F. Clifford Rose

RED WINE AS A CAUSE OF MIGRAINE

Patients with migraine who believed that red wine but not alcohol in general had a headache-provoking effect on them were challenged either with red wine or with a vodka and diluent mixture of equivalent alcohol content, both consumed cold out of dark bottles to disguise colour and flavour. The red wine, which had a negligible tyramine content, provoked a typical migraine attack in 9 of 11 such patients, whereas none of the 8 challenged with vodka had an attack. Neither red wine nor vodka provoked such episodes in other migrainous subjects or controls. These findings show that red wine contains a migraine-provoking agent that is neither alcohol nor tyramine.

The seasonal variation in mortality from cerebrovascular disease

The frequency distribution of deaths from cerebrovascular disease in England and Wales in 1975 by month of occurrence is described. The distribution is compared with that for related diseases, in particular ischaemic heart disease, hypertensive disease, pneumonia and bronchitis. The principal feature in all these diseases is high mortality in winter and spring and low mortality in late summer, but the range of variation is wider for pneumonia and bronchitis. The seasonal distribution of cerebrovascular disease death is similar in both sexes, all ages at death and for deaths at home and deaths in a hospital or institution. For both sexes the proportion of cerebrovascular disease deaths occurring at home increases significantly with age at death. Four hypotheses are examined to explain this characteristic seasonal mortality pattern, which is related inversely to ambient temperature, and similar to the seasonal pattern of the incidence and prevalence of cerebrovascular disease.

A comparison of the distributions of eight peptides in spinal cord from normal controls and cases of motor neurone disease with special reference to Onuf's nucleus

The distributions of 8 peptides were studied in the 4 major segmental levels (cervical, thoracic, lumbar, sacral) of the spinal cord in 52 neurologically normal cases. Similar regions from 36 cases of motor neurone disease (MND) were compared using the same procedures to determine possible changes in the distribution of peptides in areas associated with sensory, motor and autonomic function. In normal spinal cords, calcitonin gene-related peptide (CGRP)-, the C-flanking peptide of neuropeptide Y (CPON)-, enkephalin-, galanin-, neurokinin-like-, somatostatin- and vasoactive intestinal polypeptide (VIP)-immunoreactive fibres were abundant in the dorsal horn. Numerous somatostatin-immunoreactive cell bodies were also present. In the ventral horn, immunoreactive fibres were less abundant. Most motoneurones were closely apposed by fibres immunoreactive for enkephalin, neurokinin, somatostatin and thyrotrophin-releasing hormone (TRH). A subpopulation of motoneurones, most notable in lumbar segments, displayed CGRP immunoreactivity. In common with autonomic nuclei, Onufs nucleus, which is thought to innervate perineal striated muscle and external urethral and anal sphincters, was densely innervated with CPON-, enkephalin-, and in particular somatostatin-immunoreactive fibres, thus suggesting Onufs nucleus may have an autonomic component. In the diseased cords, there was a reduction in the area of the ventral horn and numbers of motoneurones as revealed by conventional histological staining and immunostaining of neurofilament triplet proteins. No changes in the distribution of peptides was noted in the dorsal horn or autonomic nuclei. By contrast, in the ventral horn, neurokinin-, enkephalin-, somatostatin- and TRH-immunoreactive fibres, which are normally found associated with motoneurones, were absent. Therefore, not only are motoneurones lost in MND, but also the fibres which innervate them. CGRP-immunoreactive motoneurones were not observed, a finding consistent with the proposed role of this peptide as a muscle-trophic factor. In contrast to the large motoneurone groups in the ventral horn, the neuronal integrity of Onufs nucleus and the peptides associated with it were spared. These data further imply that Onufs nucleus is not a typical motor nucleus and it is not purely somatic. The coincident loss of peptide immunoreactivity and motoneurones from the large motor nuclei and sparing of Onufs nucleus and its peptide-containing constituents in the diseased state suggests that peptides contribute to maintenance of neural integrity.

The prevalence of diet-induced migraine.

Nineteen percent of about 490 patients with classical or common migraine reported that headaches can be precipitated by chocolate, 18% by cheese and 11% by citrus fruit. and a highly significant majority of these patients were sensitive to all three foods. Twenty-nine percent of the patients reported sensitivity to alcohol; again this was significantly associated with sensitivity to the three food stuffs, though a substantial number of patients were sensitive to alcohol but not foods. Thirty-one percent of 331 female patients believed that oral contraceptives precipitated headaches, but this could not be related to any dietary response. Patients with affected relatives were significantly more likely to report sensitivity to alcohol and chocolate; sensitivity to cheese and citrus fruit was less strongly related, and there was no relationship at all for oral contraceptives. These correlations suggest that food induced headaches are mediated by chemical constituents common to these foods.

The Platelet Release Reaction During Migraine Attacks

SYNOPSIS

Head Movement Correlates of Juncture and Stress at Sentence Level

Body movement during speech has been recognized as closely relating to suprasegmental features, but little evidence has been offered to support this thesis, probably for lack of adequate techniques. The present study investigated this issue by continuously recording, with a polarized-light goniometer, movement of the head in four subjects engaged in conversation. Rapid movements were found to indicate stress, while juncture involved contrasting ordinary movements with stillness. This was believed to indicate that the dissipative structure coordinating speech resorts to body movement in regulating high energies, and that prosodic features may accentuate inner continuity by varying smoothly towards terminal juncture.

Kinematics of head movements accompanying speech during conversation

Abstract Head movement during conversation is closely related to the suprasegmental features of concurrent speech. Study of this relationship builds heavily on speed-related parameters of movement, the kinematic description of which is made here. In 4 subjects, movement of the head monitored by polarised-light goniometer was continuously recorded, together with the associated speech and a signal proportional to the peak loudness of speech. Results revealed a division of head movements into five kinematic classes: recognition of these may be helpful in understanding the role of head movements during speech.

Chocolate is a Migraine-Provoking Agent

Patients with migraine who believed that chocolate could provoke their attacks were challenged with either chocolate or a closely matching placebo. In a double-blind parallel group study, chocolate ingestion was followed by a typical migraine episode in 5 out of 12 patients, while none of the 8 patients challenged with placebo had an attack (p = 0.051). The median time to the onset of the attack was 22 h. This brief study provides some objective evidence that chocolate is able to provoke a migraine attack in certain patients who believe themselves sensitive to it.

TRANSITORY DECREASE IN PLATELET MONOAMINE-OXIDASE ACTIVITY DURING MIGRAINE ATTACKS

A highly significant decrease in platelet monoamine-oxidase activity has been observed in migrainous subjects during a migraine attack compared with activity outside an attack. The effect did not derive from drugs commonly used in migraine therapy.

Metoprolol in the Prophylaxis of Migraine: Parallel‐Groups Comparison withPlacebo and Dose‐Ranging Follow‐Up

SYNOPSIS