| Background and objective: Migraine is a common and recurring neurologicaldisorder and our domestic one-year prevalence of migraine is9.3%. Depression is themost common and studied comorbidity of migraine, and patients who had bothdiseases showed more severe body dysfunction and suicidal tendencies than who hadone. So far, the influence and mechanism of comorbidity of migraine and depressionhas been unclear. In this study, rats with vascular headache induced by electricalstimulation on superior sagittal sinus, rats with depression induced by unpredictablechronic mild stress(UCMS), and rats with both diseases were performed, and the Fosand pCREB protein of different brain regions were studied to preliminarily explorethe mutual influence of the comorbidity of migraine and depression and its underlyingmechanisms.Methods: Twenty male SD rats were randomly assigned into4groups in average.They were group UCMS(U), UCMS+Electrical stimulation(U+S), Stimulation(S) andControl(C). Rats in group U and U+S were given UCMS for6weeks, and S、C wereraised normally. Open field text and body weight were systemly performed to accessthe effect of the depression model. Six weeks later each group received the electrodesimplantation. Four days later group U+S and S received stimulation of the dura matteradjacent to superior sagittal sinus and nociceptive behaviors were observed. One hourafter the stimulation, rats were perfusion fixed and their brain were collected fordetecting the quantity of pCREB and Fos protein in related brain regions byimmunohistochemistry.Results:1. Fos protein: In spinal trigeminal nucleus, caudal part(Sp5C), Fos in group S wassignificantly increased compared with C, and Fos in group U+S was significantly increased compared with S; In periaqueductal gray, Fos was significantly increased inS compared with C, and Fos was significantly decreased in U+S compared with S butincreased when compared with U; Fos in thalamus and hypothalamus was increasedin group S, U and U+S, but no significance were detected among the three groups; Nopositive cells of Fos were detected in hippocampus. In prefrontal lobe, Fos wasincreased in U and U+S compared with C.2. pCREB protein: In Sp5C, pCREB was increased significantly in group S and Ucompared with C, and also increased in U+S compared with U or S; In PAG andhypothalamus, pCREB was significantly increased in S, U, U+S compared with C,but no significance were detected among the three groups; In thalamus, nosignificance were detected among the four groups. In dentate gyrus of hippocampus,pCREB was significantly decreased in U and increased in S when compared with C.In prefrontal lobe, pCREB was decreased in U, S, U+S compared with C, while nosignificance were detected among the three groups.Conclusion:1. Stimulation of the dura matter adjacent to superior sagittal sinus could increaseFos protein expression in Sp5C, PAG, thalamus and hypothalamus, which indicatedthat a vascular headache model was established properly.2. Protein pCREB was decreased in dentate gyrus and prefrontal lobe, whileincreased in Sp5C, PAG and thalamus, which indicated that a depression model wassuccessfully established.3. Comorbidity of migraine and depression could increase Fos expression in Sp5Ccompared with rats who had only one disease, which indicated the combineddepression could exacerbate headache; Combined headache could increase pCREB inSp5C, which implied depression was exacerbated by headache.4. Combined depression could decrease Fos expression in PAG, which implied thatdepression might weaken the descending modulation of pain of the PAG. Background: Nummular headache, or coin-shaped cephalagia, is defined as a mild tomoderate, pressure-like pain that is felt exclusively in a circumscribed area. Over200cases of nummular headache have been reported since defined in2002, but thepathogenesis remains unclear.Methods: A patient with nummular headache who had his scalp of the symptomaticarea removed but suffered headache reappearance was reported. All published casesof nummular headache in the English literature were reviewed and analyzed fordemographic and clinical features, image and laboratory findings, and response totreatment.Results: The patient with nummular headache had the symptomatic area of the scalpremoved but suffered reappearance of headache in another area which overlappedwith the former one. The literature review showed that nummular headache was achronic, mild to severe, pressure-like pain with a circular or elliptical shape of1-10cm in diameter. The parietal region was the most affected region. Exacerbations andsensory disturbances in the affected area were reported in43%and56%casesrespectively. Observational data suggested botulinum toxin type A (BoNTA) andgabapentin may be beneficial.Discussion: Our case and evidence from the literature review support the peripheralmechanism of nummular headache. Nummular headache might be a local paindisorder stemming from terminal branches of a sensory nerve and could induceperipheral sensitization in one or several primary sensory neurons... |
PDF Full Text Request