Acquisition And Extinction Of Headache-eliciting Properties Of Trigger Factors
Funder
National Health and Medical Research Council
Funding Amount
$91,082.00
Summary
Standard advice in the clinical management of headaches is to counsel headache sufferers to avoid any factors that could trigger a headache. There is a compelling logic to this approach but is there a danger that it amounts to being over-protective in the sense that it encourages headache sufferers to 'cocoon' themselves from situations that could give rise to headaches, ultimately resulting in them losing their ability to cope with such situations. Certainly, avoiding situations that elicit anx ....Standard advice in the clinical management of headaches is to counsel headache sufferers to avoid any factors that could trigger a headache. There is a compelling logic to this approach but is there a danger that it amounts to being over-protective in the sense that it encourages headache sufferers to 'cocoon' themselves from situations that could give rise to headaches, ultimately resulting in them losing their ability to cope with such situations. Certainly, avoiding situations that elicit anxiety leads to a sensitisation process whereby the situations elicit greater anxiety. And the converse is true, exposure to anxiety-eliciting situations results in a desensitisation process whereby the situations elicit less anxiety. Whether avoidance or exposure is more appropriate in the management of headache disorders depends on the processes by which sensitivity to trigger factors is gained and lost. Two studies will be completed that test different models of these processes. The expected outcome of these studies is that they will support the theory that stimuli acquire the capacity to elicit headaches as a function of individuals trying to avoid or escape from any factor that they believe could trigger a headache. This sensitisation process can be reversed by prolonged exposure to headache trigger factors. Such results would suggest that the established practice of counselling headache sufferers to avoid triggers is counterproductive as it may lead to a reduction of headaches in the short-term but may also lead to an insidious sensitisation process that ultimately results in an increase in headaches. Given that headaches are so common and associated with such high direct and indirect costs, changes in clinical management arising from these findings could have major benefits to individuals, families and society.Read moreRead less
Combined Electroacupuncture And Cognitive Behavioural Therapy For Tension-type Headache: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$302,068.00
Summary
Tension-type headache (TTH) affects many and the direct and indirect costs are significant. Medications are either not effective long-term or have side-effects. Acupuncture and Cognitive behavioural therapy (CBT) are effective and safe treatments. The combination of acupuncture and CBT could provide a better outcome. We will undertake a rigorous clinical study to evaluate this. This is the first examination of the combination, and will be of significant value to patients and to clinicians.
Improving Behavioural Treatment For Frequent Headaches By Incorporating A New Approach To Managing Triggers
Funder
National Health and Medical Research Council
Funding Amount
$499,255.00
Summary
The standard clinical advice is that the best way to prevent headaches is to avoid the triggers, but we have argued that this may lead to decreased tolerance for triggers and therefore more headaches. We have developed an innovative approach to managing triggers which focuses on training people to cope with triggers. The proposed research will evaluate a new treatment for headaches based on integrating our approach to managing triggers into our behavioural treatment program for headaches.
Trigeminal pain includes such disorders as headache, migraine, trigeminal neuralgia, dental and temporomandibular joint pain. These disorders affect more than 10 % of the population and many of the afflicted get only partial relief from current treatments. Trigeminal pain is conveyed from the head to the brain via primary afferent nerves. Work in the current proposal focuses on transmission of information in the brainstem as well as in the primary afferent nerves. Previously our group has report ....Trigeminal pain includes such disorders as headache, migraine, trigeminal neuralgia, dental and temporomandibular joint pain. These disorders affect more than 10 % of the population and many of the afflicted get only partial relief from current treatments. Trigeminal pain is conveyed from the head to the brain via primary afferent nerves. Work in the current proposal focuses on transmission of information in the brainstem as well as in the primary afferent nerves. Previously our group has reported that adenosine- 5' triphosphate (ATP) causes an increase in excitatory neurotransmission from primary afferent nerves; such an increase has been reported to be painful in previous human and animal studies. Recently we have shown that the ATP induced increase in neurotransmission is dependant on activation of a specific excitatory receptor, the N-methyl D aspartate (NMDA) receptor, which has been widely implicated in other brain functions such as memory, and in disorders such as neuron death following stroke. The chief investigators involved in this application plan to study the role of the ATP receptor and the interaction with NMDA receptors in an inflammatory trigeminal pain model. Electrophysiological, pharmacological and immunohistochemical studies will be performed in order to address the aims of this proposal. A greater understanding of how these receptors modulate neurotransmission in pain pathways will lead to a greater understanding of trigeminal pain and the potential development of new therapeutics.Read moreRead less
Behavioural Management Of The Triggers Of Recurrent Headache: Avoidance Versus Coping
Funder
National Health and Medical Research Council
Funding Amount
$503,233.00
Summary
The traditional approach to headache management is to advise that the best way to prevent headaches is to avoid the trigger factors. This approach has never been systematically evaluated, however, and it may lead to headache sufferers losing tolerance for the factors that could precipitate a headache. This study will be the first to evaluate the traditional approach, and will also evaluate an innovative approach that includes techniques designed to desensitise people to headache triggers.
Genome-wide Association Study Of Migraine In Women With Endometriosis
Funder
National Health and Medical Research Council
Funding Amount
$320,036.00
Summary
Typical migraine, is a frequent, debilitating and painful disorder that affects people during their most productive years (25% of females and 7.5% of males). Women suffering endometriosis (a painful gynecologic disorder affecting up to 10% of women) are at an increased risk of suffering migraine headaches. Our proposed collection of migraine phenotype data on our endometriosis cohort will facilitate identification of genes underlying both disorders.
Association Screen Of High Priority Positional Candidate Genes For Migraine
Funder
National Health and Medical Research Council
Funding Amount
$187,521.00
Summary
Typical migraine, is a frequent, debilitating and painful disorder that normally affects people during their most productive years (25% of females and 7.5% of males). The World Health Organization recently identified migraine among the world's top 20 leading causes of disability, with an impact that extends far beyond the suffering individual, to the family and community. Although migraine is highly prevalent in our society, its aetiology remains relatively obscure and there are no laboratory ba ....Typical migraine, is a frequent, debilitating and painful disorder that normally affects people during their most productive years (25% of females and 7.5% of males). The World Health Organization recently identified migraine among the world's top 20 leading causes of disability, with an impact that extends far beyond the suffering individual, to the family and community. Although migraine is highly prevalent in our society, its aetiology remains relatively obscure and there are no laboratory based diagnostic tests that identify those who suffer from the disorder. Twin studies indicate that migraine has a significant genetic component, with heritability estimates of 33-65%. Therefore, in an effort to identify the molecular mechanisms underlying the disorder, we have been looking for genomic regions co-inherited (linked) with migraine. The resulting genome-wide linkage scan involving 756 Australian families found significant evidence for the presence of a novel migraine gene on chromosome 5q21 and highly suggestive evidence for a gene on chromosome 10q22. Importantly, we recently replicated linkage to the 5q21 and 10q22 regions in an independent collection of Australian migraine families. Consequently, these regions hold great promise for identifying migraine susceptibility genes in our sample. Using a bioinformatics computer-assisted search of public databases we have ranked the potential candidature of the genes within the 5q21 and 10q22 regions This project will screen the top 21 candidate genes in 768 cases and 768 controls highly selected for the presence and absence of familial migraine, respectively. Our proposed association screen of high priority genes in two strongly implicated regions has high power to identify genes underlying common migraine susceptibility. Such genes will provide clues to the further elucidation of the complex molecular pathways of migraine and , finally, will help in the development of diagnostic tests and rational treatment strategies.Read moreRead less
Mapping Genes For Typical Migraine Using Twin Families.
Funder
National Health and Medical Research Council
Funding Amount
$439,124.00
Summary
Current evidence suggests multiple genes may underlie susceptibility to the more common forms of migraine. The project will look to see if the these genes provide clues to the further elucidation of the complex molecular pathways of migraine and will help in the development of diagnostic tests and evidence-based treatment strategies.