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Exercise as good as medication at relieving migraine?

exercise

Exercise, relaxation, and medication

found to be equally effective in reducing migraine headaches.

In this small study published in the peer-reviewed, headache journal Cephalgia, 91 migraine sufferers were randomized to 3 different groups: Exercise (40 minutes per day, 3 days per week), relaxation (following a recorded program) or topiramate (a medication commonly used to prevent migraine). These participants all reported an average of about 4 migraine attacks per month prior to starting the study. During treatment, all three groups had an average of one less attack per month and there were no significant differences among the three groups.

The take home point here is that there are many different ways to manage migraines and that different people may respond to different therapies. Treatment needs to be tailored to each individual based on his/her personal preferences. For some people, a combination of a daily medication, an exercise program, and a relaxation program could be beneficial. Others may find just one of these options or a combination of two different options effective. In this study, medications, which can be expensive and which can have side effects, were not necessarily better than non-pharmacologic treatments like exercise and relaxation.

We’re excited to offer FL-41 tinted spectacles to our customers because they are not expensive and they do not have “side effects”. They do not preclude our customers from employing other methods of migraine prevention, including medications, exercise and relaxation. For most people, a combination of therapies is the best prevention.

Exercise as Migraine Prophylaxis: A randomized Study Using Relaxation and Topiramate as Controls. Varkey E, Cider A, Carlsson J, Linde M. Cephalgia Published online 2 Sept 2011.

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EGP News Report: Over 3 Million Look to Hospitals for Headache Relief, Particularly for Migraines

3 Million… that's a lot of ER visits!  Think about all the time, money, pain, and wasted energy that goes into those visits.  

By EGP News Report October 6, 2011  Copyright © 2012 Eastern Group Publications, Inc.  Originally posted here: http://egpnews.com/2011/10/over-3-million-look-to-hospitals-for-headache-relief-particularly-for-migraines/

U.S. emergency rooms are full of people seeking relief from headaches, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ) released earlier this year.

According to the report, more than 3 million Americans went to hospital emergency rooms seeking relief from headaches and 81,000 of those resulted in hospitals admissions. One third of the emergency visits and two thirds of the hospital stays were for migraine headache, according to the data.

AHRQ also found that in 2008:

— Women accounted for nearly three out of four emergency department visits and hospital admissions for headaches.
— Migraines were about 4 times more common among women than men in both the emergency department and the hospital.
— People from the lowest-income communities were 2.3 times more likely than those from the highest-income communities to go to the emergency room for headaches—1,300 versus 565 visits per 100,000 people, respectively.
— Rural residents were 1.6 times more likely than their urban counterparts to make emergency department visits for headaches (1,425 vs. 896 visits per 100,000 people).
— By age, people 18 to 44 years old were the most likely to make emergency department visits for headache (1,626 visits per 100,000 people) and the least likely were those 18 and younger (345 visits per 100,000 people).
— The Midwest and South led the country in emergency department visit rates for headache (1,158 and 1,131 per 100,000 people), compared to the Northeast’s 809 visits per 100,000 people and the West’s 744 visits per 100,000 people.

This AHRQ News and Numbers is based on data in Headaches in U.S. Hospitals and Emergency Departments, 2008.

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Photophobia: Looking for Causes and Solutions (EyeNet Magazine Interview with Dr. Digre & Dr. Katz)

By Marianne Doran, Contributing Writer, EyeNet Magazine

Originally published by EyeNet Magazine, the original article can be found here: http://www.aao.org/publications/eyenet/200511/neuro-ophthalmology.cfm

Photophobia is a vexing problem for patients and physicians alike. Although extreme light sensitivity was first described in the 1930s, its origins and management remain elusive even today. But researchers at the University of Utah are working to decipher this troubling and often misunderstood symptom.

“Light sensitivity is a very common problem, and most ophthalmologists—most physicians in general—don’t know what to do with it,” said Kathleen B. Digre, MD, professor of ophthalmology and neurology at the University of Utah in Salt Lake City. “They need to know that this is a real symptom and not a figment of someone’s imagination.”

Dr. Digre noted that the literature is rife with references to psychiatric disease among people complaining of photophobia and with suggestions that photophobia really doesn’t have any pathophysiology.

Co-investigator Bradley J. Katz, MD, PhD, added, “Photophobia is not a psychological problem. It is a neurologic problem, and physicians should take it seriously.”

Two Possible Connections
Because photophobia is a symptom, the key to managing it is to identify and treat the underlying condition. The list of potential causes is long and includes both ophthalmic and nonophthalmic conditions (see “Conditions Commonly Associated With Photophobia”). Iritis, uveitis and corneal disease all produce photophobia, and light sensitivity is a common complaint with dry eye and migraine.

The migraine connection. About 80 percent of people who have migraines have photophobia. It is one of the diagnostic criteria and is considered one of the predictors of the debilitating headaches nearly 98 percent of the time. Migraine sufferers are more sensitive to light between migraine episodes than are other people. Moreover, people who have chronic migraines are more light-sensitive than those who have sporadic migraines. Research has shown that migraine sufferers also have a low threshold of tolerance to loud noises and are more susceptible to motion sickness than are people who do not have migraines.

Although photophobia is not a psychiatric disorder, people with agoraphobia, depression, bipolar disease and seasonal affective disorder are more light-sensitive than are people without these conditions. “In fact, some people can tell how depressed they are by how light sensitive they are,” Dr. Digre noted.

Blepharospasm, too. Photophobia is known to be associated with blepharospasm. In one survey, four out of five blepharospasm patients cited bright lights, television viewing, driving, reading and stress as factors that aggravate their condition.1

In a series of studies reported at North American Neuro-Ophthalmology Society (NANOS) meetings over the last three years, the University of Utah researchers have explored the relationship between blepharospasm and photophobia. In one study, they tested the light sensitivity of 30 people with blepharospasm, 30 people known to have migraines and 30 normal controls. Using a rheostat to measure light intensity, the researchers exposed each study participant to increasing light intensity in 50-lux increments every two seconds. The volunteers were instructed to stare at the light and signal when the light intensity became uncomfortable. The researchers found that the participants with blepharospasm were as light sensitive as those who had migraines, and both were more sensitive than the controls.

Dr. Katz, assistant professor of ophthalmology and neurology at the University of Utah, said that his group also surveyed members of the Benign Essential Blepharospasm Research Foundation about their light sensitivity. “We found that 94 percent of the blepharospasm patients reported some level of light sensitivity and that their light sensitivity made their blepharospasm worse and sometimes triggered spasms,” he said. “They also reported that many activities of daily living, such as walking about, driving, reading, watching television and shopping, were adversely impacted by their abnormal light sensitivity.”

A Constellation of Causes
The mechanisms that cause certain people to experience light as painful have not been well-understood, but neuro-ophthalmologists are beginning to untangle some of the mysteries.

In a presentation at the 2005 NANOS meeting, Dr. Digre highlighted some of what is known about the pathophysiology of photophobia. In addition to the associations with migraine and blepharospasm, these are among the findings about light and photophobia:

  • Individual thresholds of light sensitivity vary among most people.
  • Light sensitivity may be modulated by seasons, with lower discomfort thresholds in the winter months than in the summer months.
  • The total amount of light influences the discomfort threshold. For example, binocular viewing of a light stimulus is associated with a lower discomfort threshold than uniocular viewing.
  • Retinal adaptation (dark adaptation, for example) determines the interpretation of light brightness.
  • Different wavelengths affect an individual’s comfort level. Some studies have indicated that migraine sufferers experience more discomfort with blue- or red-wavelength light.
  • Flickering lights cause discomfort in people with migraines. A photogenic stimulus of 2 to 8 cycles/second has been shown to cause the greatest discomfort among people with migraine or photoinduced epilepsy.
  • Certain patterns of light, especially stripes, also cause greater discomfort for people with migraine or photoinduced epilepsy.
  • Migraine patients appear to have a hyperexcitable occipital lobe, which increases sensitivity to stimulation by light, sound, odors and touch.
  • Light-sensitive individuals may have different levels of photopigments in the retina. People with blepharospasm or migraine, for example, have been found to have higher macular levels of the carotenoids lutein and zeaxanthin, perhaps as protective mechanisms.

Maybe not an “eye” problem? Where does light-induced pain originate? Prevailing theories focus on a connection between the trigeminal system and the retina. “For sure it has to do with the trigeminal system, which is the sensory input for the orbit, the eye, the head and the meninges of the brain,” Dr. Digre said. “The first division of the trigeminal system is intimately involved in light sensitivity.”

She pointed out that vision is not required to have light sensitivity and that light can stimulate the trigeminal nerve in other ways. “Even people who have retinitis pigmentosa and are almost blind have horrible light sensitivity,” she said. “We’re hungry for studies to help us understand this.”

Dr. Katz noted that they are looking at this phenomenon in conjunction with Craig Evinger, PhD, professor of neurobiology and behavior, and ophthalmology, at the State University of New York, Stony Brook.

Dr. Evinger has studied light sensitivity in rats. “Dr. Evinger has shown that sectioning the optic nerve does not eliminate blinking in response to bright light,” Dr. Katz said, “but cutting the trigeminal nerve does eliminate spontaneous blinking in the presence of bright light. These data indicate that it may be the trigeminal system, not the visual system, that is responsible for photophobia.”

blepharospasm

Bright Light Trigger? Bright Light Target? Light sensitivity is often associated with blepharospasm.

 

Relief Remains a Challenge
For now, the most important step is to diagnose and treat any associated conditions, and to talk with patients about a few things they can do, including not wearing sunglasses indoors. “People who wear really dark glasses can actually dark-adapt themselves and increase their photosensitivity,” Dr. Digre said. “Sunglasses outside, of course, are fine, but the darker the glasses inside, the more light-sensitive the person will become.”

Rose-colored sunglasses. Preliminary research at the University of Utah suggests that specially tinted lenses may help some people with photophobia. Anecdotally, many photophobic patients prefer an FL-41 tint on their sunglasses instead of green or yellow. The FL-41 tint, which has a pinkish look to it, is a mixture of colors that blocks the blue-green wavelengths.

“We randomized patients with blepharospasm to wearing FL-41 sunglasses for two weeks and then to wearing plain sunglasses for two weeks,” said Dr. Katz. “The patients filled out questionnaires at the end of each period. We found that patients with blepharospasm definitely preferred wearing lenses with the FL-41 tint to wearing conventional sunglasses. So there does seem to be some therapeutic benefit.”

In a new study, the researchers have used electromyography to measure blink frequency, duration and amplitude in blepharospasm patients while they read for five minutes at a time with regular eyeglasses, glasses with a light gray tint or glasses with an FL-41 tint. The results are still being analysed, but Dr. Katz said they appear to provide more objective evidence that FL-41 does reduce blepharospasm.

"FL-41 lenses are noninvasive, they have no side effects and they're not expensive," Dr. Katz added. "So it's a cheap, easy way to improve the lives of these patients, who in some cases are very disabled by their disease."

Be sure glasses block blue-green. FL-41 lenses are available in optical shops, but Dr. Digre cautioned that some so-called FL-41 lenses are not the real thing. "You really have to know who your supplier is in order to know whether the lenses are real or not," she said. "Some lenses can look like FL-41, but they don't act like it. We have done spectral analysis of our lenses to make sure they are blocking the right light."

Where does photosensitivity research go from here? Dr. Katz said more research is needed at the basic science level. "Work with animal models of light sensitivity will help determine the anatomical pathway that controls the sensitivity. Once we better understand the wiring of light sensitivity, we'll be able to treat it better."

____________________________________________
1 Anderson, R.L. et al. Ophthal Plast Reconstr Surg 1998; 14:305-317.

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Migraine Headaches: Frequently Misdiagnosed

Migraine headaches are very common and affect about 18% of women and 9% of men at some point in their lives. However, this common illness is often misdiagnosed as “tension headache”, “sinus headache”, or allergy. Here are some of the characteristics of migraines that help differentiate them from other headache syndromes:

Unilateral headache. A headache that is primarily on one side only, or “unilateral”, is very typical of migraine, but not typical of other headache types.
Throbbing. Headaches that throb, or pulse with the heartbeat are more often migraine.
Photophobia. Light sensitivity is very common in migraine, but very uncommon in other headaches. Patients often report that light, especially outdoor light, is very bothersome during a headache. FL-41 tint was specifically engineered for migraine patients with light sensitivity.
Phonophobia. Sound sensitivity is also common during a migraine. Even the regular sound of the TV can be irritating during a headache.
Nausea and Vomiting. Nausea, even if mild, is more likely to be associated with a migraine than with other headache types.
Car Sickness. Adults with migraine often have a history of being carsick or motion sick as children.
Note that headache severity is not one of the criteria! Although migraines can be severe, they run on a spectrum – Some people have mild migraines – they might not even take an aspirin for it. Others have severe headaches that land them in the local emergency room. Most migraines are somewhere in-between.

If you think you have migraines, you should discuss it with your primary care physician. He/she can help make the correct diagnosis and guide you toward appropriate medical and non-medical therapy.

Sources:
*Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgia and facial pain. Cephalgia 1988; 8(Suppl. 7): 1-96.
*Headache in Clinical Practice. S D Silberstein, R B Lipton, P J Goadsby (eds). Mosby-Year Book Inc., St Louis, MO. 1998.
*Cuomo-Granston A, Drummond PD. Migraine and motion sickness: Prog Neurobiol 2010. 91:300-12.

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Doctor Biography: Dr. Steve Blair, Optics Engineer

Steve Blair optics engineer professor FL-41 expert

Steve Blair, PhD:  Steve is a researcher with expertise in bio-optics and optical systems, including design, simulation, fabrication, and testing. He has authored over 100 scientific publications that have been cited over 1500 times by other researchers.  As with Dr. Katz, Dr. Blair does not receive any payment for his research or expertise into FL-41 or the causes of photophobia.

Research Summary

My overall research focuses on the application of optics/photonics to problems in biology and medicine. My current research includes plasmonic antennas for enhancing light matter interactions, real-time DNA and protein microarrays, and neural photonics – using light to effect and/or record neural signals.

Research Statement

Current research includes: plasmonics – study of nanophotonic systems based on metallic structures to improve light collection and emission; development of optical neural interfaces; resonance enhancement in fluorescence-based molecular transduction using microscale and nanoscale structures; microfabricated optical biosensor array systems incorporating microfluidics and microthermal management for quantitative affinity assay.

Research Keywords

  • Professor, Elect & Computer Engineering, University of Utah
  • Director, Engineering Clinic Program
  • Adjunct Professor, Physics And Astronomy, University of Utah
  • Adjunct Professor, Bioengineering, University of Utah
  • Adjunct Professor, Materials Science and Engineering, University of Utah
  • Steve Blair received the B.S. and M.S. degrees in Applied Optics from Rose-Hulman Institute of Technology, Terre Haute, IN, in 1991 and 1993, respectively, and the Ph.D. degree in Electrical Engineering from the University of Colorado, Boulder, in 1998. Since 1998, he has been with the Electrical and Computer Engineering Department, University of Utah, Salt Lake City, and is now a Professor. His research interests include optical neural interfaces, plasmonic materials and devices, single-molecule spectroscopy, and silicon photonics. He also currently serves as Director of the Engineering Clinic Program, a capstone design program that connects students with industrial research projects.

  • Education

  • Ph.D. 1998, Electrical Engineering, University of Colorado. Project: Dissertation: Optical Soliton-Based Logic Gates
  • M.S. 1996, Electrical Engineering, University of Colorado
  • Honors & Awards

  • General Chair, "5th Symposium on Photonics, Networking, and Computing," part of the 10th Joint Conference on Information Sciences, July 17-19, 2007, Salt Lake City, UT. 5th Symposium on Photonics, 07/2007
  • Associate Editor. Advances in Optical Technology, 07/2006
  • Co-editor (with Ajay Nahata) of Optics Express focus issue on "Extraordinary light transmission through sub-wavelength structured surfaces," Vol 12, No. 16, 2004. Optics Express, 07/2004
  • CAREER Award. NSF, 07/2002
  • Biomedical research grant for young investigators. Whitaker Foundation, 07/2001
  • Young Investigator Program grant recipient. ARO, 07/2000
  • Elected Senior Member. Optical Society of America, 05/2011
  •  
  • M.S. 1993, Applied Optics, Rose-Hulman Institute of Technology. Project: Thesis: Photochromic Methyl-Violet as a Holographic Medium Advisor: Azad Siahmakoun
  • B.S. 1991, Applied Optics, Rose-Hulman Institute of Technology
  • B.S. 1991, Computer Engineering, Rose-Hulman Institute of Technology
  • Optics, Interest Level: 5
  • Neural photonics, Interest Level: 5
  • Nanophotonics, Interest Level: 5
  • Molecular Nano-optics, Interest Level: 5
  • Bioinstrumentation, Interest Level: 5
  • Patents

  • Method of Making and Using Microarrays Suitable for High-Throughput Detection (# ). Status: Published. Inventors: Alexander Chagovetz, Steven M. Blair, Colby Wilson. File date 08/13/2008. Assignee: The University of Utah. Country: United States.
  • Resonant Optical Cavities for High-Sensitivity, High-Throughput Biological Sensors and Methods (#7,384,797). Status: Issued. Inventors: Steven M. Blair. File date 08/21/2002; Issue date 06/10/2008. Assignee: The University of Utah. Country: United States.
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Doctor Biography: Dr. Bradley Katz

Bradley Katz FL-41 neuro-ophthalmologist professor expert

Dr. Katz is a tenured Associate Professor in the Department of Ophthalmology and Visual Sciences and holds an Adjunct appointment in the Department of Neurology. He splits his time between clinical care, surgery, research and teaching. Dr. Katz chairs the Department’s Adjunct Faculty Committee and serves in the University’s Academic Senate (admin.utah.edu/academic-senate). Dr. Katz is a Fellow of the American Academy of Ophthalmology (www.aao.org) and a Fellow of the North-American Neuro-Ophthalmology Society (www.nanosweb.org).

Dr. Katz received undergraduate degrees in Electrical Engineering and Biomedical Engineering from Northwestern University in 1986. After completing the MD/PhD program at the University of Illinois and a medical internship, he trained in ophthalmology at the University of Iowa. In 1998 he moved to Salt Lake City to become the Department’s first neuro-ophthalmology fellow. Dr. Katz joined the faculty the following year.

Along with his partners Dr. Steven Blair and Benjamin Rollins, Dr. Katz founded Axon Optics (www.axonoptics.com). Axon is developing thin-film spectacle coatings for the prevention and treatment of migraine headaches. Dr. Katz is part of an inter-departmental project at Utah to find new treatments for giant cell arteritis, a blinding disease that exclusively affects the elderly. Dr. Katz is also collaborating on a project with the National Institutes of Health to find new ways to evaluate treatments for optic neuritis and multiple sclerosis.

Dr. Katz is a native of St. Louis, Missouri. He has lived in Utah for 14 years with his wife and three children. Outside of the Moran Eye Center, Dr. Katz enjoys biking, swimming, good food and loud music.

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Benign Essential Blepharospasm, Photophobia and FL-41

Benign Essential Blepharospasm, Photophobia and FL-41: a presentation by Dr. Bradley Katz.

Dr. Katz explains the research, science, and nature of light sensitivity and blepharospasm is eas-to-understand terms.  He does not receive any payment for his research into better solutions.  Click this text to watch Dr. Katz discuss the efficacy of FL-41 glasses in treating benign essential blepharospasm!  

This video is from the 27th International Conference and Scientific Symposium of the Benign Essential Blepharospasm Research Foundation in Irvine, California on August 8, 2009.  Hosted courtesy of the non-profit  Benign Essential Blepharospasm Research Foundation (BEBRF). Learn more about their foundation at www.Blepharospasm.org.

Dr. Katz is a tenured Associate Professor in the Department of Ophthalmology and Visual Sciences and holds an Adjunct appointment in the Department of Neurology. He splits his time between clinical care, surgery, research and teaching. Dr. Katz chairs the Department’s Adjunct Faculty Committee and serves in the University’s Academic Senate (admin.utah.edu/academic-senate). Dr. Katz is a Fellow of the American Academy of Ophthalmology (www.aao.org) and a Fellow of the North-American Neuro-Ophthalmology Society (www.nanosweb.org).

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OUCH! Why do some colors HURT? Understanding the Visual Spectrum with Dr. Katz

visual spectrum fl-41 tint axon optics therapeutic  fluorescent

Understanding the Visual Spectrum with Dr. Katz

The visual spectrum, the wavelengths of light that the human eye can see, include long wavelength light (red) all the way through short wavelength light (blue). The visual spectrum includes all colors of the rainbow: red, orange, yellow, green, blue, indigo, violet. Red and orange have longer wavelengths and blue/indigo/violet have shorter wavelengths.

Infrared light (heat) is invisible to us because it has a wavelength longer than red, thus the name “infra-red” (literally "Below-Red"). Infrared technology is used in many technologies, including night-vision goggles, LEDs (Light-emitting diodes), and telescopes that look into outer space. Most of the heat emitted from objects is infrared.

Ultraviolet light (UV) is invisible to us because it has a shorter wavelength, thus the name “ultra-violet" (Literally "Beyond-Violet"). UV light cannot be seen, but has the potential to damage our skin and eyes. We need a small amount of UV light to help our bodies make Vitamin D. UV light is also used in inventions, including LEDs (Light-emitting diodes), forensics, fluorescent dyes, neon signs and black lights, and many more.

Why do some colors HURT? Different wavelengths affect an individual’s comfort level. Some studies have indicated that migraine sufferers experience more discomfort with blue- or red-wavelength light. We can help about 90% of people with light sensitivity (photophobia) with our proprietary blend of FL-41 tinted lenses. Axon Optics lenses filter the portion of the light spectrum which is most distressing to people with light sensitivity (photophobia) and its associated conditions. The filter is especially helpful in relieving pain from fluorescent lights, LEDs, and electronic devices – the majority of our modern world. In addition, all of our lenses block 100% UVA/UVB light for the most therapeutic possible lens. Our research continues on the causes of photophobia, both ocular and neurological.

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Multi-Use Transitions versus Indoor Eyeglasses and Outdoor Sunglasses

Axon Optics Prime s 59 Indoor and Outdoor

I am often asked: "Which is better, a single pair of Transitions lenses, or to have a Pair of Indoor Lenses and a Pair of Outdoor Lenses, respectively? It's about the same price, what should I choose?"

Let's compare the pros and cons of each option.

A single pair of Transitions: Some people would find it annoying to switch pairs over the course of the day. They'd like to have a single pair of glasses on their face, and forget about it. The pros to a single pair of transitions are the convenience and simplicity of a single pair. It may cost more or less than two pairs, depending on what you order. You're less likely to misplace a single pair.
The cons – Some people need to switch frames during the day, because the pair of glasses they'd wear in an office is much smaller than what they'd wear in the sun, and what they'd wear as sunglasses is far too bulky for the office.

An Indoor and an Outdoor Pair: The Pros to having two different pairs are the ability to change frame coverage and aesthetic style.  Our outdoor tint is more therapeutic than our indoor or transitions lenses, giving you a higher level of relief.  Again, the cost may be more or less than a single pair of transitions, depending on what is purchased; and the potential for a backup pair in case one pair is lost, stolen, or damaged.

For me personally, I prefer the latter. I find that the transitions aren't quite dark enough to replace our outdoor tint when the lights are especially bright or my photophobia is extreme. I like switching to my bigger Mistral frame in those situations, which would be too big for business meetings. I also like having a backup pair for emergencies – I've been on trips before where a lens was damaged, and I was glad to have the other pair available.

Thanks for reading.  Have a Pain-Free Day!

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