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Biomedical subjects

Ann I Scher

Publications and source records attributed to Ann I Scher.

7 recordsLinked to original sources

Migraine and MTHFR C677T genotype in a population-based sample.

OBJECTIVE: Migraine with aura is associated with increased risk of stroke. The MTHFR C677T genotype has been associated with increased risk of migraine in selected clinical samples and with elevated homocysteine, a risk factor for stroke. We assessed the association of the MTHFR C677T variant with migraine and the mediating effect of cardiovascular risk factors and metabolic markers of genotype status. METHODS: We compared adult migraineurs with aura (MA; n = 187), without aura (MO; n = 226), and nonmigraineurs (n = 1,212) from the population-based Genetic Epidemiology of Migraine study. RESULTS: Compared with the wild-type genotype, the T/T genotype was associated with increased odds of MA (odds ratio [OR], 2.05; 95% confidence interval, 1.2-3.4; p < 0.006), with a trend of increasing numbers of T alleles (OR, 1.40; 95% confidence interval, 1.1-1.8; p < 0.007). ORs were slightly attenuated after adjusting for homocysteine. INTERPRETATION: Risk of MA is associated with MTHFR C674T homozygosity, independent of other cardiovascular risk factors.

Adult↗

The comorbidity of headache with other pain syndromes.

In this article, we consider the possible reasons and supporting evidence for the comorbidity of chronic pain conditions. To simplify the discussion, we primarily focus on the epidemiology of headache with other pain conditions, dividing studies into those based on children or adolescents and those based on adults. We consider exogenous and endogenous factors, and methodological challenges, in understanding whether and how 2 pain conditions may be related.

Adaptation, Psychological↗

Comorbidity of migraine.

PURPOSE OF REVIEW: Comorbidity refers to the greater than coincidental association of separate conditions in the same individuals. Historically, a number of conditions have been noted to be comorbid with migraine, notably psychiatric disorders (anxiety, depression, panic disorder), epilepsy, asthma, and some congenital heart defects. Migraine sufferers have increased medical costs overall compared with others of the same sex and age, even after considering the cost of specific migraine treatment. Thus, estimates of the burden of migraine often include the costs of conditions comorbid with it. RECENT FINDINGS: Conditions may be comorbid through a variety of mechanisms. Comorbidity may be an artifact of diagnostic uncertainty when symptom profiles overlap or when diagnosis is not based on objective markers. Comorbidity may arise due to unidirectional causality, such as migraine resulting in blood pressure changes due to headache-specific treatment. Finally, conditions may be comorbid because of shared genetic or other factors that increase the risk of both conditions. In such cases, understanding these shared risk factors may lead to greater understanding of the fundamental mechanisms of migraine. SUMMARY: In this article, we will review recent developments related to migraine comorbidity. We will emphasize findings related to the comorbidity of migraine with clinical and sub-clinical vascular brain lesions, congenital heart defects, coronary heart disease, psychiatric illness, and other pain conditions.

Comorbidity↗

Caffeine as a risk factor for chronic daily headache: a population-based study.

OBJECTIVE: To investigate the possible association of dietary caffeine consumption and medicinal caffeine use with chronic daily headache (CDH). METHODS: Population-based cases and controls were recruited from the Baltimore, MD, Philadelphia, PA, and Atlanta, GA, metropolitan areas. Controls (n = 507) reported 2 to 104 headache days/year, and cases (n = 206) reported > or =180 headache days/year. Current and past dietary caffeine consumption and medication use for headache were based on detailed self-report. High caffeine exposure was defined as being in the upper quartile of dietary consumption or using a caffeine-containing over-the-counter analgesic as the preferred headache treatment. RESULTS: In comparison with episodic headache controls, CDH cases were more likely overall to have been high caffeine consumers before onset of CDH (odds ratio [OR] = 1.50, p = 0.05). No association was found for current caffeine consumption (i.e., post CDH) (OR = 1.36, p = 0.12). In secondary analyses, associations were confined to younger (age <40) women (OR = 2.0, p = 0.02) and those with chronic episodic (as opposed to chronic continuous) headaches (OR = 1.69, p = 0.01), without physician consultation (OR = 1.67, p = 0.04) and of recent (<2 years) onset (OR = 1.67, p = 0.03). CONCLUSION: Dietary and medicinal caffeine consumption appears to be a modest risk factor for chronic daily headache onset, regardless of headache type.

Adolescent↗

Risk factors for chronic daily headache.

There are many people who experience headaches that are independent of illness, injury, or hangover. Approximately 4% of the population suffer from headaches on a daily or near-daily basis. It is apparent that patients with chronic daily headache in community samples differ in important ways from patients with chronic daily headache in subspecialty clinics. In this manuscript, we review clinic-based data on risk factors for chronic daily headache and summarize the current data on the epidemiology of chronic daily headache.

Chronic Disease↗

The risk of mortality or cerebral palsy in twins: a collaborative population-based study.

The purpose of the paper was to describe demographic and clinical factors associated with fetal or neonatal death or cerebral palsy (CP) in twins. Vital statistics from five populations in the United States and Australia, which included information on CP diagnosed after 1 y of age. Information on zygosity was not available. In 1,141,351 births, 25,772 of whom were twins, significant secular trends from 1980 to 1989 included increasing prevalence of twins, increasing proportion of unlike-sex twins, and increasing maternal age. Overall, twins were at an approximately 5-fold increased risk of fetal death, 7-fold increased risk of neonatal death, and 4-fold increased risk of CP compared with singletons. However, at birth weight <2500 g, twins generally did better than singletons, both with respect to mortality and to CP rates. Second-born twins and twins from same-sex pairs were at increased risk of early death but not of CP. Twins from growth-discordant pairs and twins whose co-twin died were at increased risk of both mortality and CP. The highest rates of CP were in surviving twins whose co-twin was still-born (4.7%), died shortly after birth (6.3%) or had CP (11.8%). In this large data set spanning a 10-y period, overall rates of death or cerebral palsy were higher in twins than singletons, although small twins generally did better than small singletons. Co-twin death was a strong predictor of CP in surviving twins. This risk was the same for same- and different-sex pairs, and observed both for preterm and term infants.

Adult↗