Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        New Message Board Archives >> 2004 Cluster Headache Specific Posts >> Fresh Research - left side or right side?
        
(Message started by: floridian on Jul 30^th, 2004, 9:58am)

Title: Fresh Research - left side or right side?
Post by floridian on Jul 30^th, 2004, 9:58am

Ok, this is for migraine, not clusters, but it could be relevant to us. Pain on the left and pain on the right may represent two different disease states or processes. Pain lefties are different from pain righties in migraine. In particular, slow heart beat and parasympathetic nerve activity are higher in lefties.

Not sure if something like this is true of clusters, but it should be pursued. Ultimately, our prescriptions may be adjusted on the basis of which side is affected - if the nervous tone is different, customizing for side could improve pain relief and reduce side effects. Research on the effectiveness of meds should break lefties and righties into separate groups to see if there are different treatment effects.

Quote:

Brain. 2004 Jul 28 [Epub ahead of print]

Autonomic asymmetry in migraine: augmented parasympathetic activation in left unilateral migraineurs.

Avnon Y, Nitzan M, Sprecher E, Rogowski Z, Yarnitsky D.

Department of Neurology, Rambam Medical Center, Haifa, Israel; Faculty of Medicine, Technion, Haifa, Israel.

Summary Brain autonomic control is asymmetrical, the left hemisphere affecting predominantly parasympathetic function and the right hemisphere affecting predominantly sympathetic function. It is not known whether the extent of autonomic activation is altered in migraine, although the fact that some migraineurs express parasympathetic features such as facial flushing, lacrimation and rhinorrhoea might suggest increased parasympathetic activation. We instilled diluted soapy eyedrops and measured (i) the trigemino-parasympathetic reflex by the vasodilator response of forehead skin bilaterally using photoplethysmography; (ii) the somato-sympathetic reflex by vasoconstriction in the index finger; and (iii) heart rate response. We studied 14 left-sided and 15 right-sided unilateral migraineurs outside attacks. We found that left-side migraineurs had significantly higher bilateral parasympathetic vasodilatation, regardless of the stimulation or measurement side (+60.1 +/- 6.4%) compared with right-side migraineurs (+41.9 +/- 6.4%, P < 0.05). Sympathetic vasoconstriction, however, was similar for the two groups (left, -15.9 +/- 4.2%; right, -17.7 +/- 4.1%, NS). Bradycardia was significantly more pronounced for the left-side migraineurs (interbeat, RR interval increase of +6.2 +/- 1.1% versus +3.1 +/- 1.1%, P < 0.04). We conclude that unilateral left-side migraineurs have increased parasympathetic activation in response to pain compared with right-side migraineurs. Sympathetic responses were similar in the two groups and seemed not to be affected by migraine side. Since cranial parasympathetic activity induces cerebral vasodilatation, this augmentation might be an inherent part of the migraine pathophysiology in these patients.

Title: Re: Fresh Research - left side or right side?
Post by ex_pat_asia on Aug 1^st, 2004, 8:40pm

on 07/30/04 at 09:58:42, floridian wrote:

Floridian, you keep hitting them "outta da pahk" as my red sox fan bro-in-law would say. Before I comment further I want to offer my gratitude for the splendid search-&-report nature of your posts. This one is a home-run because it helps me gain yet another new level of understanding of what may be going on in my head. Incidentally, I'm a leftie though in some handful of rare attacks I have experienced spread to the right side. These have been 9.5s on our KIPscale and longish in duration.

There is a reasonably good article on the understanding of the physiology of stress and trauma as related to the autonomic nervous system-- though it is an older one. It also features a good org chart of the nervous system, and I found it helpful in understanding better the research you pointed us to in your post. You can find it here: http://home.webuniverse.net/babette/artbrakes.htm

I've purchased and downloaded the study and will happily send you a copy if you wish. If I am reading the remarks correctly left-sider migraineuers could expect more of the eye tearing/nose dripping/facial flushing/ and possibly perceive more pain if someone drops soap in their eye and has migraine (migrainous?) headaches, and we happen to be female (all the subjects were). By the way I don't think that diminishes the importance of this study to clusterheads one whit.

I am pretty convinced that migraine and cluster are close cousins and believe that in general, male clusterheads tend to avoid the term migraine so as to avoid confusion perhaps, but mostly social stigmata. We are overwhelmingly men, and we don't want to get stuck with a label that hints at what we think is a woman's malady which may be how we see migraine. We are mindful that women have headaches at that "time of the month" ("vapors" anyone?) which is like adding an exclamation point and it triggers our gender confusion fears. (I wonder if...when that happens...parasympathetic activation occurs...) [smiley=laugh.gif]

Floridian...thank you again. I hope to keep tabs on this study to see what is picked up next by researchers and I hope that someone may think to apply it to clusterheads, male & female alike. Let me know if you (or anyone) want a copy. I may devise a way to post these things to an anonymous web site for download. I am not eager to come completely out of the closet on this or any BB but I will to share this or other info that may be helpful to someone.

"I'm very brave generally, he went on in a low voice: only today I happen to have a headache.
-Lewis Carroll"

Title: Re: Fresh Research - left side or right side?
Post by UN_SOLVED on Aug 1^st, 2004, 9:18pm

12 straight years epesodic with RIGHT SIDED headhaches ONLY. This last (and still current) cycle has been at least 90% LEFT SIDED headaches with an occasional RIGHT SIDED headache thrown in for the fun of it ... (Now chronic for almost 4 years)

Anyone care to explain ??

Unsolved

Title: Re: Fresh Research - left side or right side?
Post by Samantha_Smith on Aug 1^st, 2004, 10:46pm

I guess I'm as puzzled as Unsolved is. I've had migraines since the age of 13 (first period) until now. The migraines can come on either side (50/50). Age 29 the cluster's come--they are predominately right (80%)but can be on the left (20%). Hmmmmm.....

Title: Re: Fresh Research - left side or right side?
Post by floridian on Aug 2^nd, 2004, 8:38am

Expat_Asia wrote:

Quote:

1) I am pretty convinced that migraine and cluster are close cousins and believe that in general,

2) male clusterheads tend to avoid the term migraine so as to avoid confusion perhaps, but mostly social stigmata.

1) Strongly agree. Meds that help migraines tend to be useful for treating clusters. The biochemistry of each type of headache overlaps. Given the limited research into cluster headaches, we need to read the migraine literature. But it must be applied carefully, as there are some important differences.

2) Be careful. :o Clusters are far more painful. The word migraine does not do justice to what we experience.

Title: Re: Fresh Research - left side or right side?
Post by ex_pat_asia on Aug 2^nd, 2004, 12:32pm

on 08/02/04 at 08:38:06, floridian wrote:

2) Be careful. :o Clusters are far more painful. The word migraine does not do justice to what we experience.

Absolutely right Floridian and I should have noted that distinction. Nevertheless I still sense that a distinction is drawn for reasons other then the difference in pain.

With regard to the pain level of Cluster I've felt the frustration of trying to explain to non clusterheads that the pain is notable, excessive, and way beyond anything I have ever felt. Frequently I will hear "oh but pain threshold differs in everyone" or I hear "oh but migraineurs have headaches that last for days even". To these remarks I always feel like I wish I could arrange 30 seconds for the one making the remark. But then, I don't think I have it in my heart even if I could arrange it.
Cheers Floridian and PFDAN

I shall take all the troubles of the past, all the disappointments, all the headaches, and I shall pack them in a bag and throw them in the East River. -Trygve Lie

Title: Re: Fresh Research - left side or right side?
Post by sturgida on Aug 6^th, 2004, 6:16pm

Cheers again to floridian. You really know your s%$@! :D

And I too have had many friends say the same thing to me ex_pat_asia! Many of my friends have told me pain is relative. I have told many of them that I would gladly drill a hole in there skulls at several places simultaneously just to get a little experience of what I go through daily but no one has taken me up on my offer! ;;D