Migraine is related to brain energy deficiency. Niacin is a required coenzyme in mitochondrial energy metabolism. However, the relationship between dietary niacin and migraines remains uncertain. We aimed to evaluate the relationship between dietary niacin and migraine. This study used cross-sectional data from people over 20 years old who took part in the National Health and Nutrition Examination Survey between 1999 and 2004, collecting details on their severe headaches or migraines, dietary niacin intake, and several other essential variables. There were 10,246 participants, with 20.1% (2064/10,246) who experienced migraines. Compared with individuals with lower niacin consumption (Q1, ≤12.3 mg/day), the adjusted OR values for dietary niacin intake and migraine in Q2 (12.4–18.3 mg/day), Q3 (18.4–26.2 mg/day), and Q4 (≥26.3 mg/day) were 0.83 (95% CI: 0.72–0.97, p = 0.019), 0.74 (95% CI: 0.63–0.87, p < 0.001), and 0.72 (95% CI: 0.58–0.88, p = 0.001), respectively. The association between dietary niacin intake and migraine exhibited an L-shaped curve (nonlinear, p = 0.011). The OR of developing migraine was 0.975 (95% CI: 0.956–0.994, p = 0.011) in participants with niacin intake < 21.0 mg/day. The link between dietary niacin intake and migraine in US adults is L-shaped, with an inflection point of roughly 21.0 mg/d.
Background Primary cough headache (PCH) is precipitated by coughing or the Valsalva manoeuver (VM), and its underlying pathophysiology remains unclear. Case report We report a case of recurrent cough headaches precipitated by VM with transient increase of intracranial pressure (ICP) diagnosed by measuring left sigmoid sinus pressure. Bilateral internal jugular vein valve incompetence (IJVVI) was also diagnosed by Doppler ultrasonography during a VM. Indomethacin was administered for over four months, and the headache had completely disappeared at the four-month follow-up. Conclusions Cough headache might be associated with a transient increase of ICP induced by IJVVI, which might partially explain the pathophysiology of VM-induced headache. Detecting the internal jugular vein during a VM might be used as diagnostic procedure for patients who have PCH during resting and VM. If it is necessary, monitoring the ICP could be considered.
Objective The study examined the relationship between dietary zinc intake and migraine. Background Neuroinflammatory and oxidative stress are involved in the pathogenesis of migraine. Little is known about the effects of zinc, an anti‐inflammatory and antioxidant trace element, on migraine. Methods The US National Health and Nutrition Examination Survey data from 1999 to 2004 were analyzed for this cross‐sectional study. Participants who had severe headache or migraine were classified as having migraine. Dietary zinc intake was evaluated using the 24 h dietary recall system. Results A total of 11,088 participants were included, of whom, 20.2% (2236/11,088) reported having migraine disease. Compared to the lowest dietary zinc intake quintile (Q1, ≤5.9 mg/day), the adjusted odds ratios for migraine in Q2 (6.0–8.4 mg/day), Q3 (8.5–11.2 mg/day), Q4 (11.3–15.7 mg/day), and Q5 (≥15.8 mg/day) were 0.73 (95% confidence interval [CI]: 0.61–0.88, p = 0.004), 0.71 (95% CI: 0.56–0.91, p = 0.013), 0.71 (95% CI: 0.57–0.90, p = 0.008), and 0.70 (95% CI: 0.52–0.94, p = 0.029), respectively. Sensitivity analysis of zinc supplementation survey participants also showed an association between dietary zinc intake and migraine. Compared to the lowest total zinc intake quintile (Q1: 0.5–9.6 mg/day), the adjusted odds ratios for migraine in Q3 (19.3–24.3 mg/day) and Q4 (24.4–32.5 mg/day) were 0.62 (95% CI: 0.46–0.83, p = 0.019) and 0.67 (95% CI: 0.49–0.91, p = 0.045), respectively. Conclusions Our findings indicate an inverse association between dietary zinc intake and migraine in adult Americans.
Background There have been a few studies regarding the pre-attack symptoms (PAS) and pre-episode symptoms (PES) of cluster headache (CH), but none have been conducted in the Chinese population. The purpose of this study was to identify the prevalence and features of PAS and PES in Chinese patients, as well as to investigate their relationships with pertinent factors. Methods The study included patients who visited a tertiary headache center and nine other headache clinics between January 2019 and September 2021. A questionnaire was used to collect general data and information about PAS and PES. Results Among the 327 patients who met the CH criteria (International Classification of Headache Disorders, 3rd edition), 269 (82.3%) patients experienced at least one PAS. The most common PAS were head and facial discomfort (74.4%). Multivariable logistic regression analysis depicted that the number of triggers (OR = 1.798, p = 0.001), and smoking history (OR = 2.067, p = 0.026) were correlated with increased odds of PAS. In total, 68 (20.8%) patients had PES. The most common symptoms were head and facial discomfort (23, 33.8%). Multivariable logistic regression analysis showed that the number of triggers were associated with increased odds of PES (OR = 1.372, p = 0.005). Conclusions PAS are quite common in CH patients, demonstrating that CH attacks are not comprised of a pain phase alone; investigations of PAS and PES could help researchers better understand the pathophysiology of CH.
Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) have not been evaluated sufficiently due to limited data, particularly in China. Methods Patients with SUNCT or SUNA treated in a tertiary headache centre or seven other headache clinics of China between April 2009 and July 2022 were studied; we compared their demographics and clinical phenotypes. Results The 45 patients with SUNCT and 31 patients with SUNA had mean ages at onset of 37.22 ± 14.54 years and 42.45 ± 14.72 years, respectively. The mean ages at diagnosis of SUNCT and SUNA were 41.62 ± 12.70 years and 48.68 ± 13.80 years, respectively (p = 0.024). The correct diagnosis of SUNCT or SUNA was made after an average of 2.5 (0–20.5) years or 3.0 (0–20.7) years, respectively. Both diseases had a female predominance (SUNCT: 1.14:1; SUNA: 2.10:1). The two diseases differed in the most common attack site (temporal area in SUNCT, p = 0.017; parietal area in SUNA, p = 0.002). Qualitative descriptions of the attacks included stabbing pain (44.7%), electric-shock-like pain (36.8%), shooting pain (25.0%), and slashing pain (18.4%). Lacrimation was the most common autonomic symptom in both SUNCT and SUNA patients, while eyelid oedema, ptosis, and miosis were less frequent. Triggers such as cold air and face washing were shared by the two diseases, and they were consistently ipsilateral to the attack site. Conclusions In contrast to Western countries, SUNCT and SUNA in China have a greater female predominance and an earlier onset. The shared core phenotype of SUNCT and SUNA, despite their partial differences, suggests that they are the same clinical entity.
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