Seiho Nishikawa

Muscle contraction headache and migraine:Platelet activation and plasma norepinephrine during the cold pressor test

For clarification of possible platelet activation in migraine and chronic muscle contraction headache (MCH) under stress, plasma platelet factor 4 (PF4), norepinephrine (NE), and free fatty acids (FFA) were investigated during the cold pressor test. Both PF4 and NE increased significantly, whereas FFA showed no remarkable changes. The increases of PF4 in MCH and migraine during this test were significantly greater than in healthy controls. The increase of PF4, however, was independent of NE increase and FFA changes. On the other hand, we observed decreased NE levels in both MCH and migraine, which might suggest peripheral sympathetic hypofunction. The platelets of MCH or migraine patients seem to be impaired, and the impairment may be caused by continuous sympathetic hypofunction. The behaviour of the above three substances in MCH was similar to that in migraine throughout the present study.

The threshold of pain and neurotransmitter's change on pain in Parkinson's disease.

Abstract: Among Parkinsons disease (PD) patients complaining of pain, 10 with pain not associated with a motor fluctuation or L‐dopa therapy were evaluated. The controls were 14 PD without pain and eight with thalamic pain syndrome. The threshold of pain and neurotransmitters in CSF were measured in the three groups. In PD with pain, the maximum tolerance level and tourniquet pain ratio decreased significantly. In PD with pain, the score on the self‐depression scale increased significantly and S‐hydroxy‐indole acetic acid (5‐HIAA) among the neurotransmitters decreased significantly. These results suggest that decreases in the threshold of pain and changes of serotonin in CSF are involved in the development of specific pain in PD who do not respond to L‐dopa.

Cluster Headache Like Symptoms Due to Sinusitis: Evidence for Neuronal Pathogenesis of Cluster Headache Syndrome

SYNOPSIS

Relation of blood serotonin and benzylamine oxidase to clinical symptoms and prognosis in Parkinson's disease.

In 21 parkinsonian patients, we investigated the contents of blood serotonin (5HT) and benzylamine oxidase (BzAO) before and during L-dopa therapy. Then, we studied the patients prospectively, and evaluated the relationship between 5HT and BzAO and the clinical characteristics. The levels of blood 5HT and BzAO varied not only with the treatment, but also with the duration and clinical type of the disease. We postulated that in certain types of Parkinsons disease, the generalized defect of 5HT and enzyme metabolism might primarily exist, and might influence the efficacy of L-dopa therapy and the prognosis of the disease.

Sublingual administration of flunarizine for acute migraine: will flunarizine take the place of ergotamine?

SYNOPSIS

Effects of mecobalamin injection at acupoints on intractable headaches

Abstract The current study attempted to relieve the symptoms of chronic tension-type headache (CTH) and migraine without aura (MWA) by injecting mecobalamin at acupoints (points where acupuncture needles are inserted). The 18 patients, ages 35 to 72 years, in this study had not responded to oral drug therapy regimens. Beta-endorphin, corticotropin (ACTH), and cortisol levels were measured immediately before and 30 minutes after injection. Patients, nine men and nine women, had significantly lower beta-endorphin levels immediately before injection as compared with healthy symptom-free volunteers. However, after injection, these patients showed significant elevations in this parameter. An assessment of clinical efficacy using the visual analog scale indicated that all patients responded to this therapy. The analgesic effect of acupoint-injection of mecobalamin apparently is derived from an elevation of beta-endorphin levels. In conclusion, acupoint-injection of mecobalamin may prove to be an effective therapy regimen for treatment of intractable headaches.

Effects of Various Drugs on Behavior and Striatal Dopamine Contents in MPTP-Treated Mice Exposed to Stress

Although the symptoms of patients with Parkinson’s disease are worsened by various stresses, a phenomenon known as stress-induced akinesia1,2 the pathophysiology and therapy of stress-induced akinesia has not been clarified. When the stress is mild, symptoms are easily improved by an increase in the dosage of 1–3,4-dihydroxyphenylalanine (L-DOPA). However, when patients with Parkinson’s disease are exposed to severe and long-term stress and the symptoms are highly aggravated, L-DOPA treatment is less effective. We previously reported that, due to a decreased dopamine (DA) level and enhancement of DA turnover, 1-methyl-4-phenyl-1,2,3,6-tetrahydroxypyridine (MPTP)-treated mice became remarkably akinetic after stress3 and that imipramine (IMP) and diazepam (DZP) were clinically more effective than L-DOPA in improving the condition.4