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Wang Y, Lou Y, Chen Y, Shi J, Zhang H. Construction and validation of a nomogram for predicting remission of migraine patients with patent foramen ovale after closure. Int J Cardiol 2024; 407:132026. [PMID: 38609055 DOI: 10.1016/j.ijcard.2024.132026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/29/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE This study aimed to construct and validate a nomogram model that predicts the remission of migraine attacks by screening factors that affect the prognosis of migraine patients with patent foramen ovale (PFO) after closure. METHOD Retrospective analysis was conducted in migraine patients with PFO who underwent PFO closure in the Department of Cardiology of Jiangsu Province Hospital from September 2020 to April 2023. Based on the Migraine Disability Assessment (MIDAS) scores from the 1-year follow-up after PFO closure, all patients who met the inclusion criteria were categorized into a remission group and a non-remission group. The primary efficacy endpoint was remission of migraine headache. After collecting clinical data, transcranial doppler sonography (TCD) results and MIDAS scores, LASSO (least absolute shrinkage and selection operator) regression and multivariable logistic regression analysis were used to filter variables predictive to migraine remission and construct the nomogram model. The Nomogram's accuracy and consistency were respectively assessed through Receiver Operating Characteristic (ROC) curves and calibration curves. Additionally, an analysis of decision curves (DCA) was conducted to evaluate the clinical utility of this newly developed model. RESULT A total of 241 consecutive patients were included in the study. The remission group included 21 males and 93 females, with a median age of 39 (30.25,50) years. The non-remission group included 26 males and 101 females, with a median age of 35 (25.5,47.5) years. All Patients were randomly divided into a training cohort and a validation cohort. Multivariable logistic regression analysis showed that 5 independent predictors, including MIDAS before closure (p = 0.0002), mitigating factors (p = 0.0057), number of attacks/month (p = 0.0058), TCD (p = 0.0093) and Platelet Crit (PCT) (p = 0.0351), played a significant role in the prediction of remission of migraine patients with PFO after closure. Based on these independent predictors, the predictive nomogram model of migraine remission in PFO patients was constructed. The application of the nomogram in the training cohort exhibited good discrimination (area under the ROC curve was 0.7763[95% CI 0.7108-0.8418]), which was confirmed in the validation cohort (AUC was 0.704[95% CI 0.5533-0.8547]). The calibration curve showed that the nomogram model demonstrated good calibration performance. Additionally, the decision curve analysis indicated the clinical utility of the nomogram model. CONCLUSION The construction of the nomogram model had a considerable predictive accuracy for migraine remission in patients after PFO closure, which may provide constructive guidance for clinical decision making.
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Affiliation(s)
- Yifei Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Yuxuan Lou
- Southeast University School of Medicine, Nanjing, China.
| | - Yanlin Chen
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Jing Shi
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Hao Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Li C, Yu Y, Li N, Yin YN, Zhang L, Xie K, Huang D. Calcitonin gene-related peptide: a possible biomarker in migraine patients with patent foramen ovale. BMC Neurol 2024; 24:126. [PMID: 38627623 PMCID: PMC11020291 DOI: 10.1186/s12883-024-03615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Serum CGRP has been found to increase during migraine attack. However, whether CGRP can identify MA with PFO subtypes in MA remains unknown. This study aimed to investigate the differential expression of calcitonin gene-related peptide (CGRP) between migraine (MA) patients with and without patent foramen ovale (PFO), and to evaluate the predictive value of CGRP for MA with PFO. METHODS A total of 153 patients with MA, 51 patients with PFO and 102 patients without. Venous blood was drawn and HIT-6 score was calculated during the onset of MA, and blood routine, inflammatory indexes and serum CGRP were detected. The differences in serum markers and HIT-6 scores were compared between the two groups, and the risk factors of MA with PFO were determined by univariate and multivariate logistics regression. Furthermore, the correlation between CGRP level with right-to-left shunt (RLS) grades and headache impact test-6 (HIT-6) score in MA patients with PFO were assessed. Independent risk factors were screened out by multivariate Logistic regression analysis. We used the receiver operating characteristic (ROC) curve to analyze the diagnostic value of these risk factors in MA complicated with PFO. RESULTS The serum CGRP level and HIT-6 scores in the MA with PFO group were significantly higher than those in the MA group (P < 0.001). Multivariate regression analysis showed that CGRP was an independent risk factor for MA with PFO (OR = 1.698, 95% CI = 1.325-2.179, P < 0.001). CGRP values increased with the increase of RLS grade(Spearmen rho = 0.703, P < 0.001). Furthermore, a positive correlation between CGRP and HIT-6 scores was found (Spearmen rho = 0.227; P = 0.016). ROC curve showed that the optimal cut-off value for diagnosing MA with PFO was 79 pg/mL, the area under the curve (AUC) for predicting MA with PFO was 0.845, with 72.55% sensitivity and 78.43% specificity. CONCLUSIONS MA patients with PFO have higher serum CGRP level. elevated CGRP concentration was associated with higher RLS grade and increased HIT-6 score. Higher serum CGRP level has certain clinical value in predicting PFO in MA patients. TRIAL REGISTRATION This study was approved by the Ethics Committee of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine (Ethics batch number: 20,201,215,005).
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Affiliation(s)
- Chaojie Li
- People's Hospital of Xiangzhou District, Zhuhai, Guangdong province, 519000, China
- Department of cardiothoracic surgery, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, Guangdong province, 519000, China
| | - Yu Yu
- Department of Health Management Division, Zhuhai Maternal and Child Health Care Hospital, Zhuhai, Guangdong province, 519000, China
| | - Ningning Li
- Institute of Integrated Chinese and Western Medicine, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, Guangdong province, 519000, China
| | - Ya-Na Yin
- Clinical Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong province, 510080, China
| | - Lianjun Zhang
- Department of cardiothoracic surgery, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, Guangdong province, 519000, China
| | - Kehang Xie
- Department of Preventive Medicine, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, Guangdong province, 519000, China.
- Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, 208 Yuehua Road, Xiangzhou District, Zhuhai, Guangdong province, 519000, China.
| | - Donghui Huang
- Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, 208 Yuehua Road, Xiangzhou District, Zhuhai, Guangdong province, 519000, China.
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Zi-Yang Y, Hezhi L, Dongling L, Ximeng W, Caojin Z. Rationale and design of the SPRING trail: effectivity and safety of Pfo closuRe vs medIcine in alleviatiNg migraine, a multicenter, randomized and open-label trail. BMC Cardiovasc Disord 2024; 24:198. [PMID: 38580946 PMCID: PMC10998302 DOI: 10.1186/s12872-024-03866-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Migraine is a leading cause of disability worldwide. Several retrospective studies have suggested that the closure of the Patent Foramen Ovale (PFO) may provide relief from migraines. However, three randomized controlled trials did not meet their primary endpoints regarding migraine cessation, reduction in monthly migraine days, and responder rates. METHODS The SPRING study is a multicenter, prospective, randomized, and open-label trial designed to compare the effectiveness and safety of PFO closure versus medication in the relief of migraines. The primary endpoint is the total cessation of migraines, as recorded in patient headache diaries during the follow-up period. Additional diagnostic tools include echocardiography with agitated saline contrast, transcranial Doppler, and routine laboratory measurements. CONCLUSION The SPRING trial aims to assess the effectiveness and safety of PFO closure versus medication in mitigating migraines in real-world settings. (Clinical Trails ID: NCT04946734).
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Affiliation(s)
- Yang Zi-Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Zhong Shan Er Road No. 106, Yue Xiu District, Guangzhou, Guangdong, 510080, China
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, Guangdong, China
| | - Li Hezhi
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Zhong Shan Er Road No. 106, Yue Xiu District, Guangzhou, Guangdong, 510080, China
| | - Luo Dongling
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Zhong Shan Er Road No. 106, Yue Xiu District, Guangzhou, Guangdong, 510080, China
| | - Wang Ximeng
- Global Health Research Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Zhang Caojin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Zhong Shan Er Road No. 106, Yue Xiu District, Guangzhou, Guangdong, 510080, China.
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, Guangdong, China.
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Mi Z, He G, Li C, Yang D, Liu X, Zhao L, Gao H, Li X, Zhou X. Efficacy and safety of transesophageal ultrasound-guided patent foramen ovale closure for migraine in adolescents. Front Pediatr 2023; 11:1296825. [PMID: 38046679 PMCID: PMC10690613 DOI: 10.3389/fped.2023.1296825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/31/2023] [Indexed: 12/05/2023] Open
Abstract
Objective This retrospective analysis aims to assess the efficacy of transesophageal ultrasound-guided patent foramen ovale (PFO) closure in treating migraine in adolescents and compare the therapeutic outcomes of PFO closure for migraine with and without aura. Methods We conducted a retrospective analysis of 86 cases of adolescents (12-20 years old) who underwent PFO closure for migraine at our institution over the past 3 years. The efficacy was evaluated using the visual analogue scale (VAS), headache impact test (HIT)-6, and pediatric migraine disability assessment (PedMIDAS) scores, as well as by assessing the monthly frequency of migraine attacks, duration of each attack, and overall migraine burden. The patients were divided into two groups: an aura group (55 cases) and a non-aura group (31 cases) to investigate difference in therapeutic efficacy between the groups. The effect of residual shunt on migraine burden was assessed. Results Among the 86 patients, 46 (54%) experienced complete remission of migraine, while 71 (83%) achieved a >50% reduction in migraine burden during the one-year follow-up period. Patients in the aura group showed more significant improvements in VAS, HIT-6, and PedMIDAS scores, as well as in monthly migraine attack frequency, duration of each attack, and overall migraine burden, than patients in the non-aura group. Moreover, patients with residual shunt did not exhibit statistically significant differences in therapeutic efficacy compared to patients with complete closure. Conclusion PFO closure can effectively alleviate migraine symptoms in adolescents with migraine with concomitant PFO. The therapeutic efficacy is particularly pronounced for migraine with aura. Furthermore, minor levels of residual shunt have no effect on the improvement in migraine symptoms.
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Affiliation(s)
- Zeyu Mi
- Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Gang He
- Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Li
- Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Deyu Yang
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Xue Liu
- Department of Medical Ultrasonics, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Libo Zhao
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Hongli Gao
- Department of Medical Ultrasonics, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Xing Li
- Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaogang Zhou
- Department of Medical Ultrasonics, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
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Wang M, Lan D, Dandu C, Ding Y, Ji X, Meng R. Normobaric oxygen may attenuate the headache in patients with patent foramen povale and migraine. BMC Neurol 2023; 23:44. [PMID: 36707824 PMCID: PMC9881355 DOI: 10.1186/s12883-023-03059-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND AND PURPOSES There has been both great interest in and skepticism about the strategies for headache inhibition in patients with patent foramen ovale and migraines (PFO-migraine). Furthermore, many questions remain about the fundamental pathophysiology of PFO-migraines. Herein, the inhibiting effect of normobaric oxygenation (NBO) on PFO-migraine was analyzed. METHODS This real-world self-control study consecutively enrolled patients during the ictal phase of migraines who had patent foramen ovale (PFO) confirmed by Trans esophageal Ultrasound(TEE). After comparing the baseline arterial oxygen partial pressure (PaO2) in their blood gas with that of healthy volunteers, all the patients with PFO-migraine underwent treatment with NBO (8 L/min. for 1 h/q8h) inhalation through a mask. Their clinical symptoms, blood gas, and electroencephalograph (EEG) prior to and post-NBO were compared. RESULTS A total of 39 cases with PFO-migraine (in which 36% of participants only had a small-aperture of PFO) and 20 non-PFO volunteers entered the final analysis. Baseline blood gas analysis results showed that the PaO2 in patients with PFO-migraine were noticeably lower than PaO2 levels in non-PFO volunteers. After all patients with PFO-migraines underwent NBO treatment, 29(74.4%) of them demonstrated dramatic headache attenuation and a remarkable increase in their arterial PaO2 levels after one time treatment of NBO inhalation (p < 0.01). The arterial PaO2 levels in these patients gradually went down during the following 4 h after treatment. 5 patients finished their EEG scans prior to and post-NBO, and 4(80%) were found to have more abnormal slow waves in their baseline EEG maps. In the follow up EEG maps post-NBO treatment for these same 4 patients, the abnormal slow waves disappeared remarkably. CONCLUSIONS Patients with PFO-migraine may derive benefit from NBO treatment. PFOs result in arterial hypoxemia due to mixing of venous blood, which ultimately results in brain hypoxia and migraines. This series of events may be the key pathologic link explaining how PFOs lead to migraines. NBO use may attenuate the headaches from migraines by correcting the hypoxemia.
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Affiliation(s)
- Mengqi Wang
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053 China ,grid.413259.80000 0004 0632 3337National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China
| | - Duo Lan
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053 China ,grid.413259.80000 0004 0632 3337National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China
| | - Chaitu Dandu
- grid.254444.70000 0001 1456 7807Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI 48201 USA
| | - Yuchuan Ding
- grid.254444.70000 0001 1456 7807Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI 48201 USA
| | - Xunming Ji
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053 China ,grid.413259.80000 0004 0632 3337National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China
| | - Ran Meng
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053 China ,grid.413259.80000 0004 0632 3337National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China
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Saka E, Atay LO, Akdemir UO, Yetim E, Balci E, Arsava EM, Topcuoglu MA. Cerebral vasomotor reactivity across the continuum of subjective cognitive impairment, amnestic mild cognitive impairment and probable Alzheimer's dementia: A transcranial Doppler and PET/MRI study. J Cereb Blood Flow Metab 2023; 43:129-137. [PMID: 36314070 PMCID: PMC9875349 DOI: 10.1177/0271678x221124656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/28/2022] [Accepted: 07/31/2022] [Indexed: 12/12/2022]
Abstract
Cerebrovascular dysfunction has been suggested as a physiomarker of Alzheimer's disease (AD)-associated neuronal degeneration, but the underlying mechanisms are still debated. Herein cerebral vasomotor reactivity (VMR, breath-hold index: BHI), metabolic activity (lobar SUVs, FDG PET MRI), amyloid load (Centiloid score, Flutemetamol PET MRI), hemispheric cortical thickness, white matter lesion load and cerebral blood flow (ASL) were studied in 43 consecutive subjects (mean age: 64 years, female 13), diagnosed with subjective cognitive impairment (SCI, n = 10), amnestic mild cognitive impairment (aMCI, n = 15), and probable Alzheimer's dementia (AD, n = 18). BHI was significantly reduced in AD and aMCI patients compared to SCI subjects. A highly significant inverse correlation was found between BHI and the centiloid score (r = -0.648, p < 0.001). There was moderate positive correlation between BHI and frontal, temporal and parietal FDG SUV and ASL values, and a borderline negative correlation with age and white matter lesion volume. The link between amyloid burden and VMR was independent and strong in linear regression models where all these parameters were included (β from -0.580 to -0.476, p < 0.001). In conclusion, our study confirms the negative association of cerebral amyloid accumulation and vasomotor reactivity in Alzheimer's disease with the most direct data to date in humans.
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Affiliation(s)
- Esen Saka
- Faculty of Medicine, Department of Neurology, Hacettepe
University, Ankara, Turkey
| | - Lutfiye Ozlem Atay
- Faculty of Medicine, Department of Nuclear Medicine, Gazi
University, Ankara, Turkey
| | - Umit Ozgur Akdemir
- Faculty of Medicine, Department of Nuclear Medicine, Gazi
University, Ankara, Turkey
| | - Ezgi Yetim
- Faculty of Medicine, Department of Neurology, Hacettepe
University, Ankara, Turkey
| | - Erdem Balci
- Faculty of Medicine, Department of Nuclear Medicine, Gazi
University, Ankara, Turkey
| | - Ethem Murat Arsava
- Faculty of Medicine, Department of Neurology, Hacettepe
University, Ankara, Turkey
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Xie QQ, Chen X, Tian Y, Fang L, Zhao H. Compromised cerebrovascular reactivity in migraineurs with right-to-left shunts: a potential mechanism of white matter hyperintensities. Neurol Res 2022; 44:754-760. [PMID: 35271423 DOI: 10.1080/01616412.2022.2051133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Our study aims to explore the changes of cerebrovascular reactivity (CVR) in migraineurs with right-to-left shunts (RLS), and further evaluate the association between CVR and the occurrence of the white matter hyperintensities (WMHs). METHODS RLS was diagnosed based on a contrast enhancement transcranial Doppler (c-TCD) examination. The breath holding index (BHI), which represents CVR, was measured from the middle cerebral artery (MCA) using a TCD with the breath-holding method. WMHs was defined as clearly hyperintense areas in 3 T magnetic resonance imaging (MRI). All migraineurs underwent a standardized questionnaire for family and personal history and detailed migraine features. RESULTS Three hundred and ninety-seven migraineurs and 100 controls were included in our study. The BHI was significantly lower in migraineurs than controls (0.527 ± 0.709 vs. 0.674 ± 0.489, P = 0.016). Moreover, migraineurs with RLS had lower BHI than those without RLS (0.504 ± 0.671 vs. 0.674 ± 0.721, p = 0.024). Migraineurs with WMHs had lower BHI than those without (0.47 ± 0.71 vs. 0.75 ± 0.49, p = 0.035). The reduced BHI was an independent influencing factor for WMHs in our study (OR = 0.338; 95% CI = 0.142-0.806, p = 0.014). CONCLUSION Our results indicated that BHI was reduced in migraineurs, and the reduced BHI was associated with RLS. Moreover, the reduced CVR in migraineurs with RLS might be related to the occurrence of WMHs.
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Affiliation(s)
- Qian Qian Xie
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaoxiang Chen
- Department of Neurology, People's Hospital of Juxian, Rizhao, Shandong, China
| | - Yuxuan Tian
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Le Fang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hongqin Zhao
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010246. [PMID: 33396262 PMCID: PMC7795912 DOI: 10.3390/ijerph18010246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.
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