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Transcranial midbrain sonography findings in migraine patients with medication overuse headache
Serbia (IFMSA-Serbia) - University of Belgrade, Belgrade
Dr Aleksandra Radojicic
Assist. dr Aleksandra Radojicic Assist. dr Milija Mijajlovic
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Migraine is a common neurological disorder affecting up to 12% of population worldwide. Medication overuse headache (MOH) is a secondary disabling disorder in which frequent acute pain medications intake causes chronic headache in patients with migraine. A dysfunction of the descending pain- inhibitory serotonergic system of the brainstem, leading to hyperexcitability in nociceptive areas has been proposed as one of the potential underlying mechanism. Functional magnetic resonance imaging (MRI), positron emission tomography (PET) and Single Photon Emission Computed Tomography (SPECT) have all demonstrated structural and functional abnormalities in these patients in several brain regions including brainstem. Transcranial sonography (TCS) and analysis of brainstem nuclei is sophisticated and widely used method in neurodegenerative disorders, but only limited research has been done in migraine. Hypoechogenicity of brainstem raphe nuclei is found to be associated with increased attack frequency in episodic migraine, but till now there is no data regarding TCS findings in patients with chronic migraine and MOH.
What is the aim of the project?
The aim of the research is to investigate echogenicity of midbrain structures, including the raphe nuclei, in patients with chronic migraine and MOH.
What techniques and methods are used?
Taking headache history and collecting data from headache diaries will be used in order to establish correct headache diagnosis. The next step will be the examination of included headache patients and age/sex matched controls by transcranial sonography.
What is the role of the student?
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The student is expected to learn to take headache history, to use headache diaries as diagnostic tools, and will be introduced to latest edition of the International classification of headache disorders. The student should gain knowledge on diagnostic criteria and clinical aspects of most common primary headache disorders including episodic and chronic migraine and medication overuse headache. In parallel, the student will be introduced to basic concepts of transcranial brain sonography and will get hands-on experience with use of ultrasound probe but is not expected to master these skills.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
The supervisors will provide introduction to theoretical concepts of both the methodology and the problem that is researched. Student will be asked to read additional literature.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- No specific outcome is expected
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- Hamerla G; Kropp P; Meyer B; Rocco A; Jürgens TP; Walter U. Midbrain raphe hypoechogenicity in migraineurs: An indicator for the use of analgesics but not triptans. Cephalalgia. 2017 Oct;37(11):1057-1066. doi: 10.1177/0333102416665225.
- Ayzenberg I; Nastos I; Strassburger-Krogias K; Obermann M; Gold R; Krogias C. Hypoechogenicity of brainstem raphe nuclei is associated with increased attack frequency in episodic migraine. Cephalalgia. 2016 Jul;36(8):800-6. doi:10.1177/0333102415617415
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