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Jes Olesen - One of the best experts on this subject based on the ideXlab platform.

  • ichd 3 is significantly more specific than ichd 3 beta for diagnosis of Migraine with Aura and with typical Aura
    Journal of Headache and Pain, 2020
    Co-Authors: Carl H Gobel, Jes Olesen, Sarah C Karstedt, Thomas F Munte, Hartmut Gobel, Sebastian Wolfrum, Elena R Lebedeva, Georg Royl
    Abstract:

    Background In the emergency room, distinguishing between a Migraine with Aura and a transient ischemic attack (TIA) is often not straightforward and mistakes can be harmful to both the patient and to society. To account for this difficulty, the third edition of the International Classification of Headache disorders (ICHD-3) changed the diagnostic criteria of Migraine with Aura.

  • effect of hypoxia on bold fmri response and total cerebral blood flow in Migraine with Aura patients
    Journal of Cerebral Blood Flow and Metabolism, 2019
    Co-Authors: Nanna Arngrim, Jes Olesen, Anders Hougaard, Faisal Mohammad Amin, Henrik Larsson, Henrik Winther Schytz, Mark B Vestergaard, Josefine Britze, Karsten Skovgaard Olsen, Messoud Ashina
    Abstract:

    Experimentally induced hypoxia triggers Migraine and Aura attacks in patients suffering from Migraine with Aura (MA). We investigated the blood oxygenation level-dependent (BOLD) signal response to...

  • characterization of consistent triggers of Migraine with Aura
    Cephalalgia, 2011
    Co-Authors: Anne Werner Hauge, M Kirchmann, Jes Olesen
    Abstract:

    ObjectiveThe aim of the present study was to characterize perceived consistent triggers of Migraine with Aura (MA).MethodQuestionnaires specifically designed to characterize various trigger factors were sent to 181 participants identified in an earlier study. All participants had formerly identified at least one factor that often or always triggered an MA attack. They only answered questions regarding this or these factor(s).ResultsThe response rate to the questionnaire was 70% (126/179). A number of subtype triggers were mentioned by a high proportion of patients: too much work (under the stress category 54/64), reflected sunlight (under the light category 35/44), too little sleep (under the sleep category 19/24), red wine (under the alcohol category 20/22), passive smoking (under the smoke category 11/11), menstruation (under the menstruation or break from the pill category 12/14) and perfume (under the fumes/heavy scents category 12/15). Hormones, light and stress were reported to cause at least 50 % o...

  • trigger factors in Migraine with Aura
    Cephalalgia, 2010
    Co-Authors: Anne Werner Hauge, M Kirchmann, Jes Olesen
    Abstract:

    The aim of the present study was to identify trigger factors in Migraine with Aura (MA). A total of 629 MA patients representative of the Danish population were sent a questionnaire listing 16 trigger factors thought to be relevant as well as space for free text. Distinction was made between attacks with or without Aura within each patient. The questionnaire was returned by 522 patients of whom 347 had current MA attacks. In total 80% with current attacks (278/347) indicated that at least one factor triggered their Migraine, and 67% (187/278) in this group indicated that they were aware of at least one factor often or always giving rise to an attack of MA. Forty-one per cent (113/278) had co-occurring attacks of Migraine without Aura (MO). Stress (following stress), bright light, intense emotional influences, stress (during stress) and sleeping too much or too little were the trigger factors mentioned by most. Attack frequency had little impact on the number of trigger factors. Women reported more trigger factors than men. Patients having attacks of both MA and MO reported more trigger factors for MO attacks than for MA attacks. In conclusion, 80% of patients with MA reported trigger factors and two-thirds of these reported at least one trigger factor often or always triggering an attack of MA. Patients should be educated to avoid these factors.

  • effects of tonabersat on Migraine with Aura a randomised double blind placebo controlled crossover study
    Lancet Neurology, 2009
    Co-Authors: Anne Werner Hauge, Henrik Winther Schytz, Mohammed S Asghar, Karl Bang Christensen, Jes Olesen
    Abstract:

    Summary Background Migraine with Aura is thought likely to be caused by cortical spreading depression (CSD). Tonabersat inhibits CSD, and we therefore investigated whether tonabersat has a preventive effect in Migraine with Aura. Methods In this randomised, double-blind, placebo-controlled crossover trial, 40 mg tonabersat once daily was compared with matched placebo in patients who had at least one Aura attack per month during the past 3 months. Randomisation was by computer-generated list. Patients kept a detailed diary to enable objective diagnosis of each attack as Migraine with Aura, Migraine without Aura, or other type of headache. Primary endpoints were a reduction in Aura attacks with or without headache and a reduction in Migraine headache days with or without an Aura. Analysis was per protocol. This trial is registered, number NCT00332007. Findings 39 patients were included in the study, of whom 31 were included in the statistical analysis of efficacy. Median (IQR) attacks of Aura were reduced from 3·2 (1·0–5·0) per 12 weeks on placebo to 1·0 (0–3·0) on tonabersat (p=0·01), whereas the other primary outcome measure, median Migraine headache days with or without Aura, was not significantly different between placebo and tonabersat groups (3·0 days in each group; p=0·09). Tonabersat was well tolerated but overall had more side-effects than placebo. Interpretation Tonabersat showed a preventive effect on attacks of Migraine Aura but no efficacy on non-Aura attacks, in keeping with its known inhibitory effect on CSD. The results support the theory that Auras are caused by CSD and that this phenomenon is not involved in attacks without Aura. Funding Minster Pharmaceuticals; Lundbeck Foundation.

W L Morrison - One of the best experts on this subject based on the ideXlab platform.

  • Clopidogrel reduces Migraine with Aura after transcatheter closure of persistent foramen ovale and atrial septal defects
    Heart, 2005
    Co-Authors: Peter Wilmshurst, S. Nightingale, Kevin Walsh, W L Morrison
    Abstract:

    Objective: To report the clinical events leading to alteration of an anticoagulation regimen for patients undergoing transcatheter closure of an atrial shunt and how this affected Migraine symptoms after the closure procedure. Method: Audit of a change of anticoagulant regimen. Results: In the first few weeks after a closure procedure Migraine frequency and severity increased despite treatment with aspirin for six months in 71 patients. Severe attacks of Migraine with Aura, including status migrainosus, in the first few weeks after transcatheter closure were terminated by addition of clopidogrel to aspirin treatment. Therefore, the anticoagulant regimen was changed with addition of clopidogrel for the first month after the closure procedure (90 procedures in 89 patients). Fewer patients had Migraine with Aura in the first month after transcatheter closure when taking the combination of clopidogrel and aspirin compared with aspirin alone (11 of 90 (12.2%) v 30 of 71 (42.3%), p Conclusion: The combination of clopidogrel for four weeks and aspirin for six months is superior to aspirin alone for six months for preventing Migraine with Aura after transcatheter closure of an atrial shunt. This beneficial effect of a powerful inhibitor of platelet aggregation suggests that platelets may have a role in pathogenesis of Migraine. This may be because of an effect on serotonin stores. Whether clopidogrel has a role in treatment of Migraine in other clinical situations requires investigation.

  • inheritance of persistent foramen ovale and atrial septal defects and the relation to familial Migraine with Aura
    Heart, 2004
    Co-Authors: Peter Wilmshurst, S. Nightingale, Kevin Walsh, Matthew Pearson, W L Morrison
    Abstract:

    Objective: To determine whether smaller atrial shunts (large persistent foramen ovale (PFO) and small atrial septal defect (ASD)) are inherited and whether this has a role in the inheritance of Migraine with Aura. Methods: Contrast echocardiography was used to detect atrial shunts in 71 relatives of 20 probands with a significantly sized atrial shunt (large PFO or ASD). Four families with three generations, 14 families with two generations, and two sibships were studied. The contrast echocardiograms were performed blind to history of Migraine. A consultant neurologist, who was blinded to cardiac findings, categorised Migraine symptoms in subjects. Results: The occurrence of atrial shunts was consistent with autosomal dominant inheritance. Usually shunts were large PFOs, but in some cases they were ASDs. There was also evidence that inheritance of more complex congenital heart disease may be related to the inheritance of PFOs. When the proband had Migraine with Aura and an atrial shunt, 15 of the 21(71.4%) first degree relatives with a significant right to left shunt also had Migraine with Aura compared with three of 14 (21.4%) without a significant shunt (p Conclusions: There is dominant inheritance of atrial shunts. This is linked to inheritance of Migraine with Aura in some families.

Roland Wiest - One of the best experts on this subject based on the ideXlab platform.

  • Imaging Neurovascular Uncoupling in Acute Migraine with Aura with Susceptibility Weighted Imaging
    Clinical Neuroradiology, 2020
    Co-Authors: Frauke Kellner-weldon, Marina Jossen, Philipe S. Breiding, Lorenz Grunder, Christoph Schankin, Adrian Scutelnic, Urs Fischer, Raphaela Muri, Manuela Pastore-wapp, Roland Wiest
    Abstract:

    Purpose Migraine with Aura (MwA) in the emergency setting is common and sometimes difficult to distinguish from mimicking conditions. Susceptibility weighted imaging (SWI), a magnet resonance (MR) technique is sensitive to deoxygenated hemoglobin in cerebral veins and depicts these according to their level of oxygenation. Our study aimed at evaluating the frequency of regions of prominent focal veins (PFV) on SWI in the acute phase. Methods Between 2011 and 2018 we evaluated symptoms and MR imaging of adult patients with acute MwA attacks (

Heinrich Mattle - One of the best experts on this subject based on the ideXlab platform.

  • percutaneous closure of patent foramen ovale in Migraine with Aura a randomized controlled trial
    European Heart Journal, 2016
    Co-Authors: Heinrich Mattle, Stefan Evers, David Hildicksmith, Werner J Becker, Helmut Baumgartner, Jeremy Chataway, Marek J Gawel, H Gobel, Axel Heinze, Eric Horlick
    Abstract:

    Aims Migraine with Aura and patent foramen ovale (PFO) are associated. The Percutaneous Closure of PFO in Migraine with Aura (PRIMA) trial is a multicentre, randomized trial to investigate the effect of percutaneous PFO closure in patients refractory to medical treatment. Methods Migraine with Aura patients and PFO who were unresponsive to preventive medications were randomized to PFO closure or medical treatment. Both groups were given acetylsalicylic acid 75–100 mg/day for 6 months and clopidogrel 75 mg/day for 3 months. The primary endpoint was reduction in monthly Migraine days during months 9–12 after randomization compared with a 3-month baseline phase before randomization. The committee reviewing the headache diaries were blinded to treatment assignment. Results One hundred and seven patients were randomly allocated to treatment with an Amplatzer PFO Occluder ( N = 53) or control with medical management ( N = 54). The trial was terminated prematurely because of slow enrolment. Eighty-three patients (40 occluder, 43 control) completed 12-month follow-up. Mean Migraine days at baseline were 8 (±4.7 SD) in the closure group and 8.3 (±2.4) in controls. The primary endpoint was negative with −2.9 days after PFO closure vs. −1.7 days in control group ( P = 0.17). Patent foramen ovale closure caused five adverse events without permanent sequelae. Conclusion In patients with refractory Migraine with Aura and PFO, PFO closure did not reduce overall monthly Migraine days.

  • prevalence and size of directly detected patent foramen ovale in Migraine with Aura
    Neurology, 2005
    Co-Authors: Markus Schwerzmann, Krassen Nedeltchev, F Lagger, Heinrich Mattle, S Windecker, Bernhard Meier, C Seiler
    Abstract:

    Background: Transcranial contrast Doppler studies have shown an increased prevalence of right-to-left shunts in patients with Migraine with Aura compared with controls. The anatomy and size of these right-to-left shunts have never been directly assessed. Methods: In a cross-sectional case-control study, the authors performed transesophageal contrast echocardiography in 93 consecutive patients with Migraine with Aura and 93 healthy controls. Results: A patent foramen ovale was present in 44 (47% [95% CI 37 to 58%]) patients with Migraine with Aura and 16 (17% [95% CI 10 to 26%]) control subjects (OR 4.56 [95% CI 1.97 to 10.57]; p p p Conclusions: Nearly half of all patients with Migraine with Aura have a right-to-left shunt due to a patent foramen ovale. Shunt size is larger in Migraineurs than controls. The clinical presentation of Migraine is identical in patients with and without a patent foramen ovale.

Peter Wilmshurst - One of the best experts on this subject based on the ideXlab platform.

  • Clopidogrel reduces Migraine with Aura after transcatheter closure of persistent foramen ovale and atrial septal defects
    Heart, 2005
    Co-Authors: Peter Wilmshurst, S. Nightingale, Kevin Walsh, W L Morrison
    Abstract:

    Objective: To report the clinical events leading to alteration of an anticoagulation regimen for patients undergoing transcatheter closure of an atrial shunt and how this affected Migraine symptoms after the closure procedure. Method: Audit of a change of anticoagulant regimen. Results: In the first few weeks after a closure procedure Migraine frequency and severity increased despite treatment with aspirin for six months in 71 patients. Severe attacks of Migraine with Aura, including status migrainosus, in the first few weeks after transcatheter closure were terminated by addition of clopidogrel to aspirin treatment. Therefore, the anticoagulant regimen was changed with addition of clopidogrel for the first month after the closure procedure (90 procedures in 89 patients). Fewer patients had Migraine with Aura in the first month after transcatheter closure when taking the combination of clopidogrel and aspirin compared with aspirin alone (11 of 90 (12.2%) v 30 of 71 (42.3%), p Conclusion: The combination of clopidogrel for four weeks and aspirin for six months is superior to aspirin alone for six months for preventing Migraine with Aura after transcatheter closure of an atrial shunt. This beneficial effect of a powerful inhibitor of platelet aggregation suggests that platelets may have a role in pathogenesis of Migraine. This may be because of an effect on serotonin stores. Whether clopidogrel has a role in treatment of Migraine in other clinical situations requires investigation.

  • inheritance of persistent foramen ovale and atrial septal defects and the relation to familial Migraine with Aura
    Heart, 2004
    Co-Authors: Peter Wilmshurst, S. Nightingale, Kevin Walsh, Matthew Pearson, W L Morrison
    Abstract:

    Objective: To determine whether smaller atrial shunts (large persistent foramen ovale (PFO) and small atrial septal defect (ASD)) are inherited and whether this has a role in the inheritance of Migraine with Aura. Methods: Contrast echocardiography was used to detect atrial shunts in 71 relatives of 20 probands with a significantly sized atrial shunt (large PFO or ASD). Four families with three generations, 14 families with two generations, and two sibships were studied. The contrast echocardiograms were performed blind to history of Migraine. A consultant neurologist, who was blinded to cardiac findings, categorised Migraine symptoms in subjects. Results: The occurrence of atrial shunts was consistent with autosomal dominant inheritance. Usually shunts were large PFOs, but in some cases they were ASDs. There was also evidence that inheritance of more complex congenital heart disease may be related to the inheritance of PFOs. When the proband had Migraine with Aura and an atrial shunt, 15 of the 21(71.4%) first degree relatives with a significant right to left shunt also had Migraine with Aura compared with three of 14 (21.4%) without a significant shunt (p Conclusions: There is dominant inheritance of atrial shunts. This is linked to inheritance of Migraine with Aura in some families.