Gülcan Göçmez Yılmaz

Background: MOH (medication overuse headache) is regarded as a complication of chronic migraines (CMs), with a general acknowledgment of reciprocal triggering between these two conditions. The present study aims to investigate the clinical parameters of relevance for the development of MOH among patients with CM, as well as for the subtype classification of MOHs. Method: We compared two groups of CM patients, with and without MOH, separated based on their demographic data and migraine characteristics. A subgroup of MOH accompanied by psychiatric co-morbidities (depression, anxiety, sleep disorder) was delineated, and the clinical features of relevance for the progression of MOH into the complicated state were evaluated. Results: The study revealed a higher prevalence of a family history of migraine in both the MOH and potentially complicated MOH subgroups (p < 0.001, p = 0.036), along with a higher prevalence of bilateral pain localization (p = 0.033, 0.021). Symptoms commonly associated with migraines, such as nausea, vomiting, photophobia, phonophobia, and osmophobia, were more common in both the MOH and potentially complicated MOH subgroups (p < 0.05). Furthermore, a positive correlation was found for the frequency (p < 0.001) and severity (p = 0.010) of migraine attacks and the duration of headaches (p = 0.007), atopy (p = 0.017), sleep disturbances (p = 0.011), and emotional stress (p = 0.022) in the MOH group. Conclusion: We found a positive correlation between the prevalence of MOH among patients with CM and a family history of migraines, higher frequency and intensity of headaches, bilateral manifestation, sleep disturbances, and emotional stress. Moreover, symptoms accompanying migraines were found to be more prevalent in individuals with MOH and potentially complicated MOH.

Background: Headache is the most common neurological side effect of coronavirus disease 2019 (COVID-19) vaccination. However, the underlying reason for COVID-19 postvaccine headache has not been fully understood. In this study, we addressed the potential association of vaccine-related headaches with a history of allergy, atopic diseases, as well as other comorbid conditions to gain insight about the pathophysiology of this headache. Materials and Methods: This study analyzed the data from the Vaccine Adverse Event Reporting System database and reorganized dataset accordingly. The study included individuals aged 16–85 years who received the first or second dose of COVID-19 vaccines approved by the Food and Drug Administration. Allergy and atopic disease histories (reported food or drug allergy, allergic rhinitis, asthma, and other autoimmune diseases) and other accompanying diseases such as depression, anxiety, sleep disorders, fibromyalgia, and obesity of these subjects were examined from the revised data, and their relationship with COVID-19 vaccine-related headaches was investigated. Results: We found a statistically significant positive association in patients with a history of headache after COVID-19 vaccination and reported a history of allergy (P < 0.001). In the allergy subgroup (n = 14547 [37.1%]), the frequency of headaches following COVID-19 vaccine was found to be higher in those with drug, food, and/or multiple allergies (P < 0.05). A statistically significant relationship was disclosed between asthma, autoimmune diseases, and headache, but no association was found with allergic rhinitis (P < 0.001, P = 0.160). Furthermore, the rate of headaches after vaccination was found to be higher in people with fibromyalgia and depression (P < 0.001, both). Conclusion: Significant associations between headaches triggered by the COVID-19 vaccine and histories of allergy, fibromyalgia, and depression may suggest a shared predisposing mechanism for pathophysiology. Knowledge about allergy history and related comorbid conditions can be helpful in predicting COVID-19 vaccine headache. Future prospective data may provide further enlightenment on management.

Amaç: Bu çalışmanın amacı, demans tiplerini ayırt etmede saat çizme testinin (SÇT) etkinliğini araştırmaktır. Gereç ve Yöntem: 48 Alzheimer hastalığı (AH), 68 vasküler demans (VaD) ve 13 frontotemporal demans (FTD) hastası çalışmaya dahil edildi. Tüm hastalara SÇT ile mini mental durum muayenesi (MMSE) ve diğer nörofizyolojik testler (ileri-geri sayım aralık, hesaplama testi, soyutlama testi, kelime hafıza testleri, boston adlandırma testi, kelime listesi hatırlama ve tanıma testleri) uygulandı. SÇT ve diğer nörofizyolojik testlerin skorları AH, VaD ve FTD grupları arasında karşılaştırıldı. SÇT ile diğer nörofizyolojik testler arasındaki ilişki değerlendirildi. Bulgular: AH, VaD ve FTD grupları arasında SÇT testinin anlamlı bir fark olmadığı görülmüştür. Demans grupları arasında MMSE and geri sayım aralık skorları istatiksel olarak anlamlı bulunmuştur. MMSE ve SÇT testlerinin birlikte kullanımında özellkle AH ve VaD hastalarında pozitif korelasyon saptanmıştır. Ek olarak FTD tipi için SÇT ve boston anlamlandırma testi arasında da pozitif bir ilişki saptanmıştır. Sonuç: SÇT primer demans tipi belirlemede benzersiz bir öngörücü değildir, ancak çalışmada kullandığımız nörofizyolojik test bataryaları arasında, özellikle MMSE ve SÇT nin birlikte kullanımı ve SÇT’nin diğer testlerle kombine kullanımının demans farklılaşmasında önemli bir yeri vardır.