Abstract:
OBJECTIVE:The objective of this study was to assess the clinical benefits of onabotulinumtoxinA (BOTOX®) treatment on the symptoms of cervical dystonia and the frequency, severity, and associated symptoms of migraine in patients with cervical dystonia and concurrent migraine. BACKGROUND:Botulinum toxin is established as first-line treatment of cervical dystonia. Recent clinical trials have shown onabotulinumtoxinA to be an effective prophylactic therapy for patients with chronic migraine, and onabotulinumtoxinA has been approved for use in this patient population by the Food and Drug Administration. Patients with headache associated with cervical dystonia have been identified as a specific subpopulation of patients in whom botulinum toxin treatment may be effective for controlling the symptoms of both conditions. METHODS:An open-label pilot study was conducted for 7.5 months in patients at least 18 years old with primary cervical dystonia of moderate severity (baseline rating of at least 20 on the Toronto Western Spasmodic Torticollis Rating Scale) complicated by migraine headache meeting the International Classification of Headache Disorders-II criteria for migraines with or without aura. Each patient received 2 cycles of treatment at Visit 3 (baseline) and Visit 6 (Day 90). For cervical dystonia, each patient was injected with a maximum of 175 units. At the same visit, a maximum of 125 units was also injected for migraine using a fixed-site, fixed-dose injection paradigm, with additional cervical dystonia injection-site treatment to a maximum dose of 300 units. Patients were assessed following onabotulinumtoxinA injection and at follow-up on Visit 4 (Day 30), Visit 5 (Day 60), Visit 6 (Day 90), and at Visits 7, 8, and 9 (Days 120, 150, and 180). The primary outcome measures for this study were change in Toronto Western Spasmodic Torticollis Rating Scale total score for cervical dystonia and frequency of headache episodes per 28-day period. Migraine episodes were defined as at least 4 hours of sustained pain with no upper limit. An episode was considered new if the patient was pain free for at least 24 hours. Secondary study end points included number of headache days per month, headache intensity, headache disability (assessed using Headache Impact Test-6 and the Migraine Disability Assessment score scales), acute headache medication use, resource utilization, and allodynia pain. Adverse events were reported. RESULTS:A total of 25 patients (24 women, mean age 50.5 years; mean age of disease onset 21.9 years) were enrolled in the study. Patients experienced improvement in cervical dystonia symptoms with significant reductions from baseline in Toronto Western Spasmodic Torticollis Rating Scale scores at 30, 60, 90, 120, 150, and 180 days (-9.84 ± 8.49, -12.67 ± 8.22, -13.63 ± 7.27, -14.92 ± 7.05, -14.76 ± 6.97, -14.49 ± 6.14, respectively, P < .0001 at all time points from a baseline of 31.03 ± 3.61). Changes from baseline were assessed using the t-test. Reductions in the number of headache episodes from baseline on concurrent onabotulinumtoxinA treatment for coexistent chronic migraine did not attain significance. However, patients experienced significant reductions from baseline in the number of headache days at 90, 120, and 180 days (-3.39 ± 6.78, P = .0289; -4.29 ± 7.94, P = .0194; -4.38 ± 7.99, P = .0178, respectively, from a baseline of 15.33 ± 6.76). Changes from baseline were assessed using the t-test. The change from baseline in Headache Impact Test-6 total scores was significant at 30, 60, 90, 150, and 180 days (3.21 ± 4.14, P = .0009; -3.04 ± 4.04, P = .0012; -2.41 ± 2.79, P = .0006; -2.59 ± 3.87, P = .0050; -3.09 ± 3.80, respectively, from a baseline of 22.68 ± 3.20). Changes from baseline were assessed using the t-test. The change from baseline in Migraine Disability Assessment was significant at 120, 150, and 180 days (-38.09 ± 47.87, P < .0001, Wilcoxon signed rank test; -16.91 ± 62.69, P = .0358, Wilcoxon signed rank test; -23.73 ± 40.57, P = .0122, t-test, respectively, from a baseline of 56.68 ± 50.41). There were no serious adverse events or treatment-related discontinuations. CONCLUSIONS:Concurrent treatment with onabotulinumtoxinA is effective and well tolerated in controlling the symptoms of cervical dystonia complicated by concurrent migraine.
journal_name
Headachejournal_title
Headacheauthors
Winner PK,Sadowsky CH,Martinez WC,Zuniga JA,Poulette Adoi
10.1111/j.1526-4610.2012.02164.xsubject
Has Abstractpub_date
2012-09-01 00:00:00pages
1219-25issue
8eissn
0017-8748issn
1526-4610journal_volume
52pub_type
临床试验,杂志文章相关文献
HEADACHE文献大全abstract:BACKGROUND:Despite the expanding therapeutic armamentarium, many people with episodic migraine (EM) have unmet acute treatment needs. OBJECTIVE:To determine the relative frequency of prespecified types of "unmet treatment needs" in persons with EM in a US population-based sample. METHODS:Eligible participants complet...
journal_title:Headache
pub_type: 杂志文章,随机对照试验
doi:10.1111/head.12154
更新日期:2013-09-01 00:00:00
abstract::Episodic cluster headache is a well-recognized entity usually starting in the second decade of life. Uncommonly, the first typical symptoms may present in the first decade of life, but are rarely recognized as such during childhood. We report a 12-year-old girl who presented with a 1-year history of bouts of right-sid...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.1997.3705296.x
更新日期:1997-05-01 00:00:00
abstract::Chronic drug exposure can induce a significant change in neurotransmitter receptor systems and is possibly involved in the pathogenesis of drug-induced neurological disorders. Abuse of analgesics is known to induce deterioration in headache status in patients with primary headaches, especially migraine. To assess the ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.1998.3807534.x
更新日期:1998-07-01 00:00:00
abstract::Temporal arteritis is a form of systemic vasculitis that involves branches of the carotid artery. Clinical features are headache, visual loss, ophthalmoplegia, jaw claudication, temporal headache, with tenderness and thickening on the affected temporal artery. We present 3 cases of tongue necrosis due to this granulom...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2007.00890.x
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Variables that are thought to precipitate migraine or tension-type headache episodes in children hitherto have only been studied using retrospective reports. As such, there is little empirical evidence to support the actual predictive association between presumed headache triggers and actual headache occurre...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2009.01586.x
更新日期:2010-05-01 00:00:00
abstract::We report the case of a man who suffered from Valsalva-induced cluster headaches. The headaches deviated from classic cluster in that they were solely induced by activity involving the Valsalva maneuver, such as coughing and sneezing, and never occurred spontaneously. The attacks were prevented by treatment with indom...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2002.02088.x
更新日期:2002-04-01 00:00:00
abstract::Seventy-six patients with vascular (migraine or mixed migraine and tension) headache (HA) participated in a controlled evaluation of a minimal-therapist-contact, largely home-based, treatment program which combined relaxation (R) training with thermal biofeedback (TBF). One group received TBF + R administered in 3 off...
journal_title:Headache
pub_type: 临床试验,杂志文章
doi:10.1111/j.1526-4610.1990.hed3006371.x
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:New treatments are needed to treat chronic daily headache (CDH) and chronic cluster headache (CCH). New treatments are needed to treat this population and intravenous (IV) lidocaine is a novel treatment for CDH. OBJECTIVE:The aim of this study was to examine the use of IV lidocaine for refractory CDH patien...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2008.01281.x
更新日期:2009-02-01 00:00:00
abstract::Cyclic AMP (CAMP) accumulation induced by isoproterenol (IP) and forskolin in intact lymphocytes was determined in 12 patients with migraine and 12 healthy controls. Our data showed that IP CAMP accumulation (8.20 + 1.08 Pmol/million cells) was significantly (P = 0.033) lower than accumulation in the controls (14.39 +...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1993.hed33040198.x
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:To describe a case series of 7 patients presenting cluster headache (CH) criteria and a substance use disorder, reported to a French Addictovigilance center. Then, to assess clinical, pharmacological, and neurobiological linkages between substance use and CH onset. BACKGROUND:CH patients are presenting a hig...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.13516
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:This analysis evaluates and ranks efficacy endpoints often used in headache trials concerning their clinical relevance in relation to the patient-related criterion "global assessment of overall efficacy" based on data gained in a large trial investigating different over-the-counter drugs in the treatment of h...
journal_title:Headache
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1526-4610.2008.01242.x
更新日期:2009-05-01 00:00:00
abstract::Subarachnoid hemorrhage as a complication of acupuncture has been reported in only a few cases. We report another case and discuss the implications of subarachnoid hemorrhage following acupuncture. Although acupuncture has traditionally been thought to be relatively safe, physicians should be aware that it may be a ca...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2008.01139.x
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To study the therapeutic potential of the subcutaneous administration of Nalpha-methylhistamine in migraine prophylaxis. BACKGROUND:The histamine catabolite, Nalpha-methylhistamine, possesses a selective affinity for H3 receptors. We consequently considered it viable to conduct a clinical pharmacological stu...
journal_title:Headache
pub_type: 临床试验,杂志文章
doi:10.1046/j.1526-4610.2003.03074.x
更新日期:2003-04-01 00:00:00
abstract::The drug discovery programs that led to the development of the triptans were determined by the membership of the American Headache Society to be the most important breakthrough in headache medicine in the last 50 years. Dr. Humphrey, who spearheaded the drug discovery, recounts the pioneering work that took place and ...
journal_title:Headache
pub_type: 历史文章,杂志文章
doi:10.1111/j.1526-4610.2008.01097.x
更新日期:2008-05-01 00:00:00
abstract::We report the case of a man with episodic cluster headache who suffered from severe obstructive sleep apnea (OSA) as well as periodic limb movements during sleep (PLMS). His attacks of headache occurred primarily during sleep being timely to REM sleep as 90 to 120 minutes interval. OSAs were more frequent and prolonge...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2005.t01-3-05013.x
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To assess urinary 6-sulphatoxymelatonin levels in a large consecutive series of patients with migraine and several comorbidities (chronic fatigue, fibromyalgia, insomnia, anxiety, and depression) as compared with controls. BACKGROUND:Urine analysis is widely used as a measure of melatonin secretion, as it is...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2009.01547.x
更新日期:2010-03-01 00:00:00
abstract::The intimate relationship between sleep and headache has been recognized for centuries, yet the relationship remains clinically and nosologically complex. Headaches associated with nocturnal sleep have often been perceived as either the cause or result of disrupted sleep. An understanding of the anatomy and physiology...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2003.03055.x
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To look at the smoking history of migraine patients and to determine if a history of cigarette smoking is associated with the development of cranial autonomic symptoms with migraine headaches. BACKGROUND:It has recently been noted that a significant number of migraine patients may develop autonomic symptoms ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2010.01707.x
更新日期:2011-01-01 00:00:00
abstract::Pain has been considered as part of a defensive strategy whose specific role is to signal an immediate active danger to the organism. This definition fits well for acute pain. It does not work well, however, for chronic pain that is maintained even in absence of an ongoing, active threat. Currently, acute and chronic ...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/j.1526-4610.2012.02244.x
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The role of diet in the management of the headache patient is a controversial topic in the headache field. OBJECTIVES:To review the evidence supporting the hypothesis that specific foods or ingredients within foods and beverages trigger attacks of headache and/or migraine and to discuss the use of eliminati...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.12953
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Serotonergic mechanisms play an important role in the pathogenesis of headache. To search for potential indicators of altered serotonin homeostasis in migraine, we have investigated three parameters of the platelet serotonin (5HT) system, platelet serotonin level (PSL), platelet serotonin uptak...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2002.02145.x
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Migraine is a highly disabling disease affecting a significant proportion of the Australian population. The methylenetetrahydrofolate reductase (MTHFR) C677T variant has been associated with increased levels of homocysteine and risk of migraine with aura (MA). Folic acid (FA), vitamin B6 , and B12 supplement...
journal_title:Headache
pub_type: 杂志文章,随机对照试验
doi:10.1111/head.12490
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:This cross-sectional study examined the association between adverse childhood experiences (ACEs) and history of frequent headaches (including migraine) among children 3-17 years old using data from the 2016 and 2017 U.S. National Survey of Children's Health (NSCH). BACKGROUND:ACEs include abuse (physical, e...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13773
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Migraine is a common cause of headache in adolescents. Assuming that the cerebral vasculature is involved in the pathophysiology of migraine, we compared cerebral vasoreactivity in adolescents both during a migraine attack and a headache-free interval. METHODS:A functional transcranial Doppler test utilizin...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2003.03090.x
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To investigate the influence of different pharmacological treatments on the intensity dependence of auditory evoked cortical potentials in migraineurs. BACKGROUND:Between attacks, patients with migraine show abnormalities in cortical information processing and decreased brain mitochondrial energy reserve. Bo...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2000.00005.x
更新日期:2000-01-01 00:00:00
abstract::The ideal migraine medication would provide rapid “one and done” treatment of migraine for all sufferers. Unfortunately, no such intervention is available. While most people respond to triptans or DHE, some will need to combine these with an NSAID, or will choose to use an NSAID alone because of personal preference or...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12474
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between hyposerotonin and cranial microvascular responses to nitric oxide (NO). BACKGROUND:Although the mechanism underlying NO supersensitivity in migraine is still unclear, an alteration of the serotonin system is a possible explanation. METHODS:Wistar rats were divided int...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2000.00040.x
更新日期:2000-04-01 00:00:00
abstract::Neurotologic symptoms are common with migraine, yet relatively little is known about the pathophysiology of such symptoms. Motion sensitivity with bouts of motion sickness occurs in about two thirds of patients with migraine. Episodes of vertigo occur in about one fourth of patients and, in some, vertigo is the only s...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1046/j.1526-4610.1997.3710615.x
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:Previous attempts to develop a pragmatic human model for testing new anti-migraine drugs, have failed. Calcitonin gene-related peptide (CGRP) induces a mild headache in healthy volunteers and migraine-like headache in migraine patients. The induced headache must respond to already established migraine treatme...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13747
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of celecoxib for treatment of withdrawal headache vs prednisone in patients with medication overuse headache (MOH). METHODS:In this prospective, double-blind, parallel-group clinical trial, 97 consecutive subjects with MOH were randomized (simple randomization using computer-generated...
journal_title:Headache
pub_type: 杂志文章,随机对照试验
doi:10.1111/head.12487
更新日期:2015-01-01 00:00:00