Differences
This shows you the differences between two versions of the page.
| Both sides previous revision Previous revision Next revision | Previous revision | ||
|
group_4_presentation_1_-_migraines [2018/02/02 19:29] chowds6 |
group_4_presentation_1_-_migraines [2018/02/15 15:34] (current) pablahk2 [Presentation] |
||
|---|---|---|---|
| Line 5: | Line 5: | ||
| ====== Epidemiology ====== | ====== Epidemiology ====== | ||
| - | Migraines affect 8.3% of Canadians, which accounts for 2.7 million individuals. Worldwide, it is estimated to affect 14% of the entire population (Ramage-Morin & Gilmour, 2014). It should be noted that these estimates may fall short of the actual prevalence of migraines, as not many individuals actively seek medical assistance when affected (Ramage-Morin & Gilmour, 2014). Migraine prevalence is correlated with age, sex, race, geographic distribution, and socioeconomic factors. It has been found that migraines with auras occur earlier in males and females compared to migraines without. However, males tend to have migraines earlier on in life regardless of the presence of auras. Following puberty, females report migraines more frequently than males. Both sexes report having migraines within the age range of 25 to 55, followed by a decline (Ramage-Morin & Gilmour, 2014). Overall, it is found that females report migraines more frequently than males. In an American study, it was discovered that Caucasians tend to have the highest prevalence of migraines, while Asian Americans have the lowest. Geographically, data tends to support this finding as North and South Americans were observed to report migraines the most, while individuals in Asia reported migraines the least. Typically, socioeconomic status is inversely proportional to the prevalence of migraines in a population (Lipton & Bigal, 2005). | + | Migraines affect 8.3% of Canadians, which accounts for 2.7 million individuals. Worldwide, it is estimated to affect 14% of the entire population (Ramage-Morin & Gilmour, 2014). It should be noted that these estimates may fall short of the actual prevalence of migraines, as not many individuals actively seek medical assistance when affected (Ramage-Morin & Gilmour, 2014). Migraine prevalence is correlated with age, sex, race, geographic distribution, and socioeconomic factors. It has been found that migraines with auras occur earlier in males and females compared to migraines without. However, males tend to have migraines earlier on in life regardless of the presence of auras. Following puberty, females report migraines more frequently than males. Both sexes report having migraines within the age range of 25 to 55, followed by a decline as seen in **Figure 1a** (Ramage-Morin & Gilmour, 2014). Overall, it is found that females report migraines more frequently than males. In an American study, it was discovered that Caucasians tend to have the highest prevalence of migraines, while Asian Americans have the lowest. Geographically, data tends to support this finding as North and South Americans were observed to report migraines the most, while individuals in Asia reported migraines the least, as seen in **Figure 1b**. Typically, socioeconomic status is inversely proportional to the prevalence of migraines in a population (Lipton & Bigal, 2005). |
| <box 65% | >{{ :graphv3.png?700 |}}</box| | <box 65% | >{{ :graphv3.png?700 |}}</box| | ||
| Line 25: | Line 25: | ||
| Significant evidence has also displayed the cyclic nature of migraines, particularly how migraines themselves act as a stressor leading to a positive feedback and increase of migraine severity and frequency, as seen in **Figure 2** (Sauro & Becker, 2009). A noteworthy investigation lead by Holm and colleagues (1997), looked at the daily temporal relationship between migraines, appraisal, coping and stress in a group of migraineurs. From this group, it was observed that 50-70% of participants showed a significant and meaningful correlation between their recorded days of migraine attacks and days of major stress (Holm et al., 1997). In addition, migraine severity also showed to steadily increase over time, further supporting the hypothesis that migraines and stress are reciprocal and cyclically influence one another (Holm et al., 1997). | Significant evidence has also displayed the cyclic nature of migraines, particularly how migraines themselves act as a stressor leading to a positive feedback and increase of migraine severity and frequency, as seen in **Figure 2** (Sauro & Becker, 2009). A noteworthy investigation lead by Holm and colleagues (1997), looked at the daily temporal relationship between migraines, appraisal, coping and stress in a group of migraineurs. From this group, it was observed that 50-70% of participants showed a significant and meaningful correlation between their recorded days of migraine attacks and days of major stress (Holm et al., 1997). In addition, migraine severity also showed to steadily increase over time, further supporting the hypothesis that migraines and stress are reciprocal and cyclically influence one another (Holm et al., 1997). | ||
| - | <box 50% | >{{ :new.png?400 |}}</box|Figure 2: The cyclic cycle of the reciprocating relationship between stress and migraines (Stress response, 2012).> | + | <box 50% | >{{ :new.png?400 |}}</box|Figure 2: The cyclic relationship between stress and migraines (Stress response, 2012).> |
| ====Food and Drink==== | ====Food and Drink==== | ||
| Line 81: | Line 81: | ||
| ====Familial Hemiplegic Migraine==== | ====Familial Hemiplegic Migraine==== | ||
| - | Genes associated with the cause of migraines have yet to be definitive, except for in familial hemiplegic migraine (FHM) cases. FHM is a type of migraine characterized by aura symptoms mostly in the temporal order (visual, sensory, motor, aphasic) and can co-occur within families (Pietrobon, 2005). These attacks are similar to migraines with aura attacks, however, tend to last longer and may have severe attacks that include impairment of consciousness or seizures (Pietrobon, 2005). There are 3 different types of Familial Hemiplegic Migraines, which will be further explored below. | + | Genes associated with the cause of migraines have yet to be definitive, except for in familial hemiplegic migraine (FHM) cases, as visualized in **Figure 8**. FHM is a type of migraine characterized by aura symptoms mostly in the temporal order (visual, sensory, motor, aphasic) and can co-occur within families (Pietrobon, 2005). These attacks are similar to migraines with aura attacks, however, tend to last longer and may have severe attacks that include impairment of consciousness or seizures (Pietrobon, 2005). There are 3 different types of Familial Hemiplegic Migraines, which will be further explored below. |
| * **FHM1**: This is the most common type of FHM at around 50% of the cases. This migraine is characterized by mutations in CACNA1A that encodes for a pore-forming alpha1 subunit of neuronal Cav2.1 channels (located in the presynaptic terminals and somatodendritic membranes, places that have been implicated with migraines) that has 4 domains each containing 6 transmembrane regions with a voltage sensor and pore loop (Russell, 2011). These channels play a role in neurotransmitter release and have been expressed in many brain structures involving migraines such as cerebral cortex, trigeminal ganglia and brainstem nuclei. The effect of the mutation involves an influx of Ca2+ due to lower voltages of the channel activation. A study by Pietrobon (2005) demonstrates that there is also an excessive release of glutamate in relation to the Ca2+, which starts a positive feedback cycle leading to CSD (Pietrobon, 2005) This gene is related to other conditions, such as nystagmus (involuntary movement of the eyeballs) and ataxia (unsteadiness and the loss of muscle coordination). | * **FHM1**: This is the most common type of FHM at around 50% of the cases. This migraine is characterized by mutations in CACNA1A that encodes for a pore-forming alpha1 subunit of neuronal Cav2.1 channels (located in the presynaptic terminals and somatodendritic membranes, places that have been implicated with migraines) that has 4 domains each containing 6 transmembrane regions with a voltage sensor and pore loop (Russell, 2011). These channels play a role in neurotransmitter release and have been expressed in many brain structures involving migraines such as cerebral cortex, trigeminal ganglia and brainstem nuclei. The effect of the mutation involves an influx of Ca2+ due to lower voltages of the channel activation. A study by Pietrobon (2005) demonstrates that there is also an excessive release of glutamate in relation to the Ca2+, which starts a positive feedback cycle leading to CSD (Pietrobon, 2005) This gene is related to other conditions, such as nystagmus (involuntary movement of the eyeballs) and ataxia (unsteadiness and the loss of muscle coordination). | ||
| Line 136: | Line 136: | ||
| ====== Conclusion ====== | ====== Conclusion ====== | ||
| - | Overall, migraines are a primary headache disorder, characterized by recurrent throbbing, heightened severity, length, localization of pain to one side of the head and other related symptoms (such as vomiting, nausea, sensitivity to light and smell). There appears to be a high prevalence of migraines globally by age. On average, both males and females experience the most migraines, but females tend to have migraines more often than do males. | + | Overall, migraines are a primary headache disorder, characterized by recurrent throbbing, heightened severity, length, localization of pain to one side of the head, amongst other symptoms (vomiting, nausea, sensitivity to light and smell). These symptoms are observed at a high prevalence rate globally by age, with females experiencing more migraines than males overall. In addition, although the causes and triggers to migraine onset remains unclear, multiple studies have observed patients being most susceptible to stress, certain foods and drink, as well as other associated environmental and biological factors (light, weather, menstruation, hunger, etc.). What can be understood currently about this phenomenon is how migraines are a neurovascular disorders, mainly due to cortical spreading and the activation of trigeminovascular system seen in the brain and central nervous system. Beyond this scope however, the rest is relatively unclear, specifically concerning the mechanisms at play. It has been theorized that migraines are associated to a single nucleotide polymorphism on chromosome 8 or a frameshift mutation in the KCNK18 gene. With this current understanding about migraines, diagnosis can be completed quickly and treatment can be implemented at any migraine stage via acute or proactive methods. Yet, despite the efforts in providing a myriad of pharmaceutical and alternative treatments to the public, more has to be done to further learn how migraines occur and how to effectively lessen their severity for individuals. |
| + | |||
| + | ====== Presentation ===== | ||
| + | |||
| + | Click {{:presentation_1_migraines.pdf|}} for a research seminar presentation on migraines. | ||
| + | |||
| + | **Copyright ©** Miguel Cardoso, Shara Chowdhury, Sabrina Musto, Harpreet Pabla, & Ojan Yarkhani | ||
