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Emiliano Salvatori

Publications and source records attributed to Emiliano Salvatori.

3 recordsLinked to original sources

Salivary cortisol, dehydroepiandrosterone-sulphate (DHEA-S) and testosterone in women with chronic migraine.

Hypothalamus-pituitary-adrenal (HPA) axis activity was monitored in 20 women with chronic migraine (CM), previously affected by medication overuse headache (MOH), in comparison to healthy women (20 subjects) by measuring salivary cortisol, testosterone, dehydroepiandrosterone-sulphate (DHEA-S) levels, and their ratios, one week after the end of the MOH rehabilitation procedure. The participants were instructed how to collect saliva samples at home, a procedure that was performed twice a day (08:00 a.m. and 8:00 p.m.). Morning and evening levels of cortisol were significantly increased in CM patients with respect to controls. With regard to the cortisol/DHEA-S ratio, an inverse marker of psycho-physical wellbeing, CM women showed significantly higher values than controls. Moreover, testosterone/cortisol ratios (anabolic/catabolic index of physical performance) were significantly lower in CM patients than in controls. In the present study, CM appears not to be associated with an impairment of cortisol and DHEAS circadian fluctuation; however, CM patients present alterations in HPA axis function that might contribute to metabolic and psychological alterations that have also been associated with CM.

Analysis of Variance↗

Migraine with aura, bipolar depression, ACM aneurysm. A case report.

B.D. is a 48-year-old professional woman. She has been suffering for migraine since she was 28, but she did not have serious problems until last year, when headache episodes became more frequent and it was necessary an admission to emergency room. At the beginning, the events were about 6 per month, lasting from 2 to 4 days, beating and of high intensity together with nausea, vomit, photo and phonophobia and visual area. Looking at the anamnesis, we report a psychiatric treatment since about ten years, because of type II bipolar disorder. In spite of the psychopharmacological treatment, as the patient came in our Regional Headache Center, she talked about 7 events with aura (scintillating scotomas, emianopsia) per month, lasting 2-4 days with photo and phonophobia, nausea, crying crisis, anxiety. Although the neurological examination was normal, the sudden aggravation of pain symptomatology and the unresposiveness to usual painkillers, suggested a cerebral CT and CT-angiography. CT and CT-angiography discovered the presence of an aneurysm of the right middle cerebral artery (MCA) of 4 mm diameter, with parietal irregularities. The patient was operated to reduce the hemorrhagic risk, with a positive result. One year after the operation, the patient reports a decrease of headache events with a frequency of 2 per month, lasting only a few hours, which she can now solve with COXIB.

Bipolar Disorder↗

Headache and mood disorders.

The aim of the study was to estimate the occurrence of mood, anxiety and disability disorders in 300 patients affected by chronic daily headache and MOH, who were observed for a 16-month period in our centre. We monitored the patients on an interview basis, concerning the anamnestic data collection related to the pre-morbid period, information given by relatives regarding the patient's behaviour during the day, attitudes towards others, maintenance of previous interests and enjoyments, and modifications of the biological rhythm. Several tests were conducted, underlining a significant correlation between headache and mood disorders, impairment of working activity, social and family life. The study shows that patients affected by chronic daily headache and MOH present high levels of anxiety, a depressive symptomatology associated with alexithymia. Moreover, it has been discovered that anxiety and depression facilitate the onset of headache, while patients suffering from pain persistence were more vulnerable to psychiatric problems. In consideration of these results, more exhaustive evaluations relating to the psychopathological aspects in patients affected by headache are necessary.

Adult↗