Abstract:
OBJECTIVE:To evaluate the efficacy of remote nonpainful electrical upper arm skin stimulation in reducing migraine attack pain. METHODS:This is a prospective, double-blinded, randomized, crossover, sham-controlled trial. Migraineurs applied skin electrodes to the upper arm soon after attack onset for 20 minutes, at various pulse widths, and refrained from medications for 2 hours. Patients were asked to use the device for up to 20 attacks. RESULTS:In 71 patients (299 treatments) with evaluable data, 50% pain reduction was obtained for 64% of participants based on best of 200-μs, 150-μs, and 100-μs pulse width stimuli per individual vs 26% for sham stimuli. Greater pain reduction was found for active stimulation vs placebo; for those starting at severe or moderate pain, reduction (1) to mild or no pain occurred in 58% (25/43) of participants (66/134 treatments) for the 200-μs stimulation protocol and 24% (4/17; 8/29 treatments) for placebo (p = 0.02), and (2) to no pain occurred in 30% (13/43) of participants (37/134 treatments) and 6% (1/17; 5/29 treatments), respectively (p = 0.004). Earlier application of the treatment, within 20 minutes of attack onset, yielded better results: 46.7% pain reduction as opposed to 24.9% reduction when started later (p = 0.02). CONCLUSION:Nonpainful remote skin stimulation can significantly reduce migraine pain, especially when applied early in an attack. This is presumably by activating descending inhibition pathways via the conditioned pain modulation effect. This treatment may be proposed as an attractive nonpharmacologic, easy to use, adverse event free, and inexpensive tool to reduce migraine pain. CLINICALTRIALSGOV IDENTIFIER:NCT02453399. CLASSIFICATION OF EVIDENCE:This study provides Class III evidence that for patients with an acute migraine headache, remote nonpainful electrical stimulation on the upper arm skin reduces migraine pain.
journal_name
Neurologyjournal_title
Neurologyauthors
Yarnitsky D,Volokh L,Ironi A,Weller B,Shor M,Shifrin A,Granovsky Ydoi
10.1212/WNL.0000000000003760subject
Has Abstractpub_date
2017-03-28 00:00:00pages
1250-1255issue
13eissn
0028-3878issn
1526-632Xpii
WNL.0000000000003760journal_volume
88pub_type
杂志文章,随机对照试验相关文献
NEUROLOGY文献大全abstract:OBJECTIVE:To investigate whether arginine methylation is altered in patients with amyotrophic lateral sclerosis (ALS) and how it affects disease severity, progression, and prognosis. METHODS:We compared the immunoreactivity of protein arginine methyltransferase 1 (PRMT1) and its products, asymmetric dimethylated prote...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000007311
更新日期:2019-04-16 00:00:00
abstract::The authors report results of SPECT cerebral perfusion studies in two patients with familial dysautonomia (FD) during dysautonomic crises and when clinically stable. SPECT imaging studies used 99mTc ethylene cysteine dimer. During dysautonomic crises, regions in the temporoparietal and frontal lobes had increased upta...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.55.1.122
更新日期:2000-07-12 00:00:00
abstract:OBJECTIVE:To investigate clinical differences in warm and cold complex regional pain syndrome (CRPS) phenotypes. BACKGROUND:CRPS represents inhomogeneous chronic pain conditions; approximately 70% patients with CRPS have "warm" affected limbs and 30% have "cold" affected limbs. METHODS:We examined 50 patients with "c...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000341930.35494.66
更新日期:2009-02-10 00:00:00
abstract:BACKGROUND:Galantamine is a reversible, competitive cholinesterase inhibitor that also allosterically modulates nicotinic acetylcholine receptors. These mechanisms of action provided the rationale for a therapeutic trial of galantamine in AD. METHODS:A 6-month, multicenter, double-blind trial was undertaken in 636 pat...
journal_title:Neurology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1212/wnl.54.12.2261
更新日期:2000-06-27 00:00:00
abstract::The extracranial carotid systems of 105 patients with retinal ischemia were examined using B-mode ultrasonography with integrated pulsed Doppler. Sixty-four patients had amaurosis fugax (AF), 17 central retinal artery occlusions (CRAO), and 21 branch retinal artery occlusions (BRAO). The prevalence of carotid stenosis...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.38.6.858
更新日期:1988-06-01 00:00:00
abstract::We present a patient with levodopa-resistant parkinsonism due to basal ganglia calcification related to surgically-induced hypoparathyroidism. The calcification was seen on computerized axial tomography but not on skull x-rays. Such calcification should be looked for in all cases of levodopa-resistant parkinsonism, si...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.26.3.221
更新日期:1976-03-01 00:00:00
abstract::Minor head trauma precipitated oculomotor nerve palsies in two patients who subsequently were discovered to have ipsilateral posterior communicating artery aneurysms. A history of minor trauma should not dissuade investigation for underlying causes of oculomotor nerve palsy, including intracranial aneurysm. ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.44.1.148
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:To assess the association of primary retinal inflammation, namely retinal periphlebitis (RP) and microcystic macular edema, with clinical, brain, and retinal imaging biomarkers of multiple sclerosis (MS) severity. METHODS:One hundred patients with MS underwent a neurologic and ophthalmic examination, MRI, a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3182a3525e
更新日期:2013-09-03 00:00:00
abstract::Use of neuroleptic medications is common among elderly patients. Using multivariate models, the authors found that use of antipsychotic medications, age, and disability were strong predictors of developing self-reported Parkinson disease (PD) in the subsequent year among 1992 to 2000 Medicare Current Beneficiary Surve...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000203348.13337.89
更新日期:2006-03-28 00:00:00
abstract::A median safinamide (SAF) dose of 70 mg/day (range 40 to 90 mg/day) increased the percentage of parkinsonian patients improving their motor scores by > or =30% from baseline (responders) after 3 months from 21.4% (placebo) to 37.5% (p < 0.05, calculated by logistic regression analysis). In a subgroup of 101 patients u...
journal_title:Neurology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1212/01.wnl.0000134672.44217.f7
更新日期:2004-08-24 00:00:00
abstract:OBJECTIVE:Evidence of a relation between use of lipid lowering drugs and cognitive outcomes is mixed. This study aimed to test the association between use of statins and incidence of dementia and cognitive impairment without dementia (CIND) over 5 years of follow-up. METHODS:Data were from a population-based cohort st...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000319647.15752.7b
更新日期:2008-07-29 00:00:00
abstract::We studied electrically elicited blink reflex responses in patients with hemifacial spasm (HFS) by applying single isolated, as well as paired (conditioning and test), stimuli at both sides of the face. Responses after single stimuli were of larger size on the side of the spasm compared with the uninvolved side and co...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.39.8.1061
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:To investigate clinical and economic consequences following generic substitution of one vs multiple generics of topiramate (Topamax; Ortho-McNeil Neurologics, Titusville, NJ). METHODS:Medical and pharmacy claims data of Régie de l'Assurance-Maladie du Québec from January 2006 to October 2007 were used. Patie...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181aa5300
更新日期:2009-06-16 00:00:00
abstract::The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. Th...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/WNL.0b013e31829d8783
更新日期:2013-07-30 00:00:00
abstract:BACKGROUND:Recent studies demonstrated an excess of winter births in children with brain tumors and in adults with various neurologic or psychiatric diseases relative to the general population. OBJECTIVE:To investigate a possible association between month of birth and risk of brain tumors in adults using data from a l...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/01.wnl.0000129984.01327.9d
更新日期:2004-07-27 00:00:00
abstract:OBJECTIVE:To describe four patients with temporal lobe epilepsy with limbic encephalitis unrelated to neoplasm. METHODS:The authors performed a retrospective evaluation of patient data obtained during presurgical evaluation, with additional CSF analyses, serum analyses, and histopathologic investigations. RESULTS:The...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.55.12.1823
更新日期:2000-12-26 00:00:00
abstract::Two patients with acute onset of profound weakness and loss of muscle bulk during a critical illness had unusual histopathological changes of type II myofibers. Both patients had respiratory failure and prolonged neuromuscular blockade. High-dose steroids were used in only one case and atracurium in the other. Muscle ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.46.3.819
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To investigate to what extent subjective memory complaints and APOE-epsilon4 allele carriage predict future cognitive decline in cognitively intact elderly persons, by evaluating both their separate and combined effects. METHODS:We selected 1,168 subjects from the population-based Longitudinal Aging Study Am...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.57.12.2217
更新日期:2001-12-26 00:00:00
abstract::Presenilin (PSEN)1 mutations are responsible for many cases of autosomal dominant Alzheimer disease (AD), although the clinical spectrum has not been fully defined. The authors describe two members of a kindred with a novel PSEN1 mutation (R278I) presenting with language impairment and relative preservation of memory....
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000143060.98164.1a
更新日期:2004-11-09 00:00:00
abstract:OBJECTIVE:To systematically review the evidence concerning the diagnostic yield of genetic and metabolic evaluation of children with global developmental delay or intellectual disability (GDD/ID). METHODS:Relevant literature was reviewed, abstracted, and classified according to the 4-tiered American Academy of Neurolo...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/WNL.0b013e3182345896
更新日期:2011-10-25 00:00:00
abstract:OBJECTIVE:To combine MRI-based cortical morphometry and diffusion white matter tractography to describe the anatomical correlates of repetition deficits in patients with primary progressive aphasia (PPA). METHODS:The traditional anatomical model of language identifies a network for word repetition that includes Wernic...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000008746
更新日期:2020-02-11 00:00:00
abstract::We performed proton magnetic resonance spectroscopic imaging (1H-MRSI) in patients with motor neuron disease (MND) to evaluate the distribution and extent of cortical neuron damage or loss as reflected by decreased N-acetyl (NA) to creatine (Cr) resonance intensity ratios. We examined premotor (superior frontal gyrus)...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/wnl.44.10.1933
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between the presence of a circadian body temperature rhythm and behaviorally assessed consciousness levels in patients with disorders of consciousness (DOC; i.e., vegetative state/unresponsive wakefulness syndrome or minimally conscious state). METHODS:In a cross-sectional stu...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000003942
更新日期:2017-05-16 00:00:00
abstract::We prospectively evaluated the relationship between a common psychological stressor and relapses in multiple sclerosis (MS) in a group of 32 MS patients exposed to the threat of missile attacks during the Persian Gulf War of 1991. The number of relapses during the war and the following 2 months was significantly lower...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.43.7.1311
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Frontotemporal dementia (FTD) is currently distinguished from AD primarily on the basis of behavioral features because studies of cognition have shown negligible or inconsistent differences. However, the poor discriminability of cognitive measures may relate to reliance on imprecise clinically diagnosed grou...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.58.12.1801
更新日期:2002-06-25 00:00:00
abstract::We transplanted autologous adrenal medullary tissue into the caudate nucleus of 3 patients with advanced Parkinson's disease. The 1st patient, a 59-year-old man with parkinsonian symptoms for 15 years, had mild improvement in his motor functioning after the operation. However, his postoperative course was characterize...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.39.9.1227
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:To describe the clinical, genetic and MR characteristics of patients with familial mesial temporal lobe epilepsy (MTLE). DESIGN/METHODS:The familial occurrence of MTLE was identified by a systematic search of family history of seizures in patients followed in the authors' epilepsy clinic. All probands and, w...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.56.2.166
更新日期:2001-01-23 00:00:00
abstract::To study the anti-Schwann cell activity of serum from patients with Guillain-Barré syndrome (GBS), we used a 51Cr-release cytotoxicity assay. Specific release of 51Cr mediated by GBS serum did not differ from that with normals or disease controls. Heating sera from GBS patients or controls at 56 or 50 degrees C for 30...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.34.9.1240
更新日期:1984-09-01 00:00:00
abstract::The authors describe two novel mutations of the acid alpha-glucosidase gene, P361L and R437C, which define the juvenile-onset glycogen storage disease type II (GSDII) in a 16-year-old Chinese patient. The asymptomatic 13-year-old brother of the proband is also a compound heterozygote of the two mutations. These result...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000048661.95327.bf
更新日期:2003-02-25 00:00:00
abstract::The predictive value of CSF oligoclonal banding for the development of clinically definite MS (CDMS) within 5 years after optic neuritis was assessed in 76 patients enrolled in the Optic Neuritis Treatment Trial. The presence of oligoclonal bands was associated with the development of CDMS (p = 0.02). However, the res...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.51.3.885
更新日期:1998-09-01 00:00:00