis. Eur J Phys Rehabil Med 2010; 46:261-268. [PMID: 20485228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM The aim of this systematic review is to summarise the available evidence on the effectiveness of assistive technology for adults with rheumatoid arthritis in terms of improving functional ability and reducing pain, and to assess potential adverse effects related to device use. METHODS In this review, randomised controlled trials, clinical controlled trials, controlled before and after studies and interrupted time series available through systematic searches (electronic databases, grey literature, contact with authors, reference lists) up to October 2008 were included. Two reviewers independently selected trials for inclusion, assessed the validity of included trials, and extracted data. Investigators were contacted to obtain missing information. RESULTS Out of 7177 hits, 13 articles were reviewed in full text and only one trial was finally included (N.=29). The study was a randomised crossover trial, in which the use of an eye drop device was compared to a standard bottle in people with rheumatoid arthritis suffering from persistent dry eyes. The results show that the eye drop device improved application of eye drops and prevented adverse effects in terms of touching the eye with the bottle tip. The study was considered to have low quality of evidence. CONCLUSION Since only one trial met the inclusion criteria for this review, there is very limited evidence for the effect of assistive technology for adults with rheumatoid arthritis. There is an urgent need for high-quality research in this field, in order to reach sufficient evidence on the effectiveness of this commonly used intervention.
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Affiliation(s)
- H Tuntland
- Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, USA.
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Abstract
OBJECTIVES Reduced habituation of visual evoked potentials (VEP) has been reported in migraine. We aimed to study if preattack excitability changes were related to check size using a paired longitudinal design. MATERIALS AND METHODS Magnocellular and parvocellular functions were studied with monocular 31 and 62 checks in 33 adult migraine patients without aura (MwoA), 8 with aura (MA) and 31 controls. VEP was recorded in four blocks of 50 stimuli. N1P1 and P1N2 amplitudes were measured. Sessions were classified as preattack or interictal. RESULTS MA patients had significantly higher P1N2 and N1P1 amplitude than the controls and MwoA. VEP amplitude habituation was not found in controls. Migraine patients had significantly higher P1N2 amplitude before the attack compared with a paired interictal recording for large checks. CONCLUSIONS Cortical excitability is high in MA. Headache severity affects visual excitability. Increased P1N2 VEP amplitude before the attack suggests a cyclic decreased intracortical inhibition in extrastriate magnocellular pathways in migraine.
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Affiliation(s)
- T Sand
- Department of Neuroscience, Norwegian University of Science and Technology and St Olavs University Hospital, Trondheim, Norway.
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Abstract
BACKGROUND Primary headaches and chronic musculoskeletal pain are prevalent disorders with incompletely known causes. AIMS To review the data from the HUNT studies on the comorbidity of these pain disorders, and their relation to blood pressure levels. MATERIALS & METHODS Cross-sectional and prospective data from more than 50,000 persons participating in the HUNT studies, a large Norwegian population-based health survey RESULTS Headache and chronic musculoskeletal complaints in all parts of the body were comorbid, and the prevalence of pain in all locations was inversely related to blood pressure levels. DISCUSSION A likely cause for this is hypertension-associated hypalgesia, described in both animal and human experimental models, involving interactions between cardiovascular and pain modulating centres at the brainstem level, and probably also peripheral baroreceptor mechanisms. CONCLUSION Better understanding of these mechanisms may be crucial for enabling better prevention and treatment of these very prevalent, costly and disabling disorders.
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Affiliation(s)
- L J Stovner
- Department of Neuroscience, Norwegian National Headache Centre, Norwegian University of Science and Technology and St. Olavs Hospital, Trondheim, Norway.
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Syed E, Rahbin N, Weiland O, Carlsson T, Oksanen A, Birk M, Davidsdottir L, Hagen K, Hultcrantz R, Aleman S. Pegylated interferon and ribavirin combination therapy for chronic hepatitis C virus infection in patients with Child-Pugh Class A liver cirrhosis. Scand J Gastroenterol 2009; 43:1378-86. [PMID: 18615358 DOI: 10.1080/00365520802245395] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Pegylated interferon (peg-IFN) and ribavirin (RBV) treatment is less effective in patients with hepatitis C virus (HCV) and liver cirrhosis than in non-cirrhotic patients. Many patients with advanced liver disease have been excluded from the pivotal randomized controlled studies. The aim of this study was to investigate the efficacy and tolerability of combination therapy in unselected patients with Child-Pugh Class A liver cirrhosis at a Swedish university clinic. MATERIAL AND METHODS The virologic response and adverse events were retrospectively analyzed in 104 patients with HCV-associated Child-Pugh Class A liver cirrhosis who had been treated with peg-IFN and RBV. RESULTS Overall sustained virologic response (SVR) was achieved in 13% genotype 1-, 60% genotype 2-, and 31% genotype 3-infected patients. In treatment-naive patients, the corresponding rates were 13%, 82%, and 38%, respectively. In 46% of patients, treatment was discontinued prematurely owing to lack of virologic response in the majority. CONCLUSIONS SVR rates found in our study, in particular for genotype 1 patients (13%), were lower than those generally found in randomized controlled studies. For cirrhotic patients, new treatment alternatives are urgently needed to improve treatment outcome.
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Affiliation(s)
- Eliya Syed
- Department of Gastroenterology and Hepatology, Karolinska University Hospital, Sweden
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Hagen K, Albretsen C, Vilming ST, Salvesen R, Grøning M, Helde G, Gravdahl G, Zwart JA, Stovner LJ. Management of Medication Overuse Headache: 1-Year Randomized Multicentre Open-Label Trial. Cephalalgia 2009; 29:221-32. [DOI: 10.1111/j.1468-2982.2008.01711.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
It is a general belief that patients with medication overuse headache (MOH) need withdrawal of acute headache medication before they respond to prophylactic medication. In this 1-year open-labelled, multicentre study intention-to-treat analyses were performed on 56 patients with MOH. These were randomly assigned to receive prophylactic treatment from the start without detoxification, undergo a standard out-patient detoxification programme without prophylactic treatment from the start, or no specific treatment (5-month follow-up). The primary outcome measure, change in headache days per month, did not differ significantly between groups. However, the prophylaxis group had the greatest decrease in headache days compared with baseline, and also a significantly more pronounced reduction in total headache index (headache days/month x headache intensity x headache hours) at months 3 ( P = 0.003) and 12 ( P = 0.017) compared with the withdrawal group. At month 12, 53% of patients in the prophylaxis group had ≥ 50% reduction in monthly headache days compared with 25% in the withdrawal group ( P = 0.081). Early introduction of preventive treatment without a previous detoxification programme reduced total headache suffering more effectively compared with abrupt withdrawal. (ClinicalTrials.gov number, NCT00159588).
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Affiliation(s)
- K Hagen
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology
- Norwegian National Headache Centre, Section of Neurology, St Olavs Hospital, Trondheim
| | - C Albretsen
- Department of Neurology, Tromsø University Hospital
| | - ST Vilming
- Department of Neurology, Ullevaal University Hospital, University of Oslo, Oslo
| | - R Salvesen
- Department of Neurology, Nordland Hospital, Bodo, Norway
- Institute of Clinical Medicine, University of Tromsø Tromsø
| | - M Grøning
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - G Helde
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology
- Norwegian National Headache Centre, Section of Neurology, St Olavs Hospital, Trondheim
| | - G Gravdahl
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology
- Norwegian National Headache Centre, Section of Neurology, St Olavs Hospital, Trondheim
| | - J-A Zwart
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology
- Norwegian National Headache Centre, Section of Neurology, St Olavs Hospital, Trondheim
- Department of Neurology, Ullevaal University Hospital, University of Oslo, Oslo
| | - LJ Stovner
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology
- Norwegian National Headache Centre, Section of Neurology, St Olavs Hospital, Trondheim
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Rehbinder E, Rehbinder E, Engelhard M, Hagen K, Jørgensen RB, Pardo-Avellaneda R, Schnieke A, Thiele F. The technology of pharming. Ethics of Science and Technology Assessment 2009. [PMCID: PMC7123008 DOI: 10.1007/978-3-540-85793-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sand T, Zhitniy N, Nilsen KB, Helde G, Hagen K, Stovner LJ. Thermal pain thresholds are decreased in the migraine preattack phase. Eur J Neurol 2008; 15:1199-205. [DOI: 10.1111/j.1468-1331.2008.02276.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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