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Biomedical subjects

F Frediani

Publications and source records attributed to F Frediani.

At least 19 recordsLinked to original sources
PubMed2006

Improvement in quality of life and activity limitations in migraine patients after prophylaxis. A prospective longitudinal multicentre study.

Improved health-related quality of life (HRQOL) and reduced activity limitations are prime objectives of migraine therapy, but no data on the effect of preventive treatments on these outcomes are available. We monitored changes in HRQOL using the Short Form 36 (SF-36) and headache-related activity limitations using the Migraine Disability Assessment Score (MIDAS) in 141 consecutive migraine without aura patients on prophylaxis. A total of 102 patients completed the 3-month study. Mean (SD) number of headache days/month dropped from 8.0 (3.7) to 5.0 (2.3) (P < 0.001). Mean monthly consumption of acute drugs reduced from 7.4 (3.5) to 4.4 (3.1) (P < 0.001). MIDAS total score reduced (improved) significantly. All SF-36 scale scores increased (improved), most significantly. This first study to assess prospectively the impact of prophylaxis on HRQOL and daily activities in a large series indicates that migraine prophylaxis has the potential to reduce the global burden of migraine on individuals and society.

Activities of Daily Living↗
PubMed2005

Pharmacological therapy of atypical facial pain: actuality and perspective.

Atypical facial pain is a condition, which creates a difficult challenge for every physician, either for diagnosis or for choice of treatment. There are very few controlled studies and evidence-based data about what constitutes the gold standard treatment. Most physicians treat this condition with antidepressant agents, thinking that the psychiatric aspects, often present in these patients, play a fundamental role in the pathogenesis of the condition. However, antidepressant drugs are effective also in non-psychiatric patients, and new compounds, with no effect on psychological aspects, have recently seemed to show good activity in controlling pain in this disorder. We review the different possibilities available for treating this frustrating condition.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2004

Anticonvulsant drugs in primary headaches prophylaxis.

Anticonvulsant drugs have been used in migraine prophylaxis since 1970. In recent years, new antiepileptic medications have given rise to much interest in pain control. Primary headaches prophylaxis is still based on old drugs, and physicians facing these conditions are always prompted to use any new possible choice. Among primary headaches, the most studied drug over last 15 years was divalproex sodium, and many papers showed its efficacy in the treatment of migraine headaches. Valproate is well tolerated and many dosages have been used with success. For the newer drugs, such as gabapentin, lamotrigine or topiramate, evidence is less strong but has been rapidly increasing in the last 5 years. In particular, topiramate has much more evidence of a good efficacy and a safe profile. We review the principal characteristics of their use, according to dosages, lasting of treatments, side effects and significant efficacy.

Amines↗
PubMed2004

Measure of negative impact of migraine on daily activities, social relationships and therapeutic approach.

The study has been conducted in 9 European countries, interviewing 200 women in each country, aged 18-35, in fully working or studying period, to get a total of 1810 people. Migraine or severe headache was recognised and patients were studied to understand their behaviour. The features and severity of headache, the use of different drugs, the relationship between physicians and patients, the disability during attacks, the psychological aspects and the feeling of impotence that migraine patients experienced during their lives, are analysed and reported.

Activities of Daily Living↗
PubMed2003

Psychological and emotional aspects and pain.

A patient's psychological condition can be influenced by symptoms and, at the same time, it can influence the perception of symptoms. In psychological assessment, pain can modify the results of a questionnaire, so a patient's state at the moment of the evaluation should be taken into account. Questionnaires used in assessment do not always provide clear-cut answers concerning the individual psychological component. Moreover, difficulties in classifying headache patients does not permit correct comparisons between population samples whenever patients are not classified into well defined homogeneous groups. Overall, in the three groups examined - migraine, tension-type headache and cluster headache - it can be affirmed that with self-report assessment based on questionnaires, the tension-type headache subjects present a more interesting psychological profile for its clinical implications.

Cluster Headache↗
PubMed2003

The patient with medication overuse: clinical management problems.

Patients with chronic headache arise many problems in clinical management, often strictly related to medication overuse. IHS classification did not clear the different clinical presentation and a chapter dedicated to this problem is lacking. This condition is very frequently associated with psychiatric illness, so that the clinical features become more complex over the years. Most of patients share a past clinical condition of episodic migraine; this aspect is very important facing the therapeutical phase, because after discontinuing medication overuse, if present, the treatment must be direct toward this disease. To treat a patient with analgesic, or ergotamine, or triptan abuse, require much caution because stopping the drug may arise new problems, such as different headache, abstinence syndrome, epileptic seizures etc. We review the different possibility that we have to manage the overuser patient.

Analgesics↗
PubMed2000

Migraine with aura and white matter abnormalities: Notch3 mutation.

The authors report on an Italian family with eight affected members who show autosomal dominant migraine with prolonged visual, sensory, motor, and aphasic aura. These symptoms are associated with white matter abnormalities on brain MRI. All living affected members carry a Notch3 mutation (Arg153Cys) previously reported in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). White matter abnormalities occur in a variable percentage of the general migraine population; CADASIL should be suspected in migraineurs with prolonged atypical aura and white matter abnormalities.

Brain↗
PubMed2000

Verapamil in the prophylaxis of episodic cluster headache: a double-blind study versus placebo.

The authors performed a double-blind, double-dummy study to compare the efficacy of verapamil with placebo in the prophylaxis of episodic cluster headache. After 5 days' run-in, 15 patients received verapamil (120 mg tid) and 15 received placebo (tid) for 14 days. The authors found a significant reduction in attack frequency and abortive agents consumption in the verapamil group. Side effects were mild. These findings provide objective evidence for the effectiveness of verapamil in episodic cluster headache prophylaxis.

Adult↗
PubMed1995

Quantification of headache disability: a diagnostic-based approach.

The quantification of the social and economic handicaps caused by headache is a complex problem, especially given the great variability of headache patients' clinical pictures. In the present study, 400 patients, consecutively admitted to Headache Centers in Pavia and Milan, were interviewed on the relationship between headache and their work and social activities, in order to evaluate their socioeconomic handicap due to headache. The analysis of the data primarily focused on attack-type headaches (migraine, cluster headache, and episodic tension-type headache) and chronic or daily headaches (chronic tension-type headache and migraine combined with tension-type headache). These latter types were often characterized by the daily use or abuse of analgesics. The overall profile which emerged from the study reveals relatively low levels of handicap or disability in work and social activities. These low levels can be mainly attributed to timely, and at times excessive, use of analgesics.

Absenteeism↗
PubMed1992

Dexamethasone suppression test, melatonin and TRH-test in cluster headache.

The origin of Cluster Headache (CH) is still unknown. The periodicty and presence of symptoms due to both sympathetic and parasympathetic activity suggest the involvement of central nervous system structures, particularly the hypothalamus. To investigate hypothalamic involvement in CH, we employed a neuroendocrinological approach. We observed a normal dexamethasone suppression test (DST) in all patients, increased cortisol plasma levels in remission patients at 8.00am before and at the end of the DST, while only in CH patients during cluster period did we find a reduced TSH response to TRH and a reduced night-time melatonin peak. The neuroendocrinological derangements found in CH may be consistent with hypothalamic involvement.

Adult↗
PubMed1991

Dihydroergokryptine versus dihydroergotamine in migraine prophylaxis: a double-blind clinical trial.

Dihydroergokryptine has been evaluated in the prophylaxis of headache attacks in patients with migraine without aura. The study was controlled vs dihydroergotamine with a double-blind crossover design. After a 1-month run-in period, 30 patients were randomized into two groups and submitted to 4 months treatment with dihydroergokryptine 10 mg b.i.d. or dihydroergotamine (controlled release) 5 mg b.i.d. The treatment was repeated in crossover after 2 months washout. The clinical patients' evaluation was determined by monthly Pain Total Index recording, headache days/month and analgesic consumption. The patients were considered responsible when Pain Total Index decreased by 50% or more in 1 or more months of each treatment period; otherwise the patients were considered unresponsive. The response rate to dihydroergokryptine was 66% while 48% of cases were responsive to dihydroergotamine. The response rate to both treatments was 41%, while 26% did not respond to either treatment. Seven cases unresponsive to dihydroergotamine responded positively to dihydroergokryptine while two cases only, resistant to dihydroergokryptine, responded positively to dihydroergotamine. Three cases dropped out during treatment with dihydroergotamine due to gastric pain and nausea, while they did not show any side effects during dihydroergokryptine therapy. During treatment with dihydroergokryptine there was one case of skin rash which disappeared after drug withdrawal. In conclusion, dihydroergokryptine appears to be an effective drug for the prophylaxis of migraine attacks.

Adult↗
PubMed1990

A therapeutic alternative for tension headache in children: treatment and 1-year follow-up results.

Ten young subjects, ranging in age from 12 to 15 years, suffering from tension headache were treated by electromyographic biofeedback (EMG-BFB) twice a week for 12 sessions. The Pain Total Index (PTI) was recorded every month from the beginning to the end of the treatment. At the end of the treatment the PTI decreased significantly in all our patients and, at the same time, the muscular tension values also decreased. This result supports the hypothesis of a correlation between clinical symptom and muscular tension level. We saw our patients for follow-up sessions, and the clinical improvement was confirmed to 1 year from the completion of the treatment; however, the muscular tension values were increased with respect to the last-session values.

Adolescent↗
PubMed1990

Is nimodipine useful in migraine prophylaxis? Further considerations.

Nimodipine is one of the most discussed calcium antagonists used in cerebrovascular diseases and, recently, in migraine prophylaxis. Its specificity in preventing cerebral arterial constriction has been invoked to explain nimodipine's efficacy in migraine. The discovery of neuronal receptors specific for dihydropyridines, however, favours a mechanism of action for nimodipine that is not exclusively vascular. This is in accordance with a view of migraine pathogenesis which implicates a primary neuronal event as the basis of the vascular changes observed in migraine patients.

Clinical Trials as Topic↗