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Greco F, Garnier O, Macioce V, Picot MC. Prevalence of Migraine Disease in Electrohypersensitive Patients. J Clin Med 2023; 12:4092. [PMID: 37373785 DOI: 10.3390/jcm12124092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The vast majority of electrohypersensitive (EHS) patients present headaches on contact with an electromagnetic source. Clinical features suggest that the headaches of these patients could be a variant of the migraine disease and could be treated as such. We aimed to assess the prevalence of migraine disease in EHS patients using a validated questionnaire. METHODS Patients with EHS defined according to WHO criteria were contacted through EHS patient support associations. They were required to answer a self-questionnaire including clinical data and the extended French version of the ID Migraine questionnaire (ef-ID Migraine) to screen for the migraine disease. Migraine prevalence and its 95% confidence interval (CI) were reported. Patients' characteristics, symptoms (rheumatology, digestive, cognitive, respiratory, cardiac, mood, cutaneous, headache, perception, genital, tinnitus and tiredness) and impact on daily life were compared between migraineur and non-migraineur patients. RESULTS A total of 293 patients were included (97% women, mean age 57 ± 12 years). Migraine was diagnosed in 65% (N = 191; 95% CI: 60-71%) with the ef-ID Migraine. The migraine diagnosis was accompanied by nausea/vomiting in 50% of cases, photophobia in 69% or visual disturbances in 38%. All of the 12 symptoms assessed were of higher intensity in migraineurs than in non-migraineurs. The symptoms prevented social life in 88% of migraineurs and 75% of non-migraineurs (p < 0.01). CONCLUSIONS Our work encourages us to consider the headaches of these patients as a possible variant of the migraine disease and, possibly, to manage them according to the current recommendations.
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Affiliation(s)
- Frédéric Greco
- Department of Anaesthesia and Critical Care Medicine Gui de Chauliac, CHU Montpellier, University of Montpellier, 34295 Montpellier, France
| | - Océane Garnier
- Department of Anaesthesia and Critical Care Medicine Gui de Chauliac, CHU Montpellier, University of Montpellier, 34295 Montpellier, France
| | - Valérie Macioce
- Clinical Research and Epidemiology Unit, CHU Montpellier, University of Montpellier, 34295 Montpellier, France
| | - Marie Christine Picot
- Clinical Research and Epidemiology Unit, CHU Montpellier, University of Montpellier, 34295 Montpellier, France
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2
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Evers S, Tassorelli C. Migraine with aura. HANDBOOK OF CLINICAL NEUROLOGY 2023; 198:169-186. [PMID: 38043960 DOI: 10.1016/b978-0-12-823356-6.00009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
This chapter describes the different types of aura including rare aura subtypes such as retinal aura. In addition, aura manifestations not classified in the International Classification of Headache Disorders and auras in headache disorders others than migraine are also described. The differential diagnosis of migraine aura comprises several neurological disorders which should be known to specialists. Migraine aura also has impact on the choice of migraine treatment; recommendations for the treatment of the migraine aura itself are also presented in this chapter.
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Affiliation(s)
- Stefan Evers
- Faculty of Medicine, University of Münster, Münster, Germany; Department of Neurology, Lindenbrunn Hospital, Coppenbrügge, Germany.
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Ghattas J, Gorasso V, De Pauw R, Thunus S, Speybroeck N, Devleesschauwer B. The state of health in Belgium, 1990-2019: a benchmarking analysis based on the Global Burden of Disease 2019 study. Arch Public Health 2022; 80:222. [PMID: 36258249 PMCID: PMC9580164 DOI: 10.1186/s13690-022-00976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In a context of decreasing resources and growing health needs, evidence-based health and care policies are essential. This study aims to assess the health trends in Belgium between 1990 and 2019, to compare the Belgian health status to that of the EU-15 countries, and to identify the main drivers in trends over time and country differences within the EU-15. METHODS We extracted estimates from the GBD 2019 study via the GBD results tool and visualization tools. We compared the Belgian health status with 14 European Union comparator countries between 1990 and 2019, and decomposed the time trends and country differences into the unique contributions of the different underlying causes of death and disability. RESULTS Life expectancy (LE) in Belgium improved significantly between 1990 and 2019 for both men and women. Belgium age-standardised mortality rates dropped significantly for men (-40%) and women (-33%) between 1990 and 2019. Overall, Belgium age-standardised disability-adjusted life year (DALY) rates dropped by 23%. This decrease is mainly due to decreasing trends in age-standardised years of life lost (YLL) rates while age-standardised years lived with disability (YLD) rates remained stable. Compared to EU-15, Belgium's ranking in terms of age-standardised DALY rates worsened for both men and women in 2019. Self-harm and falls are major causes of disease burden, with DALY rates that are higher than in many other EU-15 countries, indicating a realistic potential for improvement. Lung cancer DALY rates remain worrisome for men, and even show an increasing trend for women. Increasing trends of headache disorders, drug use disorders, and diabetes, require further attention. CONCLUSION Non-communicable diseases remain the main contributors for health burden in Belgium, with disability accounting for an increasingly larger share of the disease burden. Despite considerable improvements, Belgium's ranking for DALYs decreased between 1990 and 2019 compared to the EU-15. This study identified priority causes of disease burden based on their contributions to current evolutions and EU-15 differences. Since many of these causes are considered to be avoidable, primary and secondary prevention are crucial elements for reducing the burden of disease on the healthcare system.
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Affiliation(s)
- Jinane Ghattas
- grid.7942.80000 0001 2294 713XInstitute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Vanessa Gorasso
- Lifestyle and Chronic Diseases, Department of Epidemiology and Public Health, Rue Juliette Wytsmanstraat 14, 1050 Sciensano Brussels, Belgium ,grid.5342.00000 0001 2069 7798Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Robby De Pauw
- Lifestyle and Chronic Diseases, Department of Epidemiology and Public Health, Rue Juliette Wytsmanstraat 14, 1050 Sciensano Brussels, Belgium ,grid.5342.00000 0001 2069 7798Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sophie Thunus
- grid.7942.80000 0001 2294 713XInstitute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Niko Speybroeck
- grid.7942.80000 0001 2294 713XInstitute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Brecht Devleesschauwer
- Lifestyle and Chronic Diseases, Department of Epidemiology and Public Health, Rue Juliette Wytsmanstraat 14, 1050 Sciensano Brussels, Belgium ,grid.5342.00000 0001 2069 7798Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
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Schembri E, Barrow M, McKenzie C, Dawson A. The evolving classifications and epidemiological challenges surrounding chronic migraine and medication overuse headache: a review. Korean J Pain 2022; 35:4-13. [PMID: 34966007 PMCID: PMC8728549 DOI: 10.3344/kjp.2022.35.1.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/15/2021] [Indexed: 11/05/2022] Open
Abstract
Changes in diagnostic criteria, for example, the various International Classification of Headache Disorders criteria, would lead to changes in the outcomes of epidemiological studies. International Classification of Headache Disorders-1 was based mainly on expert opinion, yet most of the diagnostic criteria were reliable and valid, but it did not include chronic migraine. In its second version, the classification introduced chronic migraine, but this diagnosis resembled more a high-frequency migraine rather than the actual migraine transformation process. It also introduced medication overuse headache, but it necessitated analgesic withdrawal and subsequent headache improvement to be diagnosed as such. Hence patients having medication overuse headache could only be diagnosed in retrospect, which was an awkward situation. Such restrictive criteria for chronic migraine and medication overuse headache omitted a high proportion of patients. International Classification of Headache Disorders-3 allows a diagnosis of medication overuse headache due to combination analgesics if taken for at least 10 days per month for more than three months. Hence the prevalence rate of medication overuse headache and chronic migraine can increase compared to the previous version of the headache classification. Different criteria have been used across studies to identify chronic migraine and medication overuse headache, and therefore the information acquired from previous studies using earlier criteria becomes uncertain. Hence much epidemiological research would need to be interpreted cautiously or repeated with the most updated criteria, since the subjects in studies that apply the latest criteria may be phenotypically different from those in older studies.
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Affiliation(s)
| | - Michelle Barrow
- Pain Management Centre, Overdale Hospital, St. Helier, Jersey
| | - Christopher McKenzie
- Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, UK
| | - Andrew Dawson
- Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, UK
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Ryvlin P, Skorobogatykh K, Negro A, Sanchez-De La Rosa R, Israel-Willner H, Sundal C, MacGregor EA, Guerrero AL. Current clinical practice in disabling and chronic migraine in the primary care setting: results from the European My-LIFE anamnesis survey. BMC Neurol 2021; 21:1. [PMID: 33390161 PMCID: PMC7780632 DOI: 10.1186/s12883-020-02014-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/25/2020] [Indexed: 01/19/2023] Open
Abstract
Background Migraine is a prevalent and disabling headache disorder that affects more than 1.04 billion individuals world-wide. It can result in reduction in quality of life, increased disability, and high socio-economic burden. Nevertheless, and despite the availability of evidence-based national and international guidelines, the management of migraine patients often remains suboptimal, especially for chronic migraine (CM) patients. Methods My-LIFE anamnesis project surveyed 201 General practitioners (GPs) from 5 European countries (France, Germany, Italy, Spain, and the UK) with the aim of understanding chronic migraine (CM) patients’ management in the primary care setting. Results In our survey, GPs diagnosed episodic migraine (EM) more often than CM (87% vs 61%, p < 0.001). We found that many CM patients were not properly managed or referred to specialists, in contrast to guidelines recommendations. The main tools used by primary-care physicians included clinical interview, anamnesis guide, and patient diary. Tools used at the first visit differed from those used at follow-up visits. Up to 82% of GPs reported being responsible for management of patients diagnosed with disabling or CM and did not refer them to a specialist. Even when the GP had reported referring CM patients to a specialist, 97% of them were responsible for their follow-up. Moreover, the treatment prescribed, both acute and preventive, was not in accordance with local and international recommendations. GPs reported that they evaluated the efficacy of the treatment prescribed mainly through patient perception, and the frequency of follow-up visits was not clearly established in the primary care setting. These results suggest that CM is underdiagnosed and undertreated; thereby its management is suboptimal in the primary care. Conclusions There is a need of guidance in the primary care setting to both leverage the management of CM patients and earlier referral to specialists, when appropriate. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-020-02014-6.
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Affiliation(s)
- Philippe Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland.
| | | | - Andrea Negro
- Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | | | | | - Christina Sundal
- Department of Neurology, Neuroclinic Norway, Lillestrøm, Norway.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E Anne MacGregor
- Barts Health NHS Trust, London, UK.,Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Queen Mary University of London, London, UK
| | - Angel L Guerrero
- Headache Unit, Neurology Department, Hospital Clínico Universitario, Valladolid, Spain.,Department of Medicine, University of Valladolid, Valladolid, Spain.,Institute for biomedical research of Salamanca (IBSAL), Salamanca, Spain
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Jeyagurunathan A, Abdin E, Vaingankar JA, Chua BY, Shafie S, Chang SHS, James L, Tan KB, Basu S, Chong SA, Subramaniam M. Prevalence and comorbidity of migraine headache: results from the Singapore Mental Health Study 2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:33-43. [PMID: 31456029 DOI: 10.1007/s00127-019-01755-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. Studies have revealed that those with migraine headache and coexisting psychiatric disorders have poorer treatment outcomes and increased disability. The study aims to establish the prevalence, correlates, and comorbidities of migraine headache among the multi-ethnic Asian population in Singapore. METHOD Data were extracted from the Singapore Mental Health Study 2016 (SMHS 2016), a cross-sectional epidemiological survey of a nationally representative sample. Face-to-face interviews were completed with 6126 participants between 2016 and 2017. The data relating to chronic medical conditions, psychiatric conditions, and 30-day functioning and disability were captured using the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0. RESULTS The lifetime prevalence for migraine headache in the Singapore general population was 8.2%. Malay ethnicity (versus Chinese), female gender (versus male), and diploma holders (versus university) were significantly more likely to experience migraine headache. Participants belonging to the older age group (65 years and above versus 18-34 years of age), and those who were economically inactive (versus employed) were less likely to experience migraine headache. The mean age of onset for migraine was 26.4 years (SD = 11.1). Poisson regression analyses showed that migraine headache was also significantly associated with psychiatric conditions such as major depressive disorder (MDD) (prevalence ratio (PR), 1.80; 95% CI, 1.25-2.58), bipolar disorder (BD) (PR, 3.55; 95% CI, 2.29-5.51), generalized anxiety disorder (GAD) (PR, 2.04; 95% CI, 1.12-3.69), obsessive compulsive disorder (OCD) (PR, 2.20; 95% CI, 1.49-3.26), and alcohol use disorder (AUD) (PR, 1.93; 95% CI, 1.20-3.08). Those with migraine headache were significantly associated with poor functioning and disability compared to those without migraine headache. CONCLUSIONS AND DISCUSSION Our study showed significant associations between migraine headache and psychiatric disorders, as well as with role functioning and disability. The findings of our study emphasise the need for screening for psychiatric comorbidity among those with migraine and the development of appropriate interventions for this group.
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Affiliation(s)
- Anitha Jeyagurunathan
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shi Hui Sherilyn Chang
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Lyn James
- Ministry of Health (MOH), Singapore, Singapore
| | | | - Sutapa Basu
- Early Psychosis Intervention Programme (EPIP), Department of Psychosis, IMH, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Golikhatir I, Cheraghmakani H, Bozorgi F, Jahanian F, Sazgar M, Montazer SH. The Efficacy and Safety of Prochlorperazine in Patients With Acute Migraine: A Systematic Review and Meta-Analysis. Headache 2019; 59:682-700. [PMID: 30990883 DOI: 10.1111/head.13527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this review was to evaluate the efficacy and safety of prochlorperazine (PCP) in patients with acute migraine headache in the emergency department (ED). METHODS Electronic databases (Medline, Scopus, Web of Science, and Cochrane) were searched for randomized clinical trials that investigated the effect of PCP on headache relief. The outcomes were the number of patients without headache or with reduced headache severity, the number of adverse events, and the need for rescue analgesia. RESULTS From 450 citations, 11 studies (n = 771) with 15 comparison arms met the inclusion criteria. Overall, PCP was more effective than placebo (OR = 7.23; 95% CI = 3.82-3.68), metoclopramide (OR = 2.89; 95% CI = 1.42-5.86), and other active comparators (OR = 3.70; 95% CI = 2.41-5.67) for headache relief. The odds ratio of experiencing adverse events with PCP compared with placebo was 5.79 (95% CI = 2.43-13.79). When PCP compared with other active comparators, no statistical difference was found regarding the overall number of adverse events (OR = 1.88; 95% CI = 0.99-3.59). However, PCP significantly increased the odds of akathisia/dystonia (OR = 2.55; 95% CI = 1.03-6.31). The request for rescue analgesia was significantly lower in the PCP group compared with other groups (16% vs 84%; OR = 0.16; 95% CI = 0.09-27). CONCLUSIONS For adult patients with acute migraine, PCP could effectively abort the acute attack and reduce the request for rescue analgesia in the ED. However, compared with placebo, PCP could increase the risk of adverse events.
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Affiliation(s)
- Iraj Golikhatir
- Department of Emergency Medicine, Diabetes Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Cheraghmakani
- Department of Neurology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farzad Bozorgi
- Department of Emergency Medicine, Gut and Liver Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Jahanian
- Department of Emergency Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Sazgar
- Department of Emergency Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Hosein Montazer
- Department of Emergency Medicine, Orthopedic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Macronutrient Intake in Relation to Migraine and Non-Migraine Headaches. Nutrients 2018; 10:nu10091309. [PMID: 30223543 PMCID: PMC6164759 DOI: 10.3390/nu10091309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 12/11/2022] Open
Abstract
We investigated the association of mean daily macronutrient intake with migraine and non-migraine headaches. This cross-sectional study included 8042 men and 23,728 women from the ongoing population-based NutriNet-Santé e-cohort. Headache status was assessed via an online self-report questionnaire (2013–2016). Migraine was defined using established criteria and dietary macronutrient intake was estimated via ≥3 24 h dietary records. Mean daily intake (g/day) of carbohydrates (simple, complex, and total), protein, and fat (saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and total) were the main exposure variables. Adjusted gender-specific analysis of variance (ANOVA) models were fit. Presence of migraines was noted in 9.2% of men (mean age = 54.3 ± 13.3 years) and 25.7% of women (mean age = 49.6 ± 12.8 years). In adjusted models, we observed (1) somewhat lower protein (p < 0.02) and higher total fat (p < 0.01) intake among male migraineurs compared with males without headaches and those with non-migraine headaches; (2) somewhat higher total fat (p < 0.0001) and total carbohydrate intake (p < 0.05) among female migraineurs compared with females without headaches and those with non-migraine headaches. The findings, which provide preliminary support for modest gender-specific differences in macronutrient intake by migraine status, merit confirmation in different population-based settings, as well as longitudinally, and could help to inform future dietary interventions in headache prevention.
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Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study. J Clin Med 2018; 7:jcm7090269. [PMID: 30208570 PMCID: PMC6162830 DOI: 10.3390/jcm7090269] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 09/09/2018] [Indexed: 11/16/2022] Open
Abstract
Objective: To investigate the risk and risk factors for suicide attempt by patients with regular migraines (RM) and status migrainosus (SM) in Taiwan. Methods: We analyzed a subset of the National Health Insurance Research Database of Taiwan and enrolled patients (≥20 years old) who had ever received a diagnosis of RM or SM between 2000 and 2012 in the RM and SM cohort. The SM cohort included 13,605 patients, the RM cohort had 21,485 patients, and the comparison cohort contained approximately four times that many patients. We calculated the adjusted hazard ratios and 95% confidence intervals (CI) for suicide attempts after adjusting for age, sex, monthly income, urbanization level, occupation, and comorbidities. Results: The SM cohort had a 1.81-fold risk of attempting suicide (95% CI = 1.14–2.89) compared to the comparison cohort. Other factors that predispose patients with SM to attempt suicide include the following: female sex, relatively young age (<50 years old), and low monthly income (<15,000 New Taiwan Dollars, approximately equivalent to 495 US Dollars). Additionally, the risk of attempting suicide only increased in patients who had been diagnosed with SM for longer than five years. Conclusion: SM is associated with a higher risk for suicide attempt in migraineurs in Taiwan. This finding is important to clinicians and government officials seeking to prevent patients from attempting suicide in Taiwan and other similar East Asian countries.
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Harnod T, Lin CL, Kao CH. Survival outcome and mortality rate in patients with migraine: a population-based cohort study. J Headache Pain 2018; 19:57. [PMID: 30046928 PMCID: PMC6060184 DOI: 10.1186/s10194-018-0889-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 07/13/2018] [Indexed: 11/18/2022] Open
Abstract
Background Whether the patients with migraine have an elevated mortality risk in Taiwan is unclear. Methods We analyzed a subset of the National Health Insurance Research Database of Taiwan and enrolled patients (≥20 years old) who received a diagnosis of migraine between 2000 and 2012. The migraine cohort was further divided into the ones ever with status migrainosus (SM) and non-status migraine (NM) subcohort and compared with a 1:4 age-, sex-, comorbidity-, and index date-matched comparison cohort. We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for subsequent mortality risk after adjustment for age, sex, and comorbidities. Results Compared with the comparison cohort, the corresponding aHRs for mortality were 0.81 (95% CI = 0.76–0.87), 0.89 (95% CI = 0.80–0.98), and 0.78 (95% CI = 0.72–0.84) in the total migraine, SM, and NM cohorts, respectively. SM, male sex, comorbid alcohol-related illness, depression, and mental disorders were identified as risk factors for subsequent mortality. Comorbid alcohol-related illness significantly increased the mortality risk in patients with migraine. Conclusion Taiwanese patients with migraine require comprehensive and universal medical care. These patients would benefit from controlling their migraines and reducing the subsequent mortality.
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Affiliation(s)
- Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan. .,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. .,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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11
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Andreeva VA, Fezeu LK, Hercberg S, Galan P. Obesity and Migraine: Effect Modification by Gender and Perceived Stress. Neuroepidemiology 2018; 51:25-32. [PMID: 29843127 DOI: 10.1159/000489663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 04/25/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The association between obesity and migraine has been established; however, it is unclear whether it varies by perceived stress within each gender. METHODS This cross-sectional study used data from the ongoing NutriNet-Santé e-cohort with enrollees from the general population. Anthropometric and migraine data were provided via self-report questionnaires (2013-2016). Migraine was defined using established criteria. Perceived stress was assessed with Cohen's Perceived Stress Scale-10. Associations were estimated via gender- and stress-stratified multivariable polytomous logistic regression models. RESULTS Among 32,835 participants with complete data (75% women; mean age = 51.9 ± 13.8 years), 34% reported no headache, 44% non-migraine headache, and 22% migraine with or without aura during one's lifetime. In these groups, obesity was present in 8.6, 9.9, and 11.6%, respectively. Stress was a significant moderator of the obesity-migraine association only among women. The largest significant adjusted odds ratio (aOR) was found between obesity and migraine in women with high stress (aOR 1.61, 95% CI 1.35-1.91). CONCLUSIONS We found support for gender- and stress-dependent associations between obesity and migraine using a large, heterogeneous adult sample. This underscores the need for evidence-based strategies for weight loss and stress reduction for female migraineurs.
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Affiliation(s)
- Valentina A Andreeva
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Léopold K Fezeu
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne, Bobigny, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
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Hoge A, Bernardy F, Donneau AF, Dardenne N, Degée S, Timmermans M, Nisolle M, Guillaume M, Castronovo V. Low omega-3 index values and monounsaturated fatty acid levels in early pregnancy: an analysis of maternal erythrocytes fatty acids. Lipids Health Dis 2018; 17:63. [PMID: 29606136 PMCID: PMC5879610 DOI: 10.1186/s12944-018-0716-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/21/2018] [Indexed: 12/31/2022] Open
Abstract
Background It is unanimously recognized that the maternal nutritional status at the pregnancy onset influence both short-term and long-term health of the mother and offspring. Among several nutrients, LCPUFA, particularly from the omega-3 family, are of utmost importance. This study was carried out to determine fatty acids profile of maternal erythrocyte membranes in early pregnancy and to identify potential determinants impacting on this status. Methods A cohort of 122 healthy women with a singleton pregnancy was included. Fatty acids were analyzed using gas chromatography. Because of the lack of cutoff values, reference ranges were used to determine fatty acids categories. Results Of concern, our data revealed low monounsaturated and long-chain omega-3 fatty acid status in most participants. More than 75% of Belgian pregnant women exhibited Pal, AO and EPA levels as well as IOM3 values below the laboratory reference ranges. Higher DHA concentrations and IOM3 values were found among foreign-nationality participants, non-smokers and physically active women. With regard to dietary factors, omega-3 supplements and diet seem to be complementary since DHA from supplements (but not from diet) and EPA from diet (but not from supplements) were found to be associated with higher concentrations of DHA and EPA, respectively. Conclusions Our study presents evidence demonstrating that the fatty acid status of most early pregnant women is far from being optimal based on the admitted general reference values. Clinicians should be advice to carefully evaluate and improve this status to guarantee the best possible outcome for both the mother and the baby. Electronic supplementary material The online version of this article (10.1186/s12944-018-0716-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Axelle Hoge
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium.
| | - Florence Bernardy
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Anne-Françoise Donneau
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Nadia Dardenne
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Sylvie Degée
- Department of Obstetrics and Gynecology, CHR Citadelle Hospital, University of Liège, Liège, Belgium
| | - Marie Timmermans
- Department of Obstetrics and Gynecology, CHR Citadelle Hospital, University of Liège, Liège, Belgium
| | - Michelle Nisolle
- Department of Obstetrics and Gynecology, CHR Citadelle Hospital, University of Liège, Liège, Belgium
| | - Michèle Guillaume
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Vincenzo Castronovo
- Metastasis Research Laboratory, GIGA-CANCER, University of Liège, Liège, Belgium
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de Roos NM, van Hemert S, Rovers JMP, Smits MG, Witteman BJM. The effects of a multispecies probiotic on migraine and markers of intestinal permeability-results of a randomized placebo-controlled study. Eur J Clin Nutr 2017; 71:1455-1462. [PMID: 28537581 DOI: 10.1038/ejcn.2017.57] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 03/15/2017] [Accepted: 03/28/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Migraine, associated with several gastrointestinal disorders, may result from increased intestinal permeability, allowing endotoxins to enter the bloodstream. We tested whether probiotics could reduce migraine through an effect on intestinal permeability and inflammation. SUBJECTS/METHODS In total, 63 patients were randomly allocated to the probiotic (n=31) or the placebo group (n=32). Participants ingested a multispecies probiotic (5x109 colony-forming units) or placebo daily for 12 weeks. Migraine was assessed with the Migraine Disability Assessment Scale (MIDAS), the Headache Disability Inventory (HDI) and headache diaries. At baseline and 12 weeks, intestinal permeability was measured with the urinary lactulose/mannitol test and fecal and serum zonulin; inflammation was measured from interleukin (IL) -6, IL-10, tumor necrosis factor-α and C-reactive protein in serum. RESULTS The MIDAS migraine intensity score significantly decreased in both groups (P<0.001) and the HDI score significantly decreased in the probiotic group (P=0.032) and borderline in the placebo group (P=0.053). In the probiotics group, patients had a median of 6 migraine days in the first month, 4 in the second month (P=0.002) and 5 in the last month, which was not significantly different from the 5, 4, and 4 days in the placebo group. A ⩾2day reduction in migraine days was seen in 12/31 patients in the probiotics group versus 7/29 in the placebo group (ns). Probiotic use did not significantly affect medication use, intestinal permeability or inflammation compared to placebo. CONCLUSIONS In this study, we could not confirm significant benefit from a multispecies probiotic compared to a placebo on the outcome parameters of migraine and intestinal integrity.
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Affiliation(s)
- N M de Roos
- Wageningen UR, Division Human Nutrition and Epidemiology, Wageningen University, Wageningen, The Netherlands
| | - S van Hemert
- Winclove b.v., Innovation Department, Amsterdam, The Netherlands
| | - J M P Rovers
- Hospital Gelderse Vallei, Department of Neurology, Ede, The Netherlands
| | - M G Smits
- Hospital Gelderse Vallei, Department of Neurology, Ede, The Netherlands
| | - B J M Witteman
- Wageningen UR, Division Human Nutrition and Epidemiology, Wageningen University, Wageningen, The Netherlands.,Hospital Gelderse Vallei, Department of Gastroenterology and Hepatology, Ede, The Netherlands
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Harnod T, Wang YC, Tseng CH. Male, old age and low income to predispose epilepsy in migraineurs. Eur J Clin Invest 2017; 47:63-72. [PMID: 27864941 DOI: 10.1111/eci.12703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/13/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study investigated whether sex, age, income and any comorbidity affect subsequent epilepsy development in migraineurs. MATERIALS AND METHODS A total of 4915 men diagnosed with migraine who were aged older than 20 years were identified as the study cohort. A total of 4882 female migraineurs were included in the comparison cohort. We calculated the adjusted hazard ratio (aHR) for the risk of epilepsy in the two cohorts after adjustment for age and comorbidity. Kaplan-Meier analysis was used to analyse the cumulative epilepsy incidence, and the log-rank test was used to estimate the differences between the two cumulative incidence curves. RESULTS The risk of epilepsy was 2·31-fold higher in male migraineurs than in female migraineurs. The income-specific analysis showed that the risk of epilepsy was high in migraineurs with a low monthly income [aHR: 2·73 for 15 000-25 000 new Taiwan dollar (NTD; approximately 500-833 USD) and aHR: 2·71 for < 15 000 NTD]. Among patients with one or more comorbidity, a 2·48-fold (95% confidence interval: 1·65-3·74) high risk of epilepsy was noted in male migraineurs, regardless of the presence of head injury. Additional analyses revealed that male migraineurs aged 65 years or older had the highest risk of epilepsy. CONCLUSION Migraineurs have an increased risk of subsequent epilepsy. Male sex, old age and low income may interact with migraine and result in a high risk of epilepsy in migraineurs.
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Affiliation(s)
- Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yu-Chiao Wang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chun-Hung Tseng
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Neurology, China Medical University Hospital, Taichung, Taiwan
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Abstract
Background Metabolic syndrome (MetS) and migraine are known to be associated. This study assessed the risk of MetS and its clinical characteristics in migraine with aura (MA) and without aura (MO) based on a large-scale cross-sectional survey. Methods The study material consisted of 751 participants in the Nutrition, Environment and CardioVascular Health (NESCaV) survey. Diagnosis of migraine was based on the ef-ID migraine questionnaire and MetS was defined according to the Revised-Adult Treatment Panel III criteria. Sociodemographic and risk factors were also recorded. Weighted logistic regression was used to assess the risk of MetS. Results After adjusting for stratification (gender, age, district) and other factors (smoking status, sedentary lifestyle, family history of stroke, myocardial infarction and hypertension), MA subjects were at higher risk of MetS (OR 3.45; 95% CI: 1.63–7.29) while MO individuals were not, when compared to non-migraineurs. When considering MetS components, MA was positively associated with low HDL-cholesterol (OR 2.26; 95% CI: 1.08–4.74), hyperglycemia (OR 2.77; 95% CI: 1.30–5.88) and abdominal obesity (OR 2.03; 95% CI: 1.07–3.86). Conclusion Migraineurs with aura are at higher risk of MetS, suggesting that these subjects, already more exposed to stroke, may benefit from a systematic screening for the metabolic syndrome.
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Couch JR, Stewart KE. Headache Prevalence at 4-11 Years After Deployment-Related Traumatic Brain Injury in Veterans of Iraq and Afghanistan Wars and Comparison to Controls: A Matched Case-Controlled Study. Headache 2016; 56:1004-21. [PMID: 27237921 DOI: 10.1111/head.12837] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 02/29/2016] [Accepted: 03/13/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Evaluate the extent and severity of headache following deployment-related TBI (D-TBI) in veterans of the Iraq (OIF) and Afghanistan (OEF) wars over a follow-up period of 4-11 years with comparison to age, sex, race, and time of deployment matched controls. BACKGROUND TBI has been recognized as the "signature Injury" of the OEF/OIF campaigns occurring in 14-20% of deployed soldiers. Currently, there are very few data on the longer term follow-up of soldiers with D-TBI. This study deals with prevalence and severity of headache and headache burden at 4-11 years following D-TBI for OEF/OIF veterans with comparison to controls without D-TBI. METHODS This is a matched case controlled-study. All subjects were recruited from Operation New Dawn (OND), a voluntary program for OEF/OIF Veterans at the Oklahoma VAMC designed to assist with re-integrating into civilian life. On entry into OND a medical questionnaire was administered that included a brief screen for D-TBI, and those with a possible D-TBI were referred to a TBI clinic, For this study, the first 500 TBI clinic patients who were found to have had a D-TBI (TBIS) were matched by age, sex, race, and time of deployment to control subjects (CS), drawn from the 4411 OND program members with no D-TBI, creating a pool of 500 TBIS/CS pairs. From this pool, 55 pairs (11%) were randomly selected for this study. Data were collected from both TBIS and CS by telephone interview with questionnaires regarding the DTBI, headache, depression, and PTSD. TBI severity was measured by duration of loss of consciousness (LOC) as: [a] Very Mild (VMTBI, dazed only, no LOC), [b] Mild (MTBI, LOC 1-30 minutes), and [c] Moderate-Severe (MSTBI, LOC > 30 minutes). Intensity for individual headaches was measured by disability produced by the headache as: [a] Disabling (must be in bed), [b] Severe (50-90% decrease in activity), or [c] Mild-Moderate (>50% of usual activity possible). Statistical analysis employed Fisher's exact test and odds ratio. RESULTS The 55 TBIS/CS pairs were segregated by severity of TBI for the TBIS. For the TBIS there were no significant differences among these three subgroups as to mechanism producing the TBI (blast injury or direct head trauma). Comparing TBIS vs CS for phenotypic classification of headaches, for TBIS - 89% had migraine, 2% probable migraine, 9% had tension, and 0% had no headaches, while for CS - 36% had migraine, 15% probable migraine, 27% tension, and 22% no headache (P < .0001). Migraine with aura occurred in 38% of TBIS and 6% of CS (P < .0001). As to headache frequency, for TBIS - chronic daily headache (CDH) occurred in 44%, frequent headache in 33%, and infrequent or no headache in 23%, while for CS - CDH occurred in 7%, frequent headache in 13%, and infrequent or no headache in 80% (P < .0001). For TBIS, 54% had severe or disabling headache ≥2 days/week as opposed to only 16% of CS (OR 6.13 [2.5-14.9]). As to onset of most severe and frequent headaches, this occurred shortly after TBI in 89% of TBIS while only 27% of CS reported most severe headaches starting during deployment. There was no correlation of severity of headache problem with severity of TBI. Comparing TBIS at 4-7 vs 8-11 years after injury, there was no difference in frequency or severity of headache between these groups. CONCLUSIONS At 4-11 years after D-TBI for TBIS, or after deployment for CS, the TBIS as compared to CS suffered much more frequent and severe headaches. For TBIS, there was no relation of headache intensity or phenotype to severity or cause of the TBI, and the Headache Burden has not improved over time up to 11 years after D-TBI. The process initiated by the D-TBI that relates to the headache has a prolonged effect up to and beyond 11 years.
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Affiliation(s)
- James R Couch
- Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kenneth E Stewart
- Department of Biostatistics and Epidemiology, School of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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