They also quantified impairment in school attendance and home functioning and reported the number of Bcl-2 inhibitor medical visits during the preceding 3 months. Results.— One hundred and one (25.83%) met conservative screening criteria for episodic migraine; their mean score on the Migraine Disability Assessment Questionnaire was 9.98 ± 12.10. Compared to those not screening positive for migraine, the migraine-positive group reported reduced quality of life on 5 of 6 domains, as well as a higher frequency of missed school days (2.74 vs 1.36), impaired functioning at home (2.84 vs 1.21 days), and medical visits (1.86 vs 0.95). They also reported more symptoms of both depression and anxiety than controls, although

differences in functional impairment remained after controlling for these comorbid psychiatric symptoms. These differences were highly statistically significant and corroborated by evidence of clinically significant impairment; the corresponding effect sizes were modest but non-trivial. Conclusions.— Episodic migraine is associated with negative impact in numerous domains among university students. These findings replicate and extend those of studies on other samples and have implications for future research studies with this Apoptosis inhibitor population. “
“(Headache 2010;50:273-289) Objective.— The objective of this study is to present a view of the primary headaches as genetically determined behavioral

responses consistent with sickness behavior and defense reaction, respectively. Background and Design.— A review of the literature bearing on the behavioral, humoral, and functional imaging aspects of the primary headaches shows that migraine and cluster headache (CH) are pain conditions characterized by different behaviors during the attacks. Here it is postulated that the behavioral responses to migraine and CH are evolutionary

conserved reactions consistent with sickness behavior and defense reaction. Results.— The sickness behavior observed during migraine attacks is a pan-mammalian adaptive response to internal and external stressors, characterized by withdrawal and motor quiescence, sympatho-inhibition and lethargy, in which visceral pain signals a homeostatic imbalance of the body and/or brain. In contrast, the defense reaction in CH consists of a fight-or-flight reaction, with motor ADP ribosylation factor restlessness and agitation, in which pain is exteroceptive in kind. Conclusion.— These different behavioral responses are thus specific to different kinds of pain, distinguished by the behavioral significance of the pain (visceral pain in migraine vs exteroceptive pain in CH), and imply brain matrices involving different networks in the brainstem, hypothalamus, and forebrain regions that engender evolutionarily conserved adaptive genetic responses. Cytokines play an important role in their development. Predictions and limitations of the hypothesis are discussed together with implications for genetic studies on headaches.