Try a new search

Format these results:

Searched for:

person:tb888

Total Results:

30


The Use and Method of Action of Intravenous Lidocaine and Its Metabolite in Headache Disorders

Berk, Thomas; Silberstein, Stephen D
BACKGROUND:Lidocaine, an amide anesthetic, has been used in the treatment of a wide variety of pain disorders for over 75 years. In addition to pain control, lidocaine is an anti-arrhythmic agent and has anti-inflammatory properties. Lidocaine's unique properties, including nonlinear pharmacokinetics, have limited its modern-day use. OBJECTIVE:The purpose of this review is to offer a better understanding of the properties of this unique treatment, which we hope will allow more practitioners to offer this to their patients. METHODS:An analysis of the history, pharmacokinetics, and relevant uses of lidocaine in headache medicine based on a synthesis of the medical literature and clinical experience. RESULTS:Lidocaine is an amide anesthetic that inhibits voltage gated sodium channels, and lidocaine metabolism occurs exclusively in the liver. One lidocaine metabolite has its own unique properties and may be an active form of the drug. CONCLUSION/CONCLUSIONS:Open label and retrospective studies have investigated the use of lidocaine in many headache disorders, primarily via injection or infusion. Further research into the active metabolite of lidocaine may allow for its use as a novel nonopiate treatment of chronic pain.
PMID: 29536530
ISSN: 1526-4610
CID: 2992722

Factors Related to Migraine Patients' Decisions to Initiate Behavioral Migraine Treatment Following a Headache Specialist's Recommendation: A Prospective Observational Study

Minen, Mia T; Azarchi, Sarah; Sobolev, Rachel; Shallcross, Amanda; Halpern, Audrey; Berk, Thomas; Simon, Naomi M; Powers, Scott; Lipton, Richard B; Seng, Elizabeth
Objective/UNASSIGNED:To evaluate the frequency with which migraine patients initiated behavioral migraine treatment following a headache specialist recommendation and the predictors for initiating behavioral migraine treatment. Methods/UNASSIGNED:We conducted a prospective cohort study of consecutive patients diagnosed with migraine to examine whether the patients initiated behavioral migraine treatment following a provider recommendation. The primary outcome was scheduling the initial visit for behavioral migraine treatment. Patients who initiated behavioral migraine treatment were compared with those who did not (demographics, migraine characteristics, and locus of control) with analysis of variance and chi-square tests. Results/UNASSIGNED:Of the 234 eligible patients, 69 (29.5%) were referred for behavioral treatment. Fifty-three (76.8%) patients referred for behavioral treatment were reached by phone. The mean duration from time of referral to follow-up was 76  (median 76, SD = 45) days. Thirty (56.6%) patients initiated behavioral migraine treatment. There was no difference in initiation of behavioral migraine treatment with regard to sex, age, age of diagnosis, years suffered with headaches, health care utilization visits, Migraine Disability Assessment Screen, and locus of control (P > 0.05). Patients who had previously seen a psychologist for migraine were more likely to initiate behavioral migraine treatment than patients who had not. Time constraints were the most common barrier cited for not initiating behavioral migraine treatment. Conclusions/UNASSIGNED:Less than one-third of eligible patients were referred for behavioral treatment, and only about half initiated behavioral migraine treatment. Future research should further assess patients' decisions regarding behavioral treatment initiation and methods for behavioral treatment delivery to overcome barriers to initiating behavioral migraine treatment.
PMID: 29878178
ISSN: 1526-4637
CID: 3144562

Updated process for American Headache Society Guidelines [Editorial]

Hershey, Andrew D; Armand, Cynthia E; Berk, Thomas; Burch, Rebecca; Buse, Dawn C; Dougherty, Carrie; Marmura, Michael J; Minen, Mia T; Robblee, Jennifer; Schwarz, Heidi B
PMID: 33891346
ISSN: 1526-4610
CID: 4889152

Remote electrical neuromodulation for acute treatment of migraine in adolescents

Hershey, Andrew D; Lin, Tamar; Gruper, Yaron; Harris, Dagan; Ironi, Alon; Berk, Thomas; Szperka, Christina L; Berenson, Frank
OBJECTIVES/OBJECTIVE:, Theranica Bio-Electronics Ltd., Israel) is a FDA-authorized device for acute treatment of migraine in adults. This study assessed the efficacy and safety of REN in adolescents with migraine. DESIGN AND METHODS/METHODS:This was an open-label, single-arm, multicenter study in adolescents (ages 12-17 years) with migraine. Participants underwent a 4-week run-in phase. Eligible participants continued to an 8-week treatment phase with the device. Pain severity, associated symptoms, and functional disability were recorded at treatment initiation, and 2 and 24 hours post-treatment. The primary endpoints of this study were related to the safety and tolerability of REN. The secondary endpoints were related to device efficacy and included the proportion of participants who achieved pain relief at 2 hours post-treatment and the proportion of participants who achieved pain freedom at 2 hours. The presented results reflect an interim analysis with subsequent stopping of the rest of the study. RESULTS:Sixty participants were enrolled for the study; of these, 14 failed to meet the run-in criteria and 1 was lost to follow-up. Forty-five participants performed at least one treatment, of which 39 participants completed a test treatment with REN. One device-related adverse event (2%) was reported in which a temporary feeling of pain in the arm was felt. Pain relief and pain-free at 2 hours were achieved by 71% (28/39) and 35% (14/39) participants, respectively. At 2 hours, 69% (23/33) participants experienced improvement in functional ability. CONCLUSIONS:REN may offer a safe and effective non-pharmacological alternative for acute treatment in adolescents.
PMID: 33349920
ISSN: 1526-4610
CID: 4735262

Heartrate variability biofeedback for migraine using a smartphone application and sensor: A randomized controlled trial

Minen, Mia T; Corner, Sarah; Berk, Thomas; Levitan, Valeriya; Friedman, Steven; Adhikari, Samrachana; Seng, Elizabeth B
INTRODUCTION/BACKGROUND:Although hand temperature and electromyograph biofeedback have evidence for migraine prevention, to date, no study has evaluated heartrate variability (HRV) biofeedback for migraine. METHODS:2-arm randomized trial comparing an 8-week app-based HRV biofeedback (HeartMath) to waitlist control. Feasibility/acceptability outcomes included number and duration of sessions, satisfaction, barriers and adverse events. Primary clinical outcome was Migraine-Specific Quality of Life Questionnaire (MSQv2). RESULTS:There were 52 participants (26/arm). On average, participants randomized to the Hearthmath group completed 29 sessions (SD = 29, range: 2-86) with an average length of 6:43 min over 36 days (SD = 27, range: 0, 88) before discontinuing. 9/29 reported technology barriers. 43% said that they were likely to recommend Heartmath to others. Average MSQv2 decreases were not significant between the Heartmath and waitlist control (estimate = 0.3, 95% CI = -3.1 - 3.6). High users of Heartmath reported a reduction in MSQv2 at day 30 (-12.3 points, p = 0.010) while low users did not (p = 0.765). DISCUSSION/CONCLUSIONS:App-based HRV biofeedback was feasible and acceptable on a time-limited basis for people with migraine. Changes in the primary clinical outcome did not differ between biofeedback and control; however, high users of the app reported more benefit than low users.
PMID: 33516964
ISSN: 1873-7714
CID: 4799412

Introducing the National Headache Fellowship Opportunities Website

Zhang, Niushen; Armand, Cynthia E; Berk, Thomas; Rosen, Noah
OBJECTIVE:To build a national Headache Medicine fellowship opportunities website that promotes a unified application timeline and a more transparent application process. BACKGROUND:In July 2019, the Consortium of Academic Headache Program Directors unanimously accepted the recommendations of the American Academy of Neurology Fellowship Application Timing Position Statement. To implement the unified application timeline, the American Headache Society agreed to host a fellowship opportunities website with information on the application process and resources for each fellowship program. METHODS:We designed a main landing page that features the unified timeline for applications and offers. The page also features icons for all participating US fellowship programs (identified using the United Council for Neurologic Subspecialties certification database). The icons serve as links to each fellowship program's individual webpage. We sent an electronic form to each fellowship program director, asking them to submit program information to be included on each fellowship program's individual webpage. Key contents on each program webpage include an image of the program, brief program description, names of applicants who have filled positions, and open positions. Each institution webpage also includes an electronic form that allows applicants to directly send their name, contact, and a brief message to the program director. RESULTS:We launched the website on May 15, 2020. As of June 19, 2020, the website featured 24 participating headache fellowship programs, including 5 pediatric programs and 19 adult training programs, from all regions of the US. CONCLUSION/CONCLUSIONS:The website serves as a central resource for Headache Medicine fellowship applicants and promotes a unified application timeline and a more transparent application process.
PMID: 32926438
ISSN: 1526-4610
CID: 4614772

The state of the headache fellowship application process and attitudes toward the match

Zhang, Niushen; Armand, Cynthia; Berk, Thomas; Friedman, Deborah I
OBJECTIVE:To examine the current headache medicine fellowship application process and to propose recommendations for a more unified, systematic, and transparent process. METHODS:We identified 42 headache fellowship programs using the United Council for Neurologic Subspecialties certification database. After an initial contact via e-mail, we conducted individual telephone interviews with program directors. Qualitative data coding allowed identification of emerging themes. Quantitative data were summarized with descriptive statistics. RESULTS:Forty (95%) program directors (34 adult, 6 pediatric) responded. Emerging themes included the following. (1) There are benefits and disadvantages to having a match. (2) If the match were reinstated, programs would participate only if all programs participated. (3) There should be consequences for programs that do not participate. If the match were reinstated, 37.5% of program directors responded that their program would participate without conditions; 37.5% would participate only if every program were required to participate. Fifteen percent would not participate, and 10% were not sure if they would participate. Forty percent supported sanctions against programs that did not participate in the match. CONCLUSION/CONCLUSIONS:The fellowship match potentially makes the process more systematic for both programs and applicants; however, it does not currently appear to be a feasible option for the field of headache medicine. Until the number of applicants exceeds the number of programs, we recommend instituting a universal timeline for applications and offers.
PMID: 32631925
ISSN: 1526-632x
CID: 4602002

Introducing the National Headache Medicine Fellowship Opportunities Website [Meeting Abstract]

Zhang, Niushen; Armand, Cynthia; Berk, Thomas; Rosen, Noah
ISI:000536058004163
ISSN: 0028-3878
CID: 4561442

Seizure, fever, hallucinations, and vision loss: A circuitous route to dual diagnoses [Meeting Abstract]

Carroll, Elizabeth; Wallach, Asya; Kurzweil, Arielle; Frucht, Steven; Berk, Thomas; Boffa, Michael; Kister, Ilya
ISI:000536058006022
ISSN: 0028-3878
CID: 4561582

Case Report: Seizure, Fever, Hallucinations, & Vision Loss : A circuitous route to dual diagnoses. [Case Report]

Carroll, Elizabeth; Wallach, Asya I; Kurzweil, Arielle; Frucht, Steven; Berk, Thomas; Boffa, Michael; Kister, Ilya
ORIGINAL:0014463
ISSN: 1540-1367
CID: 4216692