R B Lipton

..Diclofenac potassium for oral solution has a time to maximum plasma concentration (Tmax) of 15 minutes, suggesting the potential for a rapid onset of therapeutic effects...

..However, prevalence is high in groups other than these high-risk groups. In a subgroup of patients, migraine may be a progressive disorder...

..To determine the prevalence of chronic pain in elderly people and its relationship with obesity and associated comorbidities and risk factors...

..We assessed barriers at 3 levels: medical consultation, diagnosis, and acute pharmacologic therapy use and assessed the contribution of socioeconomic, demographic, and headache-specific variables to these barriers...

..Specifically, individuals classified with moderate to severe work-related disability had lower HRQoL scores than those classified with low disability...

..In treating migraine sufferers, physicians can choose from among seven triptans with different attributes...

..In this study we evaluated the effect of darifenacin, an M3 selective antagonist, on cognitive function in elderly volunteers without clinical dementia...

..To evaluate the clinical efficacy of a standardized special root extract from the plant Petasites hybridus as a preventive therapy for migraine...

..To assess patterns of medical consultation, diagnosis, and medication use in representative samples of adults with migraine in England and the United States...

..Persistence in treating these patients can be very rewarding. The authors provide a checklist intended to facilitate the management of refractory patients...

..02), with their level or responsibilities and duties (P = 0.02), and with their ability to perform (P = 0.001). Results from this study show that the impact of migraine extends to household partners and other family members...

..We aimed to assess the efficacy and safety of a new portable sTMS device for acute treatment of migraine with aura...

....

..To develop and assess telephone-based screening tests for dementia, especially Alzheimer's disease (AD)...

..The headaches were self-limited (69.4% placebo efficacy in 2 hours) and the incidence markedly declined over time. Acetaminophen was no more effective than placebo in the acute and preemptive treatment of these headaches...

..They conclude by presenting an approach to headache diagnosis based upon these criteria...

..To assess the attitudes, knowledge, and practice patterns of US neurologists regarding migraine management relative to the US Headache Consortium Guidelines (the Guidelines)...

....

..66, and it also correlated well with the three questionnaires (r = 0.33-0.41). The utility of the M-TOQ for assessing treatment benefit in research (M-TOQ-15) and primary care (M-TOQ-5) should be further validated...

..Emerging data on the longitudinal risk of CM suggest that, in a population at risk, CM may be a preventable disorder...

..However, no studies outline how migraine is actually discussed during clinical encounters...

..To develop and validate a questionnaire for assessing cutaneous allodynia (CA), and to estimate the prevalence and severity of CA in the migraine population...

....

..We consider clinical trials strategies designed to address the more complex clinical and policy requirements for meeting the needs of those with migraine...

..These findings highlight the paramount importance of clinical vigilance, accurate diagnosis, and appropriate, effective management - including treatment or referrals - to improve patient outcomes...

..The influence of socioeconomic status on the prevalence of migraine is unknown in adolescents. Accordingly, we investigated the prevalence of migraine in a large sample of adolescents by sociodemographic features...

..They are often classified as transformed migraine (TM), a disorder not addressed in the International Headache Society classification...

..Early life education and participation in cognitively stimulating leisure activities later in life are 2 factors thought to reflect cognitive reserve, which may delay the onset of the memory decline in the preclinical stages of dementia...

..Rates of emergent nausea in patients who were free of it at baseline were low, and no consistent differences were observed between active treatments...

....

..The goal of this pilot study was to examine MRI- and magnetic resonance spectroscopy (MRS)-derived hippocampal correlates of pain in older adults...

..A large number of headache sufferers with features of migraine fail to meet criteria for strict migraine (SM; migraine with or without aura) but do meet criteria for probable migraine (PM)...

..In this study we identified African-American race as a risk factor in the elderly for epilepsy independent of stroke...

..To test the cognitive reserve hypothesis by examining the effect of education on memory decline during the preclinical course of dementia...

..Dementia incidence increases dramatically from age 65 to age 85, with many studies reporting a doubling every 5 years. The incidence beyond age 85 is not established...

..These findings suggest that early in the process of transformation, migraine is more frequent, and that as CDH evolves, fewer typical attacks of IHS migraine occur...

..To characterise and compare the sociodemographic profiles and the frequency of common comorbidities for adults with chronic migraine (CM) and episodic migraine (EM) in a large population-based sample...

..To assess the effectiveness of the nonprescription combination of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain...

..We conclude that Braak staging provides a useful summary of Alzheimer's disease neuropathology, which is associated with both memory and mental status performance...

..5, 95% CI 5.5-28.4) or either (HR 5.9, 95% CI 3.6-9.7) had higher risk of VD over five years. Diagnosing HRNG is a clinically relevant approach to identifying older adults at high risk of VD over short intervals...

..To determine the prevalence and distribution of migraine in the United States as well as current patterns of health care use...

..Methods are discussed for selecting robust elderly samples that are relatively free of contamination by preclinical dementia...

..0005) compared with placebo. CONCLUSION: Sumatriptan, 50-mg tablets, are effective for the full spectrum of headaches experienced by patients with disabling migraine due to a sumatriptan-responsive mechanism...

..To estimate the relative rates of dementia in initially nondemented subjects with and without memory impairment defined by baseline free recall from the Free and Cued Selective Reminding (FCSR) test...

..Although age, education, and gender influenced FCSR performance, race did not. The study suggests that memory performance is not influenced by race and that race-adjustment may not be necessary in the norming of memory tests...

..Larger studies in diverse populations, including analysis of surrounding regions are recommended...

..The objective of this study was to test the hypothesis that a measure of hippocampal neuronal metabolism was associated with verbal memory in nondemented older adults after controlling for hippocampal volume...

..The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population...

..To assess the effects of treatment with onabotulinumtoxinA (Botox, Allergan, Inc., Irvine, CA) on health-related quality of life (HRQoL) and headache impact in adults with chronic migraine (CM)...

..To test whether cholesterol ester transfer protein (CETP) genotype (VV homozygosity for I405V) is associated with preservation of cognitive function in addition to its association with exceptional longevity...

..In this article, Drs Lipton, Stewart, Reed, and Diamond consider the scope and distribution of the migraine problem and the current patterns of care in the United States...

..Consistently, criteria for CM and CM+ should be revised to require at least 8 days of migraine or probable migraine per month, in individuals with 15 or more days of headache per month...

..Contrary to what we hypothesized, obesity at baseline does not seem to be related to follow-up refractoriness to preventive treatment...

..It also supports the view that VIQ as estimated by the AMNART does not decline during the preclinical onset of AD...

..To determine whether offspring of parents with exceptional longevity (OPEL) have a lower rate of dementia than offspring of parents with usual survival (OPUS)...

..These results suggest that ERT initiated soon after surgical menopause can have long-term neuroprotective effects in cognitively intact women...

..Educational strategies should focus on physician education addressing diagnosing the full spectrum of migraine and physician management of migraine with specific migraine therapy in appropriate patients...

..This study reports on the influence of migraine and comorbid depression on health-related quality of life (HRQoL) in a population-based sample of subjects with migraine and nonmigraine controls...

..When migraine features are present, classification is problematic...

..In this article, we review some of the methodological challenges in studying migraine epidemiology, report recent results from studies using IHS criteria, and suggest directions for future research...

..To determine the relative frequency of chronic daily headache (CDH) subtypes in adolescents and to compare the distribution of CDH subtypes in adolescents and adults of various ages...

..001). More rigorous prescribing guidelines for patients with frequent headaches are urgently needed. Successful detoxification is necessary to ensure improvement in the headache status when treating patients who overuse acute medications...

..To study the influence of leisure activity participation on risk of development of amnestic mild cognitive impairment (aMCI)...

..It is not yet clear if corticosteroids are useful for the treatment of migraine. We determined the efficacy of 10 mg of IV dexamethasone as adjuvant therapy for patients presenting to an emergency department (ED) with acute migraine...

..We then review previous reports of patients with coexisting TACs and HC and discuss the relationship between these families of primary headache disorders...

....

..To evaluate the extent to which head and neck injury (HANI) contributes to chronic daily headache (CDH)...

....

..It is concluded that statistically removing the contribution of dementia risk factors from memory test scores can severely decrease discriminative validity for detecting dementia in the elderly...

..7% of patients in Study 1 and 32.6% of patients in Study 2. The incidences of any adverse event and of specific adverse events were low and generally similar between S/NS and placebo...

..These findings suggest a differential effect in relating the Val(158)Met polymorphism to gait and to cognitive function while supporting the previously described sexual dimorphism in the phenotypic expressions of COMT...

..Utilizing the clinical definition of clustering should identify all seizure clusterers, and false positives can be determined with diary data...

..Whether these unclassified patients have vascular dementia or some other form of dementia is not known...

..The role of blood pressure (BP) as a risk factor for dementia is complex and may be age dependent. In very old individuals, low BP might increase risk for dementia, perhaps by reducing cerebral perfusion pressure...

..We summarize the epidemiologic evidence that migraine and epilepsy are associated and discuss specific interrelationships between migraine and epilepsy...

..5 mg, was not statistically superior to placebo for any measure. CONCLUSIONS: Naratriptan, 1 mg, with tolerability similar to placebo, is an effective, short-term, prophylactic treatment for menstrually associated migraine...

..As a low-cost highly sensitive screening tool is needed to improve case detection for genetic and epidemiologic studies, the authors developed the Beth Israel Dystonia Screen (BIDS), a computer-assisted telephone interview...

..Identifying quantitative gait markers of falls in older adults may improve diagnostic assessments and suggest novel intervention targets...

..It is unclear whether increased participation in leisure activities lowers the risk of dementia or participation in leisure activities declines during the preclinical phase of dementia...

..To conduct a systematic clinical and quantitative assessment of gait in older adults with mild cognitive impairment (MCI) syndromes...

..More prospective studies are needed; challenges certainly exist, but as the studies discussed here demonstrate, the field is rich with promise for improving the lives of patients with epilepsy...

..A small body of evidence suggests that rTMS may have a role, but further studies are needed. In this review, we summarize the data on TMS as a treatment of migraine, and we suggest directions for future research...

..In many, migraine may have a very benign (complete remission) or relatively benign (partial remission) prognosis. In some, migraine persists and in others, it progresses...

..Neurologic abnormalities affecting gait occur early in several types of non-Alzheimer's dementias, but their value in predicting the development of dementia is uncertain...

..We suggest that longitudinal robust norms may help mitigate the limitations inherent in cross-sectional normative samples...

..Neurological gaits and subtypes are independent predictors of falls in older adults. Neurological gait assessments will help clinicians identify and institute preventive measures in older adults at high risk for falls...

..The modest sensitivity of either the HVLT or the MMSE alone suggests that further neuropsychological evaluation is required to confirm dementia diagnosis...

..Prospective studies and clinical trials are needed to define the causal role of cognitive leisure activities in influencing vascular risk for cognitive decline...

..The clinicians have in their armamentariums an ever-expanding variety of medications. With experience, clinicians can match individual patient needs with the specific characteristics of a drug to optimize therapeutic benefit...

..Probable migraine is a prevalent form of migraine, and like migraine with and without aura it produces decrements in health-related quality of life and increments in disability relative to control subjects...

..Mental status impairment was not related to antiepileptic medication or mood disturbance. Further investigation will explore these associations prospectively...

..Both pharmacotherapy (acute and preventive treatment strategies) and nonpharmacological therapies play important roles in the management of migraine...

..The possibility of clinically relevant prediction should be examined through electronic data capture and more specific and more frequent sampling, and with patient training to improve prediction...

..Our objective was to develop tests of navigation and study their cognitive correlates in nondemented older adults...

..The incidence, prevalence, burden, and comorbidities of these disorders are discussed, and the risk factors for progression from episodic to chronic daily headache are also reviewed...

..Clarifying the influence of age on migraine is of importance for clinical diagnosis and treatment. It also may contain clues to evolving disease biology...

..We then review the potential pathophysiologic mechanisms to support this relationship. We close by briefly discussing clinical interventions related to obesity and migraine...

..On a long-term basis the repository will allow us to conduct genome scans and to relate any number of genes to the wealth of clinical and biological outcome data obtained in the EAS. ..