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 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 efficacy of Yangxue Qingnao Grain for migraine. Methods We searched The Cochrane Library (Issue 3, 2007), EMBASE (1974 to June 2007), PubMed (1966 to June 2007), VIP (1989 to June 2007), CNKI (1979 to June 2007) and CBM (1978 to June 2007) to identify randomized controlled trials or quasirandomized controlled trials comparing Yangxue Qingnao Grain versus sibeline for migraine. The quality of included studies was critically assessed and data analyses were performed with The Cochrane Collaboration’s RevMan 4.2.7. Results Eight studies were included, involving 5 randomized trials and 3 quasi-randomized trials. Meta-analyses showed that the total response rate (RR=1.07, 95%CI 1.00 to 1.15, P=0.06), the duration of headache (WMD 1.33, 95%CI – 0.87 to 3.52, P=0.24), and the frequency of headache episodes (WMD 0.93, 95%CI –1.00 to 2.86, P=0.35) were similar between Yangxue Qingnao Grain and sibeline. One study reported that the changes of ACA (WMD 3.70, 95%CI –3.46 to 10.86), MCA (WMD 0.60, 95%CI –10.37 to 11.57), ICA (WMD 3.40, 95%CI –4.35 to 11.15) and DCA (WMD – 2.30, 95%CI –9.52 to 4.92) revealed by transcranial doppler sonography were also comparable between the two groups. Conclusion Yangxue Qingnao Grain is effective in the treatment of migraine, but its superiority over sibeline is not demonstrated. Due to the poor quality and small sample of the included trials, more large-scale multi-center randomized trials are needed.
Objectives We aimed to assess the methodological qual ity of RCT on acupuncture for migraine prophylaxis. Methods With the searching terms including acupuncture, migraine, prophylaxis and prevent, etc, the database of the Cochrane Library (Issue 4, 2007), MEDLINE (1966-2007), EMBase (1966-2007), CBM (1978-2007) and CMCC (1994-2007) were searched from their date of start publ ication. Chinese medical journals and relevant academic conference proceedings were hand searched as well. Several items in included trials were assessed, including methodology, diagnostic criteria, inclusion/exclusion criteria, acupuncture/control interventions, outcome measures and follow-up, etc. Result Among the 12 included trials, 9 trials overseas were high-qual ity and 3 in China were low-quality. Frequency or days of migraine attacks and SF-36/SF-12 were often evaluated as outcome measures in western countries, while headache index was used in China. Among the 12 trials, 9 reported the follow-up outcomes and 8 mentioned adverse events. Conclusion There was no high qual ity trial on acupuncture for migraine prophylaxis in China. The outcome measures in trials published in China by now can not evaluate the outcomes of acupuncture for migraine prophylaxis accurately. To study designs, advantages of trials oversea can be used for reference. To Chinese cl inical physicians, prophylactic therapy and abortive therapy of migraine should be distinguished in order to design high-qual ity study on acupuncture for migraine prophylaxis.
ObjectiveTo explore the personalistic characteristics of patients with migraine and medication-overuse headache (MOH), and to provide scientific evidence for mental treatment of these patients. MethodsThe subjects were divided into three groups:migraine group, MOH group, and health group.Patients with migraine or MOH, admitted to the Deyang People's Hospital from March 2012 to March 2014, were selected in this study.In addition, healthy volunteers were selected as controls at the same time.Data were collected through the Minnesota multiphasic personality inventory computer testing software, and differences of personalistic characteristics were compared among patients with migraine, MOH and controls. ResultsPatients with migraine and MOH had mental problems and the occurrence rate of psychological problems of MOH patients was significantly higher than that of migraine patients (χ2=6.055, P=0.014).Migraine patients showed higher scores of hypochondriasis, depression, hysteria, psychasthenia, hypomania than controls (P < 0.01).Compared with migraine patients, the scales of hypochondriasis, depression, hysteria, paranoia, schizophrenia were higher in MOH patients (P < 0.01). ConclusionsPatients with migraine and MOH have personalistic and psychological problems.Early screening of personalistic characteristics and mental interventions may improve the clinical outcome of patients with migraine or MOH.
ObjectivesTo systematically review the efficacy of acupuncture for improving migraine symptoms and cerebral blood flow velocity.MethodsCBM, CNKI, VIP, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on acupuncture for improving migraine symptoms and cerebral blood flow velocity from inception to September, 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 17 RCTs involving 2 226 patients were included. The results of meta-analysis showed that, acupuncture could effectively reduce the frequency of migraine compared with placebo acupuncture (SMD=−0.97, 95%CI −1.60 to −0.34, P=0.002) and medicine group (SMD=−1.29, 95%CI −1.85 to −0.73, P<0.000 01). Acupuncture could shorten duration of headache compared with placebo acupuncture (SMD=−0.73, 95%CI −1.25 to −0.21, P=0.006) and medicine group (SMD=−0.88, 95%CI −1.32 to −0.45, P<0.000 1). Compared with placebo acupuncture, acupuncture could relieve headache intensity (SMD=−0.67, 95%CI −1.15 to −0.19, P=0.006). The acupuncture group was superior to the placebo acupuncture group (SMD=−10.99, 95%CI −16.62 to −5.36, P=0.000 1) and medicine group (SMD=−0.63, 95%CI −0.87 to −0.40, P<0.000 01) in improving the cerebral blood flow velocity.ConclusionsCurrent evidence shows that acupuncture can effectively reduce frequency of migraine, shorten duration of migraine, relieve intensity of migraine and improve cerebral blood flow velocity. Due to limited quality of the included studies, more high quality studies are required to verify above conclusion.
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.
ObjectivesTo evaluate the methodological quality of guidelines for pharmacological intervention of migraine in adults, to compare and analyze the differences in first-line drug recommendations in different regions and quality levels, so as to explore the evidence of drug recommendations, and provide a basis for clinical decision-making.MethodsPubMed, The Cochrane Library, EMbase, SinoMed, CNKI, VIP, and WanFang Data databases, Up To Date, as well as the related books, Yimaitong, Guideline Central, Guidelines International Network (GIN) and National Institute for Health and Clinical Excellence (NICE) were systematically searched to collect pharmacological intervention guidelines of migraine in adults from inception to January 12th, 2020. The methodological quality of the guidelines was evaluated by Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ).ResultsA total of 25 guidelines were included (including 22 evidence-based guidelines), covering 10 countries on 4 continents and World Health Organization (WHO) with a time span of 1997 to 2019. According to AGREE Ⅱ, 5 were A-level guidelines, 18 were B-level guidelines, and 2 were C-level guidelines. Scope and purpose, rigour of development, clarity of presentations and editorial independence obtained high average scores (more than 60%) among all 25 guidelines. The average scores of guidelines in different domains of AGREE Ⅱ varied with regions and countries. Triptans and NSAIDs were the most frequently recommended as first-line drugs for the acute management; beta-blockers and antiepileptic drugs were recommended for the first-line prevention drugs of migraine in adults. There were 2 guidelines that recommended complementary treatments, one recommended traditional Chinese medicine and another recommended herbal butterbur.ConclusionsThe methodological quality of the pharmacological intervention guidelines of migraine in adults is suboptimal among different regions or countries. The quality of evidence-based guidelines is superior to that established by consensus. The consistency of first-line drug recommendations is strong, but there are still regional differences. The therapeutic effect of traditional Chinese medicine requires further verification.
The extraction of neuroimaging features of migraine patients and the design of identification models are of great significance for the auxiliary diagnosis of related diseases. Compared with the commonly used image features, this study directly uses time-series signals to characterize the functional state of the brain in migraine patients and healthy controls, which can effectively utilize the temporal information and reduce the computational effort of classification model training. Firstly, Group Independent Component Analysis and Dictionary Learning were used to segment different brain areas for small-sample groups and then the regional average time-series signals were extracted. Next, the extracted time series were divided equally into multiple subseries to expand the model input sample. Finally, the time series were modeled using a bi-directional long-short term memory network to learn the pre-and-post temporal information within each time series to characterize the periodic brain state changes to improve the diagnostic accuracy of migraine. The results showed that the classification accuracy of migraine patients and healthy controls was 96.94%, the area under the curve was 0.98, and the computation time was relatively shorter. The experiments indicate that the method in this paper has strong applicability, and the combination of time-series feature extraction and bi-directional long-short term memory network model can be better used for the classification and diagnosis of migraine. This work provides a new idea for the lightweight diagnostic model based on small-sample neuroimaging data, and contributes to the exploration of the neural discrimination mechanism of related diseases.
Objective To investigate the incidence trend of migraine in Chinese from 1990 to 2019 in the global burden of disease database (GBD2019) and its effect on three factors: age, period and cohort. Methods Data were obtained from GBD2019. Joinpoint software was used to analyze the changes in migraine incidence. We analyzed the age-period-cohort (APC) model of migraine in the Chinese population with Stata 17.0 software and estimated the effect of age, period, and cohort on migraine incidence. Results From 1990 to 2019, the standardized incidence of migraine in the general population, and in men and women in China showed a fluctuating upwards trend, and the average annual percentage changes were 0.23%, 0.27% and 0.21%, respectively. The APC model showed that from 1990 to 2019, the risk of migraine in China decreased with the increase of age, showed a downward trend with the increase of the period, and increased with the increase of the birth cohort, indicating that the cohort effect played a dominant role in the risk of migraine in the current period, and the risk of women in the rear of the birth cohort began to be gradually higher than that of men. Conclusion The incidence of migraine in Chinese population is on the rise from 1990 to 2019, and the younger the age, the earlier the period, and the lower the birth cohort, the greater the risk of migraine, suggesting that the prevention and treatment of migraine in women aged 10 to 54 years should be strengthened to further reduce the incidence of migraine in China.