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A Piece Of The Migraine Puzzle

BIDMC Study Explains Why Light Worsens Migraine Headaches

If you've ever felt the throbbing, nausea or fatigue of a migraine headache, you know lights only make the pain worse. Now researchers at Beth Israel Deaconess Medical Center are learning what causes light sensitivity in people suffering from migraines.

Scientists at BIDMC have identified a new visual pathway that may be the basis for sensitivity to light during migraines in both blind individuals and those with normal eyesight.

Nearly 85 percent of migraine patients are also extremely sensitive to light. It's a condition called photophobia. Researchers observed that even blind people suffering from migraines were experiencing photophobia as well. This observation led them to study two groups of blind individuals who suffered from migraines. One group was totally blind and unable to see images or sense light. The other group was legally blind and had trouble perceiving images, but could detect the presence of light.

Individuals in the totally blind group did not experience any worsening of their headaches from light exposure, while those in the legally blind group described intensified pain when they were exposed to light.

This finding led researchers to a group of recently discovered retinal cells containing melanopsin photoreceptors - which help control biological functions including sleep and wakefulness. In the lab, scientists injected dyes into the eye of an animal model of migraine and traced the path of the melanopsin retinal cells through the optic nerve to the brain. There they found a group of neurons that became electrically active during a migraine headache.

"When small electrodes were inserted into these 'migraine neurons,' we discovered that light was triggering a flow of electrical signals that was converging on these very cells," says Rami Burstein, PhD, Professor of  Anesthesia and Cricial Care Medicine at BIDMC and the study's senior author.

Burstein and his team also noticed that when the light was removed, the neurons remained activated.

"This helps explain why patients say that their headache intensifies within seconds after exposure to light, and improves 20 to 30 minutes after being in the dark," notes Burstein.

The discovery gives scientists a new avenue to follow in working to address the problem of photophobia by identifying ways to block the pathway so migraine patients can endure light without pain.

The findings of the study appear in the Advance On-line issue of Nature Neuroscience.

To watch the NECN report on the study,  click here.

Helping Haiti

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BIDMC Doctors Join in Haitian Relief Efforts, Blog About Their Experiences

The devastation is indescribable - more than 100,000 people dead, tens of thousands more injured and in desperate need of medical care. Within days of the massive earthquake that shook Haiti on January 12, 2010, Beth Israel Deaconess Medical Center began stockpiling medical supplies to send to the area, and several BIDMC doctors were on the ground through Partners in Health, Operational Medicine Institute and other organizations, working with other medical teams from Boston and around the world to treat the thousands of victims of the quake.

Doctors Dave Callaway and Sean Kelly, of BIDMC's  Emergency Medicine Department and BIDMC orthopedic surgeon  Joseph DeAngelis are among the first wave of Boston and BIDMC-affiliated clinicians working together under the flag of the Operational Medicine Institute (OMI) and blogging about their experiences. The group is based at the Good Samaritan Hospital, the main medical facility in Jimani, a town in the Dominican Republic that borders Haiti. Their task: "to diplomatically create order out of chaos" so they can help those who survived the earthquake, survive the aftermath. As relief efforts grow, this group has expanded to an additional service in Fond Parisien, Haiti.

"It's amazing to see the families, especially the children," they write in the OMI blog. "Many have multiple injuries - broken bones, lacerations and sepsis. Some sit in their parent's arms quietly, giving shy little smiles when you look at them. Others are running around (as much as they can) full of smiles and laughing, as if they're on vacation."

Much of the group's initial work has been organizational - simply finding out what supplies they have, what is needed and finding a way to efficiently distribute the many donations coming in from abroad.

"Our organizational efforts are essential to the medical work on hand," they write in another blog entry. "For example, our surgeon, Dr. Joe DeAngelis, directed his efforts this morning towards maintaining the OR supply chain. This meant organizing the supply room and creating a new warehouse for newly arrived medical supplies. Donations have been generous, but uncontrolled. In fact, the majority of medical supplies essential to the surgical mission are on site, however, they had been previously inaccessible or simply un-catalogued."

Their work is hard, but the doctors are drawing strength and inspiration from the resilient spirit of the Haitian people.

"Though they have lost everything, and their loved ones lay next to them recovering from injuries, one group in the chapel area conducted their own group prayer ceremony, joyously singing and gaining strength from each other," the doctors write.

To read the blog and watch a video of the prayer ceremony, click here.

BIDMC has also set up a Haitian Relief Fund through website. All donations made on this page will go directly to fun the post-earthquake efforts of Partners in Health, a Boston-based non-profit that has worked on the ground in Haiti for 25 years.

Stand Up for Good Health

Research Finds Prolonged Sitting May Increase Risk of Disease

If you're reading this article sitting down, you may want to stand up. That's because new research suggests people who sit for prolonged periods of time have a higher risk of disease than those who get up and move, even just a little bit.

Swedish researchers warn in a recent editorial in the British Journal of Sports Medicine that even if you exercise regularly, sitting for prolonged periods of time could increase your risk of heart disease, diabetes and even certain types of cancer.

The research is still in its preliminary stages, but recent evidence found that for every hour a woman its in front of the television, her risk of metabolic syndrome, a precursor to  diabetes and heart disease, increases by 26 percent. So-called whole body muscular inactivity related to prolonged sitting has also been strongly linked to obesity and certain types of cancer.

"This study reinforces the importance of regular physical activity to maintain good health," says Dr. Murray Mittleman, Director of BIDMC's  Cardiovascular Epidemiology Research Unit at the CardioVascular Institute. "Research shows that any amount of physical activity helps prevent the occurrence of cardiovascular and other chronic diseases. So, the recommendation for physical activity is that a little is good, but more is better!"

Researchers are encouraging physicians to emphasize the importance of simple, non-exercise activities as an easy way to ward off bad health. They note that even small movements like getting up to grab a glass of water or walking up a flight of steps lowers your risk.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted January 2010