Background: Sensitization to sensory stimuli is an essential feature of migraine attacks. The relationship between the clinical course of migraine and increased sensitivity to olfactory stimuli has been little studied so far. - Methods: We analyzed the frequency and quality of osmophobia depending on the phase of migraine in patients with episodic and chronic migraine treated in an tertiary headache center with regard to gender, age, medical history and migraine disability assessment score (MIDAS). Standardized diagnostic questions were used for the assessment of osmophobia. - Results: In our cross-sectional investigation (n = 113), 38.1% of the patients showed an increased preictal hypersensitivity to odors, whereas 61.9% described ictal and 31.9% interictal hypersensitivity to odors, odor-triggered migraine was described in 30.1%. Median migraine disease duration has been statistically significantly longer in patients who suffered from interictal hypersensitivity to odors (28.5 years vs. 20 years; p = 0.012). There was a significant correlation between interictal hypersensitivity and higher age (54.50 vs. 45; p = 0.015). Patients with higher migraine disability in MIDAS experienced more frequently preictal and interictal olfactory sensitization and odor triggered migraine attacks. - Conclusions: In patients with longer migraine disease duration and higher migraine-related impairment, osmophobia was more frequently observed. These results might support the hypothesis of increasing sensitization with increasing burden of migraine.

<p>U poslednje vreme upotreba računara se smatra značajnim okidačem za nastanak primarnih glavobolja. Svi rizikofaktori pri radu na računaru značajni za nastanak glavobolja su nedovoljno jasni i ispitani, te su i strategije prevencije nepoznate. Ciljevi ovog istraživanja su utvrđivanje razlika u prevalenciji primarnih glavobolja kod ispitanika koji koriste i koji ne koriste računar, kao i utvrđivanje uticaja vremena provedenog u radu na računaru i pona&scaron;anja pri radu na računaru na ispoljavanje određenog tipa primarne glavobolje. U studiji preseka finalni uzorak je činilo 1500 ispitanika. Uzorak je podeljen na dve grupe: 1. ispitanici koji koriste računar (95.7%), 2. ispitanici koji ne koriste računar (4.3%). Obe grupe su nadalje podeljene na: 1. one koji imaju glavobolju i 2. one koji nemaju glavobolju. Kod ispitanika koji koriste računar, glavobolju je imalo 69.6% ispitanika, a kod ispitanika koji ne koriste računar 27.4%. Nadalje, kod ispitanika koji koriste računar od glavobolje tenzionog tipa boluje 30.3%, od migrene 16.7%, od verovatno sekundarne glavobolje 14.0% ispitanika. Kod ispitanika koji ne koriste računar od glavobolje tenzionog tipa boluje 19.4%, od migrene 4.8% ispitanika, i od verovatno sekundarne glavobolje 3.2% ispitanika. Utvrđeno je da su korisnici računara imali značajno veću prevalenciju primarnih glavobolja u odnosu na one koji ne koriste računar. Korisnici računara sa glavoboljom u odnosu na one bez glavobolje duže rade na računaru, če&scaron;će ne prave pauzu, a kada je i naprave, one traju kratko, če&scaron;će zauzimaju nepravilan položaj tela. Korisnici računara sa migrenom u odnosu na one sa glavoboljom tenzionog tipa značajno duže vremena provode na računaru kod kuće, ređe prave pauze, a kada ih prave one su kratke, pravilnije sede za računarom, a u pauzi ređe sede i koriste mobilni telefon ili tablet. Prilikom klasifikacije glavobolja izdvojila se grupa od 8.6% ispitanika koji su imali glavobolju koja se nije ispunjavala kriterijume za migrenu, glavobolju tenzionog tipa, ni trigeminalnu autonomnu glavobolju, a nije postojala sumnja da je to sekundarna glavobolja. Obzirom da se ona javljala isključivo kod korisnika računara i da je većina njih izvestila da rad na računaru može biti okidač, ona je svrstana u ostale primarne glavobolje, za koju se pretpostavlja da za njen nastanak upotreba računara ima značajan uticaj. Korisnici računara oboleli od ostalih primarnih glavobolja u odnosu na obolele od migrene vi&scaron;e vremena provode u radu na računaru na poslu, ređe zauzimaju pravilan položaj, ali če&scaron;će prave pauzu, a u odnosu na one sa glavoboljom tenzionog tipa, če&scaron;će izve&scaron;tavaju da vi&scaron;e vremena provode na računaru i na poslu i kod kuće, da nakon dužeg vremena prave pauzu ili nikada, i da im pauze kraće traju, ali da pravilnije sede pri radu na računaru. Na osnovu rezultata može se zaključiti da primarne glavobolje predstavljaju značajan zdravstveni problem kod korisnika računara. U uzorku su detektovani ispitanici sa glavoboljom, koja je bila prisutna samo kod korisnika računara, koja nije ogovarala postojećim kriterijumima klasifikacije ni za jednu primarnu glavobolju i za koju se sumnja da za njen nastanak rad na računaru imao značajan uticaj. Korisnici računara sa glavoboljom se ne pridržavaju definisanih ergonomskih preporuka pri radu na računaru, te se javlja potreba za sprovođenjem sistematske edukacije korisnika računara o ergonomskim preporukama u cilju prevencije ataka glavobolja.</p> / <p>As of recently, the use of computers is considered a significant trigger for the development of primary headaches. The risk factors when working on a computer which are important for the occurrence of headaches are insufficiently clear and unexamined, thus making prevention strategies unknown. The aims of this study are to determine differences in the prevalence of primary headaches in respondents who use and do not use a computer, as well as to determine the impact of time spent working on a computer and computer work related behavior on the manifestation of a particular type of primary headache. In the cross-sectional study, the final sample consisted of 1500 subjects. The sample was divided into two groups: 1. respondents who use a computer (95.7%), 2. respondents who do not use a computer (4.3%). Both groups were further divided into: 1. those who have a headache and 2. those who do not have a headache. Among respondents who use a computer, 69.6% of respondents had a headache, and among respondents who do not use a computer, 27.4%. Furthermore, in respondents who use a computer, 30.3% suffer from tension-type headaches, 16.7% from migraines, and 14.0% from probable secondary headaches. In subjects who do not use a computer, 19.4% suffer from tension-type headaches, 4.8% from migraines, and 3.2% from suspected secondary headaches. Computer users were found to have a significantly higher prevalence of primary headaches compared to those who did not use a computer. Computer users with headaches, compared to those without headaches, work on As of recently, the use of computers is considered a significant trigger for the development of primary headaches. The risk factors when working on a computer which are important for the occurrence of headaches are insufficiently clear and unexamined, thus making prevention strategies unknown. The aims of this study are to determine differences in the prevalence of primary headaches in respondents who use and do not use a computer, as well as to determine the impact of time spent working on a computer and computer work related behavior on the manifestation of a particular type of primary headache. In the cross-sectional study, the final sample consisted of 1500 subjects. The sample was divided into two groups: 1. respondents who use a computer (95.7%), 2. respondents who do not use a computer (4.3%). Both groups were further divided into: 1. those who have a headache and 2. those who do not have a headache. Among respondents who use a computer, 69.6% of respondents had a headache, and among respondents who do not use a computer, 27.4%. Furthermore, in respondents who use a computer, 30.3% suffer from tension-type headaches, 16.7% from migraines, and 14.0% from probable secondary headaches. In subjects who do not use a computer, 19.4% suffer from tension-type headaches, 4.8% from migraines, and 3.2% from suspected secondary headaches. Computer users were found to have a significantly higher prevalence of primary headaches compared to those who did not use a computer. Computer users with headaches, compared to those without headaches, work on influenced by computer use. Computer users with headaches do not adhere to the defined ergonomic recommendations when working on the computer, hence there is a need for systematic education of computer users on ergonomic recommendations in order to prevent headache attacks.</p>

Background: Migraine headache is a chronic pain condition that affects 20% of women of reproductive age, and is often treated with triptans. Triptans are serotonin 1B, 1D, and 1F receptor agonists that act as vasoconstrictors and inhibitors of the trigeminal cervical complex as well as peripheral neurons; they cross the blood brain barrier and placenta, and as such are plausible neurodevelopmental teratogens. No studies have examined risk of neurodevelopmental problems in children with prenatal triptan exposure. This dissertation had three aims: (1) to examine risk of behavioral problems in children using in the presence of time-varying confounding by concomitant medication use; (2) to examine risk of temperamental, motor, and communication disturbances associated with prenatal triptans exposure, adjusting for unmeasured confounding by migraine type and severity; and (3) to examine changes in neurodevelopment over time associated with prenatal triptan exposure. Methods: This dissertation used data from the Norwegian Mother and Child Cohort Study, a prospective birth cohort including more than 100,000 women recruited during their first prenatal ultrasound visit. Aims 1 and 3 used marginal structural models to assess the risk of (1) neurodevelopmental problems at age 36 months (Aim 1), or (2) change in risk of neurodevelopmental problems from 18 to 36 months (Aim 3) associated with prenatal triptan exposure. Aim 2 used propensity matching and calibration to adjust for unmeasured confounding by migraine type, severity, and attitudes towards medication use in pregnancy. Neurodevelopmental outcome measures included the Child Behavior Checklist (CBCL), the Emotionality, Activity, and Temperament Scale (EAS), and the Ages and Stages Questionnaire (ASQ). Exposure to triptans was ascertained by self-report. Results: Prenatal triptan exposure was associated with greater externalizing behavior problems at 18 and 36 months, as well as greater increases in emotionality and activity from 18 to 36 months. We observed no association between triptan exposure and motor skills or communication problems; triptan use during pregnancy was associated with migraine severity but not migraine type, and adjustment for unmeasured migraine characteristics moved effect estimates towards the null. Conclusions: Prenatal triptan exposure is associated with externalizing-type behaviors and temperament in children, while migraine itself is associated with internalizing-type behaviors and temperament. The use of concomitant medications and the severity of the underlying condition both exerted substantial influence on observed effect estimates, and should be considered in any future studies of triptan medication use in pregnancy.