1994 — 1999 |
Holroyd, Kenneth Allen |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Drug and Nondrug Treatment of Chronic Tension Headache
This proposed study evaluates the effectiveness of the primary pharmacological (Amitriptyline HCL) and self-regulatory (Stress- Management) therapies for chronic tension-type headaches, both separately and when combined. It also attempts to elucidate the psychological and biological mechanisms whereby pharmacologic and self-regulatory treatments produce improvement. Specifically, the primary aims are to: (1) Evaluate the separate and combined effects of amitriptyline therapy and limited- contact stress-management therapy with reference to placebo in a prospective outcome study conducted at two actual clinic sites using experienced neurologists and psychologists as therapists; (2) Evaluate treatment outcome on multiple indices, including recurrent headache activity (assessed from multiple perspectives), analgesic consumption, quality of life, health care costs, psychological distress and beliefs about headaches. Side-effects and acceptability of each intervention also will be assessed and preliminary information about characteristics of patients who are most likely to benefit from these therapies will be obtained; (3) Evaluate both immediate treatment effects (3 month) and intermediate (6 months) and longer term (l year) maintenance of improvements and examine the ability of psychophysiological and expectancy variables to predict the maintenance of improvements; (4) Elucidate therapeutic mechanism underlying the effectiveness of both amitriptyline and stress-management therapies by examining hypothesized electrophysiological, muscular and psychological mediators of improvement. Two hundred patients meeting International Headache Society diagnostic criteria for chronic tension-type headaches will participate in the following five phases of the study: (I) pretreatment evaluation that includes a structured diagnostic and psychosocial interview, neurological evaluation, psychosocial and psychophysiological testing, and one month of daily recording of headache activity and analgesic medication use; (2) treatment with placebo, amitriptyline HCL, stress-management therapy plus placebo, or stress-management therapy plus amitriptyline; (3) reassessment of (electrophysiological, muscular and psychological) variables hypothesized to mediate treatment outcome four and eight weeks after beginning treatment; (4) full reevaluation three months after beginning treatment (with neurological evaluation, psychosocial and psychophysiological assessment, and one month recording of daily headache activity and analgesic medication use); and (5) 6 and 12-month follow-up evaluations.
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0.958 |
1995 |
Holroyd, Kenneth J |
K08Activity Code Description: To provide the opportunity for promising medical scientists with demonstrated aptitude to develop into independent investigators, or for faculty members to pursue research aspects of categorical areas applicable to the awarding unit, and aid in filling the academic faculty gap in these shortage areas within health profession's institutions of the country. |
Molecular Genetics of Asthma On Chromosome 5q @ Johns Hopkins University
Dr. Holroyd proposes to investigate the genetic control of bronchial hyperresponsiveness (BHR) an IgE levels in human populations. We have recently localized major gene(s) that regulates BHR and total serum IgE to chromosome 5q. Linkage analyses suggest these genes are located near important immunoregulatory candidate genes that participate in controlling IgE levels. These findings represent a major step in mapping genes important in the regulation of allergic and asthmatic responses and delineating their role in the pathogenesis of allergic asthma. The major objectives of Dr. Holroyd's proposal are to further define and extend the preliminary genetic linkage findings. He will first attempt to narrow our localization of these genes in allergic asthma using linkage analysis. Known immunoregulatory genes, as well as other expressed sequences, will be localized on a physical map of chromosome 5q. He will also carry out a definitive examination of the DNA sequence from likely gene candidates for mutations in allergic asthmatics as compared to controls. These studies will provide useful new polymorphisms and potential mutations that can be examined by us and other investigators studying different populations for allergy and asthma.
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0.928 |
2000 — 2004 |
Holroyd, Kenneth Allen |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Drug and Non-Drug Treatment of Severe Migraines
DESCRIPTION: (Adapted from investigator's abstract) The proposed study evaluates the effectiveness of preventive drug (beta-blocker) therapy and non-drug (behavioral migraine management) therapies for frequent migraine, both separately and when combined. The specific aims are to: (1) Evaluate the separate and combined effects of Preventive Drug Therapy and limited-contact Behavioral Migraine Management, with reference to Placebo in a (n=220) prospective outcome study; (2) Evaluate the effectiveness of these treatments of individuals with frequent (4-15 migraine days/month) disabling (above the population median in disability) migraine; (3) Evaluate the effects of these treatments on multiple outcome measures, including migraine activity, disability, quality of life, psychological symptoms and beliefs about migraines; (4) Evaluate the effects of these treatments on the use, effectiveness and cost of acute (5HT1 antagonist) therapy; (5) Evaluate intermediate (6 months) and long-term (1-year) treatment effects. Examine psychological variables hypothesized to be associated with the maintenance of treatment effects. Two hundred twenty patients meeting International Headache Society (Olesen, 1988) diagnostic criteria for migraine (w or w/o aura) and who experience frequent (4 to 15 migraine/days month) and disabling (above the median of migraine sufferers in disability) migraine will participate in the following three phases of this study: (1) pretreatment evaluation that includes structured diagnostic and psychosocial interview, neurological evaluation, psychosocial testing and at least 5 weeks baseline daily monitoring of migraine activity, migraine-related disability and medication use; (2) a three-month treatment (administration/dose adjustment) phase where standard acute therapy plus one of the following four preventive therapies are administered in a 2 x 2 factorial design: Preventive Drug Therapy with beta-blockers, or Preventive Drug Therapy with placebo, or Behavioral Migraine Management Therapy + beta blockers, or Behavioral Migraine Management + placebo and, (3) a 12-month long evaluation phase where continuing care is provided and treatment efficacy is assessed at 1-month, 6-months and 12-months follow follow-up evaluations (with neurological & psychosocial evaluations and 5 additional weeks of daily headache, disability and medication recordings).
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0.958 |