Biomedical subjects

Daniela Cologno

Publications and source records attributed to Daniela Cologno.

7 recordsLinked to original sources

PubMed2005

Psychiatric disorders and pain location in unilateral migraineurs.

To explore the relationship between the side of pain during attacks and psychopathological features in strictly unilateral migraine, we recruited 35 patients affected by migraine with and/or without aura diagnosed according to the revised ICHD-II criteria. Seventeen patients had right side-locked pain (R-SUM), 11 had left side-locked (L-SUM) and 7 had side-shifting pain (SSM). Patients were administered the Hamilton Anxiety Scale, the State and Trait Anxiety Inventory-State Anxiety, the Beck Depression Inventory and the 20-item Toronto Alexithymia Scale. Statistical analyses showed that the L-SUM group was significantly more anxious and depressed than the other two groups of patients. Our preliminary data suggest that strictly left unilateral migraine is associated with more severe anxiety and depression. This finding appears to be consistent with studies that reported a higher degree of these disorders in patients with left cerebral hemispheric damage.

Adult↗

PubMed2005

Migraine disease: evolution and progression.

Migraine is a complex pathology and it should be regarded as a disease evolving during the lifetime along with other comorbid conditions. Migraine susceptibility may be unmasked by exogenous substances and the occurrence of migraine attacks may change following drugs given for therapeutical purposes. The evolution of migraine should be followed up because childhood migrainous manifestations may vary over the years and an earlier diagnosis may not apply later on.

Cardiovascular Diseases↗

PubMed2003

An epidemiological study of migraine with aura in the San Severo general population: a pilot research project of cooperation between neurologists and general practitioners.

OBJECTIVES: (A) To define the lifetime prevalence of migraine with aura (MA) in patients recruited in general practices for an epidemiologic study by the University of Parma Headache Centre from the general population of San Severo, Italy, and (B) to assess the recognition of MA in general practice. METHODS: The study was conducted over a period of 5 consecutive months (January to May 2001) on patients aged 18-65, taken from the following general practice populations: (a) from the patient population of 4 general practitioners (GPs; 3,616 patients) and (b) from the patient population of 12 GPs (12,996 patients). The clinical diagnosis of MA was subsequently confirmed by a headache specialist. RESULTS: For objective A, 648 patients (420 women and 228 men) were interviewed; MA diagnosis was confirmed in 10 patients (7 women and 3 men), lifetime MA prevalence being 1.5%. For objective B, 150 'suspected' MA cases (96 women and 54 men) were reported by the 12 GPs; however, the diagnosis of MA was confirmed in only 3 cases (2 women and 1 man). CONCLUSION: The prevalence of MA observed in our small sample of the general practice patient population was comparable with that observed in the general population of San Severo, Italy. The results also suggest that GPs may be overestimating the number of cases of MA in their patient population.

Adolescent↗

PubMed2002

Transient visual disturbances during migraine without aura attacks.

OBJECTIVE: To evaluate the prevalence and clinical features of transient visual disturbances (TVDs) during migraine without aura (MO) attacks and to point out any similarities with the disturbances listed among the diagnostic criteria of the International Headache Society (IHS) classification for migraine with aura (MA). METHODS: We studied a sample of 191 patients (145 women and 46 men) with MO and no other associated forms of primary headache who had been referred to the University of Parma Headache Centre between December 1, 1999 and December 1, 2000. RESULTS: A total of 165 patients reported that they had never experienced TVDs during their MO attacks. In the remaining 26 patients (19 women and 7 men), MO attacks were at times accompanied by TVDs, which were present in over 30% of MO attacks in 65.4% of patients. In about 60% of cases, TVDs lasted less than half a minute. TVDs consisted of phosphenes in most patients, general blurring of vision in about one-fourth, and scintillating scotomas in 15%. In 73% of cases, TVDs occurred during the headache phase, whereas in the remainder they preceded it. Strict application of the IHS diagnostic criteria would have led to a diagnosis of MA in 12 cases, corresponding to 46% of our MO patients with TVDs and to 6.3% of all patients with an established clinical diagnosis of MO. CONCLUSION: The results of our study suggest that current IHS diagnostic criteria for MA may lead to an overestimation of MA cases.

Adolescent↗

PubMedDate not supplied

Upper and lower cluster headache: clinical and pathogenetic observations in 608 patients.

UNLABELLED: OBJECTIVE, BACKGROUND, AND METHODS: Ever since it was proposed by Ekbom and Kugelberg back in 1968 on the basis of the different location of head pain during attacks, the differentiation of cluster headache into an upper syndrome (US) and a lower syndrome (LS) has been regarded as a purely academic distinction. To evaluate whether this differentiation is indeed well founded and to understand its possible significance in the light of current pathogenetic knowledge, we rigorously applied Ekbom and Kugelberg's classification criteria to a sample of 608 patients with cluster headache (CH; 440 men and 168 women), including 483 with episodic CH, 69 with chronic CH, and 56 with CH periodicity undetermined. RESULTS: Of these patients, 278 could be classified as US sufferers and 330 as LS sufferers. Our data analysis showed statistically significant clinical differences between the two syndromes: pain location was more common in the ocular, temporal, and nuchal regions among LS sufferers; in addition, patients with LS reported not only a higher rate of autonomic symptoms, but also a higher predominance of nasal congestion, ptosis, and forehead and facial sweating among these symptoms. CONCLUSIONS: Based on current anatomofunctional knowledge and on the most recent pathogenetic findings, we believe that changes in hypothalamic activity posteroinferiorly may lead to activation of the caudal part of the spinal trigeminal nucleus by way of the hypothalamus, midbrain, and trigeminal nerve fibers and consequently to activation of the trigeminovascular system with a different location in the two syndromes. More specifically, there seems to be a larger and more extensive involvement of the subnucleus caudalis in LS compared with US, where only its ventrocaudal portions are likely to be affected.

Adult↗

PubMedDate not supplied

Hypnic headache responsive to indomethacin: second Italian case.

We report a case of hypnic headache (HH) fulfilling the criteria proposed by the revised IHS headache classification and rapidly responsive to indomethacin. The patient is a 70-year-old housewife who presented with a 7-year history of strictly nocturnal headache attacks. The headache occurred every night with a frequency of 1 to 2 attacks occurring between 03.00 and 04.00 a.m. Indomethacin was prescribed at a daily dose of 150 mg/day for 30 days and tapered down in 15 days. Pain did not occur thereafter and at follow up, nine months after discontinuation of the drug, the patient was still pain-free with no relapses. This is the second Italian HH patient responsive to indomethacin, indicating that indomethacin may be a useful alternative treatment in HH patients, and providing further evidence in favour of a common pathophysiological mechanism in HH and other indomethacin-responsive primary headaches.

Aged↗

PubMedDate not supplied

Prodromes and the early phase of the migraine attack: therapeutic relevance.

A migraine attack is a multiphasic event. In some patients the initial phase of the attack is characterized by the presence of "prodromes" or "premonitory symptoms" which are not recognized by the patient as part of the attack. Premonitory symptoms are defined as "symptoms preceding and forewarning of a migraine attack by 2-48 hours, occurring before the aura in migraine with aura and before the onset of pain in migraine without aura". Migraine premonitory symptoms should be differentiated from aura and symptoms of premenstrual syndrome. This differentiation, which is crucial to correct diagnosis, is based on two principal aspects, namely, the timing of these premonitory symptoms prior to the headache pain and their clinical characteristics. The neurotransmitters dopamine and serotonin are possibly involved in the development of premonitory symptoms, as demonstrated by experimental models and by the efficacy of migraine aborting and preventive treatments. Accurate recording of premonitory symptoms may contribute to efforts to design the best therapeutic approach in migraine patients.

Female↗