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HARMANCI H, KUL B. Pain catastrophizing in migraine patients and associated factors. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.975669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Shnayder NA, Sharavii VB, Petrova MM, Moskaleva PV, Pozhilenkova EA, Kaskaeva DS, Tutynina OV, Popova TE, Garganeeva NP, Nasyrova RF. Candidate Genes and Proteomic Biomarkers of Serum and Urine in Medication-Overuse Headache. Int J Mol Sci 2021; 22:9024. [PMID: 34445731 PMCID: PMC8396559 DOI: 10.3390/ijms22169024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 01/03/2023] Open
Abstract
Chronic headache is a topical problem of neurology, psychiatry and general practice. The medication-overuse headache (MOH) is one of the leading pathologies in the structure of chronic headache. However, early diagnosis of the MOH is challenging. We analyzed potential proteomic biomarkers of serum and urine in patients with MOH. METHODS We searched PubMed, Springer, Scopus, Web of Science, ClinicalKey, and Google Scholar databases for English publications over the past 10 years using keywords and their combinations. RESULTS We found and analyzed seven studies that met the search criteria for the purpose of the review, including 24 serum proteomic biomarkers and 25 urine proteomic biomarkers of MOH. Moreover, the candidate genes and locus of the studied serum (vitamin D-binding protein, lipocalin-type prostaglandin D2 synthase, apolipoprotein E, etc.) and urine proteomic biomarkers (uromodulin, alpha-1-microglobulin, zinc-alpha-2-glycoprotein, etc.) of MOH are presented in this review. CONCLUSIONS The serum and urine proteomic biomarkers of MOH can potentially help with the identification of patients with MOH development. Due to the relevance of the problem, the authors believe that further investigation of the MOH proteomic biomarkers in different ethnic and racial groups of patients with primary headache is necessary. In addition, it is important to investigate whether medications of different drug classes influence the levels of serum and urine proteomic biomarkers.
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Affiliation(s)
- Natalia A. Shnayder
- The Center of Personalized Psychiatry and Neurology, V. M. Bekhterev National Medical Research Center for Neurology and Psychiatry, 192019 Saint-Petersburg, Russia;
- The Center of Collective Usage “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (P.V.M.); (E.A.P.); (D.S.K.); (O.V.T.)
| | - Victoria B. Sharavii
- The International School Medicine of the Future, I. M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Marina M. Petrova
- The Center of Collective Usage “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (P.V.M.); (E.A.P.); (D.S.K.); (O.V.T.)
| | - Polina V. Moskaleva
- The Center of Collective Usage “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (P.V.M.); (E.A.P.); (D.S.K.); (O.V.T.)
| | - Elena A. Pozhilenkova
- The Center of Collective Usage “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (P.V.M.); (E.A.P.); (D.S.K.); (O.V.T.)
| | - Darya S. Kaskaeva
- The Center of Collective Usage “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (P.V.M.); (E.A.P.); (D.S.K.); (O.V.T.)
| | - Olga. V. Tutynina
- The Center of Collective Usage “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (P.V.M.); (E.A.P.); (D.S.K.); (O.V.T.)
| | - Tatiana E. Popova
- The Yakutsk Scientific Center for Complex Medicine Problems, The Department of Epidemiology of Non-Infectious Diseases, 677018 Yakutsk, Russia;
| | - Natalia P. Garganeeva
- The Department of General Medical Practice and Polyclinic Therapy, The Siberian State Medical University, 634050 Tomsk, Russia;
| | - Regina F. Nasyrova
- The Center of Personalized Psychiatry and Neurology, V. M. Bekhterev National Medical Research Center for Neurology and Psychiatry, 192019 Saint-Petersburg, Russia;
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Welch-Coltrane JL, Wachnik AA, Adams MCB, Avants CR, Blumstein HA, Brooks AK, Farland AM, Johnson JB, Pariyadath M, Summers EC, Hurley RW. Implementation of Individualized Pain Care Plans Decreases Length of Stay and Hospital Admission Rates for High Utilizing Adults with Sickle Cell Disease. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:1743-1752. [PMID: 33690845 PMCID: PMC8346918 DOI: 10.1093/pm/pnab092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Patients with sickle cell disease (SCD) face inconsistent effective analgesic management, leading to high inpatient healthcare utilization and significant financial burden for healthcare institutions. Current evidence does not provide guidance for inpatient management of acute pain in adults with sickle cell disease. We conducted a retrospective analysis of a longitudinal cohort quality improvement project to characterize the role of individualized care plans on improving patient care and reducing financial burden in high healthcare-utilizing patients with SCD-related pain. METHODS Individualized care plans were developed for patients with hospital admissions resulting from pain associated with sickle cell disease. A 2-year prospective longitudinal cohort quality improvement project was performed and retrospectively analyzed. Primary outcome measure was duration of hospitalization. Secondary outcome measures included: pain intensity; 7, 30, and 90-day readmission rates; cost per day; total admissions; total cost per year; analgesic regimen at index admission; and discharge disposition. RESULTS Duration of hospitalization, the primary outcome, significantly decreased by 1.23 days with no worsening of pain intensity scores. Seven-day readmission decreased by 34%. Use of intravenous hydromorphone significantly decreased by 25%. The potential cost saving was $1,398,827 as a result of this quality initiative. CONCLUSIONS Implementation of individualized care plans reduced both admission rate and financial burden of high utilizing patients. Importantly, pain outcomes were not diminished. Results suggest that individualized care plans are a promising strategy for managing acute pain crisis in adult sickle cell patients from both care-focused and utilization outcomes.
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Affiliation(s)
- Jena L Welch-Coltrane
- Department of Anesthesiology, Section of Pain Medicine, Wake Forest School of Medicine, North Carolina, USA
| | - Anthony A Wachnik
- Department of Anesthesiology, Section of Pain Medicine, Wake Forest School of Medicine, North Carolina, USA
| | - Meredith C B Adams
- Department of Anesthesiology, Section of Pain Medicine, Wake Forest School of Medicine, North Carolina, USA
| | - Cherie R Avants
- Department of Anesthesiology, Section of Pain Medicine, Wake Forest School of Medicine, North Carolina, USA
| | - Howard A Blumstein
- Department of Emergency Medicine, Wake Forest School of Medicine, North Carolina, USA
| | - Amber K Brooks
- Department of Anesthesiology, Section of Pain Medicine, Wake Forest School of Medicine, North Carolina, USA
| | - Andrew M Farland
- Department of Hematology, Wake Forest School of Medicine, North Carolina, USA
| | - Joshua B Johnson
- Department of Internal Medicine Section of Hospital Medicine, Wake Forest University School of Medicine, North Carolina, USA
| | - Manoj Pariyadath
- Department of Emergency Medicine, Wake Forest School of Medicine, North Carolina, USA
| | - Erik C Summers
- Department of Internal Medicine Section of Hospital Medicine, Wake Forest University School of Medicine, North Carolina, USA
| | - Robert W Hurley
- Department of Anesthesiology, Section of Pain Medicine, Wake Forest School of Medicine, North Carolina, USA
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, North Carolina USA
- Correspondence to: Robert W. Hurley, MD, PhD, FASA, Department of Anesthesiology, Neurobiology and Anatomy, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157-1009, USA. Tel: 336-716-2266; Fax: 336-716-8773; E-mail:
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Constantinidis TS, Arvaniti C, Fakas N, Rudolf J, Kouremenos E, Giannouli E, Mitsikostas DD. A population-based survey for disabling headaches in Greece: Prevalence, burden and treatment preferences. Cephalalgia 2021; 41:810-820. [PMID: 33525903 DOI: 10.1177/0333102421989630] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To estimate the prevalence, burden and current treatment of disabling primary headaches in a large sample of the Greek population aged 18-70 years old. METHODS This is an observational descriptive study, with cross-sectional design performed by quantitative computer-assisted telephone interviews, using a validated 37-item questionnaire for headaches. The prevalence, burden, and current treatment of primary headaches (ICHD-3) were recorded along with participants' treatment preferences. RESULTS Out of 10,008 interviewed participants, 1197 (12.0%) reported headaches affecting performance. The annual prevalence of migraine was 8.1% (95% confidence interval, 7.6-8.7, corresponding to 0.6 million Greeks), of chronic migraine 1.0% (95% confidence interval, 0.8-1.2, corresponding to 0.1 million), and of tension-type headache 3.8% (95% confidence interval, 3.4-4.2, corresponding to 0.3 million). The participants with headaches reported 0.5 headache-induced lost workdays per month (corresponding to 5.8 million lost workdays annually) and reductions in performance on 2.8 workdays per month (corresponding to 30.9 million workdays annually). In all, 43.4% of headache participants felt bad/ashamed because of headaches and 21.9% sought professional treatment, most often from a private neurologist. 83.8% of headache participants had never taken pharmacological prophylaxis, and only 5.5% were currently under preventative treatment. For both prophylactic and acute treatment, headache participants prefer oral medication to injection or stimulation devices. CONCLUSION More than 10% of the Greek adult population up to 70 years old experience disabling headaches, causing a dramatic work loss. More than 80% of these have never taken pharmacological prophylaxis. Thus, enriching the quality of life of people with headaches relies crucially on expanding awareness about headaches and their treatment.
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Affiliation(s)
| | - Chryssa Arvaniti
- Second Neurology Department, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Fakas
- Neurology Department, 401 Army General Hospital of Athens, Athens, Greece
| | - Jobst Rudolf
- Department of Neurology, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Evangelos Kouremenos
- 251 Air Forces General Hospital of Athens, Neurology Department, Leof. Pan. Kannelopoulou, Athens, Greece
| | - Ermioni Giannouli
- Department of Neurology, Athens Medical Center, 5-7 Distomou, Marousi, Athens, Greece
| | - Dimos D Mitsikostas
- First Neurology Department, Aeginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Affiliation(s)
- Thomas F Lüscher
- Royal Brompton and Harefield Hospitals and Imperial College, London SW3 6LY, UK
- Center for Molecular Cardiology, University of Zurich, Wagistreet 12 8952 Schlieren – Zurich, Switzerland
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Rau JC, Navratilova E, Oyarzo J, Johnson KW, Aurora SK, Schwedt TJ, Dodick DW, Porreca F. Evaluation of LY573144 (lasmiditan) in a preclinical model of medication overuse headache. Cephalalgia 2020; 40:903-912. [PMID: 32580575 PMCID: PMC7412873 DOI: 10.1177/0333102420920006] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Medication overuse is a significant issue that complicates the treatment of headache disorders. The most effective medications for the acute treatment of migraine all have the capacity to induce medication overuse headache (MOH). Novel acute migraine-specific treatments are being developed. However, because the mechanism(s) underlying medication overuse headache are not well understood, it is difficult to predict whether any particular acute medication will induce MOH in susceptible individuals. LY573144 (lasmiditan), a 5-HT1F receptor agonist, has recently been shown to be effective in the acute treatment of migraine in phase 3 trials. The aim of this study is to determine whether frequent administration of lasmiditan induces behaviors consistent with MOH in a pre-clinical rat model. METHODS Sprague Dawley rats were administered six doses of lasmiditan (10 mg/kg), sumatriptan (10 mg/kg), or sterile water orally over 2 weeks and cutaneous allodynia was evaluated regularly in the periorbital and hindpaw regions using von Frey filaments. Testing continued until mechanosensitivity returned to baseline levels. Rats were then submitted to bright light stress (BLS) or nitric oxide (NO) donor administration and were again evaluated for cutaneous allodynia in the periorbital and hindpaw regions hourly for 5 hours. RESULTS Both lasmiditan and sumatriptan exhibited comparable levels of drug-induced cutaneous allodynia in both the periorbital and hindpaw regions, which resolved after cessation of drug administration. Both lasmiditan and sumatriptan pre-treatment resulted in cutaneous allodynia that was evoked by either BLS or NO donor. CONCLUSIONS In a pre-clinical rat model of MOH, oral lasmiditan, like sumatriptan, induced acute transient cutaneous allodynia in the periorbital and hindpaw regions that after resolution could be re-evoked by putative migraine triggers. These results suggest that lasmiditan has the capacity to induce MOH through persistent latent peripheral and central sensitization mechanisms.
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Affiliation(s)
| | - Edita Navratilova
- Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | | | | | | | | | | | - Frank Porreca
- Mayo Clinic, Scottsdale, AZ, USA.,Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
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van de Graaf DL, Schoonman GG, Habibović M, Pauws SC. Towards eHealth to support the health journey of headache patients: a scoping review. J Neurol 2020; 268:3646-3665. [PMID: 32529582 PMCID: PMC8463346 DOI: 10.1007/s00415-020-09981-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Abstract
Objective The aim of this study is to (1) review the digital health tools that have been used in headache studies, and (2) discuss the effectivity and reliability of these tools. Background Many headache patients travel a long and troublesome journey from first symptoms until a meaningful care plan. eHealth, mHealth, and digital therapeutic modalities have been advocated as the way forward to improve patient care. Method Online databases PubMed, Cinahl, and PsycINFO were searched using a predefined search query. A data extraction form was used to gather relevant data elements from the selected papers. Results A total of 39 studies were selected. The studies included 94,127 participants. The majority of studies focused on diaries (N = 27 out of 39). Digital (cognitive) behavioral therapy were also quite common (N = 7 out of 39). Other digital health tool categories were tele-consultations, telemonitoring and patient portals. Conclusion Many digital health tools for headache patients regarding diaries and behavioral/therapeutical treatment are described in scientific research with limited information on effectivity and reliability. Scientific knowledge with regard to other categories such as tele-consultations, patient portals, telemonitoring including medication adherence, online information resources, wearable, symptom checkers, digital peer support is still scarce or missing.
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Affiliation(s)
| | - Guus G Schoonman
- Department of Neurology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Mirela Habibović
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Cardiology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Steffen C Pauws
- TiCC-Tilburg University, Tilburg, The Netherlands.,Philips Research, Healthcare, Eindhoven, The Netherlands
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Diener HC, Antonaci F, Braschinsky M, Evers S, Jensen R, Lainez M, Kristoffersen ES, Tassorelli C, Ryliskiene K, Petersen JA. European Academy of Neurology guideline on the management of medication‐overuse headache. Eur J Neurol 2020; 27:1102-1116. [DOI: 10.1111/ene.14268] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 11/30/2022]
Affiliation(s)
- H. C. Diener
- Institute for Medical Informatics, Biometry and Epidemiology Faculty of Medicine University Duisburg‐Essen Essen Germany
| | - F. Antonaci
- IRCCS C. Mondino Foundation Pavia Italy
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
| | - M. Braschinsky
- Headache Clinic Neurology Clinic Tartu University Hospital Tartu Estonia
| | - S. Evers
- Faculty of Medicine University of Münster MünsterGermany
- Krankenhaus Lindenbrunn Coppenbrügge Germany
| | - R. Jensen
- Danish Headache Center Neurological Clinic Rigshospitalet‐Glostrup University of Copenhagen Copenhagen Denmark
| | - M. Lainez
- Department of Neurology Hospital Clínico Universitario ValenciaSpain
- Department of Neurology Universidad Católica de Valencia Valencia Spain
| | - E. S. Kristoffersen
- Department of Neurology Akershus University Hospital OsloNorway
- Department of General Practice University of Oslo Oslo Norway
| | - C. Tassorelli
- IRCCS C. Mondino Foundation Pavia Italy
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
| | - K. Ryliskiene
- Department of Neurology Institute of Clinical Medicine Faculty of Medicine Vilnius University Vilnius Lithuania
| | - J. A. Petersen
- Department Of Neurology University Hospital Zurich Zurich Switzerland
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Dabilgou AA, Dravé A, Kyelem JMA, Sawadogo Y, Napon C, Millogo A, Kaboré J. Frequency of Headache Disorders in Neurology Outpatients at Yalgado Ouedraogo University Teaching Hospital. A 3-Month Prospective Cross-sectional Study. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42399-020-00238-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Alstadhaug KB, Andreou AP. Caffeine and Primary (Migraine) Headaches-Friend or Foe? Front Neurol 2019; 10:1275. [PMID: 31849829 PMCID: PMC6901704 DOI: 10.3389/fneur.2019.01275] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/18/2019] [Indexed: 12/19/2022] Open
Abstract
Background: The actions of caffeine as an antagonist of adenosine receptors have been extensively studied, and there is no doubt that both daily and sporadic dietary consumption of caffeine has substantial biological effects on the nervous system. Caffeine influences headaches, the migraine syndrome in particular, but how is unclear. Materials and Methods: This is a narrative review based on selected articles from an extensive literature search. The aim of this study is to elucidate and discuss how caffeine may affect the migraine syndrome and discuss the potential pathophysiological pathways involved. Results: Whether caffeine has any significant analgesic and/or prophylactic effect in migraine remains elusive. Neither is it clear whether caffeine withdrawal is an important trigger for migraine. However, withdrawal after chronic exposure of caffeine may cause migraine-like headache and a syndrome similar to that experienced in the prodromal phase of migraine. Sensory hypersensitivity however, does not seem to be a part of the caffeine withdrawal syndrome. Whether it is among migraineurs is unknown. From a modern viewpoint, the traditional vascular explanation of the withdrawal headache is too simplistic and partly not conceivable. Peripheral mechanisms can hardly explain prodromal symptoms and non-headache withdrawal symptoms. Several lines of evidence point at the hypothalamus as a locus where pivotal actions take place. Conclusion: In general, chronic consumption of caffeine seems to increase the burden of migraine, but a protective effect as an acute treatment or in severely affected patients cannot be excluded. Future clinical trials should explore the relationship between caffeine withdrawal and migraine, and investigate the effects of long-term elimination.
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Affiliation(s)
- Karl B. Alstadhaug
- Nordland Hospital Trust, Bodø, Norway
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Anna P. Andreou
- Headache Research, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- The Headache Centre, Guy's and St Thomas', NHS Foundation Trust, London, United Kingdom
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Westergaard ML, Lau CJ, Allesøe K, Gjendal ST, Jensen RH. Monitoring chronic headache and medication-overuse headache prevalence in Denmark. Cephalalgia 2019; 40:6-18. [DOI: 10.1177/0333102419876909] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives To study chronic headache and medication-overuse headache (MOH) prevalence; to identify groups with high prevalence of these conditions; and to identify the most frequently used pain medications among respondents with chronic headache. Background Chronic headache and MOH prevalence in Denmark were last estimated in 2010. Methods In this cross-sectional study, 104,950 individuals aged ≥16 years were randomly sampled for the 2017 Danish Capital Region Health Survey. Responses to questions about headache and use of acute pain medications were linked to demographic registries. MOH was defined as headache ≥15 days/month plus self-report of use of pain medications ≥10 or 15 days/month, in the last three months. Weighted prevalence proportions were calculated. Results Among 55,185 respondents, chronic headache prevalence was 3.0% (95% CI: 2.3–3.2) and MOH prevalence was 2.0% (95% CI: 1.8–2.1). Both conditions were more common among females and the middle-aged. Respondents on social welfare or receiving early retirement pensions had the highest prevalences. Among those with chronic headache, 44.7% overused over-the-counter analgesics for headache; paracetamol 41.5%; a combination of different pain relievers 25.3%; ibuprofen 21.9%; opioids 17.0%; combination preparations 14.3%; and triptans 9.1%. Conclusions The highest prevalence of chronic headache and MOH was seen among people with low socioeconomic position. Overuse of paracetamol was most common. Reported opioid use was higher than expected. Groups with high prevalence of MOH should be the focus of public health interventions on rational use of OTC and prescription pain medications.
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Affiliation(s)
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Karen Allesøe
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Signe Thorup Gjendal
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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Chen PK, Wang SJ. Medication Overuse and Medication Overuse Headache: Risk Factors, Comorbidities, Associated Burdens and Nonpharmacologic and Pharmacologic Treatment Approaches. Curr Pain Headache Rep 2019; 23:60. [DOI: 10.1007/s11916-019-0796-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Prevalence of Temporomandibular Disorder in Turkish University Students: a Questionnaire Study. BALKAN JOURNAL OF DENTAL MEDICINE 2019. [DOI: 10.2478/bjdm-2019-0015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Summary
Background/Aim: Temporomandibular dysfunction (TMD) might influence any individual with different signs and symptoms irrespective of gender or age. The aim of this study is to assess the prevalence of TMD in Oral and Dental Health Program students of İstanbul University-Cerrahpaşa.
Material and Methods: This study include a sample of 486 students with age ranging from18 to 24 years. The presence and severity of TMD was evaluated using the Fonseca’s Anamnestic Index (FAI) and its questionnaire. The data were analysed using SPSS Version 22. The chisquare test was used to compare the data from different groups and to determine whether the differences were statistically significant.
Results: The results showed that a total of 47,53% of students had some degree of TMD and females were generally more affected than males. These degrees were as follows: 33,95 % were classified as mild, 11,52 % moderate and 2,05 % severe signs and symptoms. The women exhibited some degree of TMD (51,8%) at a higher frequency than men (40,33%). No significant differences were observed between gender for a same TMD severity degree (p>0.05).
Conclusions: A high prevalence of mild TMD was found in this study population. In addition, tense personalities, headaches, and temporomandibular joint (TMJ) sounds were the most prevalent findings of TMD. The present study suggests that Fonseca’s Anamnestic Index (FAI) has been used in screening for TMD for prevention and management of TMD in a non-patient young population.
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Cotta Ramusino M, De Cillis I, Costa A, Antonaci F. Impact of Medical Care on Symptomatic Drug Consumption and Quality of Life in Headache: A One-Year Population Study. Front Neurol 2019; 10:629. [PMID: 31275226 PMCID: PMC6591309 DOI: 10.3389/fneur.2019.00629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/28/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Chronic headache is one of the most common pain conditions, often leading to symptomatic drug overuse. The aim of this study was to provide data on symptomatic drug consumption in an Italian outpatient population and to describe how the clinical picture of headache may change after headache experts take charge of the care of affected individuals. Methods: A total of 199 adults complaining of chronic headache were recruited through 32 pharmacies in the Pavia health district. Participants underwent four evaluations: a baseline assessment (T0) and three follow-up evaluations performed by a neurologist at 3, 6, and 12 months (T3, T6, and T12, respectively). On each occasion, they underwent a complete neurological assessment and received therapeutic adjustments to achieve better management of their headache. Results: On the basis of a preliminary telephone interview, the prevalence rates of chronic headache and medication overuse headache (MOH) were 16 and 12%, respectively. At 12 months of follow-up, we observed a significant decrease in the frequency of attacks (T0: 9 ± 9/month vs. T12: 2 ± 2/month; p < 0.001), in the number of days/month with headache (T0: 11 ± 9 vs. T12: 4 ± 4; p < 0.001) and in single attack duration (T0: 34 ± 30 h vs. T12: 10 ± 19 h; p < 0.001). Careful headache management resulted in a significant decrease in analgesic consumption (T0: 12 ± 16 vs. T12: 4 ± 6 doses/month; p = 0.014) and a significant increase in quality of life, measured using the Migraine Disability Assessment Scale (MIDAS) and Headache Under-Response to Treatment (HURT) scales (p < 0.001). Conclusions: Headache management by a specialist is more effective than self-treatment, resulting in an overall benefit for headache patients.
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Affiliation(s)
- Matteo Cotta Ramusino
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Alfredo Costa
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Fabio Antonaci
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Arbex G, Teixeira VP, Moriyama CM, Andrade de Paula E, Santos EM, Bussadori SK. Temporomandibular disorder and headache in university professors. J Phys Ther Sci 2019; 31:217-222. [PMID: 30936634 PMCID: PMC6428655 DOI: 10.1589/jpts.31.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022] Open
Abstract
[Purpose] Temporomandibular disorder is a condition with a multifactor etiology that
involves the temporomandibular joint, bones, surrounding muscles and facial pain is the
most common symptom. This study evaluated the possible association between headache and
temporomandibular disorder in university professors. [Participants and Methods]
Twenty-seven professors were recruited and answered the Axis II of the Research Diagnostic
Criteria for Temporomandibular Disorders for the evaluation and diagnosis of
temporomandibular disorder and filled out a “Headache Diary” proposed by the American
Headache Society. [Results] The university professors showed headache and
temporomandibular disorder, but no association was found between the two conditions.
Comparing the gender, the males were most frequently affected, but females had more
intensity of signs and symptoms. There is a lack of data on the population addressed in
the present study. [Conclusion] Indeed, this was the first such study developed with
university professors. It is of considerable importance to develop further studies to
investigate the possible association between headache and temporomandibular disorder.
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Affiliation(s)
- Gabriella Arbex
- School of Dentistry, Metropolitana de Santos University, São Paulo, Brazil
| | | | | | | | | | - Sandra Kalil Bussadori
- School of Dentistry, Metropolitana de Santos University, São Paulo, Brazil.,Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho: Vergueiro Street, 235/249 Liberdade, 01504000, São Paulo, SP, Brazil
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16
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Toom K, Raidvee A, Allas KH, Floria E, Juhkami K, Klimušev G, Leping M, Liidemann M, Milovidov A, Liivak K, Paiste S, Paju G, Uhs K, Vaikjärv M, Veetõusme K, Välja P, Braschinsky M. The prevalence of primary headache disorders in the adult population of Estonia. Cephalalgia 2019; 39:883-891. [DOI: 10.1177/0333102419829909] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective To estimate the one-year prevalence of primary headaches, most importantly migraine and tension type headache, but also other primary headaches, in Estonia. Methods A population-based random sample of 2162 subjects in Tartu City and Tartu County were interviewed by telephone or face to face using a previously validated questionnaire. Results Of the 2162 contacted participants, 1215 (56%) fully completed the study. Of these, 502 (41.3%) reported headache during the previous year. The prevalences adjusted by weighting by age, gender, education, marital status and habitat were the following: All headaches 41.0%, all migraine 17.7%, all tension-type headache 18.0%, trigeminal autonomic cephalalgias 0.4%, other primary headaches 2.5%, and chronic headaches 2.7%. Conclusion The 1-year prevalences of primary headache disorders in Estonia are comparable to the previous findings in other European countries.
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Affiliation(s)
- Kati Toom
- Neurology Clinic, Tartu University Hospital, Tartu, Estonia
- Estonian Headache Society, Tartu, Estonia
| | - Aire Raidvee
- Institute of Psychology, University of Tartu, Tartu, Estonia
| | | | - Elina Floria
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | | | | | - Maria Leping
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | | | | | - Karita Liivak
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Siiri Paiste
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Gerli Paju
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Karel Uhs
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Marge Vaikjärv
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | | | - Priit Välja
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Mark Braschinsky
- Neurology Clinic, Tartu University Hospital, Tartu, Estonia
- Estonian Headache Society, Tartu, Estonia
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17
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Diener HC, Holle D, Dresler T, Gaul C. Chronic Headache Due to Overuse of Analgesics and Anti-Migraine Agents. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:365-370. [PMID: 29932046 PMCID: PMC6039717 DOI: 10.3238/arztebl.2018.0365] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 10/30/2017] [Accepted: 03/15/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND The frequent or regular use of analgesics and anti-migraine drugs can make headache more frequent and induce the transformation of episodic to chronic headache. Chronic headache due to medication overuse is defined as headache that is present on ≥ 15 days per month for at least three months in a patient who previously suffered from primary headaches, and who takes analgesics on ≥ 15 days per month or anti-migraine drugs (triptans or ergot alkaloids), opioid drugs, or combined analgesics on ≥ 10 days per month. METHODS This review is based on pertinent articles published up to December 2017 that were retrieved by a selective search in PubMed employing the terms "medication overuse AND headache" and "medication overuse headache." RESULTS The prevalence of medication overuse headache in the general population in Germany is 0.7% -1%. This disorder is more common in women and in persons suffering from comorbid mental disorders or other painful conditions. The treatment of medication overuse headache consists of three steps. Patient education and counseling are given with the goal of reducing the intake of medication for acute headache treatment. The ensuing headache prophylaxis is with topiramate, amitriptyline, or onabotulinum toxin A. If these treatment strategies fail, a drug holiday is recommended. This can be in the outpatient, day clinic, or inpatient setting, depending on the severity of the condition and its comorbidities. CONCLUSION Patients who frequently take acute medication to treat headache episodes must be identified early in order to avoid headache chronification and medication overuse headache. The suggested treatment algorithm is still in need of validation by randomized trials.
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Affiliation(s)
| | - Dagny Holle
- Department of Neurology and West German Headache Center, Essen
| | - Thomas Dresler
- Department of Psychiatry and Psychotherapy, University Hospital and Faculty of Medicine, Tübingen LEAD Graduate School & Research Network, University of Tübingen
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18
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Hagen K, Kristoffersen ES, Winsvold BS, Stovner LJ, Zwart JA. Remission of chronic headache: An 11-year follow-up study. Data from the Nord-Trøndelag Health Surveys 1995-1997 and 2006-2008. Cephalalgia 2018; 38:2026-2034. [PMID: 29629599 DOI: 10.1177/0333102418769940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To estimate remission rates of chronic headache and predictors of remission. METHODS In this longitudinal population-based cohort study, we used validated headache questionnaire data from the second (1995-1997, baseline; n = 51,856 aged ≥ 20 years, response rate: 55%) and third wave (2006-2008, follow-up, response rate: 42%) of the Nord-Trøndelag Health Study. Chronic headache was defined as ≥15 headache days/month during the last year. Chronic headache remission was defined as headache less than 15 days/month at follow-up. Potential predictors of remission were evaluated using logistic regression. RESULTS At baseline, 1266 (2.4%) participants reported chronic headache. Of these, 605 (48%) answered headache questions at follow-up. Remission was observed in 452 (74.7%), the proportion being almost identical in men and women (74.4% vs. 74.9, p = 0.92). In analyses adjusting for age, gender and education level, remission at follow-up was more than two times more likely among individuals without medication overuse headache (OR = 2.4, 95% CI 1.7-3.6) and without chronic musculoskeletal complaints (OR = 2.9, 95% CI 1.5-5.0) at baseline. CONCLUSIONS In this longitudinal population-based cohort study, three-quarters of chronic headache participants remitted from chronic headache. Remission was associated with no medication overuse headache and no chronic musculoskeletal complaints at baseline.
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Affiliation(s)
- Knut Hagen
- 1 Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,2 Norwegian Advisory Unit on Headache, St. Olav's Hospital, Trondheim, Norway
| | - Espen Saxhaug Kristoffersen
- 3 Department of General Practice, HELSAM, University of Oslo, Oslo, Norway.,4 Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Bendik Slagvold Winsvold
- 5 Department of Neurology and FORMI; Oslo University Hospital, Oslo, Norway.,6 Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Jacob Stovner
- 1 Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,2 Norwegian Advisory Unit on Headache, St. Olav's Hospital, Trondheim, Norway
| | - John-Anker Zwart
- 5 Department of Neurology and FORMI; Oslo University Hospital, Oslo, Norway.,6 Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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19
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Nichols VP, Ellard DR, Griffiths FE, Kamal A, Underwood M, Taylor SJC. The lived experience of chronic headache: a systematic review and synthesis of the qualitative literature. BMJ Open 2017; 7:e019929. [PMID: 29248887 PMCID: PMC5778309 DOI: 10.1136/bmjopen-2017-019929] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To systematically review the qualitative literature of the lived experience of people with a chronic headache disorder. BACKGROUND Chronic headaches affect 3%-4% of the population. The most common chronic headache disorders are chronic migraine, chronic tension-type headache and medication overuse headache. We present a systematic review and meta-ethnographic synthesis of the lived experience of people with chronic headache. METHODS We searched seven electronic databases, hand-searched nine journals and used a modified Critical Appraisal Skills Programme checklist to appraise study quality. Following thematic analysis we synthesised the data using a meta-ethnographic approach. RESULTS We identified 3586 unique citations; full texts were examined for 86 studies and 4 were included in the review. Included studies differed in their foci: exploring, patient-centred outcomes, chronic headache as a socially invisible disease, psychological processes mediating impaired quality of life, and the process of medication overuse. Initial thematic analysis and subsequent synthesis gave three overarching themes: 'headache as a driver of behaviour' (directly and indirectly), 'the spectre of headache' and 'strained relationships'. CONCLUSION This meta-synthesis of published qualitative evidence demonstrates that chronic headaches have a profound effect on people's lives, showing similarities with other pain conditions. There were insufficient data to explore the similarities and differences between different chronic headache disorders.
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Affiliation(s)
- Vivien P Nichols
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - David R Ellard
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Frances E Griffiths
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Atiya Kamal
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Martin Underwood
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Stephanie J C Taylor
- Complex Intervention and Social Practice in Health Care Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Coventry, UK
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20
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Scher AI, Rizzoli PB, Loder EW. Medication overuse headache: An entrenched idea in need of scrutiny. Neurology 2017; 89:1296-1304. [PMID: 28821684 DOI: 10.1212/wnl.0000000000004371] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/10/2017] [Indexed: 12/31/2022] Open
Abstract
It is a widely accepted idea that medications taken to relieve acute headache pain can paradoxically worsen headache if used too often. This type of secondary headache is referred to as medication overuse headache (MOH); previously used terms include rebound headache and drug-induced headache. In the absence of consensus about the duration of use, amount, and type of medication needed to cause MOH, the default position is conservative. A common recommendation is to limit treatment to no more than 10 or 15 days per month (depending on medication type) to prevent headache frequency progression. Medication withdrawal is often recommended as a first step in treatment of patients with very frequent headaches. Existing evidence, however, does not provide a strong basis for such causal claims about the relationship between medication use and frequent headache. Observational studies linking treatment patterns with headache frequency are by their nature confounded by indication. Medication withdrawal studies have mostly been uncontrolled and often have high dropout rates. Evaluation of this evidence suggests that only a minority of patients required to limit the use of symptomatic medication may benefit from treatment limitation. Similarly, only a minority of patients deemed to be overusing medications may benefit from withdrawal. These findings raise serious questions about the value of withholding or withdrawing symptom-relieving medications from people with frequent headaches solely to prevent or treat MOH. The benefits of doing so are smaller, and the harms larger, than currently recognized. The concept of MOH should be viewed with more skepticism. Until the evidence is better, we should avoid dogmatism about the use of symptomatic medication. Frequent use of symptom-relieving headache medications should be viewed more neutrally, as an indicator of poorly controlled headaches, and not invariably a cause.
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Affiliation(s)
- Ann I Scher
- From the Department of Preventive Medicine and Biostatistics (A.I.S.), Uniformed Services University, Bethesda, MD; and Department of Neurology (P.B.R., E.W.L.), Brigham and Women's Hospital, Boston, MA.
| | - Paul B Rizzoli
- From the Department of Preventive Medicine and Biostatistics (A.I.S.), Uniformed Services University, Bethesda, MD; and Department of Neurology (P.B.R., E.W.L.), Brigham and Women's Hospital, Boston, MA
| | - Elizabeth W Loder
- From the Department of Preventive Medicine and Biostatistics (A.I.S.), Uniformed Services University, Bethesda, MD; and Department of Neurology (P.B.R., E.W.L.), Brigham and Women's Hospital, Boston, MA
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21
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Negro A, Curto M, Lionetto L, Guerzoni S, Pini LA, Martelletti P. A Critical Evaluation on MOH Current Treatments. Curr Treat Options Neurol 2017; 19:32. [PMID: 28808924 DOI: 10.1007/s11940-017-0465-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OPINION STATEMENT Migraine is the most frequent neurological disorder observed in clinical practice characterized by moderate to severe pain attacks associated with neurological, gastrointestinal, and dysautonomic symptoms. Each year, 2.5% of patients with episodic migraine develop chronic migraine (CM). CM is characterized by high frequency of the attacks that may result into chronic intake of abortive medications. Nearly, the 70% of CM patients referring to tertiary head centers show acute pain medications overuse that may lead to the development of medication overuse headache (MOH). The management of MOH requires three steps: (1) education, (2) withdrawal of the overuse drug and detoxification, and (3) re-prophylaxis. In the last years, several real-life prospective studies provided further evidence in clinical setting of the onabotulinumtoxinA 155-195 U efficacy for the headache prophylaxis in CM with MOH patients. There is a general agreement on two factors: (1) withdrawal of the overuse drug is condicio sine qua non to reverse the pattern to medium-low-frequency migraine, and (2) the focus of management needs to shift from acute treatment of pain to prevention of headache. CM patients close to developing MOH, patients with high-frequency episodic migraine, and those already abusing of drugs require special attention and should refer to tertiary headache centers. For all of them, a solution could be an "early treatment." Early should be their referral to a tertiary headache center, early should be the withdrawal of the overuse drug and a proper detoxification, and perhaps early should be the start of a preventative therapy.
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Affiliation(s)
- Andrea Negro
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Regional Referral Headache Centre, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00191, Rome, Italy.
| | - Martina Curto
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Luana Lionetto
- Advanced Molecular Diagnostics Unit, IDI Istituto Dermopatico dell'Immacolata - IRCSS, Rome, Italy
| | - Simona Guerzoni
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Alberto Pini
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00191, Rome, Italy
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22
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McKillop HN, Banez GA. A Broad Consideration of Risk Factors in Pediatric Chronic Pain: Where to Go from Here? CHILDREN (BASEL, SWITZERLAND) 2016; 3:E38. [PMID: 27916884 PMCID: PMC5184813 DOI: 10.3390/children3040038] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/16/2016] [Accepted: 11/22/2016] [Indexed: 01/23/2023]
Abstract
Pediatric chronic pain is a significant problem associated with substantial functional impairment. A variety of risk factors have been found to be associated with chronic pain in youth. The greatest amount of evidence appears to support that temperament, anxiety, depression, subjective experience of stress, passive coping strategies, sleep problems, other somatic-related problems, and parent and/or family factors are important variables. However, a great deal of this research focuses on a single risk factor or on multiple risk factors in isolation. Much of the literature utilizes older diagnostic criteria and would benefit from replication, larger sample sizes, and comparison across pain disorders. Problems also exist with disagreement across definitions, resulting in inconsistency or unclear use of terms. Furthermore, recent consideration has suggested that outcome measures should include functional disability in addition to pain. A second generation of research is needed to shed light on the complex interactions that likely play a role in the transition from acute to chronic pain. Building on recent calls for changes in research in this area, we propose the next steps for this research, which involve consideration of both biopsychosocial and developmental contexts.
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Affiliation(s)
- Hannah N McKillop
- Case Western Reserve University, 11220 Bellflower Rd, Cleveland, OH 44106, USA.
| | - Gerard A Banez
- Cleveland Clinic Children's Hospital for Rehabilitation, Pediatric Pain Rehabilitation Program, CR 11/ 2801 MLK Jr. Drive, Cleveland, OH 44104, USA.
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23
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Martin VT, Vij B. Diet and Headache: Part 1. Headache 2016; 56:1543-1552. [DOI: 10.1111/head.12953] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 08/31/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Vincent T. Martin
- Department of Internal Medicine; University of Cincinnati College of Medicine; Cincinnati OH USA
| | - Brinder Vij
- Department of Neurology; University of Cincinnati College of Medicine; Cincinnati OH USA
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24
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Chen Z, Chen X, Liu M, Liu S, Shu S, Ma L, Yu S. Altered functional connectivity of the marginal division in migraine: a resting-state fMRI study. J Headache Pain 2016; 17:89. [PMID: 27670428 PMCID: PMC5037100 DOI: 10.1186/s10194-016-0682-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/22/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The marginal division of neostriatum (MrD) is a flat, pan-shaped zone between the neostriatum and the globus pallidus, and previous documents demonstrated that it was involved in the modulation of pain. The aim of this study is to investigate the roles of the MrD of the human brain in the chronicization migraine using resting state functional magnetic resonance imaging (rs-fMRI). METHODS Conventional MRI, 3D structure images, and rs-fMRI were performed in 18 patients with episodic migraines (EM), 16 patients with chronic migraine (CM), 44 patients with medication overuse headache plus chronic migraine (MOH + CM), and 32 normal controls (NC). MrD was defined using manual delineation on structural images, and was selected as the seed to calculate the functional connectivity (FC). RESULTS Compared with the NC group, the decreased FC of MrD was observed in the EM and CM groups, and increased FC of MrD was demonstrated in all patient groups. Compared with the EM group, the decreased FC of MrD was revealed in the CM and MOH + CM groups, and the increased FC occurred only in the CM group. Increased FC of MrD alone was observed in the MOH + CM group compared with that in the CM group. CONCLUSION This study confirmed the double neuromodulation network of MrD in pain modulation and migraine chronicization; however, the mechanism requires further investigation.
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Affiliation(s)
- Zhiye Chen
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mengqi Liu
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shuangfeng Liu
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Siyun Shu
- Institute of Cognitive Neuroscience, South China Normal University, Guangzhou, 510631, China
| | - Lin Ma
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China.
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25
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The burden of headache in people with epilepsy. Seizure 2016; 41:120-6. [PMID: 27543963 DOI: 10.1016/j.seizure.2016.07.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To investigate and classify headaches in adult people with epilepsy, to evaluate the burden of headaches, and to compare findings with a population-based epidemiological study. METHODS Two hundred eighty (61.4% women) people with epilepsy (mean age 37.8±14.5, mean duration of epilepsy 13.2±11.9years) completed a questionnaire collecting socio-demographic and clinical data, questions clarifying their type of a headache, a Qolie-10 questionnaire and a Headache-Attributed Lost Time (HALT) index. An experienced neurologist also interviewed them. RESULTS 83.2% of respondents reported some type of headache. From those with inter-ictal headaches (77.9%), 39% reported tension-type headache, 31.7% reported migraine, and 7.8% reported medication-overuse headache and 16% reported possible persistent headache attributed to traumatic head injury. The impact of headache assessed through the HALT grading showed that 40.4% were grade 1, 9.6% grade 2, 14.7% grade 3 and 35.3% grade 4. Although, the prevalences of different headache types were similar to those in our population-based study, migraine seemed to be more common in males with epilepsy than in general population, and medication-overuse headache was more common in people with epilepsy than in the general population. CONCLUSIONS People with epilepsy experience headaches irrespective of their sex or age. The burden of headaches is very important in patients with epilepsy, since headaches usually cause a moderate or severe burden to their quality of life and suggest a clear clinical need. Clinicians should recognize headache as a common comorbidity of epilepsy, as it may influence antiepileptic drug choice, and may need specific treatment.
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26
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Westergaard ML, Munksgaard SB, Bendtsen L, Jensen RH. Medication-overuse headache: a perspective review. Ther Adv Drug Saf 2016; 7:147-58. [PMID: 27493718 DOI: 10.1177/2042098616653390] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Medication-overuse headache (MOH) is a debilitating condition in which frequent and prolonged use of medication for the acute treatment of pain results in the worsening of the headache. The purpose of this paper is to review the most recent literature on MOH and discuss future avenues for research. MOH accounts for a substantial share of the global burden of disease. Prevalence is often reported as 1-2% but can be as high as 7% overall, with higher proportions among women and in those with a low socioeconomic position. Management consists of withdrawing pain medication, focusing on prophylactic and nonmedical treatments, and limiting acute symptomatic medication. Stress reduction and lifestyle interventions may support the change towards rational pain medication use. Support, follow up, and education are needed to help patients through the detoxification period. There is fertile ground for research in MOH epidemiology, pathophysiology, and neuroimaging. Randomized and long-term follow-up studies on MOH treatment protocols are needed. Further focused research could be of major importance for global health.
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Affiliation(s)
- Maria Lurenda Westergaard
- Danish Headache Center, Rigshospitalet - Glostrup, University of Copenhagen, Nordre Ringvej 67, Område Nord Bygning 14, 2600 Glostrup, Denmark
| | - Signe Bruun Munksgaard
- Danish Headache Center, Rigshospitalet - Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Lars Bendtsen
- Danish Headache Center, Rigshospitalet - Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Rigmor Højland Jensen
- Danish Headache Center, Rigshospitalet - Glostrup, University of Copenhagen, Glostrup, Denmark
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27
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Wiendels NJ, van Haestregt A, Knuistingh Neven A, Spinhoven P, Zitman FG, Assendelft WJJ, Ferrari MD. Chronic Frequent Headache in the General Population: Comorbidity and Quality of Life. Cephalalgia 2016; 26:1443-50. [PMID: 17116094 DOI: 10.1111/j.1468-2982.2006.01211.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We studied the nature and extent of comorbidity of chronic frequent headache (CFH) in the general population and the influence of CFH and comorbidity on quality of life. Subjects with CFH (headache on >14 days/month) were identified in a general health survey. We sent a second questionnaire including questions on comorbidity and quality of life to subjects with CFH and subjects with infrequent headache (IH) (1-4 days/month). We recoded comorbidity by using the Cumulative Illness Rating Scale (CIRS) and measured quality of life with the RAND-36, a Dutch version of Short Form-36. CFH subjects ( n = 176) had higher comorbidity scores than the IH subjects ( n = 141). Mean CIRS scores were 2.94 for CFH and 1.55 for IH [mean difference 1.40, 95% confidence interval (CI) 0.91, 1.89]. The mean number of categories selected was 1.92 in CFH and 1.10 in IH (mean difference 0.82, 95% CI 0.54, 1.11). Fifty percent of CFH subjects had a comorbidity severity level of at least 2, indicating disorders requiring daily medication, compared with 28% of IH subjects (mean difference 22%, 95% CI 12, 33). CFH subjects had more musculoskeletal, gastrointestinal, psychiatric and endocrine/breast pathology than IH subjects. Quality of life in CFH subjects was lower than that of IH subjects in all domains of the RAND-36. Both headache frequency and CIRS score had a negative influence on all domains. We conclude that patients with CFH have more comorbid disorders than patients with infrequent headaches. Many CFH patients have a comorbid chronic condition requiring daily medication. Both high headache frequency and comorbidity contribute to the low quality of life in these patients.
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Affiliation(s)
- N J Wiendels
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
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28
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Abstract
Chronic daily headache (CDH) is a common neurological condition that affects 1-4 % of the general population. Most individuals with CDH originally suffered from episodic headaches, but over time, this developed into CDH. Although the pathophysiology of CDH is not fully understood, recent clinical and epidemiological studies suggest some risk factors that are associated with an increased risk of transformation from episodic headaches. If risk factors can be identified, they could provide a base for aggressive preventive intervention and thus decrease the transformation from episodic headaches to eventual CDH. In this article, we review and summarize the current data on risk factors for CDH.
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Affiliation(s)
- Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
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[Modifiable risk factors for primary headache. A systematic review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:952-60. [PMID: 25002234 DOI: 10.1007/s00103-014-1997-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Strategies to prevent primary headaches could be very beneficial, especially given that primary headaches can lead to the development of chronic headache. In order to establish headache prevention strategies, the modifiable risk factors for primary headaches need to be identified. MATERIAL AND METHODS A systematic literature search on the risk factors for primary headaches was conducted independently by two persons using the databases MEDLINE and Embase. Further inclusion criteria were observational studies in adult general populations or case-control studies, where the effect sizes were reported as odds ratios or where the odds ratios could be calculated from the given data. RESULTS In all, 24 studies were included in the analysis. There was a large amount of heterogeneity among the studies concerning headache acquisition, headache classification, and risk factors for headache development. Independent of headache trigger and definition of headache, the association between headache and the risk factor "stress" was very high: The meta-analysis shows an overall effect of 2.26 (odds ratio; 95 %-CI = [1.79; 2.85]). Studies evaluating neck and shoulder pain also report a strong association with headache; however, these results could not be summarized in a meta-analysis. Equally, the overall effects of smoking and coffee consumption on headaches could not be verified because the effect sizes were rather small and predominantly noticeable only at higher doses. CONCLUSION A strong association between headache and the risk factors stress and neck and shoulder pain was confirmed. The effect sizes of smoking and coffee consumption on headaches were rather small.
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Banzi R, Cusi C, Randazzo C, Sterzi R, Tedesco D, Moja L. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of migraine in adults. Cochrane Database Syst Rev 2015; 4:CD002919. [PMID: 25829028 PMCID: PMC6513227 DOI: 10.1002/14651858.cd002919.pub3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND This is an updated version of the original Cochrane review published in 2005 on selective serotonin reuptake inhibitors (SSRIs) for preventing migraine and tension-type headache. The original review has been split in two parts and this review now only regards migraine prevention. Another updated review is under development to cover tension-type headache.Migraine is a common disorder. The chronic forms are associated with disability and have a high economic impact. In view of discoveries about the role of serotonin and other neurotransmitters in pain mechanisms, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been evaluated for the prevention of migraine. OBJECTIVES To determine the efficacy and tolerability of SSRIs and SNRIs compared to placebo and other active interventions in the prevention of episodic and chronic migraine in adults. SEARCH METHODS For the original review, we searched MEDLINE (1966 to January 2004), EMBASE (1994 to May 2003), the Cochrane Central Register of Controlled Trials (CENTRAL 2003, Issue 4), and Headache Quarterly (1990 to 2003). For this update, we applied a revised search strategy to reflect the broader type of intervention (SSRIs and SNRIs). We searched CENTRAL (2014, Issue 10), MEDLINE (1946 to November 2014), EMBASE (1980 to November 2014), and PsycINFO (1987 to November 2014). We also checked the reference lists of retrieved articles and searched trial registries for ongoing trials. SELECTION CRITERIA We included randomised controlled trials comparing SSRIs or SNRIs with any type of control intervention in participants 18 years and older of either sex with migraine. DATA COLLECTION AND ANALYSIS Two authors independently extracted data (migraine frequency, index, intensity, and duration; use of symptomatic/analgesic medication; days off work; quality of life; mood improvement; cost-effectiveness; and adverse events) and assessed the risk of bias of trials. The primary outcome of this updated review is migraine frequency. MAIN RESULTS The original review included eight studies on migraine. Overall, we now include 11 studies on five SSRIs and one SNRI with a total of 585 participants. Six studies were placebo-controlled, four compared a SSRI or SNRI to amitriptyline, and one was a head-to-head comparison (escitalopram versus venlafaxine). Most studies had methodological or reporting shortcomings (or both): all studies were at unclear risk of selection and reporting bias. Follow-up rarely extended beyond three months. The lack of adequate power of most of the studies is also a major concern.Few studies explored the effect of SSRIs or SNRIs on migraine frequency, the primary endpoint. Two studies with unclear reporting compared SSRIs and SNRIs to placebo, suggesting a lack of evidence for a difference. Two studies compared SSRIs or SNRIs versus amitriptyline and found no evidence for a difference in terms of migraine frequency (standardised mean difference (SMD) 0.04, 95% confidence interval (CI) -0.72 to 0.80; I(2) = 72%), or other secondary outcomes such as migraine intensity and duration.SSRIs or SNRIs were generally more tolerable than tricyclics. However, the two groups did not differ in terms of the number of participants who withdrew due to adverse advents or for other reasons (one study, odds ratio (OR) 0.39, 95% CI 0.10 to 1.50 and OR 0.42, 95% CI 0.13 to 1.34).We did not find studies comparing SSRIs or SNRIs with pharmacological treatments other than antidepressants (e.g. antiepileptics and anti-hypertensives). AUTHORS' CONCLUSIONS Since the last version of this review, the new included studies have not added high quality evidence to support the use of SSRIs or venlafaxine as preventive drugs for migraine. There is no evidence to consider SSRIs or venlafaxine as more effective than placebo or amitriptyline in reducing migraine frequency, intensity, and duration over two to three months of treatment. No reliable information is available at longer-term follow-up. Our conclusion is that the use of SSRIs and SNRIs for migraine prophylaxis is not supported by evidence.
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Affiliation(s)
- Rita Banzi
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Cristina Cusi
- Istituti Clinici di PerfezionamentoOut Patient Services ‐ NeurologyVia Castelvetro 22MilanoItaly20154
| | - Concetta Randazzo
- University of BolognaDepartment of Biomedical and Neuromotor SciencesVia San Giacomo, 12BolognaItaly40126
| | - Roberto Sterzi
- Azienda Ospedaliera NiguardaNeuroscience DepartmentPiazza Ospedale Maggiore, 3MilanoItaly20163
| | - Dario Tedesco
- University of BolognaDepartment of Biomedical and Neuromotor SciencesVia San Giacomo, 12BolognaItaly40126
| | - Lorenzo Moja
- University of MilanDepartment of Biomedical Sciences for HealthVia Pascal 36MilanMilanItaly20133
- IRCCS Galeazzi Orthopaedic InstituteUnit of Clinical EpidemiologyMilanItaly
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Westergaard ML, Glümer C, Hansen EH, Jensen RH. Medication overuse, healthy lifestyle behaviour and stress in chronic headache: Results from a population-based representative survey. Cephalalgia 2015; 36:15-28. [DOI: 10.1177/0333102415578430] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/25/2015] [Indexed: 01/03/2023]
Abstract
Aim This cross-sectional study investigated associations between chronic headache (CH) with and without medication overuse, healthy lifestyle behaviour, and stress. Methods Questionnaires were sent to 129,150 adults. Those with headache ≥15 days per month for three months were classified as having CH then further described as having medication-overuse headache (MOH) or CH without medication overuse. Associations between headache and daily smoking, physical inactivity, obesity, excessive drinking, illicit drug use, and high stress were analysed by logistic regression. Results CH with and without medication overuse (prevalence 1.8% and 1.6%, respectively) had strong, graded associations with stress. Associations with daily smoking, physical inactivity, and obesity were significant only for MOH. Odds for MOH were highest among people who had all three factors compared to those who had none (OR 2.8 in women and 5.1 in men). High stress plus any of these three factors had synergistic effects in MOH but not clearly in those who had CH without overuse. Associations between CH subtypes and excessive drinking or illicit drug use were not statistically significant. Conclusion Results suggest strong links between healthy lifestyle behaviour and stress in MOH. Stress reduction and promoting healthy behaviour are highly relevant in MOH management.
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Affiliation(s)
- Maria Lurenda Westergaard
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - Charlotte Glümer
- Research Center for Prevention and Health, Capital Region of Denmark, Denmark
- Department of Health Science and Technology, University of Aalborg, Denmark
| | | | - Rigmor Højland Jensen
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
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Wakefield JRH, Sani F, Madhok V, Norbury M, Dugard P. The pain of low status: the relationship between subjective socio-economic status and analgesic prescriptions in a Scottish community sample. PSYCHOL HEALTH MED 2015; 21:27-37. [DOI: 10.1080/13548506.2015.1009377] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Frese T, Druckrey H, Sandholzer H. Headache in General Practice: Frequency, Management, and Results of Encounter. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:169428. [PMID: 27350982 PMCID: PMC4897548 DOI: 10.1155/2014/169428] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 08/04/2014] [Accepted: 08/05/2014] [Indexed: 11/17/2022]
Abstract
Objective. Headache is a common reason for consulting the general practitioner. The goal of the investigation was to characterize the headache consultation rates, the associated symptoms, the frequency of diagnostic and therapeutic procedures, and the results of the encounter of patients with headache. Methods. Cross-sectional data were collected from randomly selected patients during the German SESAM 2 study and compared with unpublished but publicly available data from the Dutch Transition Project. Results. Headache accounts for up to five percent of all general practice consultations. Women consult the general practitioner for headache twice as often as men. Physical examination and drug prescription are the most frequent procedures. Most of the patients suffer from primary headache; secondary headache is due to upper respiratory tract infections or problems of the spinal column. Dangerous courses occur in very rare cases. Conclusion. This work confirms the findings of earlier studies regarding the management of patients that consult the general practitioner for headache. It broadens the preexisting database since cross-sectional data regarding headache in general practice was rarely published.
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Affiliation(s)
- Thomas Frese
- Department of Primary Care, Leipzig Medical School, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Henriette Druckrey
- Department of Primary Care, Leipzig Medical School, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Hagen Sandholzer
- Department of Primary Care, Leipzig Medical School, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
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34
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Westergaard ML, Glümer C, Hansen EH, Jensen RH. Prevalence of chronic headache with and without medication overuse: Associations with socioeconomic position and physical and mental health status. Pain 2014; 155:2005-13. [DOI: 10.1016/j.pain.2014.07.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/27/2014] [Accepted: 07/03/2014] [Indexed: 01/03/2023]
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Lund N, Westergaard ML, Barloese M, Glümer C, Jensen RH. Epidemiology of concurrent headache and sleep problems in Denmark. Cephalalgia 2014; 34:833-45. [PMID: 25078716 DOI: 10.1177/0333102414543332] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS There are no previous epidemiologic studies on concurrent headache and sleep problems (HSP). This cross-sectional study aimed to determine the prevalence of HSP in Denmark, broadly characterize those with HSP, and examine associations between HSP and socioeconomic/lifestyle factors. METHODS A total of 129,150 randomly selected individuals were invited to participate in the Danish National Health Survey 2010. Respondents were asked about headache, sleep problems, depression and anxiety in the last two weeks, health-related lifestyle and quality of life (SF-12). Socioeconomic data were retrieved from national registers. Prevalence proportions were adjusted for stratified sampling and non-response. Regression analyses examined associations between HSP and socioeconomic/lifestyle factors. RESULTS Of 68,518 respondents, 16.3% reported only headache, 21.1% only sleep problems, and 18.1% HSP with 2.6% being severely affected. Prevalence was higher among women and the middle-aged. Severe HSP was associated with low socioeconomic position, non-Western ethnicity, unhealthy lifestyle, high stress and anxiety/depression. Those with HSP had substantially reduced quality of life; more so than those having only headache or only sleep problems. CONCLUSIONS HSP is a highly prevalent condition. Lifestyle modification, stress reduction, and screening for concurrent depression and anxiety may play important roles in management. The high prevalence of HSP suggests a common pathophysiological mechanism.
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Affiliation(s)
- Nunu Lund
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - Maria Lurenda Westergaard
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - Mads Barloese
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - Charlotte Glümer
- Research Center for Prevention and Health, Capital Region of Denmark, Denmark Department of Health Science and Technology, Aalborg University, Denmark
| | - Rigmor Højland Jensen
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
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Porporatti AL, Costa YM, Conti PCR, Bonjardim LR, Calderon PDS. Primary headaches interfere with the efficacy of temporomandibular disorders management. J Appl Oral Sci 2014; 23:129-34. [PMID: 25004051 PMCID: PMC4428456 DOI: 10.1590/1678-775720130557] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 03/31/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache
(PH) on efficacy of a Temporomandibular Disorders (TMD) conservative therapy and
its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I) Muscular
TMD (n=64); II) Muscular TMD+PH (n=48); III) Muscular TMD+Articular TMD (n=173);
IV) Muscular TMD+Articular TMD+PH (n=115). All groups had undergone a TMD therapy
for three months with a stabilization appliance and counseling for habits and
behavioral changes, with no specific headache management. Current pain intensity
and existence or not of self-reported bruxism were assessed. Repeated measures
ANOVA and Chi-Square test followed by Odds were used for statistical analysis,
with a significance level of 5%. RESULTS: results of this study showed that: (1) A conservative therapy with stabilization
appliance and counseling for habits and behavioral changes was effective in the
TMD pain relief; (2) Groups with an additional diagnosis of PH had worsened the
pain improvement significantly; and (3) no association between the presence of
self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD
management.
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Affiliation(s)
- André Luís Porporatti
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Yuri Martins Costa
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Leonardo Rigoldi Bonjardim
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Park JW, Moon HS, Kim JM, Lee KS, Chu MK. Chronic daily headache in Korea: prevalence, clinical characteristics, medical consultation and management. J Clin Neurol 2014; 10:236-43. [PMID: 25045377 PMCID: PMC4101101 DOI: 10.3988/jcn.2014.10.3.236] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 03/20/2014] [Accepted: 03/24/2014] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Chronic daily headache (CDH) is a commonly reported reason for visiting hospital neurology departments, but its prevalence, clinical characteristics, and management have not been well documented in Korea. The objective of this study was to characterize the 1-year prevalence, clinical characteristics, medical consultations, and treatment for CDH in Korea. Methods The Korean Headache Survey (KHS) is a nationwide descriptive survey of 1507 Korean adults aged between 19 and 69 years. The KHS investigated headache characteristics, sociodemographics, and headache-related disability using a structured interview. We used the KHS data for this study. Results The 1-year prevalence of CDH was 1.8% (95% confidence interval, 1.1-2.5%), and 25.7% of the subjects with CDH met the criteria for medication overuse. Two-thirds (66.7%) of CDH subjects were classified as having chronic migraine, and approximately half of the CDH subjects (48.1%) reported that their headaches either substantially or severely affected their quality of life. Less than half (40.7%) of the subjects with CDH reported having consulted a doctor for their headaches and 40.7% had not received treatment for their headaches during the previous year. Conclusions The prevalence of CDH was 1.8% and medication overuse was associated with one-quarter of CDH cases in Korea. Many subjects with CDH do not seek medical consultation and do not receive appropriate treatment for their headaches.
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Affiliation(s)
- Jeong-Wook Park
- Department of Neurology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Heui-Soo Moon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Moon Kim
- Department of Neurology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kwang-Soo Lee
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Min Kyung Chu
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
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Abstract
Medication-overuse headache (MOH) is a worldwide health problem with a prevalence of 1%–2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.
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Affiliation(s)
- Espen Saxhaug Kristoffersen
- Research Centre, Akershus University Hospital, Lørenskog, Norway ; Department of Neurology, Akershus University Hospital, Nordbyhagen, Norway ; Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Christofer Lundqvist
- Research Centre, Akershus University Hospital, Lørenskog, Norway ; Department of Neurology, Akershus University Hospital, Nordbyhagen, Norway ; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway
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Kristoffersen ES, Lundqvist C. Medication-overuse headache: epidemiology, diagnosis and treatment. Ther Adv Drug Saf 2014; 5:87-99. [PMID: 25083264 PMCID: PMC4110872 DOI: 10.1177/2042098614522683] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Medication-overuse headache (MOH) is one of the most common chronic headache disorders and a public health problem with a worldwide prevalence of 1-2%. It is a condition characterized by chronic headache and overuse of different headache medications, and withdrawal of the overused medication is recognised as the treatment of choice. However, the strategy for achieving withdrawal is, at present, based on expert opinion rather than scientific evidence, partly due to the lack of randomised controlled studies. This narrative review investigates different aspects of epidemiology, diagnosis, risk factors and pathogenesis as well as management for MOH. We suggest that the first step in the treatment of MOH should be carried out in general practice and should focus primarily on detoxification. For most patients, both prevention and follow up after detoxification can also be performed in general practice, thus freeing resources for referral of more complicated cases to headache clinics and neurologists. These suffering patients have much to gain by an earlier treatment-focused approach lower down on the treatment ladder.
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Affiliation(s)
- Espen Saxhaug Kristoffersen
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, and Research Centre, Akershus University Hospital, Lørenskog, Norway
| | - Christofer Lundqvist
- Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway, and Department of Neurology, Akershus University Hospital, Nordbyhagen, Norway
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Abstract
PURPOSE OF REVIEW Medication-overuse headache (MOH) is a well described clinical entity. There is a growing body of knowledge on the epidemiology of MOH, risk factors, and treatment strategies. RECENT FINDINGS The International Headache Society updated the classification criteria for MOH. Population-based studies provided an insight into the prevalence and peculiarities of MOH patients in eastern Europe and Asia. Large-scaled population-based longitudinal studies made it possible to analyze risk factors leading to the development of MOH. Imaging studies helped to better understand the pathophysiology of headache chronicity. New treatment strategies have been suggested. SUMMARY MOH is a common headache disorder and a serious public health problem all over the world. Although the treatment regimen for MOH patients is straightforward and the outcomes are favorable, it is time now to move forward and establish a predictive model for early recognition of patients at high risk, to intervene early and avoid development of chronic headache.
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Affiliation(s)
- Zaza Katsarava
- Evangelic Hospital Unna, University of Duisburg-Essen, Germany.
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Westergaard ML, Hansen EH, Glümer C, Olesen J, Jensen RH. Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: a systematic review. Cephalalgia 2013; 34:409-25. [PMID: 24293089 DOI: 10.1177/0333102413512033] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Case definitions of medication-overuse headache (MOH) in population-based research have changed over time. This study aims to review MOH prevalence reports with respect to these changes, and to propose a practical case definition for future studies based on the ICHD-3 beta. METHODS A systematic literature search was conducted to identify MOH prevalence studies. Findings were summarized according to diagnostic criteria. RESULTS Twenty-seven studies were included. The commonly used case definition for MOH was headache ≥15 days/month with concurrent medication overuse ≥3 months. There were varying definitions for what was considered as overuse. Studies that all used ICHD-2 criteria showed a wide range of prevalence among adults: 0.5%-7.2%. CONCLUSIONS There are limits to comparing prevalence of MOH across studies and over time. The wide range of reported prevalence might not only be due to changing criteria, but also the diversity of countries now publishing data. The criterion "headache occurring on ≥15 days per month" with concurrent medication overuse can be applied in population-based studies. However, the new requirement that a respondent must have "a preexisting headache disorder" has not been previously validated. Exclusion of other headache diagnoses by expert evaluation and ancillary examinations is not feasible in large population-based studies.
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Affiliation(s)
- Maria L Westergaard
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
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Prevalence of chronic headache in Croatia. BIOMED RESEARCH INTERNATIONAL 2013; 2013:837613. [PMID: 24078925 PMCID: PMC3773924 DOI: 10.1155/2013/837613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 07/27/2013] [Accepted: 07/28/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chronic headache describes the presence of headache for >15 days per month on average for >3 months and fulfills the rest of the IHS criteria. The prevalence of chronic headache is within the range of 0.5-7.3% worldwide. The aim of this study was to determine the 1-year prevalence of chronic headache in adult Croatian population. METHODS The data were collected from a cross-sectional survey of an adult population (>18 years of age) sample. Randomly selected patients from the general population in four Croatian cities were asked to fulfill a self-completed questionnaire. The prevalence of chronic headache was calculated in the sample representing 3,383,769 Croatian adults. RESULTS The total sample included 1542 responders among which 616 were with headache. The 1-year prevalence of chronic headache was 2.4%, and 0.9% of responders declared having headache 30 days per month. According to these results, 81,192 adult inhabitants in Croatia suffer from chronic headache. CONCLUSIONS The prevalence of chronic headache in Croatia is comparable to other countries worldwide. These patients require special attention and should be offered multidisciplinary medical support.
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Kocasoy Orhan E, Baykan B. Medication Overuse Headache: The Reason of Headache That Common and Preventable. Noro Psikiyatr Ars 2013; 50:S47-S51. [PMID: 28360584 DOI: 10.4274/npa.y7264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/02/2013] [Indexed: 12/01/2022] Open
Abstract
Medication overuse headache (MOH) is well-defined clinically and is one of the common reasons of chronic daily headache, but its pathophysiology has not been elucidated yet. MOH has varying clinical features in regard to regional, psychosocial, medical and economic factors. Even though, the studies have shown that many factors may play a role, MOH is likely to occur in patients who are prone to primary headaches. Mainstay of the treatment is to withdraw the excessively used analgesic drugs. The primary prevention with education of the patients as well as early diagnosis and treatment of MOH will reduce its increasing financial burden on both patients and countries. Meticulous and multifactorial evaluation of the disease besides the diagnosis and treatment of the comorbid diseases will reduce the risk of recurrences.
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Affiliation(s)
- Elif Kocasoy Orhan
- Istanbul University, Istanbul Medical Faculty, Department of Neurolog, Istanbul, Turkey
| | - Betül Baykan
- Istanbul University, Istanbul Medical Faculty, Department of Neurolog, Istanbul, Turkey
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Chiu HY, Tsai PS, Lee CC, Liu YT, Huang HC, Chen PY. The Association Between Use of Dietary Supplements and Headache or Migraine Complaints. Headache 2013; 54:355-63. [DOI: 10.1111/head.12180] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Hsiao-Yean Chiu
- Graduate Institute of Nursing; Taipei Medical University; Taipei Taiwan
| | - Pei-Shan Tsai
- Graduate Institute of Nursing; Taipei Medical University; Taipei Taiwan
| | - Cheng-Chi Lee
- Department of Neurosurgery; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Yu-Tse Liu
- Department of Neurosurgery; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Hui-Chuan Huang
- Graduate Institute of Nursing; Taipei Medical University; Taipei Taiwan
| | - Pin-Yuan Chen
- Department of Neurosurgery; Chang Gung Memorial Hospital; Taoyuan Taiwan
- Graduate Institute of Clinical Medical Sciences; Chang-Gung University; Taoyuan Taiwan
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Dekker F, Dieleman JP, Neven AK, Ferrari MD, Assendelft WJJ. Preventive treatment for migraine in primary care, a population-based study in the Netherlands. Cephalalgia 2013; 33:1170-8. [DOI: 10.1177/0333102413490343] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Preventive treatment of migraine contributes to reducing the impact of migraine but its extent of use in routine care is unknown. Objective The objective of this article is to assess current use, previous use, duration and course of preventive treatment of migraine in Dutch general practice. Methods We conducted a retrospective cohort study, for the period between 1997 and 2007, in the Interdisciplinary Processing of Clinical Information (IPCI) database, a GP research database in the Netherlands (source population of more than half a million subjects). All prevalent and incident migraine patients ( N = 7367) were included. Results About 13% of all migraine patients currently use preventive therapy and almost half of migraine patients have prior use. Of those starting with preventive treatment, 56% (95% CI: 54.3–64.7) still used it after nine months. There was a long delay between migraine diagnosis and preventive treatment start. Forty-four percent (95% CI 43.0–45.7) started preventive therapy in the study period. Conclusion This large primary-care database study shows that a limited number of patients are current users of preventive treatment, but many patients have prior use. After diagnosis there is often an extended time before preventive treatment is applied. Also there is often only one attempt. The continuation in time seems appropriate. Preventive therapy in migraine still deserves focus.
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Affiliation(s)
- F Dekker
- Public Health and Primary Care, Leiden University Medical Center, the Netherlands
| | - JP Dieleman
- Department of Medical Informatics, Erasmus Medical Centre, the Netherlands
| | - A Knuistingh Neven
- Public Health and Primary Care, Leiden University Medical Center, the Netherlands
| | - MD Ferrari
- Neurology, Leiden University Medical Center, the Netherlands
| | - WJJ Assendelft
- Public Health and Primary Care, Leiden University Medical Center, the Netherlands
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Jonsson P, Jakobsson A, Hensing G, Linde M, Moore CD, Hedenrud T. Holding on to the indispensable medication--a grounded theory on medication use from the perspective of persons with medication overuse headache. J Headache Pain 2013; 14:43. [PMID: 23697986 PMCID: PMC3671143 DOI: 10.1186/1129-2377-14-43] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 05/17/2013] [Indexed: 12/02/2022] Open
Abstract
Background Medication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication. To date, it remains unclear why some people overuse these medications. The aim of this qualitative study was to explore how individuals with MOH use medications and other strategies to manage headaches in their daily lives, and their thoughts about their own use of acute medication. Our intention was to develop a theoretical model about the development of MOH, from the perspective of those with MOH. Methods Data collection and analysis were conducted according to grounded theory methodology. The participants were recruited via newspaper advertisements. Fourteen persons with MOH were interviewed in individual qualitative interviews. Results The basic process leading to medication overuse was holding on to the indispensable medication. The acute medication was indispensable to the participants because they perceived it as the only thing that could prevent headaches from ruining their lives. The participants perceived headaches as something that threatened to ruin their lives. As a result, they went to great lengths trying to find ways to manage it. They tried numerous strategies. However, the only strategy actually perceived as effective was the use of acute medication and they eventually became resigned to the idea that it was the only effective aid. The acute medication thus became indispensable. Their general intention was to use as little medication as possible but they found themselves compelled to medicate frequently to cope with their headaches. They did not like to think about their medication use and sometimes avoided keeping track of the amount used. Conclusions This qualitative study adds understanding to the process via which MOH develops from the perspective of those having MOH. Such knowledge may help bridge the gap between the perspectives of patients and health-care professionals.
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Affiliation(s)
- Pernilla Jonsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 453SE 40530, Gothenburg, Sweden.
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Abstract
Irrespective of diagnosis, chronic daily, morning, or "awakening" headache patterns are soft signs of a sleep disorder. Sleep apnea headache may emerge de novo or may present as an exacerbation of cluster, migraine, tension-type, or other headache. Insomnia is the most prevalent sleep disorder in chronic migraine and tension-type headache, and increases risk for depression and anxiety. Sleep disturbance (e.g., sleep loss, oversleeping, schedule shift) is an acute headache trigger for migraine and tension-type headache. Snoring and sleep disturbance are independent risk factors for progression from episodic to chronic headache.
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Affiliation(s)
- Jeanetta C Rains
- Center for Sleep Evaluation, Elliot Hospital, 185 Queen City Avenue, Manchester, NH 03102, USA.
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Ohlsen BA. Combination of acupuncture and spinal manipulative therapy: management of a 32-year-old patient with chronic tension-type headache and migraine. J Chiropr Med 2013; 11:192-201. [PMID: 23449932 DOI: 10.1016/j.jcm.2012.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 02/01/2012] [Accepted: 02/09/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The purpose of this case study is to describe the treatment using acupuncture and spinal manipulation for a patient with a chronic tension-type headache and episodic migraines. CLINICAL FEATURES A 32-year-old woman presented with headaches of 5 months' duration. She had a history of episodic migraine that began in her teens and had been controlled with medication. She had stopped taking the prescription medications because of gastrointestinal symptoms. A neurologist diagnosed her with mixed headaches, some migrainous and some tension type. Her headaches were chronic, were daily, and fit the International Classification of Headache Disorders criteria of a chronic tension-type headache superimposed with migraine. INTERVENTION AND OUTCOME After 5 treatments over a 2-week period (the first using acupuncture only, the next 3 using acupuncture and chiropractic spinal manipulative therapy), her headaches resolved. The patient had no recurrences of headaches in her 1-year follow-up. CONCLUSION The combination of acupuncture with chiropractic spinal manipulative therapy was a reasonable alternative in treating this patient's chronic tension-type headaches superimposed with migraine.
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Affiliation(s)
- Bahia A Ohlsen
- Chiropractic Physician, Chiropractic, Acupuncture and Yoga Center, Buffalo Grove, IL
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De Simone R, Ranieri A, Montella S, Marchese M, Bonavita V. Sinus venous stenosis-associated idiopathic intracranial hypertension without papilledema as a powerful risk factor for progression and refractoriness of headache. Curr Pain Headache Rep 2012; 16:261-9. [PMID: 22382759 DOI: 10.1007/s11916-012-0254-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Data from two recent studies strongly support the hypothesis that idiopathic intracranial hypertension without papilledema (IIHWOP) could represent a powerful risk factor for the progression of pain in primary headache individuals. The first study highlights that an asymptomatic IIHWOP is much more prevalent than believed in the general population and occurs only in central venous stenosis carriers. In the second study, about one half of a large consecutive series of unresponsive primary chronic headache patients shows significant sinus venous stenosis. A continuous or intermittent IIHWOP was detectable in 91% of this subgroup and in no patient with normal venography. Moreover, after the lumbar puncture, a 2- to 4-week improvement in headache frequency was observed in most of the intracranial hypertensive patients. These findings strongly suggest that patients prone to primary headache who carry central venous outflow abnormalities are at high risk of developing a comorbid IIHWOP, which in turn is responsible for the progression and the unresponsiveness of the pain. Based on the available literature data, we propose that central sinus stenosis-related IIHWOP, although highly prevalent among otherwise healthy people, represents an important modifiable risk factor for the progression and refractoriness of pain in patients predisposed to primary headache. The mechanism could refer to up to one half of the primary chronic headache patients with minimal response to treatments referring to specialized headache clinics. Due to the clinical and taxonomic relevance of this hypothesis further studies are urgently needed.
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Affiliation(s)
- Roberto De Simone
- Department of Neurological Sciences, University Federico II of Naples, Via Sergio Pansini 5, Naples, Italy.
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