ObjectiveTo systematically review the association between migraine and lacunar infarcts on MR image.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials, cohort studies and cross-sectional studies on the association between migraine and lacunar infarcts from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 studies involving 5 104 participants were included. The results of meta-analysis showed that: there were no significant associations of migraine (OR=0.93, 95%CI 0.78 to 1.12, P=0.470) and aura (OR=1.10, 95%CI 0.89 to 1.36, P=0.390) with lacunar infarcts on MR image. Subgroup analysis by age, presence or absence of aura showed no significant tendency.ConclusionsThere is no significant relationship between migraine and lacunar infarcts. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective To assess the quality of randomized controlled trials (RCTs) on acupuncture for treating acute migraine attacks. Methods With the searching terms of acupuncture and migraine, the Cochrane Controlled Trials Register (CCTR), PubMed, MEDLINE, EMbase, CBM, CMCC, CNKI and VIP were searched. The reports quality of the included trials, including the quality of methodology, diagnostic criteria, inclusion/exclusion criteria, acupuncture/control interventions, outcome measures, observing time, and adverse effects reports, was evaluated. Results A total 23 RCTs involving 2645 patients were included, of which only 3 RCTs were of high quality with Jadad scores equal to or more than 4. At present, only a few high quality trials on treating acute attacks of migraine with acupuncture had been reported at home and abroad. The international recognized diagnostic criteria and common evaluation methods had not been used generally, and the design of control was kind of irrational. Conclusion Based on current clinical reports, acupuncture may be effective in the management of acute migraine attacks, but some relevant proof is still required. The further domestic studies should be designed strictly following the international recommended diagnosis and evaluation criteria of migraine, and rational control methods as well.
Objective To evaluate the effects of cold provoca tion on optic dise blood flow and retinal light sensitivity of primary open-angle glaucoma (POAG) patients,and explore the relationship between the changes of optic disc blood flow and retin al light sensitivity. Methods A total 33 POAG patients (33 eyes)and 13 normal controls (13 eyes) were tested by usin g th e Heidelberg retinal flowmetry (HRF) and Topcon automatic perimeter,and the optic disc blood flow and retinal light sensitivity of POAG patients and normal cont rols were measured at normal conditions and after cold provocation. Results The mean optic disc blood flow,volume and the mean retinal light sensitivity of POAG patients decreased significantly (Plt;0.05) after cold provocation.There was a linear and significant relationsh ip between the decrease of mean optic disc blood flow and mean retinal light sen sitivity of POAG patients (r=0.615,P＜0.001). The optic disc blood flow of POAG patients with a history of migraine were more likely to r educe in response to cold provocation and reduced much more than those without such history (Plt;0.05). Conclusion Cold provocation can significantly reduce both the optic disc blood flow and retinal light sensitivity in POAG patients.A close correlation was fo und between the amount of mean optic disc blood flow decrease and the volume of mean retinal light sensitivity decline. (Chin J Ocul Fundus Dis, 2001,17:37-40)
Objective To assess the effectiveness of acupuncture for tension-type headache. Methods A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture for tension-type headache was performed using the methods of The Cochrane Collaboration. Trials were collected from The Cochrane Library, Issue 4, 2003, MEDLINE (1966 to March 2004), CBM (1978 to August 2003), VIP (1989 to April 2003) and handsearched all related articles published in Chinese in 2003. The quality of literature was reviewed, and data were extracted by two reviewers independently. Meta-analysis was conducted using RevMan 4.2 software. Results Thirteen RCTs involving 571 patients were included, of the thirteen RCTs, six were of high methodological quality according to Jadad scale (the Jadad score≥3), and “sham acupuncture” was used as controlled intervention in eight trials. Meta-analysis indicated that no statistical difference was detected between acupuncture and sham acupuncture groups on effectiveness with RR 1.55, 95%CI 0.97 to 2.47 and P=0.07 at the end of treatment. No statistical difference was detected between acupuncture and sham acupuncture groups on visual analogue scale at the end of treatment with WMD －0.55, 95%CI －1.20 to 0.09 and P=0.09; at the end of follow-up of less than 2 months with WMD －0.22, 95%CI －0.87 to 0.42 and P= 0.50 and at the end of follow-up of more than 2 months with WMD －0.65, 95% CI －1.41 to 0.11 and P=0.09. Conclusions Comparing acupuncture with sham acupuncture and other treatments, current evidence can not evaluate whether acupuncture is significantly effective for tension-type headache, more RCTs of high methodological quality are required.
Objective To evaluate the evidence-based prevention and treatment of post-dural puncture headache (PDPH) for parturient women. Methods We searched The Cochrane Library (Issue 3, 2006), Medline (Jan. 1980 to Oct. 2006) and CBM-disc (Jan. 1980 to Oct. 2006) to identify current best evidence on the prevention and treatment of PDPH for parturient women. The quality of available evidence was critically appraised.Results We identified 2 Cochrane systematic reviews, 2 meta-analyses and 9 randomized controlled trials. Evidence indicated that posture, fluid, and pharmacological managements had no significant effect on PDPH except epidural blood patch. The selection of appropriate spinal needle and the technique of needle insertion may reduce the incidence of PDPH, whereas the effect of intrathecal saline infusion and catheter insertion need further clinical validation. Conclusions Epidural blood patch has definite therapeutic effect on PDPH. Appropriate spinal needle and insertion technique may effectively prevent PDPH for parturient women.
Objective To investigate the influencing factors of moderate to severe disability in migraine patients. Methods Patients diagnosed with migraine between September 2022 and January 2024 in the outpatient service or inpatient Department of Neurology of Baotou Central Hospital and Baotou Eighth Hospital were included. According to the scores of the Migraine Disability Assessment questionnaire, patients were divided into a group with no or mild disabilities and a group with moderate to severe disabilities. The sociodemographic, disease characteristics, and scale datas of two groups of patients were collected, and a multivariate logistic regression model was used to explore the influencing factors of moderate to severe disability in migraine patients. Results A total of 116 patients were included. Among them, there were 49 cases in the group with no or mild disabilities, and 67 cases in the group with moderate to severe disabilities. There were statistically significant differences in gender, duration of headache, severity of headache, number of headache days per month, drug overuse, the scores of Generalized Anxiety Disorder-7 scale, the scores of Patient Health Questionnaire-9 scale, the scores of Pittsburgh Sleep Quality Index scale, the scores of Headache Impact Test scale, the scores of Montreal Cognitive Assessment scale, and the scores of 36-item Short-Form Health Survey questionnaires between the two groups (P<0.05). There was no statistically significant difference in other sociodemographic information and disease characteristics between the two groups of patients (P>0.05). The results of multivariate logistic regression analysis showed that the number of headache days per month, the scores of Generalized Anxiety Disorder-7 scale, the scores of Headache Impact Test scale, and the scores of 36-item Short-Form Health Survey questionnaire were independent influencing factors for moderate to severe disability in migraine patients (P<0.05). Conclusions Headache duration, anxiety disorders and health-related quality of life are influencing factors for moderate to severe disability in migraine patients. Early screening and intervention of influencing factors for migraine patients should be emphasized.