Quantifying visual allodynia across migraine subtypes: the Leiden Visual Sensitivity Scale

Enhanced sensitivity to light (photophobia) and patterns is common in migraine and can be regarded as visual allodynia. We aimed to develop and validate a questionnaire to easily quantify sensitivity to light and patterns in large populations, and to assess and compare visual allodynia across different migraine subtypes and states. We developed the Leiden Visual Sensitivity Scale (L-VISS), a 9-item scale (score range 0-36 points), based on literature and patient interviews, and examined its construct validity. Furthermore, we assessed ictal and interictal visual sensitivity in episodic migraine with (n = 67) and without (n = 66) aura and chronic migraine with (n = 20) and without (n = 19) aura, and in healthy controls (n = 86). Differences between migraine subtypes and states were tested using a linear mixed model with 3 fixed factors (episodic/chronic, with/without aura, and ictal/interictal). Test–retest reliability and construct validity of L-VISS were good. Leiden Visual Sensitivity Scale scores correlated in the expected direction with light discomfort (Kendall's τ = −0.25) and pattern glare tests (τ = 0.35). Known-group comparisons confirmed its construct validity. Within migraine subtypes, L-VISS scores were higher in migraine with aura versus without aura and in chronic versus episodic migraine. The linear mixed model showed all factors affected the outcome (P
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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AbstractPurpose of ReviewMany studies have demonstrated that discogenic low back pain is the most common type of chronic low back pain (CLBP), one of the major causes of disability, and has a major socioeconomic impact. Our aim is to review present therapeutic interventions for discogenic low back pain.Recent FindingsThere are a multitude of treatments used in clinical practice to treat CLBP, but there is continued debate and lack of consensus among clinicians and the policy makers as to which modality is the best approach. Based on controlled evaluations, lumbar intervertebral discs have been shown to be the source of chr...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
Abstract BACKGROUND: Migraine is a diffuse and disabling disease. Its pathophysiology is complex and involves both central and peripheral dysfunctions. OBJECTIVE: This review will discuss the pathogenesis of migraine from the origin of the neuro-inflammatory theory, to the modern pathophysiological model and the latest therapies. METHODS: PUBMED and EMBASE (up to May 2019) were searched for: migraine, inflammation, immunomodulation. An additional search was carried out from the bibliography of previous review articles. RESULTS: Migraine was thought to be mainly a vascular disorder, according to the ...
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
This study examined how these understudied academic factors are associated with adolescent pain and somatic symptoms and whether sex moderates the relations. Materials and Methods: High school students (n=90) from a high-achieving community completed questionnaires assessing academic variables, various pain characteristics, and somatic symptoms. Results: The majority of adolescents (67%) experienced pain and somatic symptoms in the past month, with 56% reporting multisite pain and 58% reporting at least 1 severe somatic symptom. Headache and abdominal pain were the most frequently reported “most bothersome&rdqu...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
This study aims to evaluate the feasibility and efficacy of a complex health intervention, based on the combination of conventional Western medicine and traditional Chinese medicine (TCM), in an outpatient department of a university hospital for patients with frequent episodic or chronic tension-type headaches.Methods/designThis is a prospective randomized controlled pilot study with four balanced treatment arms (usual care, acupuncture, training, and training plus acupuncture). Each arm will have 24 patients. After the initial screening examination and randomization, a 6-week treatment period follows, with treatment frequ...
Source: Trials - Category: Research Source Type: clinical trials
In this study, we aimed to assess the safety and efficacy of sphenopalatine ganglion stimulation for treatment of chronic cluster headache.MethodsWe did a randomised, sham-controlled, parallel group, double-blind, safety and efficacy study at 21 headache centres in the USA. We recruited patients aged 22 years or older with chronic cluster headache, who reported a minimum of four cluster headache attacks per week that were unsuccessfully controlled by preventive treatments. Participants were randomly assigned (1:1) via an online adaptive randomisation procedure to either stimulation of the sphenopalatine ganglion or a sham ...
Source: The Lancet Neurology - Category: Neurology Source Type: research
Rebound headaches, also known as medication overuse headaches, are caused by the frequent or excessive use of pain-relieving and/or antimigraine drugs to treat headache attacks that are already in progress. (Note that these are not the same as oral prophylactic or preventive medicines, which should be taken daily.) In other words, the same medications that initially relieve headache pain can themselves trigger subsequent headaches if they are used too often. Medication overuse headaches can be disabling, forcing people with this condition to take sick leave and to be less productive at work and home. To be diagnosed with m...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Drugs and Supplements Headache Health Source Type: blogs
ConclusionsConsidering our results, the described withdrawal method seems to be a simple and safe method to achieve pain reduction while simultaneously preventing organ damage. Despite the preliminary character of our results, our hypothesis might stimulate a new understanding of CLBP ’s pathophysiology.
Source: Journal of Neurology - Category: Neurology Source Type: research
In conclusion, multi-modal MRI could be used to detect NVC dysfunction in chronic migraine patients, which is a new method to assess the impact of chronic pain to the brain.
Source: Neuroscience - Category: Neuroscience Source Type: research
Summary: Orofacial pain syndromes encompass several clinically defined and classified entities. The focus here is on the role of clinical neurophysiologic and psychophysical tests in the diagnosis, differential diagnosis, and pathophysiological mechanisms of definite trigeminal neuropathic pain and other chronic orofacial pain conditions (excluding headache and temporomandibular disorders). The International Classification of Headache Disorders 2018 classifies these facial pain disorders under the heading Painful cranial neuropathies and other facial pains. In addition to unambiguous painful posttraumatic or postherpetic...
Source: Journal of Clinical Neurophysiology - Category: Neurology Tags: Invited Review Source Type: research
Abstract Dental pain is the most common acute pain presenting in the orofacial region; however, chronic pain conditions are also frequent and include; temporomandibular joint disorders (TMDs), primary headaches (neurovascular pain), painful post-traumatic trigeminal neuropathy (PPTTN) and less commonly referred pain and idiopathic or centralized pain conditions. All of these conditions can mimic toothache and vice versa. Many of these conditions are comorbid with high levels of tension headache and migraine reported in patients with TMD; however, dentists remain unfamiliar with headaches and medics unfamiliar with...
Source: Headache - Category: Neurology Authors: Tags: Headache Source Type: research
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