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Friday, March 31, 2023

Migraines, cluster headaches linked to how you sleep: study - New York Post

Is it headache o’clock?

Migraines and cluster headaches are closely linked to the body’s internal clock, a new study found.

The report, published in Neurology on Wednesday, suggested that both types of headaches have strong correlations to the circadian system — the physical, mental and behavioral patterns that follow a 24-hour cycle.

Migraines are a recurrent type of headache that can range from moderate to debilitating pain, lasting anywhere from four to 72 hours, and affect women three times more often than men, according to the National Institutes of Health.

Cluster headaches are the most common of the primary headache type and are three times more likely to be experienced by men, the NIH reported.

Clusters also are often short-lasting and come with nasal congestion, with episodes occurring from every other day to as often as eight times a day.

Man with heavy headache or brain stroke
These headache disorders were found to have genetic and hormonal connections to the body’s circadian rhythm.
Getty Images/iStockphoto

A person’s circadian clock sets the timing for many important bodily functions, such as sleep cycles, hormonal activity, body temperature rhythm, eating and digestion.

The new meta-analysis — a statistical analysis using previous research — investigated the daily and yearly timing of headaches and the genes and hormones associated with the circadian clock.

Researchers found that across 16 different studies, 71% of 4,953 participants had a prominent circadian pattern of cluster headaches.

Man clenching nose with a headache
Researchers suggest that circadian-based treatments could be a viable type solution for headaches.
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The majority of those headaches occurred during the late hours of the night to early hours of the morning and in the spring and fall seasons.

When looking at genetics, cluster headaches were connected to two of the main circadian genes, and five of nine genes had a circadian pattern.

Participants who experienced cluster headaches were found with higher cortisol levels and lower melatonin levels compared to people who weren’t afflicted by cluster headaches.

Migraines had a weaker link (50%) to circadian rhythms than cluster headaches but were still found to be influenced by the body’s internal clock in some ways.

Fewer attacks happened at night.

The recurring headaches were also connected to two core circadian genes, and 110 of 168 genes had a circadian pattern of expression.

People with migraines had lower levels of melatonin in their urine than people without migraines — and those levels dropped even lower during a migraine attack.

“The data suggest that both of these headache disorders are highly circadian at multiple levels, especially cluster headache,” explained study author Mark Joseph Burish, M.D., Ph.D., of the University of Texas Health Science Center in Houston and a member of the American Academy of Neurology.

“This reinforces the importance of the hypothalamus — the area of the brain that houses the primary biological clock — and its role in cluster headache and migraine. It also raises the question of the genetics of triggers such as sleep changes that are known triggers for migraine and are cues for the body’s circadian rhythm.”

Experts note that this research suggests that circadian-based treatments — such as taking medications at certain times of the day — should be explored for headache disorders.

The Centers for Disease Control and Prevention reports every adult should be tucking themselves in for at least seven hours per night, but it appears that many Americans are not getting that — and even if they are, it’s not consistent.

Nearly half of all American adults experience sleep deprivation, citing a misalignment of their body and social clocks.

Being off balance with the body’s circadian rhythm has been associated with a higher risk of depression, obesity, Type 2 diabetes and cardiovascular problems — and now headache disorders.

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Migraines, cluster headaches linked to how you sleep: study - New York Post
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Ticking Time Bombs: How Our Biological Clock Influences Cluster Headaches and Migraines - SciTechDaily

Woman Bad Headache

A meta-analysis published in Neurology reveals strong links between cluster headaches, migraines, and the circadian system, which regulates internal body processes. The study emphasizes the role of the hypothalamus and genetics in these headache disorders. Cluster headaches displayed a circadian pattern in 71% of people, peaking in late night and early morning, and were associated with two main circadian genes. Migraine attacks followed a circadian pattern in 50% of people, peaking from late morning to early evening, and were also linked to two core circadian genes. The results suggest the potential for circadian-based treatments for headache disorders.

Meta-analysis: Cluster headache, migraine have strong links to circadian system.

Both cluster headache and migraine have strong links to the circadian system, the internal clock that regulates body processes, according to a meta-analysis published in the March 29, 2023, online issue of Neurology, the medical journal of the American Academy of Neurology.

The meta-analysis included all available studies on cluster headache and migraine that included circadian features. This included information on the timing of headaches during the day and during the year as well as studies on whether genes associated with the circadian clock are more common in people with these headaches.

The researchers also looked at studies on cluster headache and migraine and hormones related to the circadian system, including cortisol and melatonin.

“The data suggest that both of these headache disorders are highly circadian at multiple levels, especially cluster headache,” said study author Mark Joseph Burish, MD, PhD, of the University of Texas Health Science Center at Houston in Texas and a member of the American Academy of Neurology. “This reinforces the importance of the hypothalamus—the area of the brain that houses the primary biological clock—and its role in cluster headache and migraine. It also raises the question of the genetics of triggers such as sleep changes that are known triggers for migraine and are cues for the body’s circadian rhythm.”

For cluster headache, the meta-analysis found a circadian pattern of headache attacks in 71% of people. Attacks peaked in the late hours of the night to early hours of the morning. During the year, people had more attacks in the spring and fall. On the genetic level, cluster headache was associated with two main circadian genes, and five of the nine genes that increase the likelihood of having cluster headache are genes with a circadian pattern of expression.

People with cluster headache also had higher cortisol levels and lower melatonin levels than people without cluster headache.

For migraine, the meta-analysis showed a circadian pattern of attacks in 50% of people. While the peak for attacks during the day was broad, ranging from late morning until early evening, there was a circadian low point during the night when few attacks happened. Migraine was also associated with two core circadian genes, and 110 of the 168 genes associated with migraine were genes with a circadian pattern of expression.

People with migraine had lower levels of melatonin in their urine than people without migraine. In addition, melatonin levels were lower during a migraine attack.

“These results raise the potential for using circadian-based treatments for headache disorders,” Burish said. “This could include both treatments based on the circadian rhythm —  such as taking medications at certain times of the day — and treatments that cause circadian changes, which certain medications can do.”

A limitation of the study was that researchers did not have information on factors that could influence the circadian cycle, such as medications, other disorders such as bipolar disorder or circadian rhythm issues such as night shift work.

Reference: “Circadian Features of Cluster Headache and Migraine: A Systematic Review, Meta-analysis, and Genetic Analysis” by Barlas Benkli, Sun Young Kim, Nobuya Koike, Chorong Han, Celia Tran, Emma Silva, Yuanqing Yan, Kazuhiro Yagita, Zheng Chen, Seung-Hee Yoo and Mark Joseph Burish, 29 March 2023, Neurology.
DOI: 10.1212/WNL.0000000000207240

The study was supported by the Will Erwin Headache Research Foundation.

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March 31, 2023 at 07:40PM
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Thursday, March 30, 2023

Adeno-associated virus type 2 in US children with acute severe hepatitis - Nature.com

Abstract

As of August 2022, clusters of acute severe hepatitis of unknown etiology in children have been reported from 35 countries, including the United States1,2. Previous studies have found human adenoviruses (HAdVs) in the blood from cases in Europe and the United States3-7, although it is unclear whether this virus is causative. Here we used PCR testing, viral enrichment based sequencing, and agnostic metagenomic sequencing to analyze samples from 16 HAdV-positive cases from October 1, 2021 to May 22, 2022, in parallel with 113 controls. In blood from 14 cases, adeno-associated virus 2 (AAV2) sequences were detected in 93% (13 of 14), compared to 4 (3.5%) of 113 controls (P<0.001) and to 0 of 30 patients with hepatitis of defined etiology (P<0.001). In controls, HAdV-41 was detected in blood from 9 (39.1%) of the 23 patients with acute gastroenteritis (without hepatitis), including 8 of 9 patients with positive stool HAdV testing, but co-infection with AAV2 was observed in only 3 (13.0%) of these 23 patients versus 93% of cases (P<0.001). Co-infections by Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and/or enterovirus A71 (EV-A71) were also detected in 12 (85.7%) of 14 cases, with higher herpesvirus detection in cases versus controls (P<0.001). Our findings suggest that the severity of the disease is related to co-infections involving AAV2 and one or more helper viruses.

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Correspondence to Charles Y. Chiu.

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Supplementary Table 1

Detailed demographic, clinical, laboratory, and genomic characteristics for individual cases and controls.

Supplementary Table 2

Statistical associations of detected viruses in cases compared to controls.

Supplementary Table 3

Frequency of single nucleotide variants in AAV2 genomes from cases.

Supplementary Table 4

Primer sequences for detection and virus whole-genome sequencing of HAdV-41 and AAV2.

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Servellita, V., Gonzalez, A.S., Lamson, D.M. et al. Adeno-associated virus type 2 in US children with acute severe hepatitis. Nature (2023). https://ift.tt/U5BA6iK

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