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Biomedical subjects

M L Figuerola

Publications and source records attributed to M L Figuerola.

7 recordsLinked to original sources

Opioid and sympathetic nervous system activity in cluster headache under verapamil or prednisone treatment.

This study was undertaken to evaluate the effect of treatment with prednisone or verapamil on plasma met-enkephalin (ME), neutrophil met-enkephalin containing peptides (NMECP) and free and conjugated plasma catecholamines (CA) in cluster headache (CH) patients. After obtaining a basal sample, patients were randomly selected to be treated with either verapamil (n = 5) or prednisone (n = 5). A second blood sample was obtained 10 days after starting treatment. At this time all patients were free of symptoms. ME (0.49 +/- 0.10 pmol/mL) and NMECP (35.1 +/- 2.4 pmol/mg protein) levels after prednisone treatment were significantly higher (P < 0.05) than in basal conditions (0.29 +/- 0.08 pmol/mL and 27.14 +/- 2.4 pmol/mg protein), while no differences were found in catecholamine levels. No differences in ME, NMECP or CA were found during verapamil treatment. Our results suggest that in CH the two drugs act through different mechanisms. The relief of the bout obtained with prednisone may be related to the opioid system stimulation observed in these patients.

Catecholamines↗

Changes in neutrophil met-enkephalin containing peptides in episodic cluster headache.

We have previously demonstrated an increase in plasma met-enkephalin levels during the pain attacks in episodic cluster headache. The present study was undertaken in order to clarify the source of the plasma met-enkephalin increase. Recent evidence has shown that peripheral blood polymorphonuclear cells contain peptides derived from the proenkephalin A system, which can be released by specific stimuli. We studied neutrophil met-enkephalin containing peptides (NMECP) in 27 episodic cluster headache patients: 24 in a cluster period (6 of them during a pain attack), and 3 in the remission period. Neutrophil met-enkephalin containing peptide levels (after sequential enzymatic digestion with trypsin and carboxypeptidase B) were determined by radioimmunoassay with specific antiserum. Neutrophil peptide concentration (pmol/mg prot) was lower (p less than 0.01) in patients during the pain attack (14.4 +/- 0.36) than after their pain had subsided (36.7 +/- 0.31) and lower than in the remission period patients (35.8 +/- 0.4). We conclude that neutrophil met-enkephalin containing peptides decrease during pain in episodic cluster headache, and that they may be involved in the concomitant plasma met-enkephalin increase.

Adult↗

Increase in plasma methionine-enkephalin levels during the pain attack in episodic cluster headache.

Since high levels of endogenous opioids (endorphins, enkephalins) were found in brain areas classically related to nociception, their peripheral levels in humans were studied in different pain syndromes yielding contradictory results. This study was undertaken to assess changes in plasma methionine-enkephalin (met-enkephalin) levels in patients with episodic cluster headache associated with the pain period. Twenty-nine patients, 24 in the cluster period (6 of them during an attack) and 3 in the remission period were studied. Two other patients were subjected to a longitudinal follow-up. Plasma met-enkephalin levels were determined by radioimmunoassay (RIA) with specific antibody. Plasma peptide concentration (pmol/ml) was higher (p less than 0.001) in patients during the pain attack (3.97 +/- 1.18) than in controls (0.25 +/- 0.03). When measured 4 and 48 h after the pain attack lower levels were found (0.46 +/- 0.06) which decreased to control values after 24 h. These results may suggest involvement of peripheral enkephalins in pain modulation in patients with episodic cluster headache.

Adult↗

Intracranial hypotension: the nonspecific nature of MRI findings.

We present three patients who complained of postural headache related to different types of intracranial hypotension: spontaneous or primary, and secondary, but presenting the same findings on brain magnetic resonance imaging. Diffuse pachymeningeal gadolinium enhancement supports the belief that the enhancement is a nonspecific meningeal reaction to low pressure.

Adult↗

Sympathetic adrenomedullary activity in cluster headache.

It is well known that autonomic phenomena, such as lacrimation, rhinorrhea, and Horner's syndrome, are associated with the pain attacks in episodic cluster headache. In order to elucidate the cause of these symptoms we studied plasma free and sulphoconjugated catecholamines in cluster headache patients during the pain attacks and in the following hours, as well as during the remission period. No change in these amine levels was found. We conclude that dysautonomic symptoms are not reflected in plasma catecholamine modification.

Adrenal Medulla↗

Met-enkephalin increase in patients with fibromyalgia under local treatment.

Fibromyalgia is a chronic debilitating condition of unknown etiology. The clinical picture suggests increased activity and/or supersensitivity in nociceptive pathways or inadequate activity in endogenous pain attenuation mechanisms. One therapeutic approach in the treatment of this syndrome is the administration of serial local injections of lidocaine hydrochloride in the painful points. To evaluate the effect of this treatment on plasma met-enkephalin (ME) levels we studied 15 patients, all women with fibromyalgia under local treatment in the tender points, grouped as follows: 5 were treated with local injection of lidocaine hydrochloride, 5 were treated with local injection of saline and 5 treated with dry needling. Significant increases in plasma ME concentrations were observed in all groups in the last sampling of each session studied. These results show an increase in plasma ME levels 10 minutes after finishing each session, which is independent of the maneuver employed.

Adult↗