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Elisabet Waldenlind

Publications and source records attributed to Elisabet Waldenlind.

8 recordsLinked to original sources
PubMed2006

Lifetime prevalence and concordance risk of cluster headache in the Swedish twin population.

OBJECTIVE: To examine the lifetime prevalence and the concordance risk of cluster headache (CH) in a twin sample representative of the Swedish general population. METHODS: The authors assessed CH as defined by the second edition of the International Classification of Headache Disorders in 31,750 registered twins born from 1935 to 1958. Structured lay screening interviews were followed by neurologist interviews of possible cases. Co-twins of affected index twins were follow-up interviewed regardless of their screening outcome. RESULTS: A total of 250 screening-positives (0.8%) were found, of which 218 (88%) were follow-up interviewed. Forty-five (21%) had the CH diagnosis verified. Among screen-negatives, hospitalization records pointed at two more verified cases and index twins at one more verified case. A total of 48 CH cases provided a crude lifetime prevalence of 151 per 100,000 (95% CI: 108, 194). The male-to-female sex ratio corresponded to 4.8 (95% CI: 2.3, 9.9). The crude lifetime prevalence of CH was higher in the twins born from 1945 to 1958 than in the twins born from 1935 to 1944 (190 vs 90/100,000). CH recurred in 2 of 12 co-twins of monozygous index twins (including 1 nonparticipant twin), whereas all co-twins of 25 dizygous index twins proved to be unaffected. CONCLUSION: As many as 1 per 500 of the general population are affected by cluster headache. Twin concordance seems low, but genetic factors may play a role for familial clustering.

Adolescent↗
PubMed2003

Diminished nocturnal lipolysis in cluster headache: a sign of central sympathetic dysregulation?

BACKGROUND: It is unclear whether the autonomic symptoms during cluster headache (CH) attacks are of central or peripheral origin. A metabolic change such as altered lipolysis would reflect a central autonomic dysfunction. OBJECTIVE: To study nocturnal lipolysis in CH patients and healthy control subjects. METHODS: Microdialysis technique was used to measure glycerol levels, the end-product of lipolysis, in subcutaneous adipose tissue. Ten CH patients participated, of whom six were studied in remission as well as during symptomatic periods but between headache attacks. Fifteen healthy control subjects were studied. Mean glycerol, glucose, and lactate concentrations were calculated for three 2-hour intervals between 2400 and 0600 hours. RESULTS: Compared with healthy control subjects, symptomatic CH patients had lower glycerol levels during all three intervals (69, 61, and 73% of control levels; p < 0.05). CH patients in remission showed lower glycerol levels from 0200 to 0600 hours (68 and 63% of control levels; p < 0.05). There were no significant differences between the CH groups. Compared with healthy control subjects, patients in remission also showed a significantly different nocturnal temporal pattern, demonstrating declining glycerol levels during the first part of the night. CONCLUSIONS: Altered lipolysis was found in patients with CH, both in symptomatic periods and in remission. The altered lipolysis may be due to a reduced nocturnal sympathetic activity and consequently an indication of central sympathetic dysregulation and hypothalamic dysfunction.

Adipose Tissue↗
PubMed2003

Shared rearing environment in migraine: results from twins reared apart and twins reared together.

BACKGROUND: Studies of twins who are separated from each other early in life and are reared in different environments offer the opportunity to resolve variation in liability to disease. OBJECTIVE: To evaluate the importance of genetic and environmental influences in migraine; in particular, addressing the role of the shared rearing environment. METHODS: A population-based cohort of twins, including a subsample of 314 pairs reared apart and 364 matched control pairs reared together, was drawn from the Swedish Twin Registry. Data on lifetime migraine was collected via self-administered questionnaires mailed to twins aged 42 to 81 years. Quantitative genetic models and regression models were used to analyze sources of twin similarity. RESULTS: We found nonsignificant shared rearing environmental influences on migraine for men (17%) and no rearing effects at all for women. The heritability of migraine was estimated at 38% (95% confidence interval, 0 to 73) for men and 48% (95% confidence interval, 27 to 65) for women. Among monozygotic twins reared apart, those separated at 3 years of age or earlier were more similar for lifetime migraine than those separated later, and this was especially true for women. CONCLUSION: In agreement with previous twin data, family resistance in migraine is mainly due to genetic factors, whereas environmental influences make family members different, not similar.

Adult↗
PubMed2002

Lifetime prevalence and characteristics of recurrent primary headaches in a population-based sample of Swedish twins.

OBJECTIVE: To examine the lifetime prevalence and other characteristics of recurrent primary headaches in twins. BACKGROUND: The twin model may provide insights into the role of genetic and environmental influences in headache disorders. However, assumptions as to whether twins are representative of the general population, and whether monozygotic and dizygotic twins are similar have rarely been addressed. METHODS: The study population consisted of a random sample of 17- to 82-year-old twins from the Swedish Twin Registry (n = 1329). Structured interviews on the telephone by lay personnel and the International Headache Society criteria were used for assessment and diagnosis of recurrent primary headaches. Prevalence data of the general population for migraine and tension-type headache was obtained from various published reports. RESULTS: A total of 372 subjects (29%) had ever had recurrent headaches. In total, 241 recurrent headache sufferers fulfilled the criteria for migraine or tension-type headache, and the lifetime prevalence was 7.1% for migraine without aura, 1.4% for migraine always with aura, 1.9% for migraine occasionally with aura, 9.4% for episodic tension-type headache, and 1.3% for chronic tension-type headache. The lifetime prevalence of all migraine and all tension-type headache, including another 84 subjects fulfilling all but one of the criteria for migraine or tension-type headache, was 13.8% and 13.5%, respectively. The corresponding prevalence risk for women was 2.4 (95% confidence interval [CI] 1.7, 3.4) and 1.5 (95% CI 1.1, 2.1), respectively. Zygosity was not a significant predictor for migraine. In tension-type headache, the prevalence risk for dizygotic twins and unlike-sexed twins as compared with monozygotic twins was 1.9 (95% CI: 1.2, 3.1) and 1.8 (95% CI: 1.1, 2.9), respectively. CONCLUSION: There is no twin-singleton or monozygotic-dizygotic difference for the risk of migraine. In tension-type headache, twins seem to have a lower risk than singletons, and this is especially true for monozygotic twins.

Adolescent↗
PubMed2002

Genetic and environmental influences on expression of recurrent headache as a function of the reporting age in twins.

To explore age-related mechanisms in the expression of recurrent headache, we evaluated whether genetic and environmental influences are a function of the reporting age using questionnaire information that was gathered in 1973 for 15- to 47-year-old Swedish twins (n = 12,606 twin pairs). Liability to mixed headache (mild migraine and tension-type headache) was explained by non-additive genetic influences (49%) in men aged from 15 to 30 years and additive genetic plus shared environmental influences (28%) in men aged from 31 to 47 years. In women, the explained proportion of variance, which was mainly due to additive genetic effects, ranged from 61% in adolescent twins to 12% in twins aged from 41 to 47 years, whereas individual specific environmental variance was significantly lower in twins aged from 15 to 20 years than in twins aged from 21 to 30 years. Liability to migrainous headache (more severe migraine) was explained by non-additive genetic influences in men, 32% in young men and 45% in old men, while total phenotypic variance was significantly lower in young men than in old men. In women, the explained proportion of variance ranged from 91% in the youngest age group to 37% in the oldest age group, with major contributions from non-additive effects in young and old women (15-20 years and 41-47 years, respectively) and additive genetic effects in intermediate age groups (21-40 years). While total variance showed a positive age trend, genetic variance tended to be stable across age groups, whereas individual specific environmental variance was significantly lower in adolescent women as compared to older women.

Adolescent↗
PubMedDate not supplied

Gene expression profiling in cluster headache: a pilot microarray study.

BACKGROUND: Cluster headache (CH) is a primary neurovascular headache disorder characterized by attacks of excruciating pain accompanied by ipsilateral autonomic symptoms. CH pathophysiology is presumed to involve an activation of hypothalamic and trigeminovascular systems, but inflammation and immunological mechanisms have also been hypothesized to be of importance. OBJECTIVE: To identify differentially expressed genes during different clinical phases of CH, assuming that changes of pathophysiological importance would also be seen in peripheral venous blood. METHODS: Blood samples were drawn at 3 consecutive occasions from 3 episodic CH patients: during attacks, between attacks and in remission, and at 1 occasion from 3 matched controls. Global gene expression was analyzed with microarray tehnology using the Affymetrix Human Genome U133 2.0 Plus GeneChip Set, covering more than 54,000 gene transcripts, corresponding to almost 22,000 genes. Quantitative RT-PCR on S100P gene expression was analyzed in 6 patients and 14 controls. RESULTS: Overall, quite small differences were seen intraindividually and large differences interindividually. However, pairwise comparisons of signal values showed upregulation of several S100 calcium binding proteins; S100A8 (calgranulin A), S100A12 (calgranulin C), and S100P during active phase of the disease compared to remission. Also, annexin A3 (calcium-binding) and ICAM3 showed upregulation. BIRC1 (neuronal apoptosis inhibitory protein), CREB5, HLA-DQA1, and HLA-DQB1 were upregulated in patients compared to controls. The upregulation of S100P during attack versus remission was confirmed by quantitative RT-PCR analysis. CONCLUSIONS: The S100A8 and S100A12 proteins are considered markers of non-infectious inflammatory disease, while the function of S100P is still largely unknown. Furthermore, upregulation of HLA-DQ genes in CH patients may also indicate an inflammatory response. Upregulation of these pro-inflammatory genes during the active phase of CH has not formerly been reported. Data from this pilot microarray study provide a basis for further studies in CH.

Adult↗
PubMedDate not supplied

Cluster headache: the history of the Cluster Club and a review of recent clinical research.

In September 2003, a scientific meeting was held in Rome to revive the International Cluster Headache Research Group (or "Cluster Club") tradition. This group of specialists was originally formed in the late 1970s by Ottar Sjaastad in order to promote research ideas, and to generate papers and other important information in this field. Its meetings, the last of which had taken place in 1994, had been informal events at which there was ample time for lively discussion. The last decade of the 20th century brought a significant increase in clinical and experimental research into cluster headache (CH), and this review summarizes some of the results of this research. The male preponderance of CH has been shown to be progressively decreasing over the years. Revised clinical criteria and a modern classification have been presented. First-degree relatives of probands with CH have been shown to have an increased risk of suffering from CH compared with the general population. Genetic analysis suggests that an autosomal dominant gene plays a role in some families. Functional neuroimaging has contributed to a better understanding of the pathophysiology of the condition. Positron emission tomography during provoked attacks has shown activation of the ipsilateral inferior posterior hypothalamus and it has been suggested that CH might be a functional neurovascular disorder of pacemaker or circadian regions in the hypothalamic grey matter. Subcutaneously administered sumatriptan has emerged as a highly effective acute treatment, but, in our opinion, the emphasis should be on attack prevention. Deep brain stimulation of the inferior posterior hypothalamic grey matter seems to be very promising as a novel treatment targeting the presumed central origin of pain attacks.

Biomedical Research↗