171 |
Pain, motion sickness and migraine: effects on symptoms and scalp blood flowa.granston@murdoch.edu.au, Anna Cuomo-Granston January 2009 (has links)
Migraine, a neurovascular disorder, is associated with disturbances in brain stem activity during attacks. Interictal persistence of these disturbances might increase vulnerability to recurrent attacks of migraine. To explore this possibility, effects of motion sickness and pain on migrainous symptoms and extracranial vascular reponses were investigated in 27 migraine sufferers in the headache-free interval, and 23 healthy age/sex matched controls.
Symptoms of migraine and motion sickness are remarkably similar. As both maladies involve reflexes that relay in the brain stem, they most probably share the same neural circuitry. Furthermore, migraineurs are usually susceptible to motion sickness and, conversely, motion sickness-prone individuals commonly experience migraine. Participants in the present study were exposed to optokinetic stimulation (OKS), a well-established way of inducing symptoms of motion sickness in susceptible individuals.
Sensitivity to painful stimulation of the head and hand was also explored. Head pain is a hallmark of a migraine attack and cutaneous allodynia has been observed elsewhere in the body during attacks. The trigeminal nerve is associated with head pain in migraine, and trigeminal activity evokes reflexes that relay in the brain stem. To stimulate the trigeminal nerve, ice was applied to the temple. To stimulate nociceptors elsewhere in the body the participant immersed their fingers and palm in ice-water.
Procedures used in this study were physically stressful and probably psychologically stressful. The impact of stress in relation to the development of symptomatic and vascular responses, particularly anticipatory stress-responses, was explored.
This research involved one central experiment that consisted of six experimental conditions. On separate occasions participants were exposed to optokinetic stimulation and painful stimulation of the head or limb, individually and in combination.
In migraine sufferers, symptomatic responses were enhanced during all procedures involving OKS and during temple pain after OKS, in the presence of residual motion sickness. During trigeminal stimulation independent of OKS, headache initially developed followed by nausea as the procedure progressed. In contrast, symptoms barely developed in controls during any of the six procedures except for slight dizziness, self-motion and visual-illusion during conditions involving OKS, and slight nausea when the temple was painfully stimulated during OKS and during OKS alone. Trigeminal stimulation during OKS intensified nausea and headache in migraine sufferers compared to during OKS alone or limb pain during OKS. However, the remaining symptomatic ratings were not affected by temple pain during OKS, suggesting a specific association between nausea and head pain. It may be that these cardinal symptoms compound one another during a migraine attack. Enhanced symptomatic responses in migraine sufferers during the headache interval may indicate activation of hypersensitive neural pathways that mediate symptoms of motion sickness or migraine. Migraineurs found procedures generally more unpleasant, and ice-induced pain ratings more intense and unpleasant, than controls, which may further indicate hyperexcitable nociception in this group, or a difference in their criterion of discomfort.
Vascular responses, particularly during OKS alone, and during painful stimulation independent of OKS, were greater in migraine sufferers than in controls. The added stress of painful stimulation during OKS appeared to boost facial blood flow in controls to approach levels obtained in migraine sufferers. Enhanced vasodilatation was observed in migraineurs prior to painful stimulation, presumably due to anticipatory anxiety.
For both groups ipsilateral vascular responses were greater than contralateral responses when the hand was painfully stimulated. During limb pain before OKS asymmetry was minimal in migraine sufferers but more apparent in controls. An enhanced stress response in migraineurs may have drawn ipsilateral and contralateral responses closer together.
The development of symptoms during the procedures of this study provides an insight into how symptoms might develop sequentially in a migraine attack. Once the headache is in motion, nausea and headache may mutually exacerbate one another. In turn, trigemino-vascular responses and stress appear to be associated with the migraine crisis. Given the interactive nature of symptomatic, vascular, and stress responses, it may be more effective to target multiple, rather than individual, symptoms, in prophylactic or acute chemical and psychological interventions.
|
172 |
Kronik günlük başağrısında valproik asit tedavisinin sonuçlarının değerlendirilmesi /Yürekli, Vedat Ali. Akhan, Galip. January 2005 (has links) (PDF)
Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, 2005. / Bibliyografya var.
|
173 |
Two perspectives on migraine treatment : pharmaceuticals vs. acupuncture.Kool, Kat. January 2005 (has links) (PDF)
No description available.
|
174 |
Migraine et pathologie vasculaire cérébrale ischémique.Artus, Olivier, January 1900 (has links)
Th.--Méd.--Nancy 1, 1983. N°: 137.
|
175 |
En litteraturstudie om hur migrän påverkar personers dagliga liv / A literature study on how migraine affects peoples’ daily livesGöthlin, Fredrik, Kariminejad, Vesal January 2018 (has links)
Migrän är en relativt vanlig kronisk och neurologisk sjukdom, som vanligtvis kännetecknas av en återkommande och episodisk huvudvärk vilket också kan inkludera illamående, ljus- och ljudkänslighet. Syftet var att beskriva upplevelser av migrän och dess påverkan på personers dagliga liv. En allmän litteraturstudie gjordes genom systematiska databassökningar. Nio kvalitativa artiklar valdes ut som matchade med studiens syfte, vilka analyserades med utgångspunkt från innehållsanalys. Databearbetningen resulterade i tre huvudkategorier: Strategi och förhållningssätt, Känslan av migrän samt Känslan av bemötande; och sex subkategorier: Förnekelse, Förebyggande, Smärta, Påverkan, Bemötande och Förståelse. Resultatet visade att migrän hade en negativ, känslomässig påverkan på de drabbade där smärtan samt känslan att inte bli tagen på allvar av samhället, anhöriga samt vården var återkommande. Okunskap och ifrågasättande från vårdpersonal drabbade personer som led av migrän med vård som inte var individanpassad. Sökandet efter kunskap för att förstå sjukdomen migrän bättre var centralt hos de migrändrabbade. Konklusionen av studien var ett behov av vidare kvalitativ forskning, spridning av kunskap samt uppmärksamhet om migrän, vilket är rekommenderat för att öka förståelsen för personer som lider av migrän. / Migraine is a relatively common chronic neurological disorder, characterized by a reoccurring episodic headache which also can include nausea, photophobia and phonophobia. The study aimed to describe experiences of migraine and its impact on migraine sufferers’ daily lives. An overview was done through systematic database searches. Nine qualitative articles were found that matched the study’s aim, which were analyzed with the use of content analysis. This resulted in three categories: Strategy and approach, Feeling of migraine and Feeling of treatment; in addition to six subcategories: Denial, Prevention, Pain, Impact, Treatment and Understanding. The results showed that migraine had a negative, emotional impact on the sufferers where pain and the feeling of not being taken seriously by society, kindred and the healthcare system were recurring. Ignorance and negligence from healthcare providers resulted in migraine sufferers not receiving person-centered care. The search for knowledge by the sufferers was central to better understand their own migraine. The study concluded that more qualitative research, spread of knowledge and acknowledgement of migraine are recommended to improve the understanding of migraine sufferers.
|
176 |
Translaminar patterns of c-Fos activation in rat motor cortex after unilateral cortical spreading depressionBazarian, Alina 17 June 2016 (has links)
The purpose of this study was to examine the effects of cortical spreading depression on neuronal activity in the rat motor (M1) cortex. It is known that cortical spreading depression causes widespread neuronal and glial activity in the cortex, but the degree to which it exerts its effects is unclear. Cortical spreading depression was induced in eight Sprague-Dawley male rats. After two hours, animals were euthanized and immunohistochemistry was performed on the brain to stain for the presence of c-Fos, an immediate early gene that is a well-known marker of neuronal activity. Sections were counterstained for Nissl substance to reveal two populations of cells: Nissl-stained neurons that were c-Fos positive, activated cells and Nissl-stained neurons that were c-Fos negative, non-activated cells. Three sections for each animal were examined and 20-30% of the total M1 cortex was analyzed. Cells were counted using systematic random sampling for each of the six cortical layers.
Our results show that the cortical spreading depression did not produce an activation of all neurons. When layers were individually examined, there was a main effect of layer on neuronal activation. This confirmed previous findings that cortical spreading depression had the strongest effect on superficial layers of the cortex
|
177 |
Modelo experimental de diferenciação por odores entre migrânea e outras cefaleias primáriasSILVA-NÉTO, Raimundo Pereira da 01 April 2016 (has links)
Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-10-20T11:59:35Z
No. of bitstreams: 2
license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5)
Tese Doutorado_Raimundo Pereira da Silva-Néto.pdf: 12833897 bytes, checksum: 61d0b7e980e72887cfbdb059a1866d40 (MD5) / Made available in DSpace on 2016-10-20T11:59:35Z (GMT). No. of bitstreams: 2
license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5)
Tese Doutorado_Raimundo Pereira da Silva-Néto.pdf: 12833897 bytes, checksum: 61d0b7e980e72887cfbdb059a1866d40 (MD5)
Previous issue date: 2016-04-01 / Cefaleias primárias são decorrentes de disfunção cerebral e incluem migrânea, cefaleia do tipo
tensional, cefaleias trigêmino-autonômicas e outras. Diversos fatores podem desencadear crises
de cefaleia, mas os odores, especialmente o perfume, estão associados à migrânea. Objetivos:
Caracterizar a estimulação olfatória como fator desencadeante de crises de cefaleia e de
diferenciação entre migrânea e outras cefaleias primárias. Sujeitos e Métodos: O estudo foi
prospectivo, experimental, randomizado com comparação de grupos, realizado no período de
março a junho de 2015. Foram convidados 158 voluntários (73 homens e 85 mulheres)
diagnosticados com cefaleias primárias, de acordo com os critérios da International
Classification of Headache Disorders, Third Edition (beta version) (ICHD-3β). O estudo foi
realizado por dois examinadores; atribuiu-se ao primeiro, diagnosticar a presença e o tipo de
cefaleia primária, enquanto o segundo foi responsável pela exposição dos voluntários ao odor e
pelo registro dos efeitos dessa exposição. Resultados: Dos 158 voluntários com cefaleia, houve
72 (45,6%) casos de migrânea e 86 (54,4%) com outras cefaleias primárias. Dos 72 migranosos,
53 (73,6%) eram mulheres e 19 (26,4%), homens e dos 86 casos de outras cefaleias primárias, 32
(37,2%) eram mulheres e 54 (62,8%), homens. A idade dos voluntários com migrânea e com
outras cefaleias primárias foi, respectivamente, 22,5±3,10 e 22,9±3,10 anos. Essas diferenças não
foram significantes (tmédias=0,666; p=0,566). Nos dois grupos, houve diferença nas características
da cefaleia (c2=4,132; p=0,046). O odor desencadeou cefaleia (25/72; 34,7%) e náusea (5/72;
6,9%) apenas nos voluntários com migrânea, correspondendo a 19,0% (30/158) da amostra e em
nenhum com outras cefaleias primárias (χ²=43,78; p<0,001). A cefaleia ocorreu mais
frequentemente associada à náusea (p=0,146) e de localização bilateral (p=0,002) nos migranosos
que apresentaram cefaleia desencadeada por odor. A cefaleia foi desencadeada após 118,0±24,6
min e a náusea após 72,8±84,7 min da exposição ao odor. Conclusões: O odor desencadeou
crises de cefaleia ou náusea apenas nos pacientes com migrânea. Portanto, cefaleia desencadeada
por odores poderá ser considerada um fator de diferenciação entre migrânea e outras cefaleias
primárias e esse gatilho parece muito específico da migrânea. / Primary headaches are due to brain dysfunction and include migraine, tension-type headache,
trigeminal autonomic cephalalgias and others. Several factors can trigger headache attacks, but
odors, especially perfume, are associated with migraine. Objectives: To characterize the
olfactory stimulation as a trigger of headaches and differentiation of crises between migraine and
other primary headaches. Subjects and Method: The study was prospective, experimental,
randomized with comparison of groups and conducted from March to June 2015. One hundred
fifty-eight volunteers (73 men and 85 women) were diagnosed with primary headaches,
according to criteria of the International Classification of Headache Disorders, third edition (beta
version) (ICHD-3β). The study was conducted by two examiners and assigned to the first to
diagnose the presence and type of primary headache, while the second was responsible for
exposing the volunteers to odor and the recording the effects of this exposure. Results: Of the
158 volunteers with headache, there were 72 (45.6%) cases of migraine and 86 (54.4%) with
other primary headaches. Of the 72 migraineurs, 53 (73.6%) were female and 19 (26.4%) male
and 86 cases of other primary headaches, 32 (37.2%) were female and 54 (62.8%) male. The age
of subjects with migraine and other primary headache was, respectively, 22.5 ± 3.10 and 22.9 ±
3.10 years. These differences were not significant (tmean=0.666; p=0.566). In both groups, there
were differences in headache characteristics (c2=4.132; p=0.046). Headache attacks (25/72;
34.7%) and nausea (5/72; 6.9%) were triggered only in subjects with migraine, corresponding to
19.0% (30/158) of the sample, but in no with other primary headaches (χ²=43.78; p<0.001).
Headache occurred more often associated with nausea (p=0.146) and bilateral location (p=0.002)
in migraineurs who had headache triggered by odor. Headache was triggered after 118.0±24.6
min and nausea after 72.8±84.7 min of exposure to odor. Conclusions: The odor triggered
headache attacks or nausea only in migraineurs. Therefore, headache triggered by odors may be
considered a factor of differentiation between migraine and other primary headaches and this
trigger seems very specific of migraine.
|
178 |
Análise dolimiar de sensibilidade dolorosa à pressão em mulheres com cefaleia primária durante as fases do ciclo mestrualSILVA, Gabriela Almeida da 29 July 2015 (has links)
Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-02-15T14:13:18Z
No. of bitstreams: 2
license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5)
FINAL DISSERTAÇAO.pdf: 2799176 bytes, checksum: e0af1d6e674152ad70b985b0813cb374 (MD5) / Made available in DSpace on 2017-02-15T14:13:19Z (GMT). No. of bitstreams: 2
license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5)
FINAL DISSERTAÇAO.pdf: 2799176 bytes, checksum: e0af1d6e674152ad70b985b0813cb374 (MD5)
Previous issue date: 2015-07-29 / CAPES / Introdução: A avaliação da percepção dolorosa em seres humanos é fundamental
para a compreensão dos mecanismos fisiopatológicos e desenvolvimento de
métodos de controle e manejo da dor. As alterações hormonais ocorridas durante o
ciclo menstrual podem afetar diretamente o processo doloroso crânio facial em
pacientes com cefaleia e influenciar o processo de cronificação da doença.
Objetivo: O presente estudo tem como objetivo analisar o limiar doloroso à pressão
nas diferentes fases do ciclo menstrual e comparar os limiares entre as mulheres
com cefaleia e o grupo controle. Métodos: Trata-se de uma série de casos. Foram
incluídas no estudo 39 mulheres com idade entre 18 e 30 anos (22±2 anos),
eutróficas. O algômetro (Wagner Force Dial) foi utilizado para graduar o limiar de dor
à pressão nos pontos de acupuntura, no músculo trapézio, e nos ramos do nervo
trigêmeo. Foram realizadas avaliações nas fases: menstrual (1° ao 3º dia),
proliferativa (5º dia), ovulatória (14º dia) e lútea (22º dia) para todas as participantes
do presente estudo. Resultados: Houve diferença entre as fases do ciclo menstrual
apenas no grupo que não utiliza anticoncepcional, nos pontos VG20,no grupo CTT,
entre fase menstrual e lútea (p=0,044) e menstrual e proliferativa (p=0,022); e no
ponto IG4D, no grupo migrânea, entre as fases menstrual e lútea (p=0,018) e
menstrual e ovulatória (p=0,014).Houve correlação negativa entre o limiar doloroso
no ponto VG20 na fase lútea e a frequência das crises de cefaleia (p=0,012; r=0,396)
e com o MIDAS (p=0,16; r=-0,383). O ponto IG4 direito na fase lútea está
correlacionado à frequência das crises de cefaleia (p=0,002; r=-0,478) . O ponto IG4
direito na fase ovulatória está correlacionado a frequência das crises de cefaleia
(p=0,013; r=-0,396). Conclusão: mulheres com cefaleia apresentaram menores
médias de limiar de percepção dolorosa em comparação ao grupo saudável em
todos os pontos avaliados. Foi identificada diferença significativa na variação do
limiar de desconforto na migrânea no ponto IG4 direito e na CTT no ponto VG20 no
grupo que não utiliza anticoncepcional, sendo a fase menstrual a menos sensível. O
limiar de desconforto desses pontos está correlacionado positivamente com a
frequência de crises de cefaleia. / Introduction: The assessment of pain perception in humans is important for the
understanding of the pathophysiology and development of methods of control and
pain management. The hormonal changes during the menstrual cycle can directly
affect the process painful craniofacial in patients with headache and influence the
chronicity of the disease process. Objective: This study aims to analyze the pain
threshold to pressure during the different phases of the menstrual cycle and compare
the thresholds among women with migraine and the control group. Methods: This is
a series of cases. The study included 39 women aged between 18 and 30 years (22
± 2 years), eutrophic. The algometer (Wagner Force Dial) was used to measure the
pain threshold to pressure on acupuncture points in the trapezius muscle, and
branches of the trigeminal nerve. Evaluations were carried out in phases: menstrual
(1st to 3rd day), proliferative (5th day), ovulatory (14th day) and luteal (22th day) for
all participants of this study. Results: There was difference between the phases of
the menstrual cycle only in the group that does not use contraceptives, on the VG20
point in the CTT group, between menstrual phase and luteal (p = 0.044) and
menstrual and proliferative (p = 0.022); and on IG4D point,in migraine groupbetween
menstrual phases and luteal (p = 0.018) and menstrual and ovulation (p = 0.014).
There was a negative correlation between pain threshold in VG20 point in the luteal
phase and the frequency of headache attacks (p = 0.012, r = -0.396) and the MIDAS
(p = 0.16; r = -0.383). The right IG4 point in the luteal phase is correlated to the
frequency of headache attacks (p = 0.002, r = -0.478). The rightIG4point in the
ovulatory phase is correlated the frequency of headache attacks (p = 0.013, r = 0.396).
Conclusion: Women with migraine had lower mean pain perception
threshold compared to the healthy group in all points assessed. There was a
significant difference in the variation of discomfort thresholds in migraine on the right
IG4 point in CTT and on the VG20 point in the group not using contraception, with
the menstrual phase the least sensitive. The discomfort level of these points is
positively correlated with the frequency of headache attacks.
|
179 |
Efeito do treino com exercícios aeróbicos em mulheres com fibromialgia e migrâneaBARROS, Manuella Moraes Monteiro Barbosa 31 August 2016 (has links)
Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-03-09T12:28:32Z
No. of bitstreams: 2
license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5)
EFEITO DO TREINO COM EXERCÍCIOS AERÓBICOS EM MULHERES COM FIBROMIALGIA E MIGRÂNEA_CCS.pdf: 1947601 bytes, checksum: de132b63a29552bcfeaefb411d0c72e8 (MD5) / Made available in DSpace on 2017-03-09T12:28:32Z (GMT). No. of bitstreams: 2
license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5)
EFEITO DO TREINO COM EXERCÍCIOS AERÓBICOS EM MULHERES COM FIBROMIALGIA E MIGRÂNEA_CCS.pdf: 1947601 bytes, checksum: de132b63a29552bcfeaefb411d0c72e8 (MD5)
Previous issue date: 2016-08-31 / CAPES / Introdução: Fibromialgia e migrânea são doenças com alta prevalência em mulheres
entre a faixa etária de 30-60 anos, que parecem compartilhar o mesmo mecanismo
fisiopatológico; ambas originam-se de distúrbios neuro-endócrinos do eixo
hipotalâmico-hipofisário no sistema nervoso central, portanto estão intimamente
relacionadas. Além da forte relação com a migrânea, a fibromialgia também pode estar
associada com distúrbios do sono, fadiga crônica e distúrbios psicológicos. A
combinação desses fatores diminui a qualidade de vida e contribui para o aumento do
sedentarismo nessa população. Sabe-se que a prática de exercícios físicos promove
alterações positivas na via fisiopatológica da dor por aumentar a liberação de endorfinas
neuroendógenas, melhorando a sintomatologia da fibromialgia. Objetivo: Avaliar os
efeitos de treinos aeróbicos de diferentes intensidades sobre a frequência, duração e
intensidade das crises de migrânea em mulheres com fibromialgia. Métodos: Foi
realizado um ensaio clínico paralelo randomizado duplo-cego com 10 mulheres
diagnosticadas com fibromialgia e migrânea, com idade entre 30 a 57 anos de idade
(49±8 anos). Inicialmente, todas responderam questionários que avaliavam qualidade de
vida, impacto da cefaleia, nível de depressão e ansiedade, qualidade do sono, nível de
atividade física presença de catastrofização da dor, questionário de percepção de
mudança, e; foi realizada a ergoespirometria para investigação da tolerância ao
exercício. O grupo intensidade moderada (n=6) realizou protocolo composto por
aquecimento, exercícios aeróbicos (de acordo com a frequência cardíaca estabelecida
para o treinamento por meio da ergoespirometria) e desaquecimento; já o grupo
intensidade leve (n=4) realizou o aquecimento com velocidade baixa e freqüência
cardíaca 10bpm abaixo da obtida no primeiro limiar. Ambos os grupos foram
acompanhados durante 8 semanas, com frequência de três encontros semanais e,
reavaliados a cada 4 semanas. Resultados: Não houve diferenças significativas nos
desfechos principais entre os grupos intensidade moderada e intensidade leve (p>0,05).
O treino aeróbico de intensidade moderada mostrou melhoras na qualidade do sono com
4 semanas de tratamento no grupo de intensidade moderada (p=0,02), mas o resultado
não se manteve ao final das 8 semanas. Também no grupo de intensidade moderada,
83,3% das participantes relataram melhora significante ao final da intervenção.
Conclusão: O estudo não mostrou diferenças entre as características da cefaleia
(frequência, duração e intensidade) entre os grupos de intensidade moderada e
intensidade leve após a aplicação de um treino de exercícios aeróbicos. / Introduction: Fibromyalgia and migraine are diseases with high prevalence in women
between the age group of 30-60 years, which seem to share the same pathophysiological
mechanism; both originate from neuroendocrine disorders of the hypothalamic-pituitary
axis in the central nervous system, and are therefore closely related. In addition to the
strong relationship with migraine, fibromyalgia can also be associated with sleep
disorders, chronic fatigue and psychological disorders. The combination of these factors
decreases the quality of life and contributes to the increase of inactivity in this
population. It is known that physical exercise promotes positive changes in pain
pathophysiological pathway by increasing the release of endorphins neuroendógenas,
improving the symptoms of fibromyalgia. Aim: To assess the effects of aerobic training
of different intensity on the frequency, duration and intensity of migraine attacks in
women with fibromyalgia. Methods: We conducted a double-blind randomized parallel
clinical trial with 10 women diagnosed with fibromyalgia and migraine, aged 30-57
years (49 ± 8 years). Initially, all completed questionnaires that assessed quality of life,
impact of headache, level of depression and anxiety, sleep quality, physical activity
level presence of pain catastrophizing, questionnaire of perception of change, and; It
was performed spirometry for research in exercise tolerance. The moderate intensity
group (n = 6) conducted protocol consists of warm-up, aerobic exercise (according to
the heart rate established for training through spirometry) and slowdown; and the light
intensity group (n = 4) held heating with low speed and heart rate will next baseline.
Both groups were followed for eight weeks, with a frequency of three weekly meetings
and re-evaluated every 4 weeks. Results: There were no significant differences between
the groups among the main outcomes between experimental and control groups (p>
0.05). Moderate intensity showed improvements in quality of sleep with 4 weeks of
treatment (p = 0.02), but the result was not maintained to the end of 8 weeks. In the
moderate intensity, 83.3% of participants reported significant improvement at the end of
the intervention. Conclusion: The study showed no difference between the headache
characteristics (frequency, duration and intensity) between the moderate and light
intensity groups after applying a aerobic exercise training.
|
180 |
Análise do impacto da enxaqueca e de outros subgrupos de disfunção temporomandibular na severidade da dor miofascial da musculatura mastigatória e cervical / Impact of migraine and TMD subgroups on pain intensity in patients with myofascial painRafael dos Santos Silva 27 August 2007 (has links)
Objetivos: Avaliar o impacto da Enxaqueca e de outros subgrupos de DTM na severidade da Dor Miofascial da musculatura mastigatória e cervical. Adicionalmente, comparar índices de depressão e ansiedade, além da intensidade de dor subjetiva e outras características associadas entre pacientes com Dor Miofascial com e sem o diagnóstico adicional de Enxaqueca. Material e Métodos: Foram selecionados 203 pacientes, com idade média de 40,3 anos (89,2% do gênero feminino), que se apresentaram à Clínica de Dor Orofacial da UCLA-USA, todos com diagnóstico primário de Dor Miofascial. Pacientes com diagnóstico secundário de Enxaqueca, Cefaléia Tipo-Tensional, Osteoartrite e Capsulite também foram incluídos. Para a análise do impacto, foi utilizado o teste de Regressão Linear Múltipla. O teste de Mann-Whitney foi utilizado para comparar o grupo 1 (Dor Miofascial) com o 2 (Dor Miofascial +Enxaqueca) quanto à intensidade de dor objetiva (palpação) e subjetiva (EAV), ansiedade (BAI) e depressão (BDI), estado de humor, problemas com a função e qualidade do sono (EAV), e incapacidade (EAV e MIDAS). Em todos os testes foi adotado um nível de significância de 5%. Resultados: O modelo de regressão demonstrou um impacto significante de todos os diagnósticos incluídos na amostra (p<0,05) na severidade da Dor Miofascial, com valores de beta maiores para Osteoartrite (0,314), seguido da Enxaqueca (0,299), Capsulite (0,244) e Cefaléia Tipo-Tensional (0,232). O grupo 2 apresentou níveis de dor à palpação muscular estatisticamente maiores que o grupo 1 (p<0,05). Ao se analisar a intensidade de dor subjetiva obtida através de EAV, o grupo 2 apresentou níveis maiores em todas as medições, com significância estatística para \"dor no momento\" e \"dor máxima\" (p<0,05). Da mesma maneira, o grupo 2 mostrou níveis maiores, obtidos através de EAV, de problemas com humor, incapacidade, problemas com a função mandibular e problemas com sono/descanso, sendo que apenas o último apresentou significância estatística (p<0,05). Níveis estatisticamente maiores de ansiedade e depressão foram encontrados também no grupo 2 em relação ao 1 (p<0,05). A análise dos resultados do questionário MIDAS demonstrou que o grupo 2 apresentou níveis de incapacidade (dias perdidos por causa da cefaléia) significativamente maiores em 4 das 5 perguntas e no total de dias (p<0,05). Conclusões: O diagnóstico adicional de Enxaqueca, numa população com Dor Miofascial, exerce forte impacto na severidade da dor e na qualidade de vida do paciente. / Objectives: To assess the impact of migraine, tension-type headache and TMD subgroups on pain levels of masticatory and cervical Myofascial Pain (MFP) patients. Moreover, to compare anxiety and depression scores, pain intensity and associated characteristics in MFP patients with and without migraine. Material and Methods: The sample was comprised by 203 consecutive patients, mean age of 40,3 (89.9% of females), primarily diagnosed with MFP, who presented to the UCLA Orofacial Pain Clinic. Secondary diagnoses of Migraine, Tension-Type Headache, Osteoarthritis and Capsulitis were also included. Linear Regression Analysis was used to assess the impact. In order to compare group 1 (Myofascial Pain) with group 2 (Myofascial Pain + Migraine) regarding pain objective (palpation scores) and subjective (VAS) levels, anxiety (BAI) and depression (BDI) scores, mood problems, jaw function problems and sleep quality (VAS), and disability levels (VAS and MIDAS), Mann-Whiney test was performed. A significance level of 5% was adopted. Results: The regression model detected a significant impact of all diagnoses included (p<0,05) on the pain levels of the MFP patients, with higher beta values for Osteoarthritis (0,314), followed by Migraine (0,299), Capsulitis (0,224) and Tension-Type Headache (0,232). Mann- Whitney test revealed that group 2 presented significantly higher pain levels on palpation of masticatory and cervical muscles in comparison to group 1 (p<0,05). Group 2 also presented higher levels of subjective pain, with statistical significance for \"pain at the moment\" and \"highest pain\" (p<0,05). Additionally, the group 2 showed higher levels of mood problems, disability, jaw function impairment and sleep problems than group 1 with statistical significance for the later (p<0,05). Significant higher levels of anxiety and depression were found in group 2 as well (p<0,05). MIDAS questionnaire revealed that group 2 presented significantly higher levels of disability (number of missed days due to the headache) on 4 out of 5 questions and on the total of missed days (p<0,05). Conclusions: Additional diagnosis of Migraine demonstrated a significant impact on pain intensity and life quality of patients with Myofascial Pain. Clinicians should approach both conditions in order to achieve better treatment outcomes.
|
Page generated in 0.043 seconds