Current pain and headache reports
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Results from several observational studies indicate an association between migraine and patent foramen ovale (PFO). Several biological mechanisms have been proposed to explain this link, including shared genetic inheritance. ⋯ Although the results of uncontrolled observational studies suggest the PFO closure may have a beneficial effect on migraine frequency, a large randomized trial failed to support such a conclusion. Until there is more evidence from ongoing large controlled trials, PFO closure should not be performed in clinical practice for the prophylaxis of migraine.
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Curr Pain Headache Rep · Jun 2007
ReviewPhenotyping central nervous system circuitry in chronic pain using functional MRI: considerations and potential implications in the clinic.
Functional MRI (fMRI) has provided new insights into brain mechanisms in chronic pain. However, unlike acute pain measures in healthy volunteers, there are additional concerns relating to mapping brain circuits in these patients. ⋯ Nevertheless, our understanding of the centralization of pain with attendant changes in sensory, emotional, and autonomic function is being more clearly realized and has significant implications for defining the disease state and therapeutic interventions. It is possible that fMRI may become clinically useful.