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Biomedical subjects

P Kropp

Publications and source records attributed to P Kropp.

40 records · Page 3Linked to original sources

Pain sensitivity and pain reactivity of pericranial muscles in migraine and tension-type headache.

We investigated whether experimentally determined, suprathreshold pain sensitivity of pericranial musculature in patients with tension-type headache differs from that of migraine patients or from that of healthy subjects. Furthermore, we looked to see whether differences could be found in the effects of experimental pain induction on EMG activity of pericranial musculature and whether subgroups could be discovered with higher and lower pericranial pain sensitivity within the three diagnostic groups in terms of neurophysiological, psychological and clinical variables. In 20 patients with tension-type headache, 23 patients with migraine without aura, and 29 healthy individuals experimental pain was induced in the temporal muscle by mechanical pressure; pain sensitivity in the entire metrically subdivided suprathreshold pain sensitivity range was measured. Surface EMG activity of pericranial muscles was determined before, during and after experimental pain induction. In addition, headache characteristics as well as personality and mood states were determined and recorded in a standardized fashion. There were no significant differences in pain sensitivity of pericranial musculature between the three groups. Patients with tension-type headache showed significantly higher EMG scores during suprathreshold pain stimulation than did migraine patients. EMG scores of healthy subjects fell between these two groups. With respect to pericranial tenderness significant differences in clinical, neurophysiological and psychological variables were found only between subgroups within the group of patients with tension-type headache. The results indicate that significant differences in the examined groups are found not in pain perception but in the processing or reaction to experimental headache stimuli. In patients with tension-type headache subgroups evolve based on pericranial pain sensitivity with quantitatively and/or qualitatively impaired reactions; for this reason diagnostic grouping according to the IHS classification seems to be pathophysiologically relevant. The intraindividual phasic comparison of pain reactions appears to be more important than the absolute interindividual tonic comparison.

Adult↗

Factors affecting the utilization of homecare supports by caregiving relatives of Alzheimer patients.

Thirty-six homecare patients with dementia of Alzheimer type (DAT) and their caregiving relatives were studied to determine the factors influencing their use or nonuse of available medical, institutional, instrumental, and legal supports. The rate of utilization of homecare support was found to be surprisingly low. Only when the burden of providing care had become intolerable did relatives resort to homecare support (homecare allowance, counseling, outpatient services, etc.). The main reason for the low utilization was poor knowledge regarding the availability of homecare supports. Since all of the DAT patients were under the care of a family doctor, this information deficit could best be overcome by improved counseling from personal physicians.

Aged↗

How the brain anticipates an attack: a study of neurophysiological periodicity in migraine.

We investigated cortical excitability and the pattern of arousal in migraine patients using contingent negative variation (CNV) and EEG power spectrum analysis performed before and after a migraine attack. Twenty females suffering from migraine without aura and 12 healthy controls were enrolled in the study. In the group of patients, the CNV, EEG power spectrum and hemispheric asymmetry analyses were performed 1-4 days before the first day of an attack and 4 days following the last day with migraine. The recordings in healthy subjects were carried out on a day chosen by the participants. The comparisons were made using non-parametric procedures. After an attack no difference was found between patients and controls in EEG power spectrum, hemispheric asymmetry or CNV components (with the exception of the beta 1 power, which was more pronounced in patients). Before an attack, however, a significant increase in the power of delta and theta frequency bands, in the alpha asymmetry, and in early CNV amplitude were observed. The patients differed from controls both in the extent of cortical excitability and in the arousal pattern found. In such a way migraine is characterized by periodic CNV and EEG power spectrum changes during the pain-free interval. The abnormalities in cortical excitability and arousal were only observed before an attack, and could be used to predict the next migraine episode. We assume that these changes reflect the increased susceptibility of the migrainous brain to precipitating factors and the neurophysiological readiness to generate an attack. The time duration since the last attack must be taken into account when performing studies in the field of migraine research.

Adult↗

Behavioral treatment in migraine. Cognitive-behavioral therapy and blood-volume-pulse biofeedback: a cross-over study with a two-year follow-up.

The aim of the present study was to ascertain the effects of two behavioral medicine approaches to the treatment of migraine. We also evaluated the specific effect of the sequence of the two treatments. Thirty-eight patients, suffering from migraine without aura, either obtained treatment in the following sequence: blood-volume-pulse biofeedback followed by cognitive behavioral therapy (Group I) or were given the treatment in reverse order (Group II). The effects of treatment in Group I were significantly better than those in Group II. We conclude that the application of biofeedback helps the patient to recognize the influence of thoughts and emotions on bodily reactions and therefore prepares the way for successful cognitive treatment.

Adolescent↗