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Biomedical subjects

E Waldenlind

Publications and source records attributed to E Waldenlind.

30 records · Page 2Linked to original sources
PubMed1992

Episodic cluster headache. I: Personality and some neuropsychological characteristics in male patients.

The etiology and pathogenesis of cluster headache remain largely unknown. Some previous studies have focused on personality characteristics in cluster headache. However, no consistent personality profile has been found. The present study applied two personality inventories, the Karolinska Scales of Personality (KSP) and the Heart and Lifestyle Type A Measure (HALTAM), that have not previously been used in the context of cluster headache. A correlation has been suggested between left-handedness and early learning difficulties, and cluster headache. Thus, these variables were included and measured by inventory techniques. Forty-nine out of 51 consecutive male patients with episodic cluster headache participated in the present study. As compared to controls, the cluster headache patients were significantly more anxiety-prone (higher scores in the KSP Somatic anxiety and Muscular tension subscales), less successfully socialized (low scores in the KSP Socialization scale), and had a more hostile attitude towards others (higher scores in the HALTAM Hostility scale). No relationships between left-handedness or early learning difficulties, and cluster headache disease were found. The implications of the personality differences for the etiology of cluster headache disease are discussed.

Adult↗
PubMed1992

Episodic cluster headache. II: High tobacco and alcohol consumption in males.

Forty-nine out of 51 consecutive male patients with episodic cluster headache were studied with regard to their smoking and drinking habits in general and in relation to cluster headache periods. Questionnaires were constructed for data regarding tobacco intake. Situation-related smoking behavior was registered according to Frith (1971). Screening for alcohol over-consumption was made using the Malmö modification of the brief Michigan Alcoholism Screening Test (Mm-MAST). Eighty-three percent of the patients used tobacco on a regular basis at the time of the study, with an average consumption of 20 cigarettes per day. Only 3% had never used tobacco regularly. The smoking-related desire to smoke in different situations was consistent with what is found in a general population of smokers. Sixty-seven percent of the patients had scores on the Mm-MAST indicative of alcohol over-consumption (i.e. heavy social drinking or alcoholism). During active headache periods 79% decreased their alcohol intake, whereas no consistent change in tobacco consumption was reported for the group as a whole. These findings were further corroborated by the fact that alcohol, but not tobacco intake, was reported by the majority of patients to elicit headache attacks during periods. Thus, our study showed high alcohol and tobacco consumption to be prominent features in male patients with episodic cluster headache. Since neither alcohol nor tobacco appear to have properties of ameliorating headache periods or attacks, the addictive behavior in our patients more likely reflects certain personality characteristics.

Adolescent↗
PubMed1987

Retro-Gasserian glycerol injection in the treatment of chronic cluster headache.

Seven therapy-resistant patients with cluster headache (six of whom were chronic) were treated by percutaneous retro-Gasserian glycerol injections under general anesthesia. In four of the patients immediate and complete relief of attacks was obtained. There was a close correlation between pain relief and the degree of ophthalmic sensory loss. Quantitative estimation of thresholds for thermal perception and pain showed a good correlation to clinically evaluated sensory loss. As the analgesia waned, headaches returned, and the glycerol injections had to be repeated. Two patients were still considerably improved after 5 1/2 and nearly 3 years, respectively. In the other patients the results were less satisfactory at long-term follow-up study. Pure glycerol is highly hypertonic, and the damage of the trigeminal nerve root may be due to this property.

Adult↗
PubMed1987

Prolactin in cluster headache: diurnal secretion, response to thyrotropin-releasing hormone, and relation to sex steroids and gonadotropins.

The diurnal rhythmicity of serum prolactin (PRL) and the PRL and thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) were studied in 31 cluster headache patients (4 chronic cases) and 14 healthy controls. Sixteen of the patients were studied both during clinical remission and headache periods. In males the nocturnal PRL peak was blunted during remissions as compared with that in cluster periods and that in control individuals. The 24-h mean PRL levels were lower during remission and cluster periods than in the controls. There were no significant differences in the PRL levels between female patients and controls. Headache attacks were often associated with increases of serum PRL levels. The PRL response to TRH was lower in the female patients but not in the male patients as compared with controls. The maximum testosterone levels were lower during cluster periods than during clinical remission but not when compared with controls. Serum levels of luteinizing hormone, follicle-stimulating hormone, progesterone, estradiol, T3, T4, and TSH did not differ between patients and controls. The results suggest an altered regulation of PRL secretion not only during active cluster periods but also during symptom-free intervals. The possible influence of sleep, estradiol, testosterone, medication, pain, and serotoninergic and dopaminergic mechanisms are discussed.

Aged↗
PubMed1987

Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission.

The cyclic nature of cluster headache warranted a study of the 24-hour rhythms of serum cortisol and melatonin. They were both altered during cluster periods as compared with periods of remission and healthy controls. The 24-hour mean and maximal cortisol levels were higher and the timing of the cortisol minimum was delayed as compared to the same patients in remission. Although there was no relation between the cortisol and melatonin levels and headaches, the rise of cortisol following many attacks might in part represent an adaptive response to pain. The nocturnal melatonin maximum was lower during cluster periods than in remission. This finding, and the dysautonomic signs during attacks, may reflect a change of the vegetative tone in a hyposympathetic direction.

Adult↗
PubMed1985

Concentration and uptake of 5-hydroxytryptamine in platelets from cluster headache and migraine patients.

Concentrations of 5-hydroxytryptamine (5-HT) in platelets were determined in 33 cluster headache patients (17 males) and in 34 migraine patients (16 males) outside attacks. The 5-HT uptake into platelets was measured and the kinetic constants Vmax and Km determined in 26 cluster patients (14 males) and in 30 migraine patients (13 males). Significantly lower 5-HT concentrations in whole blood were found in cluster headache and migraine patients than in 50 healthy controls (19 males). The Vmax and Km values of the 5-HT uptake were significantly lower in cluster headache and migraine patients compared with 22 healthy controls (9 males). The 5-HT concentrations and the kinetics of the 5-HT uptake did not differ between cluster headache and migraine. In healthy controls a significant positive correlation was found between the 5-HT uptake rate at 0.25 microM and Km but not in cluster headache and migraine patients. The 5-HT concentrations in whole blood correlated positively with Vmax and Km, respectively, in cluster headache and with Km in healthy controls but not with Vmax nor with Km in migraine. There was no obvious relation between the kinetics of platelet monoamine oxidase (MAO) and the 5-HT uptake except for an increased incidence of low Vmax of MAO and low Km of the 5-HT uptake in cluster headache. The kinetics of the 5-HT uptake was apparently not related to the state of migraine. The results indicate a possible constitutional trait in cluster headache and migraine expressed as low 5-HT concentrations in whole blood and low Vmax and Km of the 5-HT uptake into platelets.

Adolescent↗
PubMed1984

Headache and mood: a time-series analysis of self-ratings.

Self-ratings with respect to headache and five mood dimensions were obtained twice daily from five patients suffering from migraine and six patients suffering from muscle-contraction headache during a mean period of 47.9 days (range: 38-61). The data were analysed by multiple regression, with the rated headache as dependent variable. Different time intervals between measurement of the independent variables and measurement of the dependent variable were used. A significant time-dependent relation was found between the migraine ratings and the alertness ratings. Significant time-dependent relations were also found between rated muscle-contraction headache and rated anger and alertness, respectively, but the trends were not very pronounced. In the case of no time lag, rated muscle-contraction headache tended to be negatively related to rated alertness, happiness and concentration. Significant periodic trends were found for both the migraine and the muscle-contraction headache. The major findings are discussed in terms of stress and biological rhythms.

Adolescent↗
PubMed1984

Kinetics and thermolability of platelet monoamine oxidase in cluster headache and migraine.

Platelet monoamine oxidase activity (MAO) from 33 cluster headache patients (17 males, 16 females) and 34 migraine patients (16 males, 18 females) was assayed. The kinetic constants (apparent Vmax and apparent Km) and the thermolability, measured as the ratio of the platelet MAO activity after and before heat treatment (+52 degrees C, 30 min), were determined. The MAO activity and Vmax values were significantly lower in cluster headache than in migraine and in both headache disorders compared to a control group (62 males, 66 females). When comparing all groups, Km was not significantly different except for migraine females, who had lower Km values compared to control females. Thermolability was significantly higher in cluster headache than in migraine and in both headache disorders compared to the control group. Smokers of five cigarettes or more per day had significantly lower Vmax values but similar Km and thermolability values compared to those smoking less or nothing. The findings of low maximal velocities and high thermolability of platelet MAO in cluster headache and migraine are suggested to represent constitutionally different enzyme properties.

Adolescent↗
PubMed1983

Optimal routes of administration of ergotamine tartrate in cluster headache patients. A pharmacokinetic study.

Bioavailability and rate of absorption of ergotamine were studied in eight cluster headache patients outside attacks. In a cross-over design, approximately 2 mg ergotamine tartrate was administered as effervescent tablets, suppositories, and from an inhalation device, with 0.25 mg intravenously as the reference. Ergotamine in plasma was measured by high performance liquid chromatography with fluorescence detection from 5 to 420 min. For all three routes of administration, a similar low (0.5-4.2%) bioavailability of ergotamine was estimated. Only inhalation of ergotamine resulted in early (at 5 min) peak concentrations of ergotamine in plasma and is therefore most likely to relieve the short-lived attacks of cluster headache. The inhalation route for ergotamine poses problems, however, and we suggest ways of improving the inhalation device.

Administration, Oral↗
PubMed1981

Cluster headache in women: evidence of hypofertility(?) Headaches in relation to menstruation and pregnancy.

Two hundred and forty-nine patients with cluster headache have been studied, 215 male and 34 female (ratio 6.3:1). Twenty-five of the 26 fertile female cluster patients stated that their headaches had no relation to menstrual periods. Eight had had 13 pregnancies since the onset of cluster headache. Six of them experienced remission of their headache during pregnancy. Four women with cluster headache had a history of infertility or premature menopause. Parity rate was low in patients who contracted cluster headache as nulliparae; it was lower than in those who contracted the disease after earlier pregnancy or post menopause, and also significantly lower than in 99 consecutive women with migraine. Significant differences were also found when the numbers of childbirths in the cluster patients were compared with total fertility rates up to successive ages for birth cohorts in the general population of Swedish women.

Adult↗
PubMed1981

Low biological availability of ergotamine tartrate after oral dosing in cluster headache.

An attempt was made to determine the plasma ergotamine concentrations in nine male patients with cluster headache 15-600 min after oral therapeutic doses of ergotamine tartrate (Cafergot). Some of the patients were studied twice. Five patients received a constant dose of 2-4 mg daily for at least seven days. Four patients were given 1 mg five times on one day and three patients a single oral dose of 2 mg. Ergotamine was determined by means of high performance liquid chromatography with fluorescence detection--a new highly sensitive, specific method, the detection limit of which is less than 100 pg/ml for ergotamine. Ergotamine tartrate was not discovered in any of the plasma samples. In one patient ergotamine could not be detected in the cerebrospinal fluid one hour after a single oral dose of 2 mg. The oral biological availability is less than 1%, which is the maximal available fraction of unchanged ergotamine after oral administration. A clinical benefit was observed in several of our patients. These effects of the drug may be because of active metabolites being formed and/or to high affinity of ergotamine to cranial vessels.

Administration, Oral↗