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Beyond Animal Research
By Jonathan Balcombe, Ph.D.
April 2005 |
Migraine Research, Part II
In last month’s column, I described a small sampling of “migraine”
studies on animals, involving usually terminal, invasive procedures
on unconscious (anesthetized) animals (cats, monkeys, rats, etc.)
who have no way of communicating symptoms. But other researchers
are pursuing very different paths.
The following sampling of recent studies underscores the broad
range of human clinical methods available for advancing our understanding
of this important condition:
- Fifteen patients with genetic predisposition for migraine were
examined using proton MR spectroscopy to investigate metabolic
alterations in migraine-active brain regions. Seventeen healthy
subjects served as controls.1
- A validated face-to-face interview questionnaire was used to
document clinical characteristics of migraine and patterns of
medication use in 8,618 patients from 12 Latin American urban
communities.2
- The efficacy of two migraine drugs was compared in 91 patients
at two and 24 hours post-treatment using two different pain assessment
rating instruments.3
- A systematic literature review was undertaken to assess the
clinical record of using intravenous and/or oral niacin as treatment
for various types of headache, including migraine.4
- A combination of techniques—neurological and ophthalmological
exams, EEG, visual evoked potentials (VEPs), single photon emission
computed tomography (SPECT), and brain perfusion MRI—were
used to diagnose a patient with a rare complication of migraine.5
- Contrast echocardiography was used to detect atrial defects
across up to three generations in 18 families, to determine the
heritability of this migraine-associated syndrome.6
- A meta-analysis of published case-control studies was undertaken
to address the relationship between migraine and white matter
abnormalities, a brain feature that shows up in MRIs.7
- Transcranial Doppler ultrasound (TCD) was used to assess cerebral
blood flow velocity changes in cerebral arteries (PCA) during
repetitive checkerboard visual stimulation of 19 migraine sufferers
and 19 healthy volunteers.8
- The efficacy of botulinum injections as a means of deactivating
migraine trigger sites in the brain was studied with 125 patients,
25 of whom served as controls. Various post-intervention assessment
instruments (e.g., the Migraine Specific Questionnaire) were used
to assess outcomes and adverse effects.9
- Corrugator muscle resection was performed on sixty patients,
with follow-up evaluations performed between 6 and 18 months post-surgery
to assess outcomes.10
These and other clinical approaches may not necessarily advance
the diagnosis and/or treatment of migraine on every outing. But
what can be certain is that the findings are more relevant to the
human condition and thus more likely to result in clinically useful
outcomes.
Jonathan Balcombe, Ph.D., is a PCRM research consultant with
a background in ethology. He is the author of The Use of Animals
in Higher Education, as well as many scientific papers on humane
life science education and animal behavior. His recent scientific
review showing that animal experiments are more stressful than
previously understood was published in Contemporary Topics
in Laboratory Animal Science.
Literature:
1. Dichgans M, Herzog J, Freilinger T, Wilke M, Auer DP. 1H-MRS
alterations in the cerebellum of patients with familial hemiplegic
migraine type 1. Neurology. 2005;64(4):608-13.
2. Morillo LE, Alarcon F, Aranaga N, Aulet S, Chapman E, Conterno
L, Estevez E, Garcia-Pedroza F, Garrido J, Macias-Islas M, Monzillo
P, Nunez L, Plascencia N, Rodriguez C, Takeuchi Y; Latin American
Migraine Study Group. Clinical characteristics and patterns of medication
use of migraneurs in Latin America from 12 cities in 6 countries.
Headache. 2005;45(2):118-26.
3. Friedman BW, Corbo J, Lipton RB, Bijur PE, Esses D, Solorzano
C, Gallagher EJ.
A trial of metoclopramide vs. sumatriptan for the emergency department
treatment of migraines. Neurology. 2005;64(3):463-8.
4. Prousky J, Seely D. The treatment of migraines and tension-type
headaches with intravenous and oral niacin (nicotinic acid): systematic
review of the literature. Nutr J. 2005;4(1):3.
5. Relja G, Granato A, Ukmar M, Ferretti G, Antonello RM, Zorzon
M.
Persistent aura without infarction: decription of the first case
studied with both brain SPECT and perfusion MRI. Cephalalgia. 2005;25(1):56-9.
6. Wilmshurst PT, Pearson MJ, Nightingale S, Walsh KP, Morrison
WL. Inheritance of persistent foramen ovale and atrial septal defects
and the relation to familial migraine with aura. Heart. 2004;90(11):1315-20.
7. Swartz RH, Kern RZ. Migraine is associated with magnetic resonance
imaging white matter abnormalities: a meta-analysis. Arch Neurol.
2004;61(9):1366-8.
8. Nedeltchev K, Arnold M, Schwerzmann M, Nirkko A, Lagger F, Mattle
HP, Sturzenegger M. Cerebrovascular response to repetitive visual
stimulation in interictal migraine with aura. Cephalalgia. 2004;24(9):700-6.
9. Guyuron B, Kriegler JS, Davis J, Amini SB. Comprehensive surgical
treatment of migraine headaches. Plast Reconstr Surg. 2005;115(1):1-9.
10. Dirnberger F, Becker K. Surgical treatment of migraine headaches
by corrugator muscle resection. Plast Reconstr Surg. 2004;114(3):652-7;
discussion 658-9.
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