Migraine Linked to Structural Brain Changes
Caroline Cassels


November 19, 2007 — New research suggests repetitive migraine attacks may lead to or be the result of structural changes in the somatosensory cortex (SSC), offering a potential explanation for the high comorbidity of other pain disorders observed in migraineurs.

In a comparative study of individuals with migraine vs healthy controls, investigators at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital, in Boston, found, on average, migraineurs' SSCs were 21% thicker than those of nonmigraineurs.
The study is published in the November 20 issue of Neurology.
The most significant thickness changes were noted in the caudal SSC, where the trigeminal area, including head and face, is somatotopically represented, the investigators report.

"Repeated migraine attacks may lead to or be the result of these structural changes in the brain. Most of these people had been suffering from migraines since childhood, so the long-term overstimulation of the sensory fields in the cortex could explain these changes. It's also possible that people who develop migraines are naturally more sensitive to stimulation," study investigator Nouchine Hadjikhani, MD, said in a statement from the American Academy of Neurology.

Dr. Hadjikhani added that changes in the SSC, which plays a crucial role in noxious and nonnoxious somatosensory processing, might explain why individuals with migraine frequently have other pain disorders, including back pain, temporomandibular disorders, and fibromyalgia as well as sensory disturbances such as allodynia.
Long-Term Sufferers
For the study investigators compared 24 individuals — 12 who had migraine with aura and 12 who had migraine without aura — with 12 age- and sex-matched controls.

Study subjects were assessed with magnetic resonance imaging (MRI). Patients ranged in age from 21 to 52 years. On average, those with migraine had experienced episodic attacks for the past 20 years, with age of onset occurring in most individuals during adolescence.

According to the study, the average pain intensity of the attacks was rated 6 out of 10 on the numeric analog scale, with a frequency of approximately 4 migraine attacks per month. None of the patients had a previous history of either other trigeminal chronic pain or current acute pain or any other major health disorder.

No Correlation to Clinical Data
Investigators also examined cortical thickness and correlated these findings with clinical data including migraine duration, age at onset, frequency, and disease time span.

On average, migraineurs had thicker SSCs than the control group. However, investigators found no clear correlation between cortical thickness changes and clinical data.
According to the authors, the thickening of the SSC is in line with a recent study of the same cohort, which showed diffusional abnormalities in the subcortical trigeminal somatosensory pathway.

"Repetitive migraine attacks may lead to or be the result of neuroplastic changes in cortical and subcortical structures of the trigeminal somatosensory system," they conclude.
The study was supported by the National Institutes of Health, the Swiss Heart Foundation, and the Harvard School of Dental Medicine Dean's Award. The authors report no conflicts of interest related to the study.
Neurology. 2007;69:1990-1995.

Hmm, I knew it wasn't really all just in my head. No, wait, I guess it really is; and now it's growing. And changing. Scary, isn't it.

another birthday in the house

Today is my little man's birthday. He is 7. I can't believe it. If you have the time, wish him a Happy Birthday. He's growing up so fast. (Now, to go and disinfect - YEAH, I KNOW, AGAIN) It's a good thing it's his birthday, cause it's all his fault.

Plagued

Oh yes, that sums it up EXACTLY! That is the sign that should be posted at my front door. No Happy Harvest sign,no Christmas wreath, no Happy New Year um, what have you. But this sign, up there.


The kids come in from their dad's lastnight, the usual bickering that comes in the door. No joyful, helping each other with the bags. Not my children, they wouldn't dream of helping each other bring stuff in from a long freaking weekend spent with their father and obviously, and apparent nagging (hmm bummer) step-motherdearest. What a shame. (NOT) It really is a shame for them.


My littlest guy stands against the wall, looking very wiped out, standing. against. the. wall. It is obviously holding him upright at this moment. I can see that something is still upsetting him. He was very upset in the morning on the way to church and when we got out of the van, I just stood with him for a moment as he grabbed me and let out a little cry and hugged me and told me he wanted to come home. I felt for him. I wanted to tell him he could come home, but I can't tell him that, it is his father's weekend.


Christina had been telling me how Tita had been screaming and yelling at him all weekend because he was being a brat; which I really find hard to believe. Not because he is an angel, being my son. But because he really is a good little boy. Maybe because he is at my home. Where he has boundaries anyway. I suppose this is why I find it hard to believe him being a brat. I do believe he can be pesty, but for her to scream and yell; a trained pediatrician, nontheless; hmmmm, well, where do I go from here???


Back to my little man holding up the wall; he tells me has a tummy ache and he's cold. He did just walk in from 30 degree, NO hat - what was his father thinking? And I have been on Nicholas all day about the hat thing.


Dad comes to the door behind a very angry Christina (12) who barges past me, "Yeah, I took her MP3 away because of her attitude in the van; she had to sit in the back and didn't like it."


blah blah blah............I was going to take it for my reasons, too. I know all about the attitude. ciao.


Let's all get to the table now! Meanwhile Lexi, yes, she is starving at this point, and yelling ,"PASTA" is under my feet. Gotta love this kid. She is so funny. What to do? Put her to work! Give the kid a job and she gratefully does it. I gave her things to bring to the table, and she brought them TO the table. I know what she will be doing on Thursday!


So we are sitting for dinner, ahhhh, spaghetti and meatballs! I have been craving a good old fashioned Sunday supper like this for months! So I finally convinced Frank to make it. Yeah, I could have, but hey, I like Frank to cook on Sunday.


Nick had sucked down a cup of apple juice and requested a cup of milk. "I want you to eat a little meatball first, buddy, ok."


"I'm freezing, Mom. Can I have a blanket."


By now, I'm getting the feeling that this child is getting S.I.C.K. in the tummy area. He feels warm to the touch. Not eating the meatballs????? Oh, definitely.


Frank leaves the table. Suddenly, Nick sits up straight and puffs his little cheeks out; this weird sound emits from his tummy. A rumbling, roaring sound that you KNOW cannot be stopped, controlled, no matter what you do.


My girls, both Christina and Cinderisa spring from their chairs with lightening speed - and I swear I didn't see them leave the room. Lexi, she just kept right on eating and coaxing him, "Mick, Mick, Mick"


I'm doing something like command control - no flags - "Run, to the bathroom, GO GO GO!"


To the right of the table he blows! Then he climbs MY DINING ROOM CHAIRS! (are you kidding me man????)


To the left of the table where the dog is laying just a few feet away, and in his direction - (serves him right) picture the dog squinting his eyes: Nick's head starts to spin as the juice comes flying out at Rocco.


Through the living room and on the way down the stairs, he stops; yep, on the newly carpeted steps. but. of. course. The girls in the background, are like crowd noise. They are just standing in the kitchen, hoping and praying he doesn't come near them; and at the same time, they are giving him directions and clueing Frank in as to what is going on and where he is.

GIRLS:"Oh, Nick, Not on Rocco! Frank, he just got Rocco
Here he comes. Go down to the bathroom, Nick, we turned the lights on for you!
Oh, not on the steps. He missed."

FRANK:"He got Rocco?
he puked on the stairs? THE NEW RUG?"
he emerges from the computer - "aww that's ok, little buddy"

BARFMAN: "I want my Mom! I want my Mom" Yeah, well, I'm just upstairs throwing paper towels everywhere. and laughing. oh, and trying to eat meatballs, would you believe it? with...

LEXI: "Want more Mom. More pasta meatball Mom."


It all unfolded in roughly 5 minutes. The cleanup time, that was another ordeal. Besides the dinner cleanup we still had; I had, I HAD to clean up the rest of the mess everywhere. Literally. I'm not sure really what parts of it were funniest, it was all hysterical. I was laughing through all of it, AND I actually told my friend Robin lastnight, when I was telling her about this, at least they give me blog fodder.


The girls were grossed out at me and Lexi sitting there finishing our meatballs. She's yelling for Mick! The dog had to be thrown outside for, well, obvious reasons I refuse to think about, because I will just get sick on. EEWWW. He just barked and barked and barked. Frank was in the computer room yelling SHUT UP! Yeah, like that was going to do anything. Those are times I wish I could call my friend Cesar and just hand him the phone.

Stupid dog squinting his eyes when Nick was blowing at him. I mean he didn't even think to get out of the way! DUHM DOHG!

I am thankful for the giant container of disinfecting wipes I buy. Because the girls and I wiped down every nook and cranny, every door knob and light switch, microwave, fridge, counter, cabinet, railing, you basically name it. It sparkles with disinfecting, germ- free, I'm clean! I love my Libman mops that I can throw in the washer when they get icky. Yes that is a word.


Rocco was thankful to be able to come in to a warm and stange-smelling house. Frank made sweet potato pies. There is no room in my refridg for ANYTHING! ANY. THING. We will try to eat meatballs with a different pasta tonight since our meal was rudely interupted last evening.

I must tell you, my sick little boy kept hugging my arm and saying, "I'm sorry Mom, I'm sorry" I kept saying to him, "There is no need for apologizing when you're sick Nicholas. Sick just happens. But if you make Mommy sick, I will beat you up baby!" then he giggled and threw up a little more. And that was the end of it.

He had a fever for a few hours. We read his comic Bible for a little while. He sipped some giner ale and slept throught the night. When he woke this morning, he was running up and down the walls like his normal self. Until he said, "Uh-oh, I need to change. I tooted and it was wet"
It was then I realized, it hasn't quite left him.

I wondered if I should call his dad and let him know about him getting sick and all. I thought about that last little scuttle I had with him, and the one I'm sure we'll have real soon; I thought I'd leave it up to you; I think I know your answer. I mean, it WAS pretty short lived and all, riiight.

Have a really nice day
Deborah

ick

This color sums it up.

Last week, Cinderisa had a sore throat and fever. Thankfully, she tested negative for strep. Lasted three, maybe four days.

Same week, Frank had body chills, fever, aches and pains and tummy ache. Lasted two days.

Nicholas, had a cough that lasted for approximately three days, very benign. No fever, mucous, runny nose did occur.

Christina is just ending her two days of sore throat and coughing.


I started coughing on Friday, it will NOT stop. It just keeps going like that stupid bunny on the commercial. Getting tighter and less and less productive. Went to doctors yesterday. Left with inhaler, z-pack and cough suppresant syrup to sleep. Which I need to be very careful with, as it's a narcotic.

For the first time, in many nights, I did sleep. My head is pounding; I'm not sure if it's from the change in the weather that just hit, or from the one little dose I took of the syrup. I am so reluctant to take meds anymore.

Going back to the couch.

Hope you're pain free. And flu-free, and germ-free. Thanks Jeff! you cursed me.
Deborah

Restless Leg Syndrome May be Associated with Migraines

November 2, 2007 — Restless legs syndrome (RLS) occurs more frequently in patients with migraine than in those without, according to results of a case-control study conducted in Germany. A possible co-association of depressive symptoms with both disorders also emerged in the study.


While the underlying mechanism for the comorbidity of migraine and RLS remains undetermined, it might involve dysfunction of the dopaminergic system, the researchers note in the November issue of the journal Cephalalgia.
Dr. Stefan Evers from the University of Munster and colleagues investigated the prevalence of RLS in 411 patients with migraine and 411 sex- and age-matched controls who had no history of headache suggestive of migraine.



"In addition, patients with migraine showed a trend towards worse symptoms of RLS than patients who suffer only from RLS," Dr. Evers and colleagues note.


There was no significant association between migraine and a diagnosis of depression — 9.6% of migraineurs were diagnosed with depression compared with 4.0% of controls (p = 0.190). However, the Beck's Depression Inventory (BDI) score was significantly higher in the migraine group than in the control group (8.8 vs 6.1; p < 0.001).


Similarly, rates of depression were not significantly different in the 71 migraine patients with RLS and the 340 migraineurs without RLS (13.6% and 8.7%, respectively; p = 0.312), but migraine patients with RLS had significantly higher BDI scores than migraine patients without RLS (12.1 vs 8.0; p < 0.001).


Dr. Evers and colleagues also found evidence that older age and longer duration of migraine may raise the risk of RLS. Migraine patients with RLS in the study were significantly older than patients with migraine only.


Age and the duration of migraine "are of special importance because patients with migraine and RLS have probably taken headache medication for a longer time," the clinicians note. "These patients may more often exhibit a symptomatic RLS based on renal insufficiency due to medication overuse."


Older migraine patients are likely also to have used ergotamine derivatives for headache, they point out, which "can cause myalgia and paraesthesia as a side-effect of clinical or subclinical ergotism. In these cases, the symptoms of the vascular side-effects could mimic RLS or ergotamine use, with subsequent (e)ffects on the spinal tract, and polyneuropathy might lead to symptomatic RLS," Dr. Evers and colleagues write.


They note that future studies may uncover a common genetic background for both RLS and migraine.


Migraine has been associated with sleep disorders such as prolonged rapid eye movement sleep latency and narcolepsy, and an association with RLS has been suggested, with dopaminergic pathways as a possible mediator for both conditions. RLS is a sensorimotor condition with a prevalence of 2.5% to more than 10% in the white population, and prevalence increases to a peak at age 65 years and then decreases, with diagnosis based on criteria of the International RLS study group. A positive family history is seen in 50% of patients with idiopathic RLS, and family history is also described for patients with migraine. In addition, patients with migraine have a 3-fold increased risk for depression, and a higher prevalence of anxiety and depression has also been described among patients with RLS.


This is a prospective case-control study to examine the association between migraine and RLS, and migraine and depression in patients presenting to neurology clinics.
Reuters Health Information November 2007

Little Man and His Cave

Lastnight, Nicholas had his first sleepover in his little man cave. I didn't really see too much of him for most of the night, or much of the morning.

These would be the pre-sleepover pictures. And then the following of course, you get it. His best buddy, Eric.
some of the mess

some good, old fashioned horse-play, or dog-play, with Rocco.

Yes, I know. My little guy is, well, little. Where DOES he get it?? Ok, so Eric is a good foot and a half taller than him. Oh, and 2 years older, but they are best friends. He, Nicholas, could not ask for a better friend.

He came home from school a few days ago to tell me that some kid was pulling his ears on the bus. Little brat, I'm thinking to myself. What kind of kid pulls on another kids' ears?

"What did YOU do, Nick?" I asked him.

"I told him that he better knock it off or I'd tell on him." he very quickly AND sharply replied.

Now, although he does have the Bruce Lee posters and the Marine going on in his room, I'm not for fighting; and neither is the school policy. The idea is to "Stop Bullying in it's Tracks" OK.

He has it down. Frank and Philip would rather see it the other way, and have him knock the kid on his a$$. The world is violent enough to me. I don't know.

Now, the kid starts to pick at him to another kid, "Nick's going to tell!"

By this time, the Staunch Protector, Eric (the Great) starts to climb the steps of the bus and hears the conversation, and sees the kid go for Nicholas' ears, again; Nicholas says, "Don't touch me, or..."

.....and Eric finishes his sentance "Or I'll punch your lights out!" and shows his fist. The kid sat down. And so did the rest of the kids.

They all like Eric, because he's really a big sweetheart, who is afraid of hurting anyone; mostly because of his size, and probably because he really is a great kid. Who wouldn't want a friend like him?

He told me this morning that he was so thankful to have Nicholas as a friend. That made ME feel fortunate. My little guy made Eric feel fortunate, too. There is something very special about little boys; they are special little treasures.

Please keep this litte treasure close to your heart and prayers this holiday season; he lost his Mom this past summer to cancer. I see her face in his when I look at him. He is a wonderful, sweet little-big boy. He will be going through his very first Thanksgiving and Christmas without his Mommy; and I cannot imagine how that is going to be for him, or for his Dad.

I do know that my Nicholas will be a wonderful friend to him. I am so proud of my little man. Yes little boys are truly wonderful little creatures. Snips, snails and puppy dog tails. They are wonderful.

Deborah

Nicholas' Room; One Down, Four to Go,

At long last, the day has come.....my little guy is moving. sigh...

He is moving away from the safety of my arm's reach - um, at night that is. His room has been the big, blue Yankee room directly across the hall from my room. That is, until today. He, being the youngest, has lost rank. His theme, as if anyone needed a clue:

yeah, I know. This has been a very fun room to create. He wanted me to paint an entire wall in camouflage or "cameraflage" as he calls it. It just couldn't happen that way. The border itself was killer. But fun. I won't tell how long it took. As I post this, the rug is being installed.

The mascot, who sat with me the whole time. I will remember to disengage my flash when I take the next pix.

Lastnight, as I tucked my little man into bed, I realized that it was the very last time in his big blue room. So I told him so, and he became very sad and scared and said to me, "Mom, it's so dark and far down there."

OK, so just knife my heart out why don't you, buddy! I grabbed his sweet, smelling little self and just held him tight and told him that I'd make sure he had a night light in his room and one in the bathroom and that Bosco would sleep with him. I have a sneaking feeling he may end up in my room tonight. That's OK. And as I just told Frank the story, we agreed that Rocco should sleep with him, too. I am SO glad that is solved.

As soon as the room is totally finished, I will absolutely update with more cool pics.

deborah

I Know I'm Going to Need My Abortive When......

.........I wake up this color.



...........I've seen this all night long.
sure, it's pretty and colorful and all - but the dancing and swirling of it, I know I can do without.



...........I hear the music of buzz and tweet in my ears and head.



............When I dropped my precious cargo off at their um, well, right now I'm at a loss for nice words; anyway, I was asked if I would consider letting he and his wife (entering her residency) give them one of the children for a tax write-off. (his words ) Because, afterall, this will be the last year he gets a refund from his child-support - as in the kick-back we give for the child tax credit. Yes, I said that correctly. The children live with me, I give him a kick-back on the child tax credit.



Since I have had been divorced, I have only claimed the kids for the past three years - this being the third year. For the first three, he claimed, even though, they lived with me. I never saw a dime of - well anything as far as the tax credit or the taxes that I was owed. As a matter of fact, I even waved a portion of my child support. Because of the guilt of divorce. I have since lost the stupidity of guilt and gained a spine. We pay all of, ALL of the expenses for the kids; insurance to pencils and gum, not to mention school supplies - all of it. My head is pouunding at the moment.



This is the final year of the kick-back, as I call it. And he mentioned to me yesterday, that his wife, who is now licensed in the US and seeking her residency, wants to claim MY children to get a nice little tax exemption. (his words) My children who not only do NOT live with her, but that other than the child support he pays, they get angry and refuse to add to when asked.



An example; "Dad, I need a cover for a project. " While they were out shopping. His response, "That's what I pay your Mother child support for." The cover, a mere 15cents - no lie.



Each time they ask for something, that is his reply. Fine. Mind you, that is his responsibility.

It is not my responsibility, however, to make sure that they, who are both able bodied, can make a tax exemption. Adopt.



I cannot work at the moment. My job right now, and by the way, has been, to raise MY kids. I do a great job. Get your own kids, if you want a write-off. Don't have him ask me to give you one of mine. Because you just gave me a migraine, B*tch.

Deborah

One Day, One Little Boy and Three Costumes; Man, am I Beat!

Our original plan for Nicholas' costume, of course, was for him to be a
Marine, like his brother. Complete with cammies, noisey guns, some very cool stuff we found from Phil's boxes AND a hand-made Hummer. That we had started to paint, made from boxes.


Unfortunately, when I received the letter home from school that the first graders would be participating in a scarecrow-making day, rather, half day of fun and party games; our Hummer became obsolete.


I'm not totally big on the whole Halloween thing anyways; so when our church sent out a newsletter that we were featuring a Harvest Fest on Halloween night, and games, and candy, etc.... and to dress as your favorite Bible character, I knew then, the Marine thing was going to be pretty short-lived.


So, I only had to ask him, and barely did I get the words out of my mouth, when I did; that he responded who his favorite was; Moses. We had the walking stick for his staff and I just happened to have found some drop cloth to be used for his clothing. Presto, now we have costume! But before I go there, let me just show you the scarecrow day. Because it was adorable.

This is the group I had making our scarecrow, the completed project, and the entire firstgrade class in their scarecrow costumes. This being Costume number 1 for Nicholas.

Which naturally brings me to Costume number 2. He couldn't wait to go out Trick or Treating. I never did get Marisa's picture - She had a very simple one of Batgirl. A cape from one of his Batman dolls, we painted a batman logo on a black t-shirt, she wore black jeans and a pair of my black heeled boots (note to self - LYSOL).

This child is just too cute for words, honestly. And he came up with the lifting of the staff on his own. What can I say, he chose his favorite character, because he knows him.

I introduce to you, MOSES.....MOSES...

And the most incredible and coolest thing we saw all night long. Was this.

Yes, dead alien, too. Pretty cool, huh. It was in the paper on Monday, and Nick was quite jazzed about it. Then it was on the news lastnight, so we HAD to take him to see it.

They thought he was Obi one Kanobe. (I'm sure it's spelled wrong, oh well) How cool are they! The space ship even had smoke coming from it. Pretty awesome.

A very long night indeed for my little man. ( He was totally impressed with the guns, of course!!, that they had.) He played lots of games at church and boy did he get a lot of candy there! he really raked it in.

It's time for me to go paint his Marine room now. What used to take me one day to do, has taken me weeks. And this is the smallest bedroom in the house. Poor, patient little sweetie.

Frank keeps saying, "One wall at a time!" He's not kidding.