Depressive symptoms during the different phases of a migraine attack: A prospective diary study

Factor Structures in the Depressive Symptoms Domains in the 9Q for Northern Thai Adults and Their Association with Chronic Diseases

Most of the common models to examine depression are one-factor models; however, previous studies provided several-factor structure models on each depressive symptom using the Patient Health Questionnaire-9 (PHQ-9). The Nine-Questions Depression-Rating Scale (9Q) is an alternative assessment tool that was developed for assessing the severity of depressive symptoms in Thai adults. This study aimed to examine the factor structure of this tool based on the factor structure models for the PHQ-9 provided in previous studies using confirmatory factor analysis (CFA). We also examined the association of chronic diseases and depressive symptoms using the Multiple Indicators Multiple Causes model among 1346 participants aged 19 years old or more without psychiatric disorders. The results show that the two-factor CFA model with six items in the cognitive-affective domain and three items in the somatic domain provided the best fit for depressive symptoms in the study population (RMSEA = 0.077, CFI = 0.953, TLI = 0.936). Dyslipidemia was positively associated with both cognitive-affective symptoms (β = 0.120) and somatic depressive symptoms (β = 0.080). Allergies were associated with a higher level of cognitive-affective depressive symptoms (β = 0.087), while migraine (β = 0.114) and peptic ulcer disease (β = 0.062) were associated with a higher level of somatic symptoms. Increased age was associated with a lower level of somatic symptoms (β = -0.088). Our findings suggested that considering depressive symptoms as two dimensions yields a better fit for depressive symptoms. The co-occurrence of chronic diseases associated with depressive symptoms should be monitored.

Substance use in a Dutch migraine cohort compared with the general population

OBJECTIVE

To evaluate self-reported substance user profiles for individuals with migraine and compare these to the general population.

BACKGROUND

There is increasing attention to lifestyle influences such as substance use as presumed migraine triggers.

METHODS

Data on substance use were collected by survey in a large migraine cohort and from the biannual survey in the general Dutch population for substances. A representative cohort of Dutch patients with migraine (n = 5176) and the Dutch general population (n = 8370) was included. Patients with migraine were subdivided into episodic (EM) and chronic migraine (CM). Substance consumption was compared between the general population and patients with migraine, and between migraine subgroups after standardization for sex and level of education.

RESULTS

Included patients with migraine were 83.4% female (4319/5176) and had a mean (standard deviation) age of 44.8 (11.3) years. Patients with migraine reported less illicit drug use (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.42-0.55; p < 0.001), less current and lifetime smoking (OR 0.60, 95% CI 0.55-0.65; p < 0.001 and OR 0.75, 95% CI 0.71-0.79; p < 0.001), and less current alcohol consumption (OR 0.66, 95% CI 0.62-0.70; p < 0.001) compared with the general population. Prevalence of substance use was compared between CM and EM participants and showed higher illicit drug use (OR 1.73, 95% CI 1.11-2.69; p = 0.011), higher current smoking (OR 1.61, 95% CI 1.22-2.11; p < 0.001) but less alcohol use (OR 0.54, 95% CI 0.43-0.68; p < 0.001) for participants with CM compared with EM. No differences were found for a history of smoking (OR 1.18, 95% CI 0.92-1.50, p = 0.19).

CONCLUSIONS

Individuals with migraine are less likely to use illicit drugs, smoke, or drink alcohol compared with the general population. Patients with CM less often consume alcohol, while they more often use illicit drugs and smoke compared to those with EM.

Hypoechogenicity of the raphe nuclei as a biomarker of migraine: A case-control study, review, and meta-analysis

BACKGROUND AND PURPOSE

Hypoechogenicity of the raphe nuclei (hR) has been related to major depression. Comorbidity between migraine and depression is bidirectional postulating a common mechanism of serotonergic dysfunction. We aimed to investigate the association between migraine and hR and its role as biomarker of migraine-associated depression and disease severity.

METHODS

This is a single-center cross-sectional descriptive study. We included consecutive patients with episodic (EM) and chronic migraine (CM). We collected their comorbidities, analgesic consumption, hospital anxiety and depression scale (HADS), disability, and impact on quality of life associated with migraine. We also included a group of control subjects, matched for age and sex with the patients. In both groups, hR was assessed by means of transcranial sonography. We performed a meta-analysis of the studies investigating the association between migraine and hR.

RESULTS

A total of 107 subjects were included (57 cases and 50 controls). hR rate was lower in controls than in migraine patients (22.2% vs. 42.9%, p = .02) with a progressive increase in EM and CM groups respect to the control group (33.3% and 50% vs. 22.2%, respectively; p = .03). Among patients, hR was not associated with depression, higher HADS score, greater migraine-related disability, or higher consumption of analgesic medication. The meta-analysis showed a significant association between migraine and hR (odds ratio = 2.16; 95% confidence interval: 1.42-3.29).

CONCLUSION

hR is more prevalent in migraine patients than in controls and, in our population, its prevalence increases in a stepwise manner in patients with EM and CM. These findings support the role of raphe nuclei in migraine pathophysiology.

Modelling migraine-related features in the nitroglycerin animal model: trigeminal hyperalgesia is associated with affective status and motor behavior

Migraine is a complex neurovascular disorder characterized by recurrent attacks of pain and other associated symptoms. Emotional-affective aspects are important components of pain, but so far they have been little explored in animal models of migraine. In this study, we aimed to explore the correlation between trigeminal hyperalgesia and affective status or behavioral components in a migraine-specific animal model. Male Sprague-Dawley rats were treated with nitroglycerin (10 mg/kg, i.p.) or its vehicle. Four hours later, anxiety, motor/exploratory behavior and grooming (a nociception index) were evaluated with the open field test. Rats were then exposed to formalin in the orofacial region to evaluate trigeminal hyperalgesia. The data analysis shows an inverse correlation between trigeminal hyperalgesia and motor or exploratory behavior, and a positive association with anxiety-like behavior or self-grooming. These findings further expand on the translational value of the migraine-specific model based on nitroglycerin administration and prompt additional parameters that can be investigated to explore migraine disease in its complexity.