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Harold George Wolff (New York, 26 May 1898 - Washington D.C., 21 February 1962) was an American doctor, neurologist and scientist. He is generally considered the father of modern headache research, and a pioneer in the study of psychosomatic illness.
Harold Wolff was born on May 26, 1898, in New York City, the only child of Louis Wolff, a catholic illustrator, and Emma Recknagel Wolff, Lutheran. He was educated at City College, from which he graduated in 1918, aged 20. After graduating, he worked in a government-supported fishery trying to improve drying fish. He considered becoming a priest before deciding to take up medicine at Harvard Medical School, where he received his M.D. in 1923. [1]
After medical training at New York’s Roosevelt Hospital and Bellevue Hospital Center, he started to study neuropathology with Harry Forbes and Stanley Cobb.
In 1928 he travelled abroad, spending a year in Graz, in Austria, with Otto Loewi, and then with Ivan Pavlov in Leningrad, in Russia.
Returning to America, he moved to the Psychiatry ward at Phipps Clinic of Johns Hopkins University, working with Adolf Meyer (psychiatrist). [2]
In 1932 he finally decided to come back in Boston and became the head of Neurology ward, supervised by Eugene Dubois. He later became also Professor of Medicine and Chief Neurologist at New York Hospital – Cornell Medical Center (NYH-CMC). [3]
In 1934 Dr. Wolff married the well-known painter Isabel Bishop, and had a son, Remsen N. Wolff. In 1958 he was named the first occupant of the “Anne Parrish Titzel Chair” in Medicine at Cornell University.
During his last years he devoted much of his energy to the work of the “Academy of Religion and Mental Health” and, after a lifelong agnosticism, became a member of “Christ Church (Episcopal)” in Riverdale, New York.
Harold Wolff died on February 21, 1962, in Washington D.C., of a cerebral vascular disease. [4]
He was defined a “combination of administrator and investigator”. [5]
Wolff’s pupils described him as a superb clinician, a wise man who exercised vigorously and competitively, sometimes highly obsessive. He used to teach by example, in fact his motto was: "No day without its experiment". [6]
Harold Wolff’s first major contribution was the elucidation of the mechanism of migraine and other headaches of vascular origin. He was the first neurologist that supported the hypothesis that the aura arises from a vasoconstriction and the headache from a vasodilatation. [7] In fact, vasodilators (amylnitrite, carbon dioxide) abolished the aura temporarily or persistently, and vasoconstrictors (norepinephrine, ergotamine tartrate, caffeine) induced the aura. [8]
Dr. Wolff was also interested in understanding the mind – body relationship, and established a separate category of illness to be defined as psychosomatic. There is a connection between nervous system and bodily diseases like peptic ulcer, ulcerative colitis, hypertension, etc. [9]
However, Wolff's work on migraines also reveals sexism. In his discussion of patients, he tended to focus on his male patients, who he described as being ambitious, efficient, perfectionistic, and successful. He thought were working too hard; they should relax more and get more exercise. In contrast, women patients were described as inadequate, unsatisfied, and frigid. In women, unlike men, migraines were pathologized. [10]
Dr. Wolff also headed the Society for the Investigation of Human Ecology, which received funding from the CIA to investigate the manipulation of human behavior. [11] Dr. Wolff was a key participant in the CIA's MKULTRA program, conducting research to discover effective interrogation techniques. He collaborated with the CIA to collect information on a wide variety of torture methods, and stated the intention that his research program would:
...assemble, collate, analyze and assimilate this information and will then undertake experimental investigations designed to develop new techniques of offensive/defensive intelligence use ... Potentially useful secret drugs (and various brain damaging procedures) will be similarly tested in order to ascertain the fundamental effect upon human brain function and upon the subject's mood ... Where any of the studies involve potential harm of the subject, we expect the Agency to make available suitable subjects and a proper place for the performance of the necessary experiments.
— Dr. Harold Wolff, Cornell University Medical School [12]
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Migraine is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hours to three days. Non-headache symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. The pain is generally made worse by physical activity during an attack, although regular physical exercise may prevent future attacks. Up to one-third of people affected have aura: typically, it is a short period of visual disturbance that signals that the headache will soon occur. Occasionally, aura can occur with little or no headache following, but not everyone has this symptom.
Headache, also knows as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches.
Migraine is the first book written by Oliver Sacks, a well-known New York City-based neurologist and author. The full title of the first edition was Migraine - Evolution of a Common Disorder. The book was written in 1967, mostly over a nine-day period, and first published in 1970. A revised and updated version was published in 1990.
Visual snow syndrome (VSS) is an uncommon neurological condition in which the primary symptom is that affected individuals see persistent flickering white, black, transparent, or coloured dots across the whole visual field. Other common symptoms are palinopsia, enhanced entoptic phenomena, photophobia, insomnia, and headaches. The condition is typically always present and has no known cure, as viable treatments are still under research. Migraine and tinnitus are common comorbidities and are both associated with a more severe presentation of the syndrome.
Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches. This drug class was first commercially introduced in the 1990s. While effective at treating individual headaches, they do not provide preventive treatment and are not considered a cure. They are not effective for the treatment of tension–type headache, except in persons who also experience migraines. Triptans do not relieve other kinds of pain.
Zolmitriptan, sold under the brand name Zomig among others, is a triptan used in the acute treatment of migraine attacks with or without aura and cluster headaches. It is a selective serotonin receptor agonist of the 1B and 1D subtypes.
According to spiritual beliefs, an aura or energy field is a colored emanation said to enclose a human body or any animal or object. In some esoteric positions, the aura is described as a subtle body. Psychics and holistic medicine practitioners often claim to have the ability to see the size, color and type of vibration of an aura.
An aura is a perceptual disturbance experienced by some with epilepsy or migraine. An epileptic aura is a seizure.
Methysergide, sold under the brand names Deseril and Sansert, is a monoaminergic medication of the ergoline and lysergamide groups which is used in the prophylaxis and treatment of migraine and cluster headaches. It has been withdrawn from the market in the United States and Canada due to adverse effects. It is taken by mouth.
Scintillating scotoma is a common visual aura that was first described by 19th-century physician Hubert Airy (1838–1903). Originating from the brain, it may precede a migraine headache, but can also occur acephalgically, also known as visual migraine or migraine aura. It is often confused with retinal migraine, which originates in the eyeball or socket.
The classification of all headaches, including migraines, is organized by the International Headache Society, and published in the International Classification of Headache Disorders (ICHD). The current version, the ICHD-3 beta, was published in 2013.
Preventive treatment of migraine can be an important component of migraine management. Such treatments can take many forms, including everything from surgery, taking certain drugs or nutritional supplements, to lifestyle alterations such as increased exercise and avoidance of migraine triggers.
Anne MacGregor is a New Zealand-born British medical researcher and clinician based in London. She is a leading researcher in the field of hormonal effects on migraine.
Because genetics influence susceptibility to migraine, it can be shaped by evolution. Fitness-impairing disorders, including severe headache, tend to disappear as a result of natural selection, and their frequency decreases to near the rate of spontaneous mutation. However, migraine has not diminished over millions of years of evolution. Its prevalence has at least been maintained at a high level, and has even been shown to be increasing. This phenomenon suggests that a central nervous system (CNS) susceptible to severe, intermittent headache has been linked to an important survival or reproductive advantage. Five possible evolutionary explanations exist: i) migraine as a defence mechanism, ii) migraine as a result of conflicts with other organisms, iii) migraine as a result of novel environmental factors, iv) migraine as a compromise between genetic harms and benefits, and v) headache as a design constraint. These considerations allow the treatment and prevention of migraine to be approached from an evolutionary medicine perspective.
Frank Clifford Rose was a British neurologist, active in several journals and societies related to the specialty of neurology and its history, whose research contributed to the understanding of motor neurone disease, stroke and migraine. He developed an emergency stroke ambulance service with early neuroimaging, allowing for the detection of early reversible brain damage. In 1974, he established what would later be known as the Princess Margaret Migraine Clinic, a specialist clinic for headache at Charing Cross Hospital, where in 1965 he became their first appointed consultant neurologist.
Messoud Ashina is a Danish-Azerbaijani neurologist and neuroscientist. He is currently a Professor of Neurology at the University of Copenhagen and leads the Human Migraine Research Unit at the Danish Headache Center, Rigshospitalet. Ashina is also the Director of the Danish Knowledge Center on Headache Disorders and the past President of the International Headache Society. As of 2022, Ashina is ranked as the world's leading expert on headache disorders by Expertscape.
James Waldo Lance AO, CBE (1926–2019), often referred to as James Lance and James W. Lance, was an Australian neurologist. He was the founder of the School of Neurology at the University of New South Wales and president of the International Headache Society in 1987–89, and a "world authority on the diagnosis and treatment" of headache and migraine.
A migrainous infarction is a rare type of ischaemic stroke which occurs in correspondence with migraine aura symptoms. Symptoms include headaches, visual disturbances, strange sensations and dysphasia, all of which gradually worsen causing neurological changes which ultimately increase the risk of an ischaemic stroke. Typically, women under the age of 45 who experience migraine with aura (MA) are at the greatest risk for developing migrainous infarction, especially when combined with smoking and use of oral contraceptives.
Menstrual migraine is term used to describe both true menstrual migraines and menstrually related migraines. About 7%–14% of women have migraines only at the time of menstruation, these are called true menstrual migraines. Most female migraneurs experience migraine attacks throughout the menstruation cycle with an increased number perimenstrually, these are referred to as menstrually related or menstrually triggered migraine.
Peter GoadsbyFRS FRACP FRCP is an Australian neuroscientist who is Director of the National Institute for Health Research - Wellcome Trust King’s Clinical Research Facility and Professor of Neurology at King's College London. His research has focused particularly on the mechanism and alleviation of migraine and cluster headaches.
